N4461 Final Examination Blueprint Spring 2022 This exam is composed of 61 multiple choice questions. The level of difficulty of the questions is based upon Bloom's taxonomy. Bloom's Taxonomy an Paget of ee OU Ae 2022Learning Activity 1: Foundations for Caring for Acutely Ill Complex Patients ‘Objective Remember [Understand [Apply [Analyze Identify characteristics and stratogies/abiliies that enhance crfical thinking 7 Discuss evidence-basedinformed practice in torms of bundles of care and cinical Baa practice guidelines with an understanding oftheir rationale and applications to everyday practice and patient outcomes Learning Activity 2: Coming to Know Patients Experiencing Complex Cardiac Health Challenges: Acute Coronary Syndrome and Heart Fallure ‘Objective Remember [Understand [Apply [Analyze Desorbe the risk factors, pathophysiology, (aliypical clinical presentations, siages and [5,55 ‘complications associated with acute coronary syndrome (ACS) and heart failure (HF) Determine requisite focused assessments including early findings associated with 645 {dterioration for patients experiencing ACS and HF “Apply critical thinking and evidence-based practice guidelines using the Langara Decision 7.8.5, ‘Making Framework (DMF) o individualize nursing care for patints/families experiencing 56 ACS and HE "Analyze select sinus, aval and venticular thyihms and discuss ther hemodynamic 4 70 ‘consequences, rug therapies and nursing implications Learning Activity 3: Caring for Acutely Il Pationts with Complex Respiratory Health Challenges. ‘Objective Remember [Understand [Apply [Analyze Describe the risk factors, pathophysiology, (aiypical clinical presentations, slages and 1 ‘complications associated with COPD, asthma, pneumonia and pulmonary embolism ‘Understand the clinical indications, goals of therapy, usual doses, routes of 20 ‘administration, pharmacokinetics, interactions and adverse effects of drugs commonly ‘administered to treat COPD, asthma, pneumonia and pulmonary embolism "Apply critical thinking and evidence-based practice guidelines using the Langara Decision 7 32 ‘Making Framework (DMF) to individualiz nursing care for patients/families experiencing COPD, asthma, pneumonia, pulmonary embolism and respiratory falure Page ot ee OU Ae 2022Learning Activity 4: Caring for Acutely Il Patients Experiencing Neurological Health Challenges ‘Objective Remember [Understand [Apply [Analyze Describe the risk factors, pathophysiology, (a)iypical clinical presentations, stages and 14,15 43 complications associated with deliium, seizures, ischemic stroke and Parkinson's disease “Apply critica thinking and evidence-based practice guidelines using the Langara Decision 6 ‘Making Framework (DMF) o individualize nursing care for patints/families experiencing dolium, seizures, ischemic stoke and Parkinson's disease Learning Activity 5: Etfective Handovers and Discharge Planning ‘Objective Remember [Understand [Apply | Analyze ‘Discuss the ralonale for and principles of standardized cinical handovers 38 ‘Discuss the stages of cischarge planning and the safety, communication, educaion and [39 T {evaluation processes requited fr its effective implementation Learning Activity 6: Moderate Sedation ‘Objective Remember [Understand [Apply [Analyze Provide patfentWamily education related to post procedural discharge care El ‘Understand the clinical indications, goals of therapy, usual doses, routes, 2 oS pharmacokinetics, interactions and adverse effects of drugs (e.g. IV sedatives, opioids ‘and reversal agents) commonly administered to pationts receiving moderate sedation Learning Activity 7: Coming to Know Pationts Experiencing Shock States ‘Objective Remember [Understand [Apply [Analyze "Apply oritcal thinking and evidence-based practice guidelines using the Langara Decision 17, 18, ‘Making Framework (DMF) o individualize nursing care for patints/families experiencing 44 shook states ‘Understand the cnicalindications, goals of therapy, usual doses, routes of 75,20, administration, pharmacokinetics, interactions and adverse effects of drugs commonly 45 administered to treat shock sates Paget ee OU Ae 2022Learning Activity 8: Coming to Know Patients Experiencing Glycemic Crises ‘Objective Remember [Understand [Apply [Analyze "Apply crtcalhinking and evidence-based practice guidelines using the Langara Decision~ 59, 60,61] 21,22, ‘Making Framework (DMF) o individualize nursing care for patints/families experiencing hypoglycemia, diabetic ketoacidosis, euglycemic dlabetic ketoacidosis and hyperglycemic hyperosmolar state ‘Summarize evidence-basedinformed nursing practices including those Tocusing on 25,28 prevention of complications for patients experiencing hypoglycemia, diabetic ketoacidosis and hyperalycemic hyperosmolar stato Identify core patienvfamly educational needs and discharge planning strategies to 3 promote a smooth transition from hospital to home Learning Activity 8: Caring for Acutely Il Pationts Experiencing Complex Gastrointestinal Health Challenges ‘Objective Remember [Understand [Apply [Analyze Desorbe the risk factors, pathophysiology, (a)iypical clinical presentations, siages and | 26 complications associated with liver fallure, upper Gl bleed and ulcerative colts "Apply critical thinking and evidence-based practice guidelines using the Langara Decision 7,28 23,80 ‘Making Framework (DMF) individualize nursing care for patints/iamilies experiencing liver flue, upper Gl bleed and ulcerative colts Learning Activity 10: Caring tor Acutely Il Pationts with Complex Renal Health Challenges ‘Objective Remember [Understand [Apply | Analyze ‘Understand the goals, clneal indicaions and complications ofrenal replacement a4 46,47 therapies: hemodialysis (HD), peritoneal dialysis (PD) and transplantation ‘Discuss key assessments and healing iniatives for patients receiving PD and HD. Es ‘Describe key assessments and healing iniatives for renal transplant patents 36 Page dct ee OU Ae 2022‘Learning Activity 11: Coming to Know the Deteriorating Patient and Simulation ‘©. Identity patient-specific risk factors for deterioration and related assessment/monitoring criteria Implement effective intravinter communication strategies, teamwork, ‘escalation of care and evidence-based healing intiatives (including basic Ife ‘support in response to patient deterioration Establish therapeutic communications with the patientfamily to address ‘emotional and care needs during an episode of deterioration ‘Objective Remember [Understand [Apply [Analyze "Apply critical hinking and evidence-based practice guidelines using the Langara Decision 40,47 “Making Framework (OMF) to: 42 Page Sof ee OU Ae 2022B 61.MC questions BMS questions: all or nothingl! Could be one answer, more than one answer, of ALL BYounever have to memorize blood works Insulin question rational BNPH insulin @ not going to kick in right away; first priority insulin regular with 12.3 mmol will not have hypoglycemia before breakfast insulin regular with 5.6 mmol @ low CBG may result in hypoglycemia 1 Lispro @ fast-acting insulin with low CBG @ hypoglycemia Critical thinking: Early deterioration Drug therapy Trending Key intervention to prevent HAP: mouth care, DB&C, HOB 30 degrees, early mobility Prevention bundle for CAUTI Prevention bundle for SSIs logy: Heart failure (assessments for early signs of deterioration and late signs of deterioration) Drug therapies for ACS and HF — classic drugs and one specific drug that could be prescribed for both ACS and HF (dose will differentiate what itis used for) Patient asking SIE of drugs — therapeutic response should be given PCI for patients that had STEMI {) discharge teaching information; appreciating that they will be on anticoagulants but not forever ECG rhythms interpretation Levels of severity of angina ~ criteria and clinical presentation to determine degree of stability ‘What drugs does people with A-fib need? What other tests aside from ECG should be tested for angina??? Sees ee seek sasesa Respiratory: Asthma — early signs and symptoms; ominous and late S&S [) what would suggest significantly ominous sign symptom 1B What does Ventolin do? Page of8 ee OU Ae 2022Patient education following PE ‘Analyzing ABG results and priority action/s Patient education regarding non-invasive ventilation Cause of hypercapnic respiratory failure (within a clinical situation/case) Preventions of complications associated with COPD Neurology: 1B. Know the criteria and how to assess delirium via CAM 1B Undertying pathology (chemical) for PD D3 criteria scale forthe likelinood of stroke (at least 2 out of 3 criteria = 70% likelihood of stroke) Care and assessment of ischemic stroke 1B Classic signs of parkinsonism Shock: ‘Sepsis (SIRS criteria and qSOFA criteria) Initial management of cardiogenic shock Initial management of severe anaphylactic reaction Classic S&S of anaphylaxis Priority for hypovolemic shock Endocrine/Glycemic Episod Electrolyte abnormality in HHS, DKA, EDKA (can either go high or low) DKA & HHS @) although sugars are high, we do not make insulin as the 1 line of intervention Complications of HHS Discharge planning for HHS Monitoring a patient who is in DKA Q) titrating drug therapies ‘Why would a patient diagnosed with EDKA does not realize they are getting sick? Caring for patient with EDKA @] what datailab work would suggest they are getting better? Gastroenterology: Underlying cause of Wernicke's Encephalopathy Prophylaxis for PUDs Clinical findings for severe UC Reportable S&S associated with end-stage liver disease Priors for alcohol withdrawal Page Tot 1c Ap 2022Underlying causes of esophageal varices B Une fue patent educton~ when tying o get feedback rom patent 77 lysis can do and cannot do Prioritizing care around peritoneal dialysis Kidney transplant and long-term drug therapy Assessments on patients coming back from hemodialysis, what would be your fist assessment? {B What should you do before somebody goes for dialysis? Others: 1D Healthy and effective interprofessional team Things to incorporate in handover report B When should discharge planning start? Admission BDischarge instructions for moderate sedation Fentanyl Moderate sedation respiratory effects (RR low) B how do we fx that? Code/Deteriorating patient: Ifa person slumps over in the bathroom and have a weak carotid pulse, what would you do first? Ifa person develops CP and SOB and look crappy, what would you do first? Situation @ determine degree of stablity Page Bot ee OU Ae 2022