Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 1 Homework (Preparing for Competencies in Week 2)
1. RNs on ACE Medicine are required to perform and chart a head-to-toe assessment at a
minimum of once per shift. Describe how you plan to use the head-to-toe assessment and
focused assessments (in general) to guide and inform your daily practice as an RN.
2. You walk into your patient’s room. Earlier today, she was sitting up in bed chatting with
her grandson. Now, she is diaphoretic, her blood pressure is 80/40, and her heart rate is
120.
a. What are some things you as the RN can/should do now?
b. Who should you inform about the current situation?
c. Is there a team you can call for assistance? If so, describe your role in deciding to
call the team and describe the purpose of the team.
3. There is a code blue on the floor.
a. Please describe the roles and responsibilities of the floor RNs during this
situation.
b. Ideally, what should be accomplished before the code blue team arrives to the
room?
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 2 Homework (Preparing for Competencies in Week 3)
1. Describe the pathophysiology of congestive heart failure (CHF)
a. List signs and symptoms of CHF:
b. List important teaching for patients with CHF:
c. List medical and nursing interventions for CHF:
2. Your patient has an order for a type and screen. What patient safety measure must occur
at the time of the lab draw to ensure the blood bank will accept the specimen?
a. Later in the day, the medical team orders two units of packed red blood cells to be
transfused. List nursing responsibilities/patient safety measures that must occur
before you actually hang the blood (refer to Blood Product Administration Policy
as needed):
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 3 Homework (Preparing for Competencies in Week 4)
1. Skin care and wound care are important roles of the RN. Describe a skin assessment
(what areas to check for pressure ulcers), and RN interventions to help maintain
patients’ skin integrity.
2. Describe signs and symptoms of a myocardial infarction (MI).
a. List orders you may anticipate if your patient is experiencing an acute MI or
Acute Coronary Syndrome.
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 4 Homework (Preparing for Competencies in Week 5)
1. Mr. Smith’s blood pressure is 200/95 and his heart rate is 86; his last BP was 130/70,
HR 77). What are some questions you may ask him or things you may do before
calling the physician to report the blood pressure?
2. What does the acronym FAST stand for in a stroke?
F:
A:
S:
T:
3. Ms. Harper has new slurred speech, dizziness, and right arm weakness. You and the
charge RN decide to call a stroke alert. What are some interventions and/or tasks that
should be performed before and during the stroke alert?
4. Your patient has a change in vital signs from earlier: BP 87/42, HR 110, temperature
39.2. The team is concerned about sepsis.
a. What are some orders you can anticipate during the next two hours?
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 5 Homework (Preparing for Competencies in Week 6)
1. Describe your role in patient education. What are some resources available to you to
assist with patient education?
2. Have you had any experience caring for an end-of-life patient as a RN? If you have,
describe important considerations for this patient population. If not, describe what
you believe are important professional and ethical responsibilities/considerations for
this patient population.
3. Describe the pathophysiology of a small bowel obstruction:
a. List possible medical interventions and RN responsibilities of the patient with a
SBO.
4. Your patient has a feeding tube:
a. What is required before you can use a NG or Dobhoff?
b. What Dobhoff French size is too small to push meds through?
c. All of the medications on the MAR have “oral” listed as the route of
administration. What are some things you can do to address this situation?
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 6 Homework (Preparing for Competencies in Week 7)
1. An 86 year old male patient who you were caring for earlier in the day arrives back to
the floor from the PACU after a total right hip replacement. He has a PCA with both
a continuous and a demand dose and a continuous femoral nerve block. He did well
in surgery and the PACU, his vital signs are stable, and his oxygen saturation is 92%
on 2L NC.
a. What are some orders you can anticipate (or request) now that he is back on the
floor?
b. At your first 1 hour check, your patient’s respiration rate is 8. What should you
do?
c. After your above interventions, your patient is now breathing at a respiration rate
of 18, his other vital signs are stable, but no orders to address the PCA have been
written. What are some orders/things you can advocate for?
2. Describe the differences between hemodialysis and peritoneal dialysis, and RN
considerations for each.
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 7 Homework (Preparing for Competencies in Week 8)
1. You just received report from the off-going night RN, and you are planning your
morning. Patient A was admitted for pneumonia, and has had an increase in oxygen
requirement from 2L to 5L over the last two hours. Patient B was admitted for an MI
and has a heparin drip. The next PTT needs to be drawn at 0900. Patient C is
medically stable and has been waiting for placement for the last two weeks. Patient D
is in 8/10 pain and has used his call light five times in the last ten minutes asking for
pain medication.
a. In what order do you plan to see your patients and why.
b. Are there things you could delegate? If so, what tasks/skills would you delegate,
to whom would you delegate, and why.
2. Your patient had a right total knee replacement. One of the orders is CMS checks
every four hours. During these checks, what are you assessing?
a. Identify findings that would be concerning during one of these checks.
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 8 Homework (Preparing for Competencies in Week 9)
1. Discuss the differences between delirium and dementia:
a. List some nursing interventions to help prevent delirium:
2. Compare and contrast hemorrhagic and ischemic strokes.
a. What are orders you can anticipate for each type of stroke
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 9 Homework (Preparing for Competencies in Week 10)
1. You have a patient with a chest tube. What are some nursing
responsibilities/considerations when caring for a patient with a chest tube?
a. Your patient accidentally pulls out her chest tube. Describe what
tasks/interventions you will do next:
2. The CNA calls you to inform you that Mr. Smith’s blood pressure is 68/39 and his
heart rate is 93. You are with a high fall risk patient in the bathroom. What do you
do next?
a. Upon assessing Mr. Smith, his blood pressure retake is 67/38, HR 89. He is
totally asymptomatic. What are some things you can do in this situation, and
what are some orders you may anticipate?
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 10 Homework
1. You are getting an admission from the emergency department, and the patient is
assigned to room 1218. The emergency department called to say they will send the
patient up soon and leave a number for you to call back with any questions. Upon
reviewing the patient’s chart, you notice the most recent vital signs show a respiratory
rate of 38, and an increase in oxygen demand from 4L NC to 15L non-rebreather
mask. What are some things you could do in this situation?
2. You have a patient with a history of Diabetes Type II. The patient reports their blood
sugars are controlled with diet and exercise. The admitting provider has written for
resistant, sliding scale insulin. The patient’ baseline point-of-care glucose when he
reaches the floor is 96. Before he eats lunch, his blood glucose is 102. He eats 100%
of his lunch. Based on the order, you should administer 6 units insulin lispro.
Discuss what you could do in this situation.
Melissa Morris
Level III
Weekly Homework for New Graduate RNs
Week 11 Homework
1. Please list areas in which you feel you are still uncomfortable or would appreciate
more practice. Your preceptors will be able to use this list to guide your last two
weeks of orientation.