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