Hi guys, it's me Professor D and welcome back to my YouTube channel. On this video, I'm trying something new. So please let me know in the comment section what you think.
This is the first video of its kind. I actually found some questions from the library, questions online. So I decided let me go through a couple questions with you online.
If it's something you like, you appreciate, I'll make more. And if you think it sucks, I just won't make any more. But let me know in the comment section.
what you think. These are questions for PN or VN students. However, if you are an RN student, this will still be helpful to you because these questions are foundational questions.
You absolutely will need them to know. No, that's not good English. You will need to know that information to answer a more complex question. So even if you're an RN student, I still think it'll be helpful to you.
Please in the comment section, let me know what you think. So anyway, let's get into it. It says, first question says, the nurse manager of a mental health unit is reviewing a chart entry made by a staff member. The entry reads, I feel unloved, appears confused and restless.
That's in quotation marks, which of the following statement best describes why this nursing documentation is incorrect. A, the nurse who made this chart entry failed to document that the client made the quote. B, the nurse who made this chart entry failed to explore or interpret the client's feelings. of being unloved. C, the nurse who made the chart entry failed to indicate the importance of the client's statement.
Or D, the nurse who made the chart entry failed to accurately describe the evidence of confusion and restlessness. The nurse who made the chart entry failed to accurately describe the evidence of confusion and restlessness. So how did that patient appear confused?
What did they say? What did they do? If a patient's behaving restlessly, I don't think that's a word, but they're showing signs of restlessness. Usually when we see restlessness, what are we thinking? Decreased oxygen usually to the brain, right?
But what behavior are we seeing that is exhibiting that? So the rationale says this is correct answer. The nurse should report what was observed, such as.
confused and restless that may not be the same to all healthcare providers. When you're documenting, you need to document facts, document what you see. Reporting what was actually observed is as much more accurate and objective measure for documenting behavior. Now, let me stop right there. I want to give you another example.
If you document the patient fell, was it witnessed? Did you see them fall? Because guess what?
If you walked in the room and you found them on the ground, they told you that they fell. You can put in... quotation marks what they said, but you can't document that the patient fell unless you actually saw them fall. What you would document was that you observed them on the ground upon entering the room.
Okay. So anyway, it says accurate documentation is essential as the nurse's notes become a part of the client's permanent record and can be used as evidence in a court of law. Okay. Let's move on.
All right. So it says the nurse determines the BMI for seven-year-old boy is to be 15.5. According to the chart below, this places the client at which percentile.
So it's supposed to be at 15.5. And how old is the patient? Seven years old.
So how I like to do it, I like to go to this side first, 15 and a half and follow this line, seven years old. I'm not wearing my glasses, guys. I should put on my glasses. Oh, sorry. Seven.
Am I at the 15.5? No, that's not the 15.5. Geez. No, that's higher than, oh, I was right. This is a 15.5.
So that patient should be at the 25th percentile. And basically, wait, let me make sure I'm right first. Oh, I was wrong. Look at that.
I was wrong. Hold on. Seven years old, 15.5. Let me do it the other way.
Let me go to the age seven and then go up here, 15.5. So this is at a little bit below 14. That's 14, 15. How is it 50th percentile? Seven years old. I'm above the 15 to me. Let me follow this line.
Make sure I'm not, oh, it is 50th. Oh my gosh, it is. It is 50th right here.
Follow the line here at seven, the age of seven. Yep. It's 50th percentile.
So I was wrong, but this is how you do it guys. Down here is the age and up here is the percentile. So don't do how I did go to the age first, go to the age.
Cause that's easier. And then, well, to me, I guess, and then you just go up to the percentile and you follow the line because it could be very deceiving. If you just stay where you are, you might think you're at the 25th and you're really at the 50th.
You might think you're at the 50th and you're really at the 25th because remember it's a curve. So just go back and follow the line just to make sure you're at the correct BMI that you thought. So the correct answer, it is.
It's a 50th percentile. Let's see what it says. If a seven-year-old boy has a BMI of 15.5, it's a 50th percentile. And something else so you know, when it comes to this chart, guys, you're going to teach the parents, the patient, that the healthy BMI, you want that child to be between the fifth and the 85th percentile, okay? All right, let's move on.
A client has just lost his job. He's worried that he won't be able to afford his mortgage. The nurse knows that mild levels of anxiety can cause which of the following? A, fixation.
B, motivation for growth. C, panic attack. Or D, sense of impending doom. motivation for growth. You guys need to know this.
Mild anxiety is a good thing. Why? It makes you do what you're supposed to do, right? You have a test coming up and you have mild anxiety instead of, you know, being like how I was yesterday watching the entire half series of Bridgerton, right? You're not going to do that.
You're not going to be on Netflix. You are going to be studying because you have that mild anxiety. If you're walking through the parking lot late at night, you're by your steps.
you're by yourself and you hear footsteps and you have mild anxiety, what that's going to make you do? Speed up your walking to hurry up and get in your car and lock your doors, right? So mild anxiety is a motivation for growth. It's actually a good thing. Okay.
A pregnant client's admitted to the hospital due to preterm labor. She tells the nurse that she's going to go home right now because she cannot stand being in the hospital another minute. Which of the following should the nurse do first? A, call security to stop the client. B, notify the RN.
C, place the client in restraints. Or D, tell the client she cannot leave. What do you guys think?
Okay, you're going to notify the nurse. And why? Because you can't hold that patient against their will. So you're going to get help.
You're going to let the nurse know that this patient is trying to leave, but this patient is in preterm labor. So it says the LPN should notify the RN. If the client is insistent on leaving the facility, the RN should be notified so that he or she can ask the client to sign the appropriate documentations related to leaving against medical advice when the patient wants to leave AMA. A nurse is participating in a staff development program on illicit drug overdose. The nurse recognizes additional teaching is not needed when the staff.
Member states that clients with suspected cocaine overdose are at risk for A, cardiac arrest, cardiac arrest, B, lethargy, C, psychosis, or D, respiratory arrest. What do you guys think? We're talking about cocaine here.
Yep. Patient that has a cocaine overdose, we're going to be very concerned about cardiac dysrhythmias. What can cardiac dysrhythmias lead to?
Cardiac arrest. Absolutely. And here's another thing that should have been a clue to you.
This is a multiple choice question, right? Look at your options. You have cardiac arrest, lethargy, psychosis, and respiratory arrest.
And I only want you to use this trick if you have no idea what the answer is. If you know what the answer is, go with your gut. But let's say you get a question and you have absolutely no idea what the answer is.
And you see two questions that are similar, like they have the same word in it, right? Choose one of those. Okay, moving on. The nurse is supervising a newly hired nursing assistant.
The nursing assistant is providing oral care to an unconscious client. Which of the following actions made by the nursing assistant would indicate that the nursing assistant requires further instructions from the LPN? A, assuring the client remains in the lateral position for 30 minutes after oral care. B, placing a towel under the client's chin prior to completing oral care. C, positioning the client in an upright position providing oral care.
D, placing the client in the lateral position with the head turned to the side during oral care. Sorry, I'm leaning in, guys. I cannot see and I have to figure out how to make my screen bigger.
Here we go. Normally. Under normal circumstances, of course, we're going to have them sit up.
We don't want them aspirating. But there's one word in this phrase that completely changed the question. What kind of patient are we dealing with? An unconscious patient. How are you going to sit them up in their unconscious?
Does that make any sense? Okay. That patient that's unconscious, they're not going to be able to sit up. They're going to be all falling to the side. So that's the one that you intervene.
Whenever you have a question asking. Which one needs further clarification? Which one needs further education?
Which one needs further instructions? Really what they're asking you is which one is the wrong answer choice. And if you look at the rationales, the LPN would need to intervene and provide further education or instruction on proper procedure for providing oral care to what type of patient?
The comatose patient. It's because the patient's comatose. Okay? Oh, geez.
Another one of these. All right. The nurse is documenting a 10-year-old girl's BMI on the chart below and finds the BMI is in the 25th percentile. All right, let's see if I can get it together.
How old is the child? Document. Okay, 10. 10, 25th percentile.
Okay, so let me go to my 10 and go to the 25th. This is a fifth. This is a 10th. This is a 25th.
Okay, so it's right here. Oh, what are they asking us? The nurse knows that according to the BMI chart, this child is, oh, I didn't even have to chart it. So they want to know if the child's in the 25th percentile, where are they?
Are they underweight? Are they a healthy weight? Are they overweight?
And are they obese? That child is going to be a healthy weight because you want them to be between that fifth and 85th. Oh, sorry. You want them to be between the fifth and 85th percentile. And here's the explanation.
I'm sorry, guys, this is my first time. So I got to get used to this system. If you like it, if you don't like it, I won't do it again. All right.
The nurse is providing care to a 10 year old who is blind. Which communication technique is the most appropriate? A, announce presence when entering the room.
B, face the child with explaining procedures. C, speak in a loud, slow manner or D, quietly leave the room. You're going to announce your presence when you're entering the room because remember they're blind, so they won't see you. So you're going to announce your presence. Facing them when you're explaining procedures, you're facing them, but they can't see your face.
Speaking in a loud manner, they're not deaf, quietly leave the room. why would you do that? That patient wouldn't even know that you were leaving.
So the correct answer is A, the rationale says the nurse should announce his or her presence when entering the room, and they should also let the patient know when they're leaving the room as well. Okay. NGN type question.
So it says, use the following to answer questions nine through 10. All right. At 10 o'clock, Mr. Martinez, a 58-year-old. Male with a history of CKD hypertension is admitted to the medical surgical unit with complaints of weakness, confusion, and decreased urine output. He has recently started a new antihypertensive medication, Lisinopril. All right, guys, it ends in pril.
What kind of medication is that? An ACE inhibitor. Very good. Vital signs, 170 over 98. Heart rate, 92. Respirations, 20. Temp, 98.6. O2 sat 96% on room air.
Pratinence. 2.5, BUN 35, potassium 4.8. The practical nurse in the medical surgical unit is caring for a 58-year-old male client. The practical nurse reviews Mr. Martinez's laboratory values. Drag one condition and one client finding from below to complete the sentence.
So here's the sentence we have to complete. Mr. Martinez's elevated serum creatinine and blank levels suggest blank and warrant careful monitoring. so we're looking at the labs which were already here what is el what is elevated and requires monitoring. And you know, guys, this is real easy because the creatinine is elevated because when it comes to the NGN type questions, remember they give you the normal range.
So for the serum creatinine, normal range is 0.6 to 1.3. And this patient's range is 2.5. That's elevated.
So I'm going to choose creatinine. Is it, oh, creatinine's not here. BUN, potassium, blood pressure. Oh, duh.
That was part of the question. Sorry. What else is high? Their BUN is high as well.
Normal BUN is 7 to 20 and the patient's BUN is 35. So BUN is our answer. So let me drag BUN up here. So it says Mr. Martinez's elevated creatinine and BUN level suggests potential what? When the BUN and or that creatinine is elevated, what are you thinking about?
You're thinking about the kidneys, right? When the B1 is elevated, usually it's kidney disorder, but there can be other things going on with the patient. But if you see that creatinine is elevated because the creatinine is more specific to the kidneys, it's going to be a kidney issue. So the patient's going through some type of kidney issues. So we're going to choose renal dysfunction.
Okay. So the explanation serum creatinine and BUN are key indicators of renal dysfunction. If you have to choose one between the two, it's always going to be creatinine. Keep that in mind. An increase in the values may suggest impaired kidney function, indicating potential renal dysfunction.
And one of the things you're always going to teach a patient to avoid kidney dysfunction, they need to stay hydrated because if they're dehydrated, that's going to make the kidneys work much, much harder. Okay. Hypertensive crisis. It's a blood pressure of 180 over 120 or greater and overhydration would be indicated.
Okay. So they're giving you rationales for the others. Moving on.
Unless you guys want me to go over the rationale for the others, let me know in the comment section. All right. This will be the last question we're doing together.
Um, cause I don't know if you guys are going to like this video, but if you do, I'll make sure I'll make it longer next time. Um, it says Mr. Martinez. Okay.
Same patient, same patient. Let me see if the labs are still the same. Vital same.
Okay. Lab's still the same. So let's look at the question. It says the practical nurse in the medical surgical unit is caring for, okay.
Choose the most likely options for information missing from the statement by selecting from the dropdowns. Okay. Here's a dropdown. It says, Mr. Martinez's potassium levels are within normal rent range, but trending towards higher limit. indicating a risk for, let me go back to, yeah, potassium 4.8.
Okay. So it's on the higher limit. So that's putting the patient at risk for hyperkalemia. Okay. It can't be hypernatremia because that would be high sodium.
We don't even see any sodium and it can't be hypokalemia because hypokalemia would be a potassium of less than 3.5. So it has to be hyperkalemia, which can, I can't speak, which can present. with symptoms of muscle weakness. The practical nurse should consider educating the patient on increasing potassium intake.
Absolutely not. That would make the hyperkalemia worse. Signs of dehydration, yes, because that can cause the hyperkalemia and increasing sodium intake, no. Because sodium and potassium have an inverse relationship.
So if you increase that sodium intake, that would possibly... cause, um, uh, hyponatremia or cause that sodium to go down. So what would you consider is signs of dehydration?
Because that may possibly be related to the hyperkalemia. And if this isn't the answer, that's it. I quit. I'm walking away.
Okay, good. All right. So the rationale says educating Mr. Martinez on signs of dehydration is essential considering his history of CKD and his symptoms such as weakness, confusion, decreased urine output. dehydration can contribute to electrolyte imbalance. If you are an RN student and you're taking fundamentals of nursing or foundations of nursing, or you're an LPN student either, you have to know these fluid electrolytes.
You have to know the ranges and you have to know the implications. So what happens when that fluid is high versus when it's low, what's the complication that can happen? So make sure you guys review that.
And that is it for this video because I really don't want to take too much time making this video and you guys hate it. So please be honest with me in the comments section. Be nice. Don't hurt my feelings, but be honest. Let me know.
And if you guys want more questions like this, I'll be more than happy to make them because I think this is a really cool resource and I'm hoping you guys like it so I can make more for you. But if not, we'll just go and do other things. So please let me know what you thought about this video in the comment section.
Let me know what you'd like to see more of. Don't forget, I have my official videos that are released every Sunday, 1 p.m. Eastern Standard Time.
I've got lots of cahoots and Just lots of content for you on my YouTube channel. So be sure to check out my YouTube channel. My handle is the same everywhere. Whether you go to TikTok, Instagram, Facebook, or right here, YouTube, the handle's the same, Nexus Nursing.
Be sure to check out my website. I've got lots of resources available for you there as well. NexusNursingInstitute.com. All right, guys. Thank you so much for watching this video.
And you guys will catch me on the next video. Bye.