A patient scores +3 on the RASS scale. This means they are:

Very agitated, pulling at tubes or catheters

Which statement about IABP timing is correct?

The balloon inflates at the onset of diastole & deflates just b4 systole

The Richmond Agitation-Sedation Scale (RASS) is used to:

Assess levels of consciousness and agitation

Which of the following is NOT a function of the kidney?

Production of digestive enzymes

Which of the following is NOT a function of an implantable cardioverter defibrillator (ICD)?

Continuous blood pressure monitoring

Which intervention is used to treat dilutional hyponatremia?

Administration of hypertonic saline

Which of the following criteria must be met before performing an SBT?

Patient has a FiO₂ ≤ 40% and PEEP ≤ 5

What is the primary function of an intra-aortic balloon pump (IABP)?

To reduce myocardial oxygen demand and improve coronary perfusion

A patient with a temporary pacemaker experiences “loss of capture.” What does this mean?

The pacemaker spikes are not followed by heart contractions

Hyperkalemia treatment: Shifting potassium back into the cell (temporary)

insulin plus glucose/ sodium bicarbonate

Which fibrinolytic agent is most commonly used in acute myocardial infarctions?

tPA (Tissue Plasminogen Activator)

Which intervention would the nurse plan for a client undergoing a renal scan?

Administer furosemide before initial imaging

What is the primary goal when managing prerenal AKI?

Restore adequate blood flow to the kidneys

A patient with prerenal AKI is likely to have which characteristic urine output?

Oliguria with concentrated urine

Which of the following best describes the primary purpose of Continuous Renal Replacement Therapy (CRRT)?

Remove fluids and solutes continuously in critically ill patients

studbud

NUR 4420 Exam 2

123 termsStudBud Administration1 play

Imported from external platform

Flashcards123 cardsFPractice quizPHost liveL

Questions 123

Answers

1
A patient scores +3 on the RASS scale. This means they are:
Alert and calm
Drowsy but responsive
Unarousable
Very agitated, pulling at tubes or catheters
2
Which of the following drugs is nephrotoxic and should be monitored carefully in AKI patients?
Acetaminophen
Ibuprofen
Vancomycin
Aspirin
3
Fibrinolytic therapy eligibility criteria
All of the above
BBBs that may obscure ST segment analysis and a HX suggesting an acute MI
Patients with recent onset of chest pain and persistent ST elevation
4
What is a vascular complication of IABP therapy?
Limb ischemia
Atrial fibrillation
Deep vein thrombosis (DVT)
Pulmonary embolism
5
Heparin or LMWH (enoxaparin or fondaparinux) should be administered for 48 hours after reperfusion of MI
True
False
6
What is the normal range for blood urea nitrogen (BUN) levels?
0-5 mg/dL
5-25 mg/dL
30-50 mg/dL
50-100 mg/dL
7
What is the primary cause of prerenal failure?
Acute tubular necrosis
Reduced renal blood flow
Obstruction in urine collection
Nephrotoxic drugs
8
Which drug is classified as an inotrope?
Lisinopril
Aspirin
Metoprolol
Digoxin
9
MI Patient: Antiplatelet: ASA 81-325mg continued indefinitely, 75 mg clopidogrel is recommended for 14 days at least
True
False
10
Which of the following is NOT a recommended method to manage agitation?
Haloperidol
Opioids
Benzodiazepines
Diuretics
11
Which statement about IABP timing is correct?
Balloon inflates at the onset of systole & deflates at the end of diastole
The balloon inflates during systole and deflates during diastole
The balloon remains inflated continuously
The balloon inflates at the onset of diastole & deflates just b4 systole
12
Which of the following is NOT a level of sedation?
Hyper sedation with paralysis
Deep sedation and analgesia
Moderate sedation with analgesia
Light sedation (anxiolysis)
13
The Richmond Agitation-Sedation Scale (RASS) is used to:
Determine the need for antipsychotics
Measure pain levels
Assess levels of consciousness and agitation
Assess kidney function
14
RASS score for A pt responds to voice with eye contact for more than 10 secs but does not fully awaken. (Drowsy)
-4
-2
-1
-3
15
Medication Treatment for hyperphosphatemia
Sodium polystyrene (Kayexelate)
Calcium acetate
Sodium zirconium
16
Which of the following is NOT a function of the kidney?
Activation of vitamin D
Erythropoiesis
Production of digestive enzymes
Regulation of blood pressure
17
What is the first EKG change seen in a patient with hyperkalemia?
Prolonged QT interval
ST-segment depression
Tall peaked T waves
Atrial fibrillation
18
Which of the following is NOT a function of an implantable cardioverter defibrillator (ICD)?
Defibrillation
Anti-tachycardia pacing
Bradycardia pacing
Continuous blood pressure monitoring
19
Which intervention is used to treat dilutional hyponatremia?
Increased fluid intake
Potassium supplements
Diuretics to retain sodium
Administration of hypertonic saline
20
Which of the following criteria must be met before performing an SBT?
Patient has a FiO₂ ≤ 40% and PEEP ≤ 5
Patient has frequent bradycardia episodes
Patient is on a high-dose sedative
Patient requires multiple vasopressors
21
What is the primary function of an intra-aortic balloon pump (IABP)?
To deliver medications directly into the coronary arteries
To replace the heart’s function entirely
To regulate electrical conduction of the heart
To reduce myocardial oxygen demand and improve coronary perfusion
22
A patient is completely unresponsive to both voice and physical stimulation. What is their RASS score?
-2
-3
-5
-4
23
epinephrine, norepinephrine, phenylephrine, vasopressin are all Vasopressors
False
True
24
A patient with a temporary pacemaker experiences “loss of capture.” What does this mean?
The pacemaker is delivering excessive shocks
The pacemaker spikes are not followed by heart contractions
The patient has an accelerated heart rate
The pacemaker fails to sense the heart’s rhythm
25
Hyperkalemia treatment: Shifting potassium back into the cell (temporary)
IV calcium replacement
Sodium polystyrene (Kayexelate)
calcium acetate(PhosLo)
insulin plus glucose/ sodium bicarbonate
26
Which fibrinolytic agent is most commonly used in acute myocardial infarctions?
Heparin
Clopidogrel
tPA (Tissue Plasminogen Activator)
Aspirin
27
PDE III is the target for inotropic actions. Increased cardiac contractility and stroke volume, vasodilation.
digoxin
Vasopressin
epinephrine,
Milrinone
28
Pacer wire through vein into heart. IJ or Subclavian
Transcutaneous pacing
None of the above
Epicardial pacing
Transvenous pacing
29
Which intervention would the nurse plan for a client undergoing a renal scan?
Taking precautions related to radioactive exposure
Telling the client to limit fluids after imaging
Administer furosemide before initial imaging
Asking the client to fast before the scan
30
Pacemaker malfunctions
Loss of Capture
Failure to Pace
Undersensing
Oversensing
31
Pacemaker too sensitive. Sensing wrong things as intrinsic beats.
Oversensing
Failure to capture
Undersensing
Failure to pace/ no pacing stimulus
32
What is the primary goal when managing prerenal AKI?
Remove the urinary obstruction
Restore adequate blood flow to the kidneys
Perform hemodialysis
Administer nephrotoxic antibiotics
33
Which of the following is NOT a risk factor for intrarenal failure?
NSAIDs
Rhabdomyolysis
Blood clot in the ureter
IV contrast dye
34
A patient with prerenal AKI is likely to have which characteristic urine output?
No urine output at all
High volume, diluted urine
Normal urine output
Oliguria with concentrated urine
35
Which Temporary Pacemaker pace?
Both Atrial and Ventricular
Ventricular
Atrial
36
What is the most common complication of total parenteral nutrition (TPN)?
Dehydration
Hypoglycemia
Hyperglycemia
Diarrhea
37
Which medication is used to reverse benzodiazepine overdose?
Naloxone
Dexmedetomidine
Flumazenil (Romazicon)
Haloperidol
38
Which of the following is a potential complication of pacemaker insertion?
Infection
All of the above
Pneumothorax
Cardiac tamponade
39
Medication Treatment for hyperphosphatemia
sevelamer (Renagel)
Sodium zirconium
Sodium polystyrene (Kayexelate)
40
Which of the following best describes the primary purpose of Continuous Renal Replacement Therapy (CRRT)?
Provide long-term dialysis for chronic kidney disease
Remove fluids and solutes continuously in critically ill patients
Improve urine output
Replace kidney function permanently
41
A pt is pulling at their IV lines & attempting to remove their endotrach tube.(Very Agitated) What is their RASS score?
+2
+1
+3
+4
42
Which pacemaker malfunction is caused by large T waves or movement/artifacts?
Failure to pace
Failure to capture
Oversensing
Undersensing
43
A patient is alert and calm. What is their RASS score?
+1
+2
0
-1
44
Pacemaker cannot sense pt intrinsic beats. Pacer strikes where there're not supposed to be
Failure to capture
Failure to pace/ no pacing stimulus
Oversensing
Undersensing
45
Pacemaker malfunctions
Ventricular Paced
Undersensing
Oversensing
Failure to Capture
46
Which of the following sedation goals is most appropriate for a mechanically ventilated patient?
RASS 0 to +1
RASS -4 to -5
RASS +2 to +3
RASS -2 to 0
47
A patient in the ICU is experiencing disorganized thinking and inattention. The most likely diagnosis is:
Anxiety disorder
Delirium
Hypoglycemia
Epilepsy
48
Regulates the ability of the pacemaker to detect the heart’s intrinsic electrical activity
Sensitivity control
Rate control
Output dial
On/off and locking switches
49
Which component is NOT typically found in total parenteral nutrition (TPN)?
Electrolytes
Proteins
Dextrose
Red blood cells
50
Vasodilator medications • Angiotensin-converting enzyme (ACE) inhibitors
All of the above
lisinopril PO
enalaprilat IV
51
Pacer spikes should be be before p-wave or before QRS
False
True
52
The nurse preparing to give calcium acetate to a CKD patient will monitor which lab result to assess the desired effect?
Phosphorus
Potassium
Magnesium
Sodium
53
Which sedative-hypnotic agent is commonly used in operating rooms and critical care settings?
Haloperidol
Lorazepam (Ativan)
Midazolam (Versed)
Propofol
54
What is the most common cause of intrarenal failure?
Nephrotoxic drugs and ischemia
Increased cardiac output
Urinary tract obstruction
Severe dehydration
55
No waveform after pace, due to meds or not enough energy
oversensing
Normal Pace
undersensing
loss of capture
56
Regulates the number of impulses that can be delivered to the heart per minute. Usually maintained between 60 - 100 bpm
On/off and locking switches
Output dial
Rate control
Sensitivity control
57
Which tube feeding formula is designed for patients with glucose intolerance?
Peptamen
Oxepa
Glucerna
TwoCal HN
58
What type of temporary pacemaker is applied externally to the chest?
None of the above
Transcutaneous pacing
Epicardial pacing
Transvenous pacing
59
What is the effect of balloon inflation in the aorta?
Increases coronary artery perfusion
Increases myocardial oxygen demand
Reduces cardiac output
Increases left ventricular workload
60
Pacemaker malfunctions
Failure to Pace
Undersensing
Oversensing
Loss of Capture
61
What is a common cause of agitation in critically ill patients?
Increased urine output
Hyperglycemia
High sodium levels
Hypoxia
62
What is the preferred route of nutrition if a patient is on high-dose vasopressors?
Oral nutrition
Parenteral nutrition
No nutrition until vasopressors are discontinued
Enteral nutrition
63
What is the intended result of intra-aortic balloon deflation during systole?
Decreased venous return
Decreased afterload
Increased myocardial oxygen consumption
Increased afterload
64
Which of the following interventions is used to treat hyperkalemia?
Sodium polystyrene (Kayexelate)
Increased potassium intake
Loop diuretics
Beta-blockers
65
Which of the following is NOT an indication for a temporary pacemaker?
Electrolyte imbalances
Acute myocardial infarction (MI)
Drug toxicities
Hypertension
66
What is the primary treatment for postrenal failure?
Use of ACE inhibitors
Increased fluid intake
Removal of obstruction
Administration of diuretics
67
Regulates the amount of electrical current, measured in mA, delivered to the heart to initiate depolarization
Output dial
Rate control
On/off and locking switches
Sensitivity control
68
A pt on IABP therapy suddenly develops decreased urine output and cool, pale extremities. What is the most likely cause?
Decreased preload
Balloon migration or vascular occlusion
Hypertension
Increased cardiac output
69
Which of the following drugs should be avoided in patients with kidney failure due to their nephrotoxic effects?
NSAIDs
Penicillin
Metformin
Furosemide
70
Which of the following is NOT a risk factor for delirium?
Past alcohol or sedative use
Sepsis
Older age
Low blood pressure
71
Which condition is associated with excessive potassium in the blood?
Hyperkalemia
Hyponatremia
Hypocalcemia
Metabolic alkalosis
72
What is the primary risk associated with Propofol infusion?
Seizures
Muscle rigidity
Hyperlipidemia and bradycardia
Increased blood pressure
73
A patient with postrenal AKI may present with which condition?
Bilateral kidney obstruction
Blood clots in the urine
Decreased BUN and creatinine levels
Increased glomerular filtration rate
74
Which diuretic class is commonly used to treat fluid overload in kidney failure?
Loop diuretics
Potassium-sparing diuretics
ACE inhibitors
Carbonic anhydrase inhibitors
75
Portion of strip w/ no pacer strikes. No/low HR. Caused by battery/generator/ connection
Failure to pace/ no pacing stimulus
Undersensing
Oversensing
Failure to capture
76
Which of the following is NOT an indication for IABP therapy?
Cardiogenic shock
Unstable angina refractory to medical therapy
Hypertension crisis
Acute mitral regurgitation
77
Psychologic support for sleep deprivation and anxiety is important for patients on IABP
False
True
78
Dialysis patients must avoid potassium and phosphate containing foods. Restricted intake of fluids
True
False
79
IABP does timing on own as long as art line and EKG are reading
False
True
80
What RASS is A patient exhibits frequent non-purposeful movements and is experiencing ventilator dyssynchrony? Agitated
+2
+3
0
+1
81
The RASS of a pt responds to verbal stimuli by opening their eyes for less than 10 seconds but does not stay awake.
-4 (Deep Sedation)
-3(Moderate Sedation)
-1 (Drowsy)
-2 (Light Sedation)
82
A common lab test finding in acute kidney injury (AKI) includes:
Increased serum creatinine
Increased glomerular filtration rate (GFR)
Decreased serum creatinine
Decreased blood urea nitrogen (BUN)
83
The Confusion Assessment Method for the ICU (CAM-ICU) is used to:
Evaluate kidney function
Monitor blood sugar levels
Measure sedation depth
Diagnose delirium
84
Which Temporary Pacemaker pace?
Ventricular
Atrial
Both Atrial and Ventricular
85
Which condition requires immediate intervention when administering enteral feeding?
Nausea controlled with antiemetics
Slightly slow gastric emptying
Mild bloating after feeding
High residual volume >500mL
86
What is the primary action of ACE inhibitors?
Enhance blood clot formation
Vasodilation and blood pressure reduction
Increase heart rate
Directly increase cardiac contractility
87
What percentage of ICU patients experience delirium?
10-20%
20-50%
80-90%
50-70%
88
Which type of acute kidney injury (AKI) is most commonly caused by sepsis, major surgery, or hypovolemia?
Intrarenal failure
Chronic kidney disease
Postrenal failure
Prerenal failure
89
Which of the following medications increases heart rate and contractility?
Norepinephrine
Nitroglycerin
Hydralazine
Lisinopril
90
Vasodilator(Artery/venous). Direct smooth muscle relaxants (activation of nitric oxide).
All of the above
nitroglycerin
sodium nitroprusside
hydralazine
91
Which of the following should be closely monitored in a patient with an IABP?
Neurological status
All of the above
Urine output
Peripheral pulses
92
When is it appropriate it wean a patient off of IABP?
Once the patient reaches the bridge to Terabithia
Once patient is no longer sleep deprivated
Once patient stable on no or low dose cardiac medications
Once the patient has a MI
93
What should be done when a pacemaker is failing to capture?
Give Iv bolus
Check setting, wires, & generator
Unplug it and plug it back in
Sedated the patient with propofol
94
What is included in the ABCDEF bundle for ventilated patients?
Airway, BP monitoring, Cardiac support, Exercise, and Feeding control
Awakening, Breathing coord, Delirium monitoring, Exercise & Family empower
Antibiotics, Beta-blockers, Circulatory supp, Electro bal, & Freq monitor
Anxiety manag, BS monitoring, Central line care, Exercise, & Fluid balance
95
Which Temporary Pacemaker pace?
Ventricular
Both Atrial and Ventricular
Atrial
96
During hemodialysis, the patient develops light-headedness and nausea. What should the nurse dofirst?
Give hypertonic saline.
Administer antiemetic medications.
Initiate a blood transfusion
Decrease the rate of fluid removal.
97
Pacemaker malfunctions
Loss of Capture
Undersensing
Failure to Pace
Oversensing
98
Which test result would the nurse anticipate in the lab results of a client with a diagnosis of end stagerenal disease?
Creatinine of 1.2mg/dL
arterial pH of 7.5
Potassium of 6.3 mEq/L
Hematocrit of 54%
99
Which RASS score corresponds to a patient who is anxious but not physically aggressive?(Restless)
+2
0
+1
+3
100
Which of the following is a priority nursing intervention after coronary artery bypass surgery (CABG)?
Early extubation within 6 hours post-op
Limiting fluid intake to prevent edema
Avoiding pain medication to assess for complications
Encouraging the patient to stay in bed for 48 hours
101
What is the most common complication following PCI (percutaneous coronary intervention)?
Kidney failure
Stroke
Restenosis
Atrial fibrillation
102
Pacemaker malfunctions
Ventricular Paced
Undersensing
Failure to Capture
Oversensing
103
Which of the following is an advantage of enteral nutrition over parenteral nutrition?
More convenient for the nurse
Lower risk of infection
Decreased risk of aspiration
Requires less monitoring
104
Inotropic sympathomimetic agent that increase contractility
Vasopressin
digoxin
epinephrine
Milrinone
105
Which electrolyte imbalance is commonly associated with metabolic acidosis in acute kidney injury (AKI)?
Hypocalcemia
Hyperkalemia
Hypokalemia
Hypernatremia
106
Which of the following is a characteristic of postrenal failure?
Obstruction in urine collection
Leads to rhabdomyolysis
Caused by nephrotoxic drugs
Results from severe hypotension
107
Which intervention can help prevent aspiration pneumonia in tube-fed patients?
Elevating the head of the bed to at least 30-45 degrees
Infusing enteral nutrition as quickly as possible
Placing the patient in a supine position
Checking residuals every 8 hours
108
How long should an SBT typically last?
4-6 hours
5-10 minutes
12-24 hours
30-120 minutes
109
Older adult with endocrine disorder needs which lab test before contrast study?
Urine pH
Serum albumin
Creatinine clearance
Serum creatinine
110
What is the role of aldosterone in kidney function?
Reduces blood pressure
Increases sodium reabsorption and potassium excretion
Enhances bicarbonate excretion
Increases water loss
111
A patient with an ICD asks if the device will cure their heart failure. What should the nurse explain?
"The ICD will only function during physical activity."
"No the ICD helps regulate ur heart rhythm but does not cure heart failure"
"You will no longer require any medications."
"Yes, the ICD will completely cure your heart condition."
112
Which diagnostic indicator suggests acute kidney injury (AKI)?
Decreased glomerular filtration rate (GFR)
Increased urine output
Decreased serum creatinine
Increased hemoglobin levels
113
If a Patient comes in w/ STEMI you want to get them to Cath lab within 30-90 min
True
False
114
Which findings will the nurse expect when caring for a patient with chronic kidney disease (CKD)?
All of the above
Anemia
Hypertension
Increased fracture risk
115
tPA, rPA, TNKase clot specific agents dissolve clots quickly. Door to needle goal 30 minutes acute MI.
True
False
116
After receiving fibrinolytic therapy, no invasive procedures w/in the 1st 24 hrs. No IVs, no IMs, Except in emergencies
True
False
117
Which of the following is a non-pharmacologic method to prevent delirium?
Increased sedation levels
Early mobility and sleep protocols
Continuous use of restraints
Routine use of benzodiazepines
118
During which phase of the cardiac cycle does the intra-aortic balloon inflate?
P-wave
T-wave
Diastole
Systole
119
During which phase of the cardiac cycle does the intra-aortic balloon deflate?
During the QRS complex
During the T-wave
Systole
Diastole
120
Albumin level < 3.5g/dl common incritically ill patients
True
False
121
Which of the following is a contraindication for fibrinolytic therapy?
History of hypertension
Recent onset of chest pain with ST elevation
Active internal bleeding
Use of aspirin in the last 24 hours
122
What is a hallmark sign of acute tubular necrosis (ATN)?
Decreased serum creatinine
Increased urine output
Increased calcium levels
Formation of cellular casts in the tubules
123
Open heart/ Bypass. Pacer wire sewn into cardiac tissue
Transcutaneous pacing
None of the above
Epicardial pacing
Transvenous pacing

NUR 4420 Exam 2 Flashcards | StudBud