CELBAN Reading Patient Charts 2 — Questions and Answers
Question 1: A patient's chart shows 'NPO after midnight.' What does this instruction mean for the nursing staff?
- The patient should only drink water after midnight
- The patient must not eat or drink anything after midnight (Correct answer)
- The patient can have clear fluids but no solid food after midnight
- The patient should receive IV fluids after midnight
Correct answer: The patient must not eat or drink anything after midnight
NPO stands for 'nil per os' (nothing by mouth), meaning the patient must not consume anything orally after midnight.
Question 2: A chart entry reads: 'Pt. c/o dyspnea on exertion x 3 days.' Which of the following best interprets this note?
- The patient complains of difficulty breathing during physical activity for three days (Correct answer)
- The patient has chest pain when exercising for three days
- The patient reports dizziness during exertion for three days
- The patient complains of difficulty swallowing for three days
Correct answer: The patient complains of difficulty breathing during physical activity for three days
C/o means 'complains of,' dyspnea means difficulty breathing, and 'on exertion' indicates it occurs during physical activity.
Question 3: In a patient's chart, the vital signs section reads: 'BP 90/60 mmHg, HR 118 bpm, RR 24, Temp 38.9°C.' Which finding is most immediately concerning?
- The elevated temperature
- The low blood pressure combined with high heart rate
- The increased respiratory rate
- The combination of all four abnormal findings (Correct answer)
Correct answer: The combination of all four abnormal findings
All four findings together suggest possible septic shock: hypotension, tachycardia, tachypnea, and fever are classic signs requiring immediate intervention.
Question 4: A nurse reads in a patient's progress note: 'Wound site shows erythema, warmth, and purulent discharge.' What condition does this describe?
- Normal wound healing
- A wound infection (Correct answer)
- An allergic reaction to dressing material
- Wound dehiscence
Correct answer: A wound infection
Erythema (redness), warmth, and purulent (pus-containing) discharge are classic signs of a wound infection.
Question 5: A chart reads: 'Hx of HTN, DM Type 2, and CKD Stage 3.' What does this mean about the patient's medical background?
- History of hypertension, diabetes mellitus type 2, and chronic kidney disease stage 3 (Correct answer)
- History of heart transplant, diabetes mellitus type 2, and chronic knee disease stage 3
- Hypertension, diabetic neuropathy, and coronary kidney disease stage 3
- Hypotension, diabetes insipidus, and congenital kidney defect stage 3
Correct answer: History of hypertension, diabetes mellitus type 2, and chronic kidney disease stage 3
Hx = history, HTN = hypertension, DM = diabetes mellitus, CKD = chronic kidney disease.
Question 6: A medication administration record (MAR) lists: 'Metoprolol 25 mg PO BID.' How should this medication be administered?
- 25 mg by injection twice daily
- 25 mg by mouth twice daily (Correct answer)
- 25 mg by mouth once daily at bedtime
- 25 mg intravenously twice daily
Correct answer: 25 mg by mouth twice daily
PO means 'per os' (by mouth) and BID means 'bis in die' (twice a day).
Question 7: A nurse reviews a patient's fluid balance chart showing: 'I&O: 1,850 mL / 650 mL.' What should the nurse report to the physician?
- The patient is adequately hydrated
- The patient has a significant positive fluid balance suggesting fluid retention (Correct answer)
- The patient is dehydrated and needs less fluid intake
- The output is higher than intake, indicating normal kidney function
Correct answer: The patient has a significant positive fluid balance suggesting fluid retention
A difference of 1,200 mL between intake (1,850 mL) and output (650 mL) represents a significant positive fluid balance that may indicate fluid retention.
CELBAN Reading Patient Charts 2
A patient's chart shows 'NPO after midnight.' What does this instruction mean for the nursing staff?