A.
Patient needs more sedation
✓
B.
Dexmedetomidine-induced bradycardia and hypotension, requiring physician notification and possible dose reduction
✓
C.
Pain is not controlled
✓
B.
Pancreatic necrosis with potential for sepsis and organ failure
✓
D.
Urinary tract infection
✓
B.
Check lead placement, ensure good skin contact, clean skin, and replace electrodes
✓
D.
Turn off the monitor
✓
B.
CO2 narcosis in patients with chronic hypercapnia (e.g., COPD) due to excessive oxygen
✓
A.
Administer insulin only
✓
B.
Administer aggressive intravenous fluid resuscitation with normal saline
✓
C.
Administer oral glucose
✓
D.
Administer a diuretic
✓
A.
Insufficient dobutamine dose
✓
B.
Dobutamine-induced tachycardia and increased myocardial oxygen demand, requiring physician notification and possible dose reduction
✓
A.
To increase heart rate
✓
B.
To relieve pain and reduce myocardial oxygen demand
✓
D.
To increase blood pressure
✓
B.
Reposition the patient, instruct to cough, and assess for kinks or clot in the line; do not force flush
✓
C.
Inject air into the line
✓
D.
Administer a strong flush
✓
A.
Patient is recovering
✓
B.
Risk of barotrauma and lung injury
✓
C.
Low risk of lung injury
✓
D.
Patient is hyperventilating
✓
A.
Administer more diuretics
✓
B.
Titrate sedation and analgesia to ensure patient comfort and prevent anxiety/agitation
✓
C.
Discontinue all pain medication
✓
D.
Administer more fluid
✓
A.
Patient is recovering
✓
B.
Persistent infection or inadequate antibiotic coverage, requiring further investigation
✓
C.
WBC is falsely elevated
✓
D.
Patient needs more fluid
✓
A.
Patient is recovering
✓
B.
Brain herniation, requiring immediate neurosurgical intervention
✓
A.
Prepare without double-check
✓
B.
Use an infusion pump with dose error reduction system (DERS) and perform independent double-check with another nurse
✓
C.
Administer as a bolus
✓
D.
Use a gravity infusion
✓
A.
Patient is well hydrated
✓
B.
Worsening acute kidney injury or inadequate renal perfusion
✓
C.
Patient is over-hydrated
✓
D.
Patient needs more fluids
✓
A.
Nitroglycerin is not working
✓
B.
Nitroglycerin-induced hypotension, requiring patient to lie down, fluid bolus if ordered, and physician notification
✓
A.
Immediately apply restraints
✓
B.
Assess for underlying causes (e.g., pain, hypoxemia, delirium), and administer appropriate sedation/analgesia as ordered
✓
C.
Leave patient unattended
✓
D.
Increase the ventilator settings
✓
B.
Hepatic encephalopathy and coagulopathy
✓
A.
Apply a warm compress
✓
B.
Apply direct pressure to the site, notify physician, and assess for hematoma formation
✓
C.
Remove the arterial line without pressure
✓
D.
Administer a diuretic
✓
