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AH3 Exam Flashcards | StudBud
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AH3 Exam
AH3 Exam
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1
what kind of distributive shock is happening when a pt has vasodilation due to a parasympathetic stimulation?
neurogenic
obstructive
anaphylactic
septic
2
What organism is most common in causing SIRS?
viral
gram (-) bacteria
fungal
gram (+) bacteria
3
What does CVP monitor?
pressures of the left side of the heart
fluid status
systemic vascular resistance
pulmonary pressures
4
After a pt is extubated and becomes anxious and dyspneic with o2 sats 87%. What is the first intervention to perform?
use the Ambu bag on the pt
prepare to reintubate
Prepare to use noninvasive positive pressure ventilation
increase the amount of o2 via nasal cannula to 8L
5
what acid-base imbalance is seen in the initial presentation of ARDS?
resp. acid
resp. alk.
met. acid.
met. alk.
6
what type of shock presents with decrease venous return to the heart due to inadequate circulating volume?
hypovolemic
septic
neurogenic
obstructive
7
what is ventilator synchrony?
when the pt is compliant on the vent
when the pt fights the vent
when the pt is waking up from sedation
when the pt bites the ET tube
8
if a pt is exhibiting signs of increase in preload what are meds we would anticipate giving? select all
nitrates
beta blockers
epinephrine
diuretics
9
What are indications for intubation? (SATA)
drug overdose
PaO2 82
no gag reflex
COPD exacerbations
aspiration
unresponsiveness
10
A pt has a hemothorax to the right side with trachea deviation. what is the goal of the chest tube placement?
to force more air into the pleural space
allowing air to escape
allowing blood to drain
inserting a tube to the left side to equal pressure
11
what is the progressive dysfunction of 2 or more organ systems?
SIRS
refractory stage of shock
ARDS
MODS
12
a pt presents with tracheal deviation to the right, lung sounds are absent, o2 sats are 78%. What is the cause?
myocardial infarction
pulmonary embolism
pneumothorax
pneumonia
13
what stage of shock presents with increase in lactic acid, decrease UOP, no bowel sounds, cool clammy skin?
compensatory
refractory
initiation
progressive
14
what is priority treatment interventions in septic shock?
HR control
antibiotics
vasoactive support
fluid resuscitation
15
the vent. setting SIMV is best characterized but which phrase?
the vent works with the pt by allowing the pt to spontaneously breathe
delivers a set amount of volume for every breath
the preferred setting used while a pt is paralyzed
delivers a set of pressure every breath
16
What nursing tool is at our disposal to aid in identifying at risk pts for SIRS?
RASS
CAM
MEWS
MORSE
17
what meds would be anticipated to be ordered when a pt has decreased cardiac contractility? select all
bronchodilators
catecholamines
beta blockers
inotropes
18
which shock presents with hypovolemia s/s due to blood volume pooling in the peripheral vessels?
obstuctive
cardiogenic
distributive
hypovolemic
19
a pt has the following ABG - pH 7.33 CO 50 HCO3 21. what is your intervention?
coach to deep breathe and cough
notify respiratory therapy
apply 3L o2
use a flutter valve
20
If the PEEP was increased on a vent. what could we see as a response to the increase in PEEP? SATA
increased BP
decreased BP
increased CO
decreased CO
21
neurogenic shock presents with what s/s? select all
HTN
dry warm skin
hyperglycemia
hypotension
22
In treating ARDS what therapy is not in the standards of care?
proning
sedation and pain relief
allowing disconnecting the vent when turning
paralytics
23
What type of pneumonia is it, when the bacteria is multi-drug resistant?
community acquired
hospital acquired
healthcare-associated
aspiration
24
What should we monitor for when we have a pt with an arterial line? select all
cyanosis of the lips
distal ischemia
arterial dissection
arteriospasms
25
where do we measure the inserted depth of an ET tube that is placed every shift?
at the lip or teeth
the tip of the nose
top of the throat
the base of the pallet
26
what are causes of obstrucive shock? select all
PE
MI
cardiac tamponade
tension pnuemothorax
27
what happens if a chest tube becomes severed?
place an occlusive dressing over the site
place the end of the tube in fluid to create a water seal
clamp the tube
remove the tube and hold pressure
28
if a pt has a IABP inserted what are the main goals of this treatment? select all
increase CO/CI
decrease CO2
increase blood supply to coronaries
increase UOP
29
A pt arrives at the ED after an MVA. the pt has a paradoxical chest rise and fall. what is the suspected cause?
PE
pneumothorax
sternal rib fracture
flail chest
30
What anatomical area of the lungs is used to confirm the placement of an ET tube?
right bronchial branch
carina
left lower lobe
trachea
31
a pt was rapidly intubated. chest X-ray confirms ETT. after 45min the pt's BP 76/45, HR 138, O2 75%. what is a cause?
aspiration
pulmonary embolism
pulmonary edema
shunting
32
what stage of shock presents with mottled skin, oliguria, MAPs <65, and lethargy?
progressive
refractory
compensatory
initiation
33
what are common casues of anaphylactic shock? select all
dander
meds
food
insects
34
What is included in VAP bundle of care for intubated patients? SATA
perform oral hygiene q2h
pause tube feedings before repositioning
deep suction trachea once per shift
daily awakening trials
stress ulcer prophylaxis
maintain bed at 15 degrees
35
In ARDS what is causing the inability of gas to exchange?
loss of fluid to pleural space
hyaline membranes forming
fluid in the alveoli
loss of surfactant
36
if a pt presents with temp of 102, HR 126, RR 22, and a 10% bands increase what is this a precursor to?
sepsis
anaphylactic
SIRS
neurogenic
37
What should you do if the vent alarms are ringing, the pt is in distress, and you cannot troubleshoot the issue?
disconnect the vent and manually ventilate
clamp the tube while you disconnect the vent
remove the ET tube
turn off the ventilator
38
what does pulmonary artery (PA) pressure monitor?
dysrrhythmias
fluid status
coronary occlusions
left ventricle function
39
after successful intubation, the end-tidal CO2 detector color should do what?
change from purple to yellow
turn black
stay yellow
stay purple
40
anaphylactic shock presents when what s/s occur? select all
skin/mucosal irritation
hypotension
increased UOP
resp. compromise
41
What is the P/F ratio for the pt: pH 7.2, CO2 58, HCO3 14, PaO2 68, on FiO2 75% round to the nearest tenth
0.9
90.7
907
9.7
42
in the refractory stage of shock what is happening? select all
supportive care is delivered
aggressive management is started
severe organ damage
pt is not responding to treatment
43
in the previous question about the end-tidal CO2 detector, what does the colors mean? SATA
purple = CO2 present
yellow = oxygen present
yellow = CO2 present
purple = oxygen present
44
what test should be done before insertion of an arterial line of the radial?
Fick's
Homan's
Chvostek's
Allen's
45
what is the formula for cardiac output?
CO = HR/SV
CO = HR X BP
CO = SV X BP
CO = HR X SV
46
in cardiogenic shock what are the preferred treatments for increasing o2 supply and decreasing demand ? select all
ECMO
Plasmaphoresis
CCRT
IABP
47
what is range of PEEP?
1-5 cm H2O
0-15 cm H2O
5-20 cm H2O
5-15 cm H2O
48
what is the leading cause of coronary cardiogenic shock?
hypocalcemia
cardiomyopathy
LAD infarction
cardiac tamponade
49
a pt is intubated awake alert and tolerating the vent well. they want to talk but can't. what can you use to help aid?
use a vision board with pictures and phrases
ask the pt to blink once for yes, two for no
teach the pt morse code
tell them they cannot speak and will have to wait until extubation
50
What are findings that are consistent with a pt heading towards ARDS? (SATA)
p/f ratio below 200
one side of CXR blacked out
p/f ratio below 400
ventilation with no gas exchange
progressive worsening of white opacities on xray
o2 sats below 80%
