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