Reading Comprehension Flashcards

A policy on restraint use reads: 'Physical restraints may only be applied when less restrictive alternatives have been attempted and failed, a physician order has been obtained, and patient safety cannot otherwise be ensured. Reassessment must occur every 2 hours.' A nurse applies a wrist restraint without a physician order because the patient keeps pulling at their IV line. What should happen next?

Answer: The nurse must obtain a physician order immediately and document the emergent application

Even in emergent situations, a physician order must be obtained as soon as possible after applying a restraint, as required by policy and legislation.

A patient's discharge summary reads: 'Diagnosis: Community-acquired pneumonia (CAP). Treatment: Azithromycin 500 mg daily x 5 days. Follow-up: Chest X-ray in 6 weeks to ensure radiographic resolution.' Why is a 6-week follow-up X-ray recommended rather than one at discharge?

Answer: Because radiographic changes in pneumonia resolve more slowly than clinical symptoms

Clinical improvement in pneumonia typically precedes radiographic clearing, which can take 4–8 weeks, so a follow-up X-ray confirms full resolution and rules out underlying pathology.

A nursing textbook passage states: 'The Glasgow Coma Scale (GCS) assesses three areas: eye opening (scored 1–4), verbal response (scored 1–5), and motor response (scored 1–6). A total score of 15 indicates full consciousness, while a score of 8 or below indicates severe impairment requiring airway protection.' A patient scores: eyes open to voice (3), confused verbal response (4), localizes pain (5). What is this patient's GCS score?

Answer: 12

Eyes to voice = 3, confused speech = 4, localizes pain = 5; total GCS = 3 + 4 + 5 = 12.

A clinical protocol for blood transfusion reads: 'Vital signs must be obtained before transfusion, at 15 minutes, and at completion. The transfusion must be completed within 4 hours of issue from the blood bank. If a transfusion reaction is suspected, STOP the transfusion immediately and notify the physician.' At 20 minutes into a transfusion, a patient develops hives and pruritus. What is the FIRST action?

Answer: Stop the transfusion and notify the physician

The protocol explicitly states to stop the transfusion immediately if a reaction is suspected, before any other interventions.

A patient teaching sheet about warfarin states: 'Warfarin interacts with many foods and medications. Vitamin K-rich foods (leafy greens) can reduce its effectiveness. Avoid significant changes in your diet, and tell all healthcare providers you are on warfarin. Have your INR checked regularly.' A patient asks if they need to stop eating salads entirely. What is the BEST response based on the handout?

Answer: No, the goal is consistency — avoid sudden large changes in vitamin K intake rather than eliminating it

The handout advises avoiding significant changes in diet, not elimination; consistent vitamin K intake allows for stable warfarin dosing.

A triage note reads: 'Patient is a 4-year-old male brought in by parents. Presenting complaint: high fever, drooling, difficulty swallowing, and the child is sitting upright leaning forward (tripod position). Stridor noted on auscultation.' Which condition is MOST consistent with this presentation?

Answer: Epiglottitis

Drooling, high fever, dysphagia, stridor, and tripod positioning in a child are classic signs of epiglottitis, a medical emergency.

A hospital policy on medication errors reads: 'Any medication error, regardless of patient harm, must be reported through the incident reporting system. Near-miss events — errors caught before reaching the patient — must also be reported. Reporting is non-punitive and used for quality improvement.' A nurse catches a colleague about to give a double dose of morphine and corrects it before administration. What should the nurse do?

Answer: File a near-miss report in the incident system per policy

The policy explicitly requires near-miss events to be reported through the incident system; the non-punitive culture supports reporting to improve safety.