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| <noinclude> | | <noinclude> |
| Nursing Pharmacology Jeopardy Game for NSG 520 - Pathophysiology and Pharmacology | | Nursing Pharmacology Jeopardy Game for NSG 520 |
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| ==Usage== | | ==Usage== |
| <nowiki>{{#widget:520Jeapordy}}</nowiki> | | <nowiki>{{#widget:520Jeapordy}}</nowiki> |
| </noinclude><includeonly><div id="jep520"> | | </noinclude><includeonly>< iframe style=" width:100%;height:800px;border:none;" srcdoc=" <!DOCTYPE html><html><head><style> *{margin:0;padding:0;box-sizing:border-box}body{font-family:Arial,sans-serif;background:linear-gradient(135deg,rgb(30,58,95),rgb(12,25,41));padding: 15px; min- height: 100vh}. title{text-align:center;color:rgb(251,191,36);font-size: 1.8rem;font-weight:bold;margin-bottom: 5px}. sub{text-align:center;color:rgb(147,197,253);margin-bottom: 10px;font-size:. 85rem}. scores{display:flex;justify-content:center;gap: 20px;margin-bottom: 10px}. team{background:rgb(30,64,175);padding: 8px 15px;border-radius:8px;text-align:center}. team.on{box-shadow:0 0 12px rgb(251,191,36)}. team h3{color:white;margin-bottom: 3px;font-size:. 85rem}. score{font-size:1. 2rem;font-weight:bold}. pos{color:rgb(74,222,128)}. neg{color:rgb(248,113,113)}. turn{text-align:center;color:rgb(251,191,36);font-size: .9rem;margin-bottom: 10px}. board{display:grid;grid-template-columns:repeat(6,1fr);gap: 4px;margin-bottom: 10px}. cat{background:rgb(30,64,175);color:white;padding: 8px 4px;text-align:center;font-weight:bold;font-size:. 7rem;border-radius: 4px 4px 0 0;min-height: 40px;display:flex;align-items:center;justify-content:center}. cell{background:rgb(37,99,235);color:rgb(251,191,36);padding: 12px 4px;text-align:center;font-size: 1rem;font-weight:bold;border-radius: 4px;cursor:pointer;border:none }.cell:hover{background:rgb(59,130,246)}. cell.done{background:rgb(30,58,95);color: transparent;cursor:default}. btns{ text-align: center; margin-bottom: 8px}.btn{padding: 6px 12px;border-radius: 4px;font-weight:bold;cursor:pointer;border:none; margin:0 3px}. reset{background:rgb( 220, 38, 38); color:white}. mute{background:rgb(30,64,175);color:white}. tips{text-align:center;color:rgb(147,197,253);font-size:. 65rem}.qview{background:rgb(30,64,175);border-radius:8px;padding: 15px;color:white;max-width: 600px;margin:0 auto}. qhead{text-align:center;margin-bottom: 10px}. qcat{display:inline-block;background:rgb(251,191,36);color:rgb(30,58,95);padding: 4px 12px;border-radius: 12px;font-weight:bold;font-size:. 8rem}. qteam{color:rgb(251,191,36);margin-top: 5px; font-size:.85rem}. timer{text-align:center;margin-bottom: 8px}. tbadge{display:inline-block;padding: 5px 12px;border-radius: 12px;font-size: 1rem;font-weight:bold;background:rgb(251,191,36);color:rgb(30,58,95)}. tbadge.warn{background:rgb(220,38,38);color:white}. sbox{background:rgb(29,78,216);border-radius:6px;padding: 10px;margin-bottom: 8px}. sbox h4{color:rgb(251,191,36);margin-bottom: 4px;font-size:. 8rem}. sbox p{font-size:. 85rem;line-height:1. 3}. qbox{background:rgb(37,99,235);border-radius:6px;padding: 10px;margin-bottom: 8px}. qbox h4{color:rgb(251,191,36);margin-bottom: 4px;font-size:. 8rem}. qbox p{font-size: .9rem;font-weight:600}. abox{background:rgb(22,101,52);border-radius:6px;padding: 10px;margin-bottom: 8px}. abox h4{color:rgb(251,191,36);margin-bottom: 4px;font-size:. 8rem}. abox p{font-size:. 85rem;line-height:1. 3}. qbtns{display:flex;gap: 8px;justify-content:center;flex-wrap:wrap;margin-top: 10px}. qbtn{padding: 8px 16px;border-radius: 4px;font-weight:bold;cursor:pointer;border:none;font-size:. 85rem}. reveal{background:rgb(251,191,36);color:rgb(30,58,95)}. correct{background:rgb(34,197,94);color:white}. wrong{background:rgb(239,68,68);color:white}. over{ text-align: center;padding: 20px}. over h1{font-size: 1.8rem;color:rgb(251,191,36);margin-bottom: 10px}. final{font-size: 1rem;color:white;margin-bottom: 5px}. winner{font-size:1. 3rem;color:rgb(251,191,36);font-weight:bold;margin-bottom: 15px}</style> </head><body><div id= g></div><script>var cats=[{name: 'Cardiovascular ',q:[{pts:200,s: 'A 58-year-old patient with heart failure is prescribed digoxin. Before administering, the nurse checks the apical pulse and finds it to be 52 bpm. ',q: 'What should the nurse do? ',a: 'Hold the medication and notify the healthcare provider. Digoxin should be held if apical pulse is below 60 bpm due to risk of toxicity and bradycardia. '},{pts:400,s: 'A patient taking warfarin for atrial fibrillation has an INR of 4.8. The patient reports dark, tarry stools and dizziness. ',q: 'What is the priority nursing intervention? ',a: 'Hold warfarin, notify provider immediately, prepare for possible Vitamin K administration. Patient shows signs of GI bleeding with supratherapeutic INR. '},{pts:600,s: 'A post-MI patient on a cardiac monitor suddenly shows a wide QRS complex rhythm at 180 bpm with no detectable pulse. ',q: 'What is this rhythm and immediate action? ',a: 'Ventricular tachycardia (pulseless VT). Begin CPR immediately and prepare for defibrillation per ACLS protocol. '},{pts:800,s: 'A patient with chronic heart failure is started on carvedilol. Two weeks later, reports increased SOB and weight gain of 5 lbs. ',q: 'Why might this occur? ',a: 'Beta-blockers can initially worsen heart failure symptoms before providing long-term benefit. Assess for fluid retention, monitor daily weights. '},{pts:1000,s: 'A hypertensive patient on lisinopril develops a persistent dry cough. The provider switches to losartan. ',q: 'What is the best explanation? ',a: 'ACE inhibitors cause dry cough due to bradykinin accumulation. ARBs like losartan work similarly but dont cause bradykinin buildup. '}]},{name: 'Pain Mgmt ',q:[{pts:200,s: 'A post-surgical patient rates pain as 7/10 and requests PRN morphine. Last dose was 3 hours ago, ordered every 4 hours. ',q: 'What is the appropriate action? ',a: 'Offer non-pharmacological interventions and reassess in 1 hour. Cannot give morphine until 4-hour interval has passed. '},{pts:400,s: 'An elderly patient with dementia is grimacing, guarding abdomen, and restless but cannot verbally report pain. ',q: 'What pain assessment tool should be used? ',a: 'Use behavioral pain scale such as PAINAD or FLACC scale. Assess for nonverbal cues. '},{pts:600,s: 'A patient with chronic back pain on oxycodone for 6 months now requires higher doses for same relief. ',q: 'What phenomenon is this vs addiction? ',a: 'Tolerance - physiological adaptation requiring higher doses. Differs from addiction which involves compulsive use despite harm. '},{pts:800,s: 'A patient on IV morphine PCA has respiratory rate of 8, difficult to arouse, pinpoint pupils. ',q: 'What is occurring and priority interventions? ',a: 'Opioid overdose. Stop PCA, stimulate patient, call for help, prepare naloxone, support airway and breathing. '},{pts:1000,s: 'A cancer patient on around-the-clock MS Contin still has breakthrough pain episodes. ',q: 'What medication modification to anticipate? ',a: 'Add immediate-release morphine for breakthrough pain, typically 10-15 % of total 24-hour dose. '}]},{name: 'Teaching ',q:[{pts:200,s: 'A newly diagnosed diabetic needs insulin teaching. Patient appears anxious and keeps checking phone. ',q: 'What should nurse do first? ',a: 'Assess readiness to learn. Address anxiety first, minimize distractions, determine learning style and priorities. '},{pts:400,s: 'An elderly patient with newly prescribed warfarin has mild hearing loss and reads at 6th-grade level. ',q: 'What teaching strategies to employ? ',a: 'Face patient when speaking, use simple language, provide written materials at appropriate reading level with large print, use teach-back method. '},{pts:600,s: 'A patient being discharged on metformin asks if they can drink alcohol on weekends. ',q: 'What education should nurse provide? ',a: 'Alcohol increases risk of lactic acidosis with metformin and can cause hypoglycemia. Limit alcohol , never drink on empty stomach. '},{pts:800,s: 'A CHF patient is being discharged. Nurse has 15 minutes to teach about medications, diet, activity, warning signs. ',q: 'How to prioritize teaching? ',a: 'Focus on survival skills: daily weights (report 2+ lb gain), sodium restriction basics, medication names/times, warning signs needing immediate attention. '},{pts:1000,s: 'A 16-year-old with newly diagnosed epilepsy needs phenytoin teaching. Mother wants to handle all medication. ',q: 'What developmental considerations ?',a: 'Adolescents need autonomy. Include teen in teaching, address appearance concerns (gingival hyperplasia) and driving restrictions. '}]},{name: 'GI/Hepatic ',q:[{pts:200,s: 'A cirrhosis patient has ammonia level of 95 mcg/dL (normal 15-45). Patient is confused with asterixis. ',q: 'What medication to anticipate and why? ',a: 'Lactulose - acidifies colon converting ammonia to ammonium which cannot be absorbed, promotes bowel movements to eliminate ammonia. '},{pts:400,s: 'A post-cholecystectomy patient complains of severe right shoulder pain despite abdominal surgery. ',q: 'What causes this? ',a: 'Referred pain from CO2 used during laparoscopic surgery irritating diaphragm. Encourage ambulation to absorb gas. '},{pts:600,s: 'A patient with peptic ulcer disease is prescribed omeprazole, clarithromycin, and amoxicillin for 14 days. ',q: 'What is this treating and essential teaching? ',a: 'H. pylori eradication (triple therapy). Complete entire course even if feeling better, take PPI before meals. '},{pts:800,s: 'A patient with acute pancreatitis has NG tube to suction, IV fluids, NPO status. Asks why they cant eat. ',q:' Best explanation? ',a: 'Pancreas needs rest to heal. Eating stimulates pancreatic enzyme secretion which worsens inflammation and pain. '},{pts:1000,s: 'A Crohns patient on long-term prednisone develops round face, central obesity, blood glucose 180. ',q: 'What is occurring? ',a: 'Cushing syndrome from chronic corticosteroid use. Never stop medication abruptly, report infection signs, monitor blood glucose. '}]},{name: 'Med Admin ',q:[{pts:200,s: 'A nurse is preparing IV vancomycin. Pharmacy sends it to infuse over 30 minutes. ',q: 'What concern should nurse have? ',a: 'Vancomycin too rapidly causes Red Man Syndrome - flushing, hypotension, rash. Should infuse over at least 60 minutes. '},{pts:400,s:'MAR shows potassium chloride 40 mEq IV ordered. Nurse receives medication as 40 mEq vial. ',q: 'What must nurse verify? ',a: 'IV potassium must NEVER be given as bolus push - causes fatal arrhythmias. Verify diluted appropriately, via pump, max 10-20 mEq/hour. '},{pts:600,s: 'Nurse is to administer insulin lispro (Humalog) and insulin glargine (Lantus) before breakfast. ',q: 'How should these be administered? ',a: 'Give in SEPARATE syringes - Lantus should never be mixed with other insulins as it alters action of both. '},{pts:800,s: 'A patient on IV heparin drip has aPTT of 120 seconds (therapeutic 60-80). Patient needs invasive procedure. ',q: 'What should nurse do? ',a: 'Hold heparin infusion, notify provider. If urgent reversal needed, protamine sulfate is antidote. Monitor for bleeding. '},{pts:1000,s: 'Patient receiving first IV penicillin dose develops hives, wheezing, BP drop to 80/50 after 5 minutes. ',q: 'What is occurring and priority interventions? ',a: 'Anaphylaxis. 1) Stop infusion, 2) Call for help, 3) Epinephrine IM, 4) Maintain airway, 5) IV fluids, 6) Diphenhydramine. '}]},{name: 'Pathophys ',q:[{pts:200,s: 'A patient with uncontrolled diabetes has glucose 450, breathing rapidly and deeply, fruity breath. ',q: 'What condition and what causes symptoms? ',a: 'DKA. Lack of insulin causes fat breakdown producing ketones. Metabolic acidosis triggers Kussmaul respirations. '},{pts:400,s: 'A COPD patient on 2L nasal cannula has O2 increased to 6L by family. Patient becomes drowsy. ',q: 'What is happening physiologically? ',a: 'CO2 narcosis. COPD patients rely on hypoxic drive. High-flow O2 removes this drive causing hypoventilation and CO2 retention. '},{pts:600,s: 'A post-thyroidectomy patient develops tingling around mouth, muscle cramps, positive Chvosteks sign. ',q: 'What complication and why? ',a: 'Hypocalcemia due to parathyroid gland damage during surgery. Treat with IV calcium gluconate. '},{pts:800,s: 'Trauma patient receives 6 units PRBCs. Labs: pH 7.28, K+ 6.2, calcium 7.8, hypothermia. ',q: 'What massive transfusion complications? ',a: 'Metabolic acidosis, hyperkalemia (K+ leaks from stored RBCs), hypocalcemia (citrate binds calcium), hypothermia. '},{pts:1000,s: 'Severe sepsis patient has BP 78/40, HR 128, lactate 6, urine output 10 mL/hr for 2 hours. ',q: 'What is occurring and priority interventions? ',a: 'Septic shock. Fluid resuscitation 30 mL/kg, obtain cultures, broad-spectrum antibiotics within 1 hour, vasopressors if needed. '}]}];var st={ s1:0, s2:0,tm:1,done:{},cur:null,tmr:30,ti:null}; function render(){var g=document.getElementById(' g');if(st. cur===null) {var h= '<h1 class= title>🏥 Nursing Jeopardy</h1><p class= sub>NSG 520 - Pathophysiology and Pharmacology</p>'; h+=' <div class=scores><div class=\"team'+(st. tm===1?' on':'')+'\"><h3>Team 1</h3><div class=\"score '+(st. s1>= 0?'pos':'neg')+'\">$'+st. s1+'</div></div>'; h+='<div class=\"team'+(st. tm=== 2?' on':'') +'\"><h3>Team 2</h3><div class=\"score '+(st. s2>=0 ?'pos':' neg') +'\">$'+st. s2+' </div></div></div>'; h+='<p class=turn>🎯 Team '+st. tm+' Pick</p><div class=board>' ;for(var c=0; c<6; c++) h+='<div class=cat>'+cats[ c]. name+' </div>' ;for(var r=0; r<5;r++) for(var c=0; c<6; c++){ var k=c+' -' +r;h+=st. done[k]?'<button class=\"cell done\"></button>' :' <button class=cell onclick=\"pick(' +c+',' +r+') \">$'+cats[c].q[r]. pts+' </button>';} h+='</div><div class= btns>< button class= \" btn reset\" onclick=reset()>Reset</button></ div><p class= tips> 💡 Questions increase in difficulty</p>'; g.innerHTML=h; }else if(st. cur.show){var c=cats[st.cur.c],q=c.q[st.cur.r];var h='< div class=qview>< div class=qhead>< span class= qcat>'+ c. name+' - $' +q.pts+' </span><p class=qteam> Team '+st. tm+'</ p></div>';h+='<div class= sbox><h4>📋 Scenario:</h4><p>'+ q. s+' </p></div>' ;h+ =' <div class=qbox>< h4> ❓ Question:</ h4>< p>'+ q. q+'</p></div> ';h+=' <div class=abox><h4>✅ Answer: </h4><p>'+ q. a+'</ p></div>';h+='<div class=qbtns>< button class= \"qbtn correct\" onclick=\" ans(1)\"> ✓ Correct +$'+ q. pts+'</ button>< button class= \" qbtn wrong\" onclick=\" ans(0) \"> ✗ Wrong -$'+ q. pts+' </button></div></div>'; g.innerHTML= h; }else{var c=cats [st.cur.c ],q=c .q[st. cur.r] ;var h='< div class= qview>< div class=qhead>< span class= qcat>'+c .name+' - $'+q.pts+'</ span><p class=qteam> Team '+ st.tm+' </p></div>';h+='<div class= timer><span class=\"tbadge'+(st.tmr<=10?' warn': '')+'\" >⏱️ '+st.tmr+'s</span></div>';h+='< div class= sbox><h4>📋 Scenario:</h4><p>'+q.s+'</p></ div>';h+='< div class= qbox> <h4>❓ Question: </h4><p>' +q.q+'</ p></div>';h+='< div class=qbtns><button class= \" qbtn reveal\" onclick=reveal()>Reveal Answer</button></div></ div>'; g.innerHTML=h;} }function pick( c,r){ if(st. done[c +'-'+r] )return;st.cur ={c:c,r:r ,show:false}; st.tmr= 30;clearInterval(st.ti); st.ti= setInterval(function(){st. tmr-- ;if(st. tmr<= 0)clearInterval(st. ti);render(); },1000); render();}function reveal(){clearInterval(st. ti) ;st. cur.show=true;render();}function ans(ok){clearInterval(st.ti); var q= cats[st.cur.c].q [st.cur. r]; if(st.tm=== 1)st.s1+ =ok?q. pts:-q .pts; else st.s2+= ok?q.pts:-q.pts; st.done[st.cur.c+' -' +st.cur. r] =true; st.tm= st. tm===1?2:1;st.cur =null; if(Object.keys(st.done).length=== 30){var w= st.s1> st.s2?' 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| <script> | |
| (function() {
| |
| var cats = [
| |
| {name:"Cardiovascular",q:[
| |
| {pts:200,s:"A 58-year-old patient with heart failure is prescribed digoxin. Before administering the medication, the nurse checks the apical pulse and finds it to be 52 bpm.",q:"What should the nurse do?",a:"Hold the medication and notify the healthcare provider. Digoxin should be held if the apical pulse is below 60 bpm in adults due to risk of toxicity and bradycardia."},
| |
| {pts:400,s:"A patient taking warfarin for atrial fibrillation has an INR of 4.8. The patient reports dark, tarry stools and dizziness.",q:"What is the priority nursing intervention?",a:"Hold warfarin, notify the provider immediately, and prepare for possible administration of Vitamin K. The patient shows signs of GI bleeding with supratherapeutic INR levels."},
| |
| {pts:600,s:"A post-MI patient on a cardiac monitor suddenly shows a wide QRS complex rhythm at 180 bpm with no detectable pulse.",q:"What is this rhythm and what is the immediate action?",a:"Ventricular tachycardia (pulseless VT). Begin CPR immediately and prepare for defibrillation. This is a shockable rhythm requiring immediate intervention per ACLS protocol."},
| |
| {pts:800,s:"A patient with chronic heart failure is started on carvedilol. Two weeks later, the patient reports increased shortness of breath and weight gain of 5 lbs.",q:"Why might this occur and what should the nurse assess?",a:"Beta-blockers can initially worsen heart failure symptoms before providing long-term benefit. Assess for fluid retention, monitor daily weights, lung sounds, and edema."},
| |
| {pts:1000,s:"A hypertensive patient on lisinopril develops a persistent dry cough. The provider switches to losartan.",q:"What is the nurse's best explanation for this change?",a:"ACE inhibitors like lisinopril can cause dry cough due to bradykinin accumulation. ARBs like losartan work similarly but don't cause bradykinin buildup, so cough is not a side effect."}
| |
| ]},
| |
| {name:"Pain Mgmt",q:[
| |
| {pts:200,s:"A post-surgical patient rates their pain as 7/10 and requests PRN morphine. The last dose was given 3 hours ago, ordered every 4 hours.",q:"What is the appropriate nursing action?",a:"Offer non-pharmacological interventions (repositioning, ice/heat, relaxation) and reassess in 1 hour. Cannot give morphine until 4-hour interval has passed."},
| |
| {pts:400,s:"An elderly patient with dementia is grimacing, guarding their abdomen, and has increased restlessness but cannot verbally report pain.",q:"What pain assessment tool should the nurse use?",a:"Use a behavioral pain scale such as PAINAD (Pain Assessment in Advanced Dementia) or FLACC scale. Assess for nonverbal cues."},
| |
| {pts:600,s:"A patient with chronic back pain has been on oxycodone for 6 months and now requires higher doses to achieve the same pain relief.",q:"What phenomenon is this, and how is it different from addiction?",a:"This is tolerance - a physiological adaptation requiring higher doses. It differs from addiction, which involves compulsive use despite harm and loss of control."},
| |
| {pts:800,s:"A patient receiving IV morphine via PCA pump has a respiratory rate of 8, is difficult to arouse, and has pinpoint pupils.",q:"What is occurring and what are the priority interventions?",a:"Opioid overdose/toxicity. Stop PCA, stimulate patient, call for help, prepare naloxone (Narcan), support airway and breathing."},
| |
| {pts:1000,s:"A patient with cancer pain is on around-the-clock MS Contin but still has breakthrough pain episodes.",q:"What medication regimen modification should the nurse anticipate?",a:"Add immediate-release morphine for breakthrough pain, typically 10-15 percent of the total 24-hour dose."}
| |
| ]},
| |
| {name:"Teaching",q:[
| |
| {pts:200,s:"A newly diagnosed diabetic patient needs insulin teaching. The patient appears anxious and keeps checking their phone.",q:"What should the nurse do before beginning education?",a:"Assess readiness to learn. Address anxiety first, minimize distractions, and determine the patient's learning style and priorities."},
| |
| {pts:400,s:"An elderly patient with newly prescribed warfarin has mild hearing loss and reads at a 6th-grade level.",q:"What teaching strategies should the nurse employ?",a:"Face the patient when speaking, use simple language, provide written materials at appropriate reading level with large print, use teach-back method."},
| |
| {pts:600,s:"A patient is being discharged on metformin for type 2 diabetes. They ask if they can drink alcohol on weekends.",q:"What patient education should the nurse provide?",a:"Alcohol increases risk of lactic acidosis with metformin and can cause hypoglycemia. Recommend limiting alcohol and never drinking on empty stomach."},
| |
| {pts:800,s:"A patient with CHF is being discharged. The nurse has 15 minutes to provide discharge teaching about medications, diet, activity, and warning signs.",q:"How should the nurse prioritize this teaching?",a:"Focus on survival skills: daily weights (report 2+ lb gain), sodium restriction basics, medication names/times, and warning signs requiring immediate attention."},
| |
| {pts:1000,s:"A 16-year-old with newly diagnosed epilepsy needs teaching about phenytoin. The mother wants to handle all medication administration.",q:"What developmental considerations should guide the nurse's approach?",a:"Adolescents need autonomy. Include the teen in teaching, address concerns about appearance (gingival hyperplasia) and driving restrictions."}
| |
| ]},
| |
| {name:"GI/Hepatic",q:[
| |
| {pts:200,s:"A patient with cirrhosis has a serum ammonia level of 95 mcg/dL (normal: 15-45). The patient is confused and has asterixis.",q:"What medication should the nurse anticipate and why?",a:"Lactulose - it acidifies the colon, converting ammonia to ammonium which cannot be absorbed, and promotes bowel movements to eliminate ammonia."},
| |
| {pts:400,s:"A patient post-cholecystectomy complains of severe right shoulder pain despite the surgery being abdominal.",q:"What causes this and what should the nurse do?",a:"Referred pain from CO2 used during laparoscopic surgery irritating the diaphragm. Encourage ambulation to absorb the gas."},
| |
| {pts:600,s:"A patient with peptic ulcer disease is prescribed omeprazole, clarithromycin, and amoxicillin for 14 days.",q:"What is this regimen treating and what teaching is essential?",a:"H. pylori eradication (triple therapy). Complete entire course even if feeling better, take PPI before meals, return for follow-up testing."},
| |
| {pts:800,s:"A patient with acute pancreatitis has NG tube to suction, IV fluids, and NPO status. The patient asks why they can't eat.",q:"What is the nurse's best explanation?",a:"The pancreas needs rest to heal. Eating stimulates pancreatic enzyme secretion, which can worsen inflammation and pain."},
| |
| {pts:1000,s:"A patient with Crohn's disease on long-term prednisone develops round face, central obesity, and blood glucose of 180 mg/dL.",q:"What is occurring and what patient education is needed?",a:"Cushing syndrome from chronic corticosteroid use. Never stop medication abruptly, report signs of infection, monitor blood glucose."}
| |
| ]},
| |
| {name:"Med Admin",q:[
| |
| {pts:200,s:"A nurse is preparing to administer IV vancomycin. The pharmacy sends it to infuse over 30 minutes.",q:"What concern should the nurse have?",a:"Vancomycin infused too rapidly causes Red Man Syndrome - flushing, hypotension, rash. Should infuse over at least 60 minutes."},
| |
| {pts:400,s:"A patient's MAR shows potassium chloride 40 mEq IV ordered. The nurse receives the medication as a 40 mEq vial.",q:"What must the nurse verify before administration?",a:"IV potassium must NEVER be given as bolus push - causes fatal arrhythmias. Verify diluted appropriately, infused via pump, max 10-20 mEq/hour."},
| |
| {pts:600,s:"A nurse is to administer insulin lispro (Humalog) and insulin glargine (Lantus) to a diabetic patient before breakfast.",q:"How should these insulins be administered?",a:"Give in SEPARATE syringes - Lantus should never be mixed with other insulins as it can alter the action of both."},
| |
| {pts:800,s:"A patient on IV heparin drip has an aPTT of 120 seconds (therapeutic range 60-80). The patient now needs an invasive procedure.",q:"What should the nurse do?",a:"Hold heparin infusion, notify provider. If urgent reversal needed, protamine sulfate is the antidote. Monitor for bleeding."},
| |
| {pts:1000,s:"A patient receiving first dose of IV penicillin develops hives, wheezing, and BP drop to 80/50 after 5 minutes.",q:"What is occurring and list interventions in priority order?",a:"Anaphylaxis. 1) Stop infusion, 2) Call for help, 3) Epinephrine IM, 4) Maintain airway, 5) IV fluids, 6) Diphenhydramine/corticosteroids."}
| |
| ]},
| |
| {name:"Pathophys",q:[
| |
| {pts:200,s:"A patient with uncontrolled diabetes has blood glucose of 450 mg/dL, breathing rapidly and deeply, and fruity-smelling breath.",q:"What condition is this and what causes these symptoms?",a:"Diabetic Ketoacidosis (DKA). Lack of insulin causes fat breakdown producing ketones. Metabolic acidosis triggers Kussmaul respirations."},
| |
| {pts:400,s:"A patient with COPD on 2L nasal cannula has oxygen increased to 6L by family. The patient becomes increasingly drowsy.",q:"What is happening physiologically?",a:"CO2 narcosis. COPD patients rely on hypoxic drive. High-flow oxygen removes this drive, causing hypoventilation and CO2 retention."},
| |
| {pts:600,s:"A patient after thyroidectomy develops tingling around the mouth, muscle cramps, and positive Chvostek's sign.",q:"What complication is this and why does it occur?",a:"Hypocalcemia due to damage to parathyroid glands during surgery. Treat with IV calcium gluconate."},
| |
| {pts:800,s:"A trauma patient receives 6 units of PRBCs. Labs show: pH 7.28, K+ 6.2 mEq/L, calcium 7.8 mg/dL, hypothermia.",q:"What complications of massive transfusion are occurring?",a:"Metabolic acidosis, hyperkalemia (K+ leaks from stored RBCs), hypocalcemia (citrate binds calcium), and hypothermia."},
| |
| {pts:1000,s:"A patient with severe sepsis has: BP 78/40, HR 128, lactate 6 mmol/L, urine output 10 mL/hr for 2 hours.",q:"What is occurring and what are the priority interventions?",a:"Septic shock. Fluid resuscitation (30 mL/kg), obtain cultures, broad-spectrum antibiotics within 1 hour, vasopressors if needed."}
| |
| ]}
| |
| ];
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