PCT Practice Test 5

Respect patient autonomy while exploring reasons for refusal and offering non-pharmacological comfort measures. Document refusal and notify nurse.

Celebrity patients have same privacy rights as all patients. Confidentiality breaches involving public figures often receive extra scrutiny and penalties.

Patient safety comes first. Try de-escalation but stop procedure if patient becomes agitated or combative. Get help rather than risking injury.

Hematemesis (bloody vomit) poses aspiration risk. Priority is maintaining airway and breathing while getting immediate medical help.

Severe symptoms during stress testing suggest cardiac emergency. Stop test immediately and get emergency help – cardiac events can be triggered by exercise stress.

Gifts and tips create conflicts of interest. Politely decline and explain that excellent care is provided to all patients as part of professional responsibilities.

IV drug users have higher risk of bloodborne pathogens (HIV, Hepatitis). Use standard precautions strictly and consider this risk when selecting sites.

Tracheostomy obstruction is emergency requiring immediate nursing or respiratory therapy intervention. Don’t attempt suctioning if not trained and authorized.

Falls require immediate help to properly assess for injuries and provide appropriate care. Don’t move patient until injury assessment completed.

Mouth-breathing with nasal cannula reduces oxygen effectiveness. Nurse needs to assess if different oxygen delivery method is needed.

Dementia patients need calm, gentle approach with repeated introductions. Don’t argue with their perception but provide reassurance and orientation.

Provide basic factual information about their isolation precautions without diagnosing. Explain that precautions protect everyone while they recover.

Correct documentation errors with single line through mistake, write ‘error’ and initial. This maintains legal record integrity while showing correction was made.

IV site pain and swelling may indicate infiltration or phlebitis. Notify nurse for assessment – don’t remove IV without orders as it may be functioning properly.

Remain calm, reapply leads as tolerated and provide reassurance. Forced restraint could cause injury and worsen agitation.

Water near electrical equipment creates electrocution hazard. Block area immediately and report to appropriate personnel for safe cleanup.

CSF specimens require immediate transport and analysis as cellular elements deteriorate rapidly and bacterial counts can change affecting diagnosis.

Multiple blood culture sets should be drawn from different venipuncture sites to differentiate true bacteremia from skin contamination.

Contaminated phlebotomy equipment including needles, syringes and blood-soaked materials must be disposed in appropriate biohazard containers.

Therapeutic drug monitoring requires precise timing: trough levels just before next dose, peak levels at time of maximum drug concentration.

ABG specimens must be transported on ice and analyzed quickly as continued cellular metabolism can alter pH and gas values.

Bandages should be applied immediately after venipuncture with instructions to leave on for several hours to prevent bleeding and bruising.

Sharps containers should be replaced when 3/4 full to prevent overpacking that could cause injury during disposal or needle stick accidents.

SST tubes contain clot activator to enhance clotting and gel barrier that separates serum from cells after centrifugation.

Electrolyte testing (sodium, potassium, chloride, CO2) uses serum or plasma from red top or green top tubes respectively.

Bundle branch blocks cause wide QRS complexes (>0.12 seconds) due to delayed ventricular conduction through alternative pathways.

Wandering baseline results from patient movement, breathing, loose electrodes or electrical interference making rhythm interpretation difficult.

Catheter bags should be emptied every 8 hours or when becoming full to prevent backflow and reduce infection risk.

NG tube placement must be verified by chest X-ray before use for feeding or medication to prevent aspiration from tube in lung.

Peak drug levels are drawn at time of maximum drug concentration, usually just before next dose is due (trough level).

Good skin contact reduces artifact. Clean skin, remove hair if necessary and ensure electrodes adhere well to minimize electrical interference.

Icterus (jaundice) causes yellow discoloration indicating liver dysfunction or excessive red blood cell breakdown affecting bilirubin levels.

Coagulation studies require sodium citrate anticoagulant in light blue top tubes with specific blood-to-anticoagulant ratio for accurate results.

Pulse oximetry accuracy is affected by nail polish, cold extremities, poor circulation, movement and certain medical conditions affecting light transmission.

Orthostatic hypotension is assessed by measuring blood pressure lying down then after standing for 1-3 minutes. Drop >20/10 mmHg indicates positive result.

Ammonia levels rise rapidly at room temperature so specimens must be placed on ice immediately and processed quickly for accurate results.

Lithium testing requires sodium heparin tubes, not lithium heparin as lithium in the anticoagulant would falsely elevate results.

Malpractice implies intent or willful misconduct while negligence is failure to meet standard of care without intent to cause harm.

V-tach shows wide QRS complexes (>0.12 seconds) at rate >150 BPM without clear P waves. This is life-threatening rhythm requiring immediate intervention.

Lead II is a limb lead showing electrical activity from right arm (negative) to left leg (positive) providing inferior view of heart.