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Duplicate of Duplicate of FINAL! FINAL!
Duplicate of Duplicate of FINAL! FINAL!
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26 plays
Review for last final exam in the LPN to RN program
Flashcards
200 cards
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Practice quiz
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Host live
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Questions
200
Answers
1
The mean ICP under normal physiologic conditions is around:
5 mm hg
15 mm hg
20 mm hg
30 mm hg
2
Which biomarkers are monitored to identify myocardial injury? (select two)
Tronponin I
BNP
CRP
CK-MB
3
The patient with ______has an excess of ADH in their blood, causing water retention, decr. Na+
Hyperglyemia
Hypernatremia
Diabetes insipidus
Syndrome of inappropriate Antidiuretic hormone (SIADH)
4
Name the following rhythm
Sinus bradycardia
Second degree heart block type 2
Sinus arrhythmia
Second degree heart block type 1 (Wenckebach)
5
Which type of medication is generally used for alcohol withdrawal syndrome related agitation?
antipsychotics
Benzodiazepines
Thiamine
Hypnotics
6
What is the number one priority when assessing fluid balance?
Temperature
assessing for edema
Weight
Blood pressure/heart rate
7
When is prone positioning appropriate in a patient with respiratory difficulty?
A patient who is sedated
A patient with pneumonia
A patient who is diagnosed with pulmonary edema
A patient who is diagnosed with ARDS
8
Which type of life threatening dysrhythmia could be caused as a result of low magnesium?
Sinus bradycardia
Torsades des pointes
Third degree heartblock
SVT
9
T or F: Ischemic damage to kidneys may be from prolonged hypotension or low cardiac output.
T
F
10
Fluid that exists outside of cells in our body is known as:
Solutes
Transcellular fluid
Intracellular fluid
Extracellular fluid
11
What is the most sensitive indicator of increased ICP?
Impaired swallowing
Increased blood pressure
Decreased O2 sat.
A Change in the level of consciousness
12
Which of the following are age related pulmonary changes? Select all that apply
Increased lung size
Increased stiffness of chest wall
Reduced mucociliary clearance
Decreased anterior-posterior diameter of thorax
13
The value of SVO2 monitoring is to determine
An imbalance between oxygen supply and tissue demand
The diffusion of gases at the alveolar capillary membrane
The predicted cardiac output for pulmonary edema
Oxygen saturation at the capillary level
14
When assessing a trauma patient's breathing, one must also pay attention to:
stabilizing the cervical spine
pt's neuro status
amount of noticable bleeding
presence of peripheral pulses
15
What is a proper intervention for Metabolic acidosis?
diuretics
Prescribing bp meds
Sedation
Hydration
16
What are some signs/symptoms of pulmonary edema? (select all)
Pink frothy sputum
Gurgling sounds
Profuse diaphoresis
Decreased respiratory rate
17
The most common problem in the patient with type 2 diabetes is a(an)
Complete lack of insulin production
overproduction of glucose
imbalance between insulin production and use
increased uptake of glucose in the cells
18
What has beome one of the greatest threats of old age?
Deteriorating circulation
Heart failure
Cognitive functioning
Renal failure
19
What types of complications can occur during intubation? (select all)
hypoxemia
dysrhythmias
pharyngeal and hypopharyngeal trauma
hypocapnia
20
What is a #1 nursing priority in acute lung failure?
Preventing the spread of infection
Optimizing oxygenation and ventilation
providing comfort
Involving family in pt's care
21
A patient is diagnosed with acute liver failure. Signs/symptoms of acute liver failure are:
Jaundice
Hyperventilation
Peripheral neuropathy
Palmar erythema
22
What are the three hormones that help control fluid and electrolyte balance?
Aldosterone, ADH and Creatinine
ADH, Cortisol and Creatinine
Aldosterone, ADH and natriuretic peptides
Cortisol, FSH and aldosterone
23
A severe asthma attack that doesn't respond to a pt's usual bronchodilators is known as
acute lung failure
Status Asthmaticus
COPD
pneumonia
24
To prevent trauma to alveoli, what are some medical interventions used for ARDS? (select all)
Permissive hypercapnea
Diuretic therapy
High frequency oscillatory ventilation
Low tidal volume
25
Decr. PETCO2 can also occur when alveolar ventilation is increased such as:
hyperthermia
hyperventilation
hypoventilation
sepsis
26
Which meds can be rx'd to break the RAAS cycle? Select all that apply
Phosphodiesterase inhibitors
ARB's (Angiotensin receptor blockers)
Diuretics
ACE inhibitors
27
Any obstruction hindering the flow of urine from kidney thru remainder of urinary tract may:
cause urethritis
Lead to postrenal AKI
Lead to prerenal AKI
Lead to Intrarenal AKI
28
For respiratory acidosis, what are the priority nursing interventions focused on?
monitoring for drug toxicities
improving ventilation and oxygenation
Decreasing blood pressure
Increasing urinary output
29
Which of the can be signs of left ventricular failure? (select all that apply)
Cough
Orthopnea
Weight loss
Cyanosis
30
Which dysrhythmia is recognized on the ECG by a sawtooth atrial pattern?
Ventricular Tachycardia
Atrial flutter
Ventricular fibrillation
Atrial fibrillation
31
This pulmonary disorder is defined by bacterial invasion of the lower resp. tract
Status asthmaticus
Sepsis
Acute Pneumonia
ARDS
32
What are some signs/symptoms of intra-abdominal hypertension? (select all)
Decreased Cardiac output
Decreased urinary output
hypoxia
Increased urinary output
33
Causes of decr. PETCO2 includes situations where CO2 production is decreased these include:
hyperthermia
seizures
hypothermia
Cardiac arrest
34
Acid base balance occurs through:
Control of hydrogen production and elimination.
Proper breakdown of glucose
Cell destruction
Normal metabolism
35
What helps to reduce chances of a fat embolism?
Early stabilization of fractures
Improve nutritional status
Good pain management
Increase hydration
36
In advanced heart failure, what measures can be taken to decr fluid overload/improve Card outpt
Admin oxygen
Admin. oxygen
Admin diuretics
Administer nipride (vasodilator)
37
What is the
initial
treatment priority in a pt with GI bleed?
Administer IV fluids, blood and blood products.
Prep pt for endoscopy
Administer coagulation products
Insert a Nasogastric tube
38
Which factors can place a pt at high risk for infectious endocarditis? Select all that apply
IV Drug abuser
Pre existing structural abnormality of a cardiac valve
ICD's
Heavy smoker
39
Which of the following are complications related to ruptured diaphragm? (select all)
Decreased venous return and decreased cardiac output
Lung compression
Tension pneumothorax
strangulation or perforation of bowels
40
How does the sympathetic nervous system compensate for low cardiac output?
Decreasing levels of catecholamines
Decreases heartrate and blood pressure
Vasodilation to periphery
Increases heart rate and blood pressure
41
Which of the following are responsible for causing coronary artery obstruction? (select all)
Plaque rupture
Coronary artery spasm
Ischemia
New Coronary artery thrombosis
42
What are some causes of acute liver failure? (select all)
Hypermetabolism
Toxins or medications
Malignancy
Herpes and Hepatitis
43
Fluid loss occurs through: (select all that apply)
urinating
wound drainage
sweating
Administration of IV fluids
44
What is the best way to monitor for fluid retention and overload?
Monitoring for peripheral edema
Monitoring daily weights
Monitoring O2 sats
Daily electrolyte levels
45
Which type of med. is used to relax bronchial smooth muscle and dilate airways?
Beta agnoists
Anticholinergic Agents
inhaled corticosteroids
mucolytics
46
Tall peaked T Waves, Prolonged PR interval, Wide QRS complexes can be a sign of:
Hypermagnesemia
Hyperkalemia
dehydration
Hyponatremia
47
The shift of tissue from one brain compartment to another causing pressure on the brain is:
Glioblastoma
Herniation
Intracranial hypertension
cerebral hemorrhage
48
Name the following rhythm
Third degree heartblock
Normal Sinus rhythm
Sinus bradycardia
Atrial fibrillation
49
Hematoma to flank areas may indicate: (select all)
Retroperitoneal bleeding
Kidney injury
Pelvic fracture
Perforated colon
50
T or F: It is Recommended pt's with septic shock and hypotension are given high dose steroids
F
T
51
What is a multidisciplinary team?
A team of advanced practice nurses
A Team of physicians with varying specialties
Dr's, nurses, RT's etc emphasizing continuity of care
52
A narrowing of the aortic valve is called:
Aortic stenosis
Aortic obstruction
Triscuspid stenosis
Aortic valve regurgitation
53
The following are signs/symptoms of a subarachnoid hemorrhage (SAH): Select all
Cloudy CSF
nausea/vomiting
stiff neck
"worst headache of my life"
54
Tissue ischemia occurs as a result of: (Select all)
hypoxia
hypotension
Increased cardiac output
hyperoxia
55
What types of meds are used to prevent GI bleeding in high risk patients? (select all)
H2 antagonists (pepcid)
Vitamin K
Proton pump inhibitors (prilosec)
Cytoprotective agents (Carafate)
56
Following neurosurgery a patient is at risk for the following EXCEPT:
Corneal abrasions
Hypovolemia
injury from fall or seizures
Infection
57
What are some lifestyle changes recommended for Diabetes type 2 patients? (select all)
Rest as much as possible
Change in their diet pattern
Crash diets
Increased physical exercise
58
Where does the majority of thrombotic emboli arise from?
fat
heart
Deep leg veins
tumors
59
Rebound tenderness and rigidity of the abdomen can indicate: (select all)
Pancreatitis
Peritoneal inflammation
Ruptured bowel
Gallstones
60
Organ donation
Must be requested by the nurse caring for the dying patient
is mandated by legal and regulatory agencies
Is a choice only the patient can make for him/herself
is controlled by individual institutional policies
61
What helps to decrease atherosclerotic plaque size?
Cessation of smoking
Decreasing blood cholesterol levels
Decreasing blood sugar
Decreasing blood pressure
62
Which of the following is an indication for Temporary pacing?
Hr 40, BP 110/64, pt alert, no complaints
HR 40 BP 80/42, skin ashen, c/o chest pain
HR 42 Pt awake, alert, runs 5 miles daily
Cool clammy skin, HR 35 pt confused
63
A test assessing ocular function by holding a pt's eyes open while turning the head is;
Checking for cushing reflex
Checking for pupil response
Checking for an Oculovestibular reflex
checking for oculocephalic (doll's eye) reflex
64
What does individualized care mean?
Placing emphasis on efficienty and quality of life
Merging psychosocial elements with the tech environment
Learning your pt's preferences and tailoring the careplan
65
A procedure that involves IV injection of contrast, and with Xray to visualize kidney tissue is
An intravenous pyelogram (IVP)
CT scan
Kidney biopsy
Kidney ureter bladder radiograph (KUB)
66
When assessing a patient's neuro status, the mnemonic AVPU is used. This stands for:
Alert, responds to Verbal, resp to Pain, Uncomfortable
Alert, resp. to Verbal, resp. to Pain, Unconscious
Alert, viability, pulse, understanding
Angry, Viable, severe Pain, Unaware
67
True or false: ST segment is always elevated when a pt is experiencing an MI
True
False
68
What are some nursing interventions for a pt with a salem sump? (nasogastric tube) select all:
Administer rx'd meds thru the salem sump
Irrigating the tube every 4 hours or as ordered
Frequent mouth and nares care
Use high continuous suction
69
What is the best way to evaluate arterial circulation in an extremity?
Capillary refill
Skin turgor
Peripheral edema
Homans sign
70
What types of changes are the most obvious in hyponatremia?
Intestinal changes
Neuromuscular changes
Cerebral changes
Cardiovascular changes
71
What types of EKG changes might you see with hyperkalemia?
ST elevation
ST depression
Narrow QRS complex
Tall peaked T waves
72
What is the blood pressure gradient across the brain?
Cerebral perfusion pressure
Cerebral blood perfusion
Mean arterial pressure
Intracranial pressure
73
Which types of medications should be administered post MI to prevent ventricular remodeling?
Potassium supplements
Diuretics
ACE inhibitors or ARB's
antidysrhythmics
74
What is the number one priority intervention for a patient with pulseless Ventricular tach?
Administer IV fluids
Administer high flow O2
Secure airway
Defibrillate and CPR
75
Transjugular Intrahepatic portosystemic shunt (TIP) is a procedure for:
decreasing portal hypertension
controlling bleeding of ulcers
removing pancreatic tumors
removing esophageal tumors
76
What is involved in hypermetabolism due to trauma?
Weight gain occurs
There is an increase in mobility of amino acids
Oxygen consumption is decreased
protein synthesis increases, and the body requires incr nutritional support
77
What is the number one priority in nursing management of the patient with stroke?
Sedation
Monitoring for changes in neuro and hemodynamic status.
Family and pt. education
hyperoxygenation
78
A patient is in hypovolemic shock, good airway and breathing are established, what is the next immediate intervention?
Remove all of patient's clothes
Start two lg bore IV's but keep fluid at KVO rate
Perform a 12 lead EKG
Start two lg bore IV's and give large fluid boluses or blood if needed.
79
What type of emergency medications are administered to STEMI patients if PCI is not available?
Inotropes
Nitrates
Fibrinolytics
NSAIDS
80
What is the leading cause of upper GI hemorrhage?
Infectious Colitis
Peptic ulcer disease
Liver failure
Esophagogastric varices
81
What is a medical intervention to prevent the recurrence of a pulmonary embolism?
administration of thrombolytics
administration of supplemental O2
Decreasing pt's activities
Heparin and coumadin
82
A sudden onset of neurologic deficit lasting >24 hr caused by interruption of blood to brain is
Transient ischemic attack (TIA's)
Cerebral aneurysm
Cerebrovascular accident (stroke)
Increased intracranial pressure
83
An endoscopic procedure that involves applying bands around bleeding varices is:
Endoscopic injection therapy
Esophagectomy
Transjugular intrahepatic portosystemic shunt
Endoscopic Variceal Ligation
84
For severe heart muscle damage, what are some interventions that will incr. O2 supply? (3 ans)
Inotropic medications
Nitroglycerin
diuretics
Supplemental O2
85
Which of the following is NOT a complication of oxygen therapy?
Oxygen toxicity
Carbon dioxide retention
hypocarbia
Absorption atelectasis
86
What are some signs/symptoms of an anastomotic leak? (select all)
Tachycardia
severe abdominal pain
Subcutaneous emphysema in the chest
Increased diuresis
87
A patient with Ventricular Fibrillation is:
hypertensive
diaphoretic
bradypneic
Pulseless
88
A measure of the amount of oxygen bound to hemoglobin compared with hgb's max capability is:
PCO2
Oxygen saturation
PaO2
hemoglobin affinity
89
What are some causes of Fluid overload? select all that apply
Kidney failure
Long term corticosteroid tx
SIADH
Diabetes insipidus
90
What are some signs/symptoms of blunt cardiac injury? (select all)
Cardiac dysrhythmias
Sternal fractures
Muffled heart tones
cp with no relief after taking ntg.
91
Select which are priority patient problems for a pt with spinal cord injury
Diminished Gas exchange d/t alveolar hypoventilation
Low Cardiac output d/t sympathetic blockade
Urinary retention
Skin breakdown r/t poor mobility
92
What type of Biomarkers are used to aid in diagnosis of an MI? (select all)
BNP
Troponin I
CK-MB
Cholesterol
93
How does angiotensin II affect the kidneys?
Acts directly on tubules making them more permeable to water
Binds to receptors in nephrons, which decr reabsorp. of Na+
Causes Adrenals to secrete Aldosterone
Constricts arterioles in the nephrons causing a lower GFR
94
In renal failure, the kidney longer produces erythropoietin, this could result in:
hyperkalemia
anemia
hypernatremia
hypophosphatemia
95
If administered in a timely fashion following symptoms of CVA, what may reverse CVA damage?
Fibrinolytic therapy
heparin
antiplatelet therapy
Aspirin
96
What is one of the most common causes of heart failure in the elderly patient?
Renal failure
Stroke
Diabetes
Myocardial infarction
97
Which of the following conditions will cause chemical pneumonitis?
aspirated contents with pH <2.5
Aspiration of contents with pH >2.5
exposure to a patient with TB
Foreign body airway obstruction
98
What is a common cause of adverse medication reactions in the older adult population?
Polypharmacy
multiple allergies
Alcohol use
Cigarette use
99
Which hormone is secreted by the posterior pituitary in response to blood osmolarity?
Aldosterone
ADH or vasopressin
Cortisol
Natriuretic peptides
100
What is a preferred mode of access for long term hemodialysis?
AV fistula
Subclavian catheter
Femoral catheter
AV graft
101
Glycosylated hemoglobin levels provide information about:
The average blood glucose level over the previous 3-4 mo
Blood glucose levels in comparison with serum hgb
Serial glucose levels after ingestion of high glucose drink
The difference between serum and urine glucose levels
102
Which test is used to differentiate neurogenic DI (diabetes insipidus) from nephrogenic DI
Cortisol levels
ADH test
Water depravation test
Presence of ketone bodies
103
Who should be present during the process of a terminal wean?
Physician
Respiratory therapist
All of the above
Nurse
104
Which type of MI causes injury to all three cardiac layers?
Subepicardial infarction
Epicardial infarction
Transmural infarction
Subendocardial infarction
105
What type of emergent treatment is appropriate for an unstable pt with 3rd degree heartblock?
Transcutaneous Pacing
CPR
Epinephrine administered IV
Synchronized Cardioversion
106
T or F: ALL trauma patients are considered to be in hypovolemic shock until proven otherwise
true
False
107
What is defined as a bleeding directly into the cerebral tissue?
Sub arachnoid hemorrhage
Intracerebral hemorrhage
Subdural hemorrhage
Cerebral vasospasm
108
Which lab findings are found in patients with SIADH? Select all
Increased plasma Osmolality >295
Decreased plasma osmolality < 275 mOsm/kg H2O
Hypernatremia
Hyponatremia
109
Which is the most common type of shock?
Septic
Hypovolemic
Cardiogenic
Neurogenic
110
What is the accumulation of lipoproteins and fibrinous prod. within a vessel?
Arteriosclerosis
Hypertension
Atherosclerosis
Thrombosis
111
Patients with central DI (Diabetes Insipidus) can be treated with:
Vasopressin
Propylthiouracil
Glucagon
Insulin
112
Nursing
priorities
for inspecting a pt with kidney dysfunction are: (select all)
Assessing for bleeding
Evaluating volume depletion or overload
Evaluating for pain
Evaluating for infection
113
What is the mission of the SCCM?
Reward facilities that demonstrate exceptional care.
To be the largest specialty nursing organization
To secure and establish quality, cost effective care for pts
114
Which type of med has powerful amnesic properties, but not recommended for mech. ventilated pt?
Sedative-hypnotics
Opiates
Benzodiazepines
Central alpha adrenergic receptor agonists
115
What are some evidence based practices that will prevent aspiration? select all
Keep HOB at 30-45 degrees
Give supplemental O2
Maintain ET cuff pressures at an appropriate level
obtain a swallow test before starting oral feedings
116
What is a normal Serum osmolality?
285-300
375-395
280-290
275-295
117
Which medication is frequently used at low doses to stimulate blood flow to the kidney?
Dopamine
Epinephrine
Bumex
Magnesium
118
Older adults with poor bp control have increased risk of the following except:
COPD
Chronic kidney disease
Coronary artery disease
Cerebrovascular disease
119
Older adults with CAD, Htn, angina, or prev. MI should be rx'd:
AN SSRI
A potassium supplement
A Diuretic
A Beta blocker
120
What is the most important organ involved in fluid balance?
kidneys
Heart
bladder
liver
121
Which of the following is considered to produce most damage to the heart?
Subepicardial infarction
Subendocardial infarction
Intramural infarction
Transmural infarction
122
The sympathetic nervous system compensates for low cardiac output by: (select all that apply)
Increasing heartrate
Causing vasodilation
Decreasing heart rate
Increasing blood pressure
123
What medication is given to help control ammonia levels in a patient with liver failure?
Vitamin K
Insulin
Lactulose
Albumin
124
Which of the following conditions is usually associated with clubbing?
Central Cyanosis
Peripheral cyanosis
Acute hypoxemia
Carbon monoxide poisoning
125
Which diagnostic test is considered a gold standard for diagnosing pancreatitis?
Ultrasound
Abdominal Xray
Computed tomography (CT)
Magnetic resonance imaging (MRI)
126
A normal Fasting plasma glucose (FPG) is:
140-180
100-200
60-120
70-100
127
With Rhabdomyolysis, what is the
primary
treatment to prevent Acute Kidney injury? (AKI)
IV Crystalloids
Bicarb and mannitol
Lasix IV
IV Albumin
128
Which of the following has the potential to decrease risk of Vent' assoc. pneumonia? (VAP)
Maintaing good oxygenation
Humidification of air
Good oral hygiene/suctioning
Use of a closed tracheal suction system
129
A vasospasm that can occur with or without atherosclerotic lesions, commonly occurs at rest
Myocardial infarction
unstable angina
stable angina
Variant (prinzmetal) angina
130
Which of the following fits the criteria for Normal sinus rhythm? (select all that apply)
Rate: 60-100 beats/min
P wave present with each QRS complex
PVC's present
PR interval 0.22
131
Which medication should be avoided in patients with hypokalemia?
Aspirin
Spironolactone
Furosemide
Potassium supplements
132
Which of the following serum lab values is increased in acute pancreatitis?
Bilirubin
Ammonia
Amylase
Albumin
133
Which of the following are diagnostic criteria for diabetic ketoacidosis? (DKA) select all
pH greater than 7.45
Mild or absent ketones in serum or urine
Serum bicarbonate less than 18 mEq/L
Blood sugar greater than 250 mg/dl
134
Which
TWO
vasopressors will stimulate gluconeogenesis thereby causing incr. blood sugar?
Dobutamine
Isuprel
Epinephrine
Norepinephrine
135
The process of breaking down fat or protein to make new glucose is called:
hypoglycemia
Ketoacidosis
Hyperglycemic Hyperosmolar State (HHS)
Gluconeogenesis
136
Nursing priorities for assessment of a patient with pancreatic dysfunction focuses on:
Prevention of hypo/hyperglycemia
preventing hemorrhage
Monitoring for jaundice
preventing infection
137
How is hyperglycemic hyperosmolar state different from DKA?
HHS has an arterial pH >7.3, DKA is <7.3
With DKA, serumBicarbonate is normal, in HHS it is <15
HHS is strongly positive for urine acetone, DKA is not.
DKA's onset is slow, HHS is sudden
138
What are some signs of fluid overload? (Select all that apply)
Bradypnea
Elevated CVP
Elevated blood pressure
Tachycardia
139
What are some complications that can occur following GI surgery? (select all)
pruritus
Atelectasis/pneumonia
DVT
Anastomotic leak
140
Name the following rhythm
Supraventricular Tachycardia
Atrial flutter
Sinus Tachycardia
Ventricular Tachycardia
141
Which
hormone
controls the amount of fluid lost and retained in the body?
glucose
insulin
aldosterone
Antidiuretic hormone (ADH)
142
What is the mean arterial pressure (MAP) for a blood pressure of 135/82
102
90
110
100
143
What are some clinical manifestations of hyperglycemia? (select all)
irritability/trembling
N/V, Adominal cramps
Acetone breath odor
Flushed dry skin
144
an interval on an EKG that shows time between sinus node discharge and vent' depolarization
PR interval
QT interval
P wave
QRS complex
145
Which statement is true regarding blunt trauma?
Only occurs with falls
It is always easily noticable
A stabbing or gunshot is an example of a blunt force injury
It is sustained during a rapid change in velocity
146
What are some symptoms of Rhabdomyolysis? (select all)
Decreased UOP
Dark, tea colored urine
Flank pain
Elevated Creatine Kinase
147
Family members become dissatisfied and stressed because of a lack of _____among care providers.
patient's prognosis
patient's outcome
communication
care provided
148
If a patient's bladder is injured, causing urine to leak into the peritoneum, what may be some symptoms? (select all)
Rebound tenderness of abdomen
Blood @ urethra
Perineal discoloration
SubQ Emphysema lower abd.
149
A pt involved in an MVC arrives in the ER with the RLE swollen, tight, no pedal pulse. What intervention may be needed?
Fasciotomy
Aggressive pain medications
Anticoagulation
Sequential compression hose
150
What 3 tx's are used for cerebral vasospasm that can occur 3-12 days post SAH?
induced hypertensive, hypervol, hemodilution tx (HHH)
oral nimodipine
Nipride Iv drip
transluminal cerebral angioplasty
151
Which of the following lab values could reflect an acute kidney injury? (select all)
Creatinine 2.4
pH 7.50
pH 7.29
Potassium 6.0
152
Interpret this ABG: pH 7.15, PCO2 65, HCO3 23
Uncompensated metabolic acidosis
Uncompensated respiratory acidosis
Partially compensated respiratory acidosis
Uncompensated respiratory alkalosis
153
A subdural hematoma is located:
between the inner skull and the outermost layer of the dura mater
within the brain tissue
between the arachnoid mater and the dura mater
between the dura mater and the skull
154
What are some signs in a patient with multiple trauma that indicates initial surgery should be damage control only?
Massive hemorrhage, Temp >35 C
pH >7.2 and temp <35 C
ph <7.0, Massive hemorrhage
pH <7.2, temp <35 C
155
What type of lab testing is done to determine if there is adrenal dysfunction?
Glycated hemoglobin
ADH level
serum cortisol level
TSH level
156
When administering propofol over an extended period, what should be monitored?
Serum triglyceride level
Sodium and potassium
Platelet count
Acid-base balance
157
Which is true regarding age related changes in the older adult patient?
decreased mucociliary clearance
Increased lean body mass
Increased GFR and renal blood flow
Increase in fine motor skills
158
You are assessing your pt for right ventricular dysfunction. What s/s may indicate this? (2ans)
hepatomegaly
Decreased CVP
JVD
Weight loss
159
What is the "golden hour" referring to?
Trauma victim is able to urinate within the first hour following injury
Pre-hospital resuscitation
The first hour of care in the hospital
160
A med. induced depression of consciousness in which pts respond to verbal commands is:
General anesthesia
Deep sedation
Light sedation
Moderate sedation
161
The most common contributing factor to the development of delirium in ICU pts is
electrolyte disturbances
sensory overload
sleep deprivation
hypoxemia
162
Name the following rhythm
Supraventricular tachycardia
Ventricular Fibrillation
Ventricular Tachycardia
Sinus Tachycardia
163
What is the most important aspect of the neurologic examination?
pupillary function
vital signs
Level of consciousness
motor function
164
when a pacing stimulus fires but fails to initiate depolarization, this is known as
No pacing stimulus
OVersensing
Undersensing
Loss of capture
165
Fluids with an osmolarity of > 300mOsm/L are considered
isosmotic
Hypotonic
Hypertonic
isotonic
166
What is a byproduct of rapid fat breakdown?
Ketone bodies
acetone
glucose
Lipids
167
When treating a pt diagnosed with DKA, what are some complications the nurse should watch for?
Fluid overload
Hypernatremia
hypo/hyperkalemia
infection
168
What types of medications are used to facilitate dilation of airways (select all)
Steroids
mucolytics/expectorants
Beta agonists
Methylxanthines
169
In the rapid primary survey, D for disability refers to:
Musculoskeletal status
Neuro status
How many bones are broken
cardiovascular status
170
With a cerebral injury the body produces a compensatory response by: (select all)
Increasing the heart rate
Increased blood pressure
Decreasing the cardiac output
Decreased respiratory rate
171
When aspiration is witnessed, what is the FIRST emergency intervention a nurse must perform?
Call patient's physician
Check vital signs
Give supplemental O2
Turn pt's head to the side and suction airway/oral cavity
172
What are some causes of respiratory alkalosis? (select all that apply)
Increased ingestion of antacids
Mechanical ventilation
Prolonged vomiting
Fear, anxiety
173
What are some triggering events that will activate the Renin-angiotensin II pathway ? select 2
Low blood pressure
hypervolemia
hypoxemia
hypertension
174
What is the lethal triad of death?
Temp <35 C, pH <7.2, Coagulopathy
Temp >38 C pH <7.0, hemorrhaging
Temp < 35 C, GCS <8, pH <7.2
Temp <35, pH>7.5, crush injury
175
_______is reached when enough fluid leaves one space and enters the other to equalize pressure
disequilibrium
hydrostatic pressure
Osmosis
equilibrium
176
When is administration of nitrates for a cardiac pt. c/o chest pain contraindicated?
Pt has frequent PVC's on cardiac monitor
A patient with a bp of 105/62
Patient c/o shortness of breath
The pt took Viagra 6 hr prior
177
Which statement is true regarding natriuretic peptides?
they cause adrenal glands to secrete aldosterone
they are secreted by the adrenal cortex
they respond to blood osmolarity
secreted by special cells in the heart, respond to incr bp
178
Which of the following nursing interventions is NOT appropriate within first 4 hours after PCI?
Monitor arterial puncture site for hematoma/bleeding
Place patient in semifowler position
Assess pedal pulses frequently
Increase IVF's to 100 ml/hr, and encourage oral fluids.
179
Brain Trauma foundation guidelines recommend a CPP in the range of:
50-70 mm hg
60-80 mm hg
70-90 mm hg
40-80 mm hg
180
What is a quick but temporary fix for hyperkalemia?
Administration of Kayexalate
IV insulin and glucose
Administer Vasopressin
Increase IV fluids
181
Who tracks and receives reports for all implanted devices?
FDA
AACN
QSEN
182
A patient with diabetes in the critical care unit is at risk for developing DKA due to:
physiologic and psychologic stress
Excess insulin administration
inadequate food intake
Increased release of Antidiuretic hormone (ADH)
183
What is the most common type of lung injury?
Hemothorax
Flail chest
Open pneumothorax
Pulmonary contusion
184
The following are signs of left ventricular failure (select all)
Tachycardia
Strong peripheral pulses
Gallop rhythm
Crackles in lungs
185
Which lab test aids in diagnosing heart failure vs a pulmonary disorder?
BMP
CK-MB
Creatinine
BNP
186
Priority
interventions for a pt with DKA are: (select all that apply)
Ensure pt has a full meal
Aggressive fluid volume replacement
Administer IV antibiotics
Initiate insulin drip with hourly blood sugar checks
187
Managing dyspnea during end of life care involves: (select all that apply)
Opioids
increasing fluids
hypnotics
Benzodiazepines
188
Cushing's triad refers to symptoms that are r/t pressure on the medullary brainstem, they are:
abnormal respirations
bradycardia
tachycardia
systolic hypertension
189
What is the main concern in the setting of abdominal trauma?
Hemorrhage
Ischemic bowel
Myocardial ischemia
Infection
190
According to the RASS scale, a pt who is restless, makes nonaggressive movements is scored:
+2
+1
-1
0
191
Which one of the following are appropriate nursing intervention for a pt with SIADH? Select all
Administer Vasopressin
Iv fluid rehydration
Fluid restriction of 800-1200 ml/day
Administration of hypertonic saline
192
which type of med treats cerebral edema by pulling fluid from extravasc into intravasc space?
Osmotic diuretics
Anticonvulsants
Barbiturates
sedatives
193
What is considered the treatment of choice in patients with Torsades de Pointes?
Nipride
Magnesium
Lidocaine
epinephrine
194
When blood reaches the arterial system without participating in gas exchange is called:
hypertension
Poor cardiac output
bronchostriction
Pulmonary shunting
195
What are some nursing interventions used to optimize oxygenation/vent' after a pneumonectomy?
with holding pain meds
Positioning
Deep breathing/spirometry
early ambulation
196
A pt is diagnosed with ARDS, what type of ABG results would you expect to see?
Decreased pH, Decreased PaCO2, Decreased PaO2
Increased PaCO2, Decreased pH, Decr. PaO2
Increased PaO2, decreased PaCO2, decreased pH
Increased pH, decreased PaO2, Increased PaCO2
197
In a post op craniotomy pt, the nurse needs preserve adeq. CPP. What interventions will help?
avoidance of vomiting and fever
HOB elev. 30-45 degrees
Frequent suctioning of airway
closely monitor for fluid imbalance
198
Which diag. test is used to view intracranial structures, identify tumors, edema, + hemorrhage
PET scan
Skull Xrays
CT Scan
Angiography
199
In the post op GI surgical pt, what interventions will help optimize oxygenation/ventilation?
Keep pt on bedrest
Administer sedatives
Frequent use of incentive spirometry
Administer pain meds
200
A Missile injury is:
When an object penetrates the skull but does not exit
A blunt head or neck injury
Object enters and exits
