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RGH Medical Skills Day Review

Total questions: 17

Worksheet time: 6mins

Name
Class
Date
1.

Select the recommended frequency of chest tube dressing change on medical units at RGH

a)

Every 3 days 

b)

Only as needed 

c)

Daily, and sooner if soiled or if no longer occlusive 

d)

Every 1-3 days 

2.

While assessing the patient with a chest tube, you note constant bubbling in the water seal chamber. What could be the cause? (select all that apply) 

a)

There is a chinook outside

b)

The patient has a pneumothorax

c)

The Chest Drainage system has an air leak 

d)

The chest tube is obstructed 

3.

When does this PICC dressing need to be changed? (select all that apply) 

a)

2 days (48 h) post-insertion

b)

7 days post-insertion 

c)

PRN if compromised 

d)

Never it is good as long as the PICC stays in

4.

Which of these CVADs can be removed on the unit by any CVAD certified nurse? (select all that apply) 

a)

Tunneled CVAD 

b)

Non-tunneled direct percutaneous CVAD (“IJ”) 

c)

PICC 

d)

Femoral non-tunneled CVAD 

5.

You have a patient with a CGM. There is a physician order to use the CGM reading to dose nurse-administered insulin. What is best action? (select all that apply)

a)

Ask the patient what their blood glucose is before administering insulin 

b)

Inform physician nurses cannot use CGM readings to dose insulin 

c)

Suggest physician enter order for patient to manage own insulin dosing using CGM if appropriate 

d)

Ignore all things BGL- the patient is managing their own

6.

 

Your patient's BG is 3.4, what is the most appropriate nursing action? 

a)

Provide meal tray ASAP and encourage patient to eat 

b)

Mix 4 sugar packages in a container of apple juice for patient to drink 

c)

Page physician and ask how they would like to treat 

d)

Choose appropriate treatment option based on hypoglycemia treatment algorithm 

7.

How often do you observe and monitor a patient who has just recently had 2 Pinel limb Wrist restraints applied? 

a)

Every 1hr 

b)

Every 4hrs 

c)

Every 15 to 30 minutes at minimum 

d)

Every 8hrs 

8.

Your newly admitted patient with dementia is becoming verbally escalated as he wanders down the hall. How should you respond? 

a)

Threaten the patient with restraint use 

b)

Go ahead and restrain the patient using 4 Pinel limb restraints

c)

Review current care plan and engage family to find strategies to de-escalate 

d)

Administer Haldol to de-escalate the patient 

9.

You would suspect a spinal injury and call a code 66 in which of the following situations

a)

Patient found lying on the floor with bed not in the lowest position and all 4 side-rails up

b)

Any unwitnessed fall

c)

An unwitnessed fall with scalp laceration and altered LOC

10.

Select the correct frequencies for nursing tracheostomy care

a)

Trach tie change PRN, check patency of inner cannula q4h and PRN, clean inner cannula q12h, stoma care qshift 

b)

Trach tie change qshift, check patency of inner cannula q4h and PRN, clean inner cannula q12h, stoma care qshift

c)

Check patency and clean inner cannula, stoma care and trach tie change each once per shift

d)

Nurse to check patency of inner cannula q4h and PRN, RTs do the rest.  
 

11.

When my patient with a trach is coughing and has lots of mucous, deep suctioning (more than 12cm) is needed to clear their airway and is more effective than superficial suctioning (10-12cm).  

a)

True

b)

False

12.

Possible signs of a transfusion reaction are

a)

Hypertension, bradycardia, erythema 

b)

Mild headaches, itchy palms, vision changed 

c)

Cyanosis, urticaria, fever 

d)

Agitation, joint pain, hematuria  

13.

We can refer to Give Life Alberta BEFORE a patient passes away

a)

True

b)

False

14.

What portions of the tissue donation process are mandatory for floor nurses, (select all that apply)

a)

Screening

b)

Documentation

c)

Obtaining consent

d)

Calling Give Life Alberta (if the patient DOES NOT meet the exclusion criteria)

e)

Make something up 

15.

Why do we flush with sterile water between every single medication? Pick all that apply:

a)

We don’t want medications to mix in the stomach

b)

We don’t want medications to mix in the tube

c)

We want to prevent mixing incompatible medications in the tube. These types of occlusions cannot be unclogged

d)

Because it is the Patient's preference

16.

 

NSWOC should be consulted for ostomies when? 

a)

For new ostomies 

b)

For ostomies that nursing is concerned about (leaking/skin breakdown) 

c)

Consultation is not required. 

d)

Consult NSWOC for all ostomies 

17.

The MRHP assesses your patient after an unwitnessed fall and determines that they DO NOT require c-spine precautions or a CT scan. However, you must continue to complete neuro-vitals? 

a)

True

b)

False