(1)Mrs Paula Young is a renal dialysis patient who returned to your floor from Recovery unit.In her right arm, she has internal dialysis access.Upon assessment you noticed that the bruit is distant and the thrill is weak.This is a negative findings, and a change from the information you received from the Recovery unit nurse.What would be your immediate reaction?.
(A) Call the doctor immediately to report your evaluation which is different from Recovery unit report.
(B )Do nothing. It is what it is.
(C) Notify the charge nurse. Let her follow up after all she gave you the worst assignment.
(D) Notify your supervisor immediately.
Correct answer A.
Rationale: You have to notify the doctor immediately. B,C,D are wrong.
(2 )The Registered Nurse should evaluate for bruit and thrill in Hemodialysis patients with internal access device.
Bruit and thrill sound like?.
(A) Bruit will sound like blood rushing through internal device,while thrill will sound like feeling of blood rushing through the internal device.
(B )Smooth feeling of coolness all over your body.
(C )The feeling of tiredness and mild pain for bruit,while feeling warm for thrill.
(D)Feeling of bruising and pain combined.
Correct answer A.
(3)What would be the recommendation for patients who have frequent episodes of low blood pressure during dialysis?.
(A )Decrease the dosage of blood pressure medications.
(B)Don’t take blood pressure medication on the day of dialysis.
(C) Take blood pressure medication more often.
(D )Report your case to your doctor.
Correct answer A.
Rationale: If your blood pressure is low during Hemodialysis. Talk to your doctor and take your blood pressure medication after hemodialysis.
(4) Why is low albumin common in ESRD patients?.
(A) It is caused by a combination of reduced in the synthesis and increased in degradation of albumin.
(B) The cause remains unknown.
(C )Hemodialysis patients are not compliant to their diets.
(D) Blood pressure medications are really affecting dialysis patients.
Correct answer A.
Rationale: The alteration in albumin homeostasis in ERSD is caused by a systemic inflammatory state which correlates closely with mortality.
(5) What IS RULE OF 15 in the treatment of low blood sugar?.
(A )Take 15gm of rapid carbohydrate, wait for 15minutes recheck blood sugar. If result is between 70 to 90.Take snacks consisting of protein, carbohydrates and fat.If result is not between 70 to 90.Repeat 15gm of rapid carbohydrate and take protein, carbohydrate and fat.
(B) Do nothing, make it a medical emergency.
(C )Call your doctor, if he is on vacation go to emergency room.
(D) Ignore your symptoms because it will disappear.
Correct answer A.
Rationale: A is the correct thing to do. Low blood sugar is not medical a emergency, don’t let it be one.Never ignore your symptoms. Eat regularly at least three times in a day.If you are experiencing hypoglycemia which is low blood sugar. Follow up with your primary care physician.
(6) How many people are required to to turn a patient with C- spine precautions?.
(A )Six people are required to turn a patient with c- spine precautions. Some of these patients can be huge.
(B )One person is enough to reposition this patient.
(C )A minimum of two nurses are required to turn the patient with a C- spine precautions because one person holds the neck in alignment with the turning.Three nurses will be perfect.
(D) None of the above is correct.
Correct answer C.
Rationale: C is correct, A,B,and D are incorrect.
Nurses You Move Me 