Fy 15: ICU Annual Policy / Procedure Review
(343).webp "Fy 15: ICU Annual Policy / Procedure Review - Quiz")
- 1.
This facilities' organ procurment agency is:
- A.
Life Point
- B.
Death Star
- C.
SCOPA
- D.
LOPA
Correct Answer
A. Life PointExplanation
per CPM 00- 14 - 16, ORGAN AND TISSUE DONOR PROGRAMRate this question:
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- 2.
This facilities' organ procurment agency is:
- A.
Life Point
- B.
Death Star
- C.
SCOPA
- D.
LOPA
Correct Answer
A. Life PointExplanation
per CPM 00- 14 - 16, ORGAN AND TISSUE DONOR PROGRAMRate this question:
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- 3.
When is necessary to call Life Point? [CHECK ALL THAT APPLY]
- A.
For all discharges
- B.
Patients who death is imminent
- C.
Patients who are deceased
- D.
For all admissions
Correct Answer(s)
B. Patients who death is imminent
C. Patients who are deceasedExplanation
per CPM 00- 14 - 16, ORGAN AND TISSUE DONOR PROGRAMRate this question:
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- 4.
How does one contact the Ethics Consultation Service? [CHECK ALL THAT APPLY]
- A.
An urgent consultation request to the Ethics Consultation Service is to be by direct page to the designated Ethics Consultation Service Pager: 219-0143
- B.
Non-urgent consultation requests to the Ethics Consultation Service can be made by a CPRS formal consult, direct call or page to the Ethics Consultation Service Coordinator, 789-7133, Pager: 449
- C.
Non-urgent consultation requests to the Ethics Consultation Service can be made by calling theEthics Consultation Service Hotline: 789-6910.
- D.
There is no ethics consultation service - don't call anyone - figure it out by yourself
Correct Answer(s)
A. An urgent consultation request to the Ethics Consultation Service is to be by direct page to the designated Ethics Consultation Service Pager: 219-0143
B. Non-urgent consultation requests to the Ethics Consultation Service can be made by a CPRS formal consult, direct call or page to the Ethics Consultation Service Coordinator, 789-7133, Pager: 449
C. Non-urgent consultation requests to the Ethics Consultation Service can be made by calling theEthics Consultation Service Hotline: 789-6910.Explanation
PER CPM 00 - 14 - 25, INTEGRATED ETHICS, Attachment ARate this question:
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- 5.
Asking a patient their last name and last four digits of thier social security number constitutes proper identificaion? TRUE or FALSE
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
per CPM 118-14-23, PATIENT IDENTIFICATIONRate this question:
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- 6.
Labeling blood tubes at the nurses' station is the proper place for this action.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
per CPM 118-14-23, PATIENT IDENTIFICATIONRate this question:
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- 7.
When completing the admission assessment - PRESSURE ULCER SECTION - if a score of less than 18 is tallied, then
- A.
Interventions must be docuemented in the Admission Assessment flow sheet
- B.
Move on to the next section
- C.
Pressure ulcers do not exist in unit
- D.
Write an incident report
Correct Answer
A. Interventions must be docuemented in the Admission Assessment flow sheetExplanation
If a score of less than 18 is tallied in the pressure ulcer section of the admission assessment, it means that there is a risk or presence of pressure ulcers in the patient. Therefore, interventions must be documented in the Admission Assessment flow sheet to address and prevent the development or worsening of pressure ulcers. This ensures that appropriate measures are taken to provide the necessary care and treatment for the patient's condition.Rate this question:
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- 8.
According to the MISSING PATIENT POLICY, an "at risk patient" [CHECK ALL THAT APPLY]
- A.
Is legally committed.
- B.
Has a court appointed legal guardian.
- C.
Is considered dangerous to self or others.
- D.
Lacks cognitive ability (either permanently or temporarily) to make relevant decisions.
- E.
Has physical or mental impairments that increase their risk of harm to self or others.
Correct Answer(s)
A. Is legally committed.
B. Has a court appointed legal guardian.
C. Is considered dangerous to self or others.
D. Lacks cognitive ability (either permanently or temporarily) to make relevant decisions.
E. Has pHysical or mental impairments that increase their risk of harm to self or others.Explanation
per CPM 07B-13-01, MISSING PATIENT POLICYRate this question:
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- 9.
Here at the RHJ VAMC, a missing child alert is announced overhead as
- A.
Amber Alert
- B.
Ahsley Alert
- C.
Code Adam
- D.
Missing Child Alert
Correct Answer
C. Code AdamExplanation
per CMP 07B-13-10, Missing Child Alert.
The Nationwide missing child alert. Only specially trained Charleston Police Department (CPD) officers can declare an AMBER ALERT.Rate this question:
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- 10.
Accordng to the RHJ VAMC's CMP for PROCEDURES FOR ACTIVE SHOOTER RESPONSE the employees' responsibilities include [CHECK ALL THAT APPLY]
- A.
Immediately calling extension 7251, 7268 or 7911 to report the incident
- B.
Immediately locking themselves in a secure room or evacuate if able to do so safely.
- C.
Remaining in a secure location until the “All Clear” is given by VA or local Police
- D.
following all instruction given by VA Police or local Police
Correct Answer(s)
A. Immediately calling extension 7251, 7268 or 7911 to report the incident
B. Immediately locking themselves in a secure room or evacuate if able to do so safely.
C. Remaining in a secure location until the “All Clear” is given by VA or local Police
D. following all instruction given by VA Police or local PoliceExplanation
per CPM 07B-12-15, PROCEDURES FOR ACTIVE SHOOTER RESPONSE.Rate this question:
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- 11.
According to the ORDERING AND REPORTING TEST RESULTS CPM, if the nurse takes a critical lab value from the lab, then the nurse will use what procedure?
- A.
Nurses never take critical lab reports
- B.
Put the Lab on HOLD until the MD can be tracked down and told personally
- C.
Write the lab value on a paper towel and tell the PCC to call the MD
- D.
Read back process and records the name of the responsible provider to whom the results were reported and the time the result was communicated in the medical record
Correct Answer
D. Read back process and records the name of the responsible provider to whom the results were reported and the time the result was communicated in the medical recordExplanation
per CPM 11-14-01, ORDERING AND REPORTING TEST RESULTS.Rate this question:
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- 12.
According to the Medication Reconcilliation CPM, what is the ICU's nurses' role?
- A.
Nothing, that's the pharmacist's job
- B.
Nothing, that's the MD's job
- C.
Reinforce medication teaching & documenting it in the Pt -Family Education Note
- D.
What's med rec?
Correct Answer
C. Reinforce medication teaching & documenting it in the Pt -Family Education NoteExplanation
per CPM 11-12-23, Medication Reconcilliation
The Registered Nurse will complete the nursing portion of the Discharge Instructions template and will reinforce the medications and other instructions with the patient prior to discharge. A copy of the discharge instructions, which includes complete and reconciled list of the patient’s medications, is provided directly to the patient, and the patient’s family as needed and the list is explained to the patient and/or family.Rate this question:
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- 13.
How should the nurse respond to VIEW ALERTS? [CHECK ALL THAT APPLY]
- A.
Ignore them - that's not my job
- B.
Acknowledge them by signing them
- C.
Sign them - even if it was sent erronously
- D.
What's view alert?
Correct Answer(s)
B. Acknowledge them by signing them
C. Sign them - even if it was sent erronouslyExplanation
View Alerts are the responsibility of every employee of the Medical Center. All employees with a CPRS/Vista account must ensure alerts are resolved in a timely manner.
C. If View Alerts are erroneously sent to an employee an action is still required. Employees must contact the sender (previous signer) for explanation or forward to appropriate individual within 7 days of receipt.Rate this question:
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- 14.
Veteran’s state portable orders for “Do Not Resuscitate” (DNR) and /or other life sustaining treatment are recognized by this VA. TRUE / FALSE
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
per CMP 11-13-26, ADVANCE HEALTH CARE AND MENTAL HEALTH CARE PLANNING AND RESUSCITATION INSTRUCTIONS
Veteran’s state portable orders for “Do Not Resuscitate” (DNR) and /or other life sustaining treatment are recognized by VHA and authorized VHA practitioners. If the veteran has both an advance directive and state portable order which are inconsistent with one another, priority will be given to the most recent statement by the patient of his/her wishes. (Note: See VHA Handbook 1004.04 for more information specific to state portable orders.)Rate this question:
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- 15.
According to the CPM for ADULT VICTIMS OF ALLEGED ACUTE SEXUAL ASSAULT, this VA treats acute alleged sexual assaults. TRUE / FALSE
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
per CPM 11-14-40, ADULT VICTIMS OF ALLEGED ACUTE SEXUAL ASSAULT
Patients will be transferred for medical care and treatment and for forensic examinationRate this question:
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- 16.
Check below the types of patients who are at risk for aspiration and should be made NPO until evaluated by the speech pathologist: [CHECK ALL THAT APPLY]
- A.
A patient experiencing a TIA / CVA
- B.
A patient who was recently extubated after a long period of time
- C.
A patient who is drooling after putting food in their mouth
- D.
A patient who AAOx3
Correct Answer(s)
A. A patient experiencing a TIA / CVA
B. A patient who was recently extubated after a long period of time
C. A patient who is drooling after putting food in their mouthExplanation
per CPM 112-11-07, MANAGEMENT OF PATIENTS WITH SWALLOWING (DYSPHAGIA) OR FEEDING DISORDERS &
Mosby's nursing procedures for Dysphagia as well as Aspiration PrecautionsRate this question:
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- 17.
Signs and symptoms of blood transfusion reaction include [CHECK ALL THAT APPLY]
- A.
Fever with or without chills
- B.
Tachycardia and/or tachypnea and dyspnea
- C.
Hives or rash to the patient's trunk and back
- D.
Sudden change in BP
- E.
Wheezing
- F.
Improvement of the hemoglobin and hematocrit values
Correct Answer(s)
A. Fever with or without chills
B. Tachycardia and/or tachypnea and dyspnea
C. Hives or rash to the patient's trunk and back
D. Sudden change in BP
E. WheezingExplanation
per CPM 113-13-01, TRANSFUSION OF BLOOD COMPONENTS &
Mosby's nursing procedure Transfusion ReactionRate this question:
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- 18.
What are the nurse's actions for a patient experiencing a blood transfusion reaction? [CHECK ALL THAT APPLY]
- A.
Stop the transfusion
- B.
Notifiy the MD and Blood Bank
- C.
Obtain four, seven ml lavender tubes from a site distant from the infusion. Label as immediate post-transfusion reaction with patients full name, full social security number, and signature of the person drawing the blood with date and time
- D.
Return the blood bag, transfusion set and patient samples to the Blood Bank with the completed Blood Transfusion Record Form
- E.
Report the suspected reaction to Quality Management by calling the Patient Safety Hotline
Correct Answer(s)
A. Stop the transfusion
B. Notifiy the MD and Blood Bank
C. Obtain four, seven ml lavender tubes from a site distant from the infusion. Label as immediate post-transfusion reaction with patients full name, full social security number, and signature of the person drawing the blood with date and time
D. Return the blood bag, transfusion set and patient samples to the Blood Bank with the completed Blood Transfusion Record Form
E. Report the suspected reaction to Quality Management by calling the Patient Safety HotlineExplanation
per CPM 113-13-01, TRANSFUSION OF BLOOD COMPONENTS &
Mosby's nursing procedure Transfusion ReactionRate this question:
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- 19.
When asking a patient about suicide risk, the nurse should ask what? [CHECK ALL THAT APPLY]
- A.
Do you have thoughts of hurting yourself?
- B.
Do you have a plan?
- C.
What is the plan? (assertain if it is doable)
- D.
What did you have for lunch today?
Correct Answer(s)
A. Do you have thoughts of hurting yourself?
B. Do you have a plan?
C. What is the plan? (assertain if it is doable)Explanation
CPM 116-13-03, SUICIDAL PRECAUTIONSRate this question:
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- 20.
Once a patient has been deteremined to be 'at risk' for suicide, what are the nurses' actions? [CHECK ALL THAT APPLY]
- A.
Report any suicidal self-harm behaviors or threats to the Nurse Manager and physician
- B.
Placed on one to one observation pending a mental health provider’s determination that suicidal precautions are necessary or until such time as these orders are rescinded.
- C.
Allow the patient to use the restroom in privite to maintain patient privacy.
- D.
Remove all patient belongs from the room
Correct Answer(s)
A. Report any suicidal self-harm behaviors or threats to the Nurse Manager and pHysician
B. Placed on one to one observation pending a mental health provider’s determination that suicidal precautions are necessary or until such time as these orders are rescinded.
D. Remove all patient belongs from the roomExplanation
CPM 116-13-03, SUICIDAL PRECAUTIONSRate this question:
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- 21.
A written order must be signed before a patient can be considered 'committed & placed on 1:1.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
2. Once it has been determined that the patient will be committed for psychiatric treatment, the patient will be placed in the safest setting possible and under constant 1:1 supervision to prevent harm to self or others. The consulting mental health provider/psychiatrist will write an order for 1:1 Observation in CPRS and contact the appropriate administrative staff in the clinical area who will then take the lead role in coordinating the continuous observation of the patient.Rate this question:
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- 22.
This is a latex free facility. TRUE / FALSE
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
per CPM 118-12-08, LATEX ALLERGY/SENSITIVITYRate this question:
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- 23.
Because this is the ICU and all our patients are HIGH RISK FOR FALLS, we do not need to document fall prevention interventions.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
per CPM 118-13-18, ASSESSMENT AND CARE OF PATIENTS/RESIDENTS AT RISK OF FALLING
All patients in the ICU are identified as high fall risks due to medications, numerous invasive lines and critical condition. All ICU patients will be assessed on admission and prior to transfer to another unit.
Interventions: All staff will implement interventions to create a safe environment and maintain the safety of all patientsRate this question:
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- 24.
Please hold the tube feeding for 1hour before and 1hour after administration of medication[CHECK ALL THAT APPLY]
- A.
Warfarin
- B.
Monoamine Oxidase Inhibitors
- C.
Phenytoin
- D.
Disulfiram
Correct Answer(s)
A. Warfarin
B. Monoamine Oxidase Inhibitors
C. pHenytoin
D. DisulfiramExplanation
per CPM 120-14-07, DRUG - NUTRIENT INTERACTION POLICYRate this question:
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- 25.
According to the CPM for ADULT/CHILD VICTIMS OF ALLEGED ABUSE, all suspected abuse must be acted upon. Who is the RHJ VAMC's designated reporter?
- A.
The MD
- B.
The RN
- C.
The Social Worker
- D.
The Case Manager
Correct Answer
C. The Social WorkerExplanation
per CPM 122-13-02, ADULT/CHILD VICTIMS OF ALLEGED ABUSE
All professionals have a responsibility to act on all suspected abuse. A person, who, acting on good faith, in an emergency situation, reports or participates in an investigation resulting from a report, is immune from civil and criminal liability which may otherwise result by reason of this action.
Social Work Service has been designated as mandatory reporters for the Ralph H. Johnson VA Medical Center.Rate this question:
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- 26.
Every effort will be made communicate with hearing impaired Veterans and non–English speaking family members to assure Veterans are afforded every available treatment and service to which they are entitled. This Medical Center will be properly equipped with TTY telephones to communicate effectively with hearing impaired Veterans and request sign interpreters when necessary. Non-English speaking individuals, generally Veterans’ family members or persons acting on their behalf, will be offered the services of a language interpreter when necessary. What's a nurse to do to get this assistance to this patient / family?
- A.
Change the assignment - surely the new nurse learned this in orientation
- B.
Look up the CPM for COMMUNICATION WITH HEARING IMPAIRED/NON-ENGLISH SPEAKING INDIVIDUALS
- C.
Intubate the patient so they can't speak
- D.
Use a picture boad
Correct Answer
B. Look up the CPM for COMMUNICATION WITH HEARING IMPAIRED/NON-ENGLISH SPEAKING INDIVIDUALSExplanation
per CPM 136-12-02, COMMUNICATION WITH HEARING IMPAIRED/NON-ENGLISH SPEAKING INDIVIDUALSRate this question:
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- 27.
Glucose management of any patient admitted to this hospital who is wearing a Continuous Subcutaneous Insulin Infusion (CSII) commonly known as an Insulin Pump include [CHECK ALL THAT APPLY]
- A.
Place an Endocrinology Consult and CDE consult
- B.
Maintain the patient/family/significant other responsible for their CSII pump as well as its supplies
- C.
Continute to perform prescribed finger blood glucose monitor using this facilities' glucometer unless preceded by physician order for inpatient to use his/her own glucometer.
- D.
Discontinue the pump and send it home with the family
Correct Answer(s)
A. Place an Endocrinology Consult and CDE consult
B. Maintain the patient/family/significant other responsible for their CSII pump as well as its supplies
C. Continute to perform prescribed finger blood glucose monitor using this facilities' glucometer unless preceded by pHysician order for inpatient to use his/her own glucometer.Explanation
per CPM 118-13-03, Use of Insulin Pumps During HospitalizationRate this question:
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- 28.
According the Patient Clothing, Valuables, Incidentals and Services CPM, patient's belongings only need to be inventoried upon arrival / admission to the hospital.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
per CPM 118-12-35, Patient Clothing, Valuables, Incidentals and ServicesRate this question:
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- 29.
According to the CPM, CONSERVATION OF MEDICAL CENTER LINENS, how can we ensure the control of linens within our areas to prevent pilferage, loss and misuse? [CHECK ALL THAT APPLY]
- A.
Linen storage closets will be closed and locked when not in use. Only authorized employees are allowed in linen storage closets.
- B.
Linen carts should be covered at all times.
- C.
When patients are to be transported from the medical center to another location by ambulance, the VA employee responsible for the patient transfer will ensure that ambulance drivers exchange linens. VA linens are to remain in the medical center
- D.
Do not wear patient clothing such as pajama tops, gowns or robes.
- E.
Do not use linens for anything else but paient care
Correct Answer(s)
A. Linen storage closets will be closed and locked when not in use. Only authorized employees are allowed in linen storage closets.
B. Linen carts should be covered at all times.
C. When patients are to be transported from the medical center to another location by ambulance, the VA employee responsible for the patient transfer will ensure that ambulance drivers exchange linens. VA linens are to remain in the medical center
D. Do not wear patient clothing such as pajama tops, gowns or robes.
E. Do not use linens for anything else but paient careExplanation
per CPM, 137-12-03. CONSERVATION OF MEDICAL CENTER LINENSRate this question:
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- 30.
What medications can be sent home with a patient at discharge? [CHECK ALL THAT APPLY]
- A.
Insulin
- B.
Unopened inhalers
- C.
Eye drops
- D.
Ointments / creams
Correct Answer(s)
C. Eye drops
D. Ointments / creamsExplanation
per CPM 119-14-06, PROVIDING BULK INPATIENT MEDICATIONS ON DISCHARGE FOR OUPATIENT USERate this question:
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- 31.
You suspect that your patient is having a stroke. Upon immediate notification of the MD, you are asked to call the stroke team. Who do you call?
- A.
7911, ask for the stroke team
- B.
1-800-I-CARE
- C.
Neurology consult residnet
- D.
We don't have a stroke team, the MD is responsible for handeling this his / her self
- E.
The Emergency Department
Correct Answer
C. Neurology consult residnetExplanation
per protocol, Neurology Acute Stroke ProtocolRate this question:
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- 32.
If you suspect that your patient is having a stroke, do ALL of following, EXCEPT
- A.
Make patient NPO
- B.
Start an IV and draw labs
- C.
Place patient on telemetry
- D.
Do nothing unitil the Rapid Response Team to arrives and gives orders
Correct Answer
D. Do nothing unitil the Rapid Response Team to arrives and gives ordersExplanation
per Neurololgy Stroke ProtocolRate this question:
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- 33.
According to the Alcohol Detox Protocol (AKA, CIWA), when can the protocol be discontinued?
- A.
Only upon the MD's order
- B.
After a score of less than 8 x 3 in a row
- C.
After a score of less than 10 x 3 in a row
- D.
After the last dose of the tapered Ativan
Correct Answer
B. After a score of less than 8 x 3 in a rowExplanation
per Alcohol Detox ProtocolRate this question:
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- 34.
Spinal Cord Injury (SCI) patients with an injury at T6 or above is at risk for autonaumic dysreflexia (AD). What is AD?
- A.
A skin disease
- B.
A hypertensive crisis / medical emergency caused by a noxious stimuli below the level of injury
- C.
A contracture that occurs from a mal-adaptive fitting to a wheel chair
- D.
This is the VA, we can cure SCI
Correct Answer
B. A hypertensive crisis / medical emergency caused by a noxious stimuli below the level of injuryExplanation
per Spinal Cord Injury Treatment Guideline for Nurses and PhysiciansRate this question:
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- 35.
What are the nursing actions for a spinal cord injury patient in autonaumic dysreflxia crisis? [CHECK ALL THAT APPLY]
- A.
Sit the patient up and recheck the BP
- B.
Loosen / remove all clothes below the waist including socks
- C.
Check the patient for any stool impaction
- D.
Check the paitne for a full bladder
- E.
Be prepared to apply 1" NTG paste if BP remains elevated and causes cannot be easily eliminated
Correct Answer(s)
A. Sit the patient up and recheck the BP
B. Loosen / remove all clothes below the waist including socks
C. Check the patient for any stool impaction
D. Check the paitne for a full bladder
E. Be prepared to apply 1" NTG paste if BP remains elevated and causes cannot be easily eliminatedExplanation
per SCI Treatment and Guideline for Nurses and PhysiciansRate this question:
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- 36.
Total Parental Nutrition (TPN) administration guidelines can be found on the T drive under -
- A.
CPM
- B.
Service Line Policies
- C.
Clinical Guidelines and Protocols
- D.
Infection Control Guidelines
Correct Answer
D. Infection Control GuidelinesExplanation
ICG # 17Rate this question:
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- 37.
Where can one find the 'frequency of IV tubing changing'. Yes, on the T drive, but where?
- A.
CPM for IV administraion
- B.
Service Line Policy under Mosby's Nursing Skills
- C.
Clinical Protocols and Guidelines for the prevention of central line blood stream infections
- D.
Infection Control Guideline # 16, Prevention of IV Device Related Infection
Correct Answer
D. Infection Control Guideline # 16, Prevention of IV Device Related InfectionExplanation
The correct answer is "Infection Control Guideline # 16, Prevention of IV Device Related Infection." This source specifically focuses on the prevention of infections related to IV devices, which would likely include information on the frequency of IV tubing changing. The other options listed are not as directly related to IV device infections or may not provide specific information on IV tubing changing frequency.Rate this question:
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- 38.
Which of the following statements is TRUE?
- A.
Single-dose vials are intended to be used once for a single patient during the course of a single procedure. Discard the vial after this single use. Single-dose vials typically lack preservatives; therefore, using these vials more than once carries substantial risks for bacterial contamination, growth and infection. Used vials should never be returned to stock on clinical units, drug carts, anesthesia carts, etc.
- B.
Multiple-dose parenteral medication vials (MDVs) must be labeled with the date it expires once it is opened. The vial will be discarded after 28 days, or when suspected or visible contamination occurs, or when the manufacturer’s expiration date is reached (which ever occurs soonest). MDVs are stored in accordance with the manufacturer’s guidelines.
- C.
Glucometer control solution expires 90 days after opening.
- D.
When multiple-dose vials are used more than once, a new needle and new syringe should be used for each entry. Needles or other objects left in vial entry diaphragms may contaminate the vial’s contents.
- E.
All the above
Correct Answer
E. All the aboveExplanation
per IC Guideline # 25, HANDLING AND STORAGE OF SINGLE-USE AND MULTIDOSE MEDICATION VIALS AND UNITSRate this question:
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- 39.
Provider priviledges can be found on the U drive?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
provider priviledges are found on the T drive under PRIVILEDES folderRate this question:
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