Final Exam
Which of the following is not an appropriate intervention for all atrial dysrhythmias? A. An ECG B. A pulse check C. Blood pressure D. Cardioversion
ABC
A patient recovering from an ischemic stroke is prescribed verapamil (Calan). In preparation for patient teaching, which medication category will the nurse review? 1) Diuretic 2) Beta blocker 3) Lipid-lowering agent 4) Calcium channel blocker
4
A patient is being cardioverted for symptomatic atrial fibrillation. At which point of the cardiac cycle will the electric impulse occur? 1) At the end of the P wave 2) Before the QRS complex 3) At the peak of the R wave 4) After the QRS complex but before the T wave
3
A patient receives a definitive diagnosis of multiple sclerosis. What finding occurred to validate this diagnosis? 1) Onset of double vision 2) Loss of bowel and bladder control 3) Numbness and tingling of one limb 4) MRI changes in two separate locNaUtioRnSs
4
A patient admitted with smoke inhalation injuries develops signs and symptoms of acute respiratory distress syndrome (ARDS). Which health-care provider prescription does the nurse anticipate for this patient? 1) Mechanical ventilation 2) Oxygen via a nasal cannula 3) Face mask oxygen administration 4) Continuous positive airway pressure
1
A patient is being evaluated for chest pain in the emergency department. Which laboratory test is the best to determine if this patient has experienced an acute myocardial infarction? 1) Troponin 2) Prothrombin time 3) Creatine kinase-MB 4) Complete blood count
1
A patient with heart failure is prescribed an angiotensin-converting enzyme inhibitor. What should the nurse explain as being the purpose of this medication? 1) Reduce afterload 2) Decrease preload 3) Increase contractility 4) Control sympathetic nervous system response to decreased cardiac output
1
A patient with multiple sclerosis experiences exacerbations of new symptoms that last a few days and then disappear. Which type of multiple sclerosis is this patient most likely experiencing? 1) Relapsing-remitting 2) Primary progressive 3) Progressive relapsing 4) Secondary progressive
1
A patient with pericarditis is prescribed corticosteroids. What should the nurse emphasize when teaching about this medication? 1) Take the medication as prescribed 2) Increase the dose if symptoms get worse 3) Reduce the frequency when symptoms subside 4) Consider taking a dose every other day to reduce side effects
1
A patient recovering from a motor vehicle crash develops hypotension and jugular distension with a tracheal deviation. Based on this data, which should the nurse suspect occurred? 1) Hemorrhage 2) Compensatory shock 3) Hypovolemic shock 4) Tension pneumothorax
4
The nurse is concerned that a patient admitted for a total hip replacement is at risk for thrombus formation and pulmonary embolism. Which assessment finding supports the nurse's concern? 1) Body mass index (BMI) 35.8 2) Former cigarette smoker 3) Blood pressure 132/88 mm Hg 4) Age 45 years
1
The nurse is concerned that a patient with heart failure is decompensating. What assessment finding supports the nurse's clinical decision? 1) Dyspnea on exertion 2) Dry persistent cough 3) Weak peripheral pulses 4) Increased urine output
1
The nurse is conducting a primary survey during an emergency assessment. Which is the priority nursing action related to breathing in response to this assessment? 1) Having suction available 2) Assessing pupil size and reactivity 3) Immobilizing any obvious deformities 4) Obtaining blood samples for type and crossmatch
1
The nurse is conducting a secondary survey as part of the emergency assessment. Which is the priority nursing action during the health history portion of the assessment? 1) Determining drug allergies 2) Noting the general appearance 3) Examining the neck for stiffness 4) Auscultating for heart and lung sounds
1
The nurse is reviewing the manifestations of an acute myocardial infarction with a patient diagnosed with type 2 diabetes mellitus. What should the nurse emphasize as being an atypical manifestation of this cardiac disorder? 1) Fatigue 2) Dyspnea 3) Tachycardia 4) Hypertension
1
The nurse notes crusting of secretions around the pins of a patient with a Halo device. What action should be taken at this time? 1) Wrap the pins with gauze soaked with normal saline 2) Gently pick the crusting off of the pins with a dry gauze pad 3) Apply gauze soaked with hydrogen peroxide around the pins 4) Syringe 1/2 strength hydrogen peroxide and sterile water to the crusted areas
1
The nurse is caring for a patient with a potentially life-threatening cardiac dysrhythmia. What should be included in this patient's plan of care? Select all that apply. 1) Document frequency of dysrhythmia 2) Administer antiarrhythmic medications 3) Maintain continuous cardiac monitor 4) Prepare to administer advanced cardiac life support 5) Complete preoperative checklist for pacemaker insertion
1 2 3 4
The school nurse is preparing material for National Fire Prevention week. What information should be added to the classroom posters? Select all that apply. 1) Never leave a burning candle unattended. 2) Set heating pads on "low" when sleeping. 3) Keep a flashlight and telephone near the bed. 4) Check smoke alarm batteries every six months. 5) Never use the oven as a method to warm the home.
1 3 4 5
Which assessment findings would indicate to the nurse that a patient is exhibiting early symptoms of shock? Select all that apply. 1) Pallor 2) Increased bowel sounds 3) Restlessness 4) Decreased blood glucose 5) Increased respiratory rate
1 3 5
Which are the top priorities when conducting a primary patient survey during the emergency assessment? Select all that apply. 1) Airway 2) Disability 3) Breathing 4) Circulation 5) Cervical spine
1,5
A patient with pericarditis is being prepared for an emergency pericardiocentesis. What did the nurse most likely assess to support this immediate procedure? Select all that apply. 1) Hypotension 2) Pulsus paradoxus 3) Muffled heart sounds 4) Jugular vein distention 5) Lower extremity edema
1234
The nurse is assigned to a patient with a newly inserted central line. What actions should be taken to prevent the patient from developing an infection? Select all that apply. 1) Perform line care 2) Use aseptic technique 3) Minimize handling the line 4) Use normal saline to flush the line 5) Ensure an occlusive dressing is applied
1235
A patient with amyotrophic lateral sclerosis (ALS) is being prepared for discharge. What teaching would be essential for the family to receive prior to taking the patient home? Select all that apply. 1) Skin care 2) Aspiration precautions 3) Recognizing exacerbations 4) Lower extremity circulation 5) Reporting changes in continence
124
While planning care the nurse identified interventions to reduce a patient's risk for developing heart failure. Which assessment findings did the nurse use to make this clinical determination? Select all that apply. 1) Body mass index 31.3 2) Smokes 1/2 pack of cigarettes 3) Employed in a textile factory 4) Blood pressure 168/90 mm Hg 5) Fasting blood glucose 146 mg/dL
1245
A patient with an ischemic stroke is being considered for recombinant tissue plasminogen activator (rt-PA). What would cause this procedure to be contraindicated in this patient? Select all that apply. 1) Age 83 years 2) Symptoms present for 45 minutes 3) CT scan demonstrates area of ischemia 4) 10-year history of type 2 diabetes mellitus 5) Takes warfarin sodium for atrial fibrillation
145
A nurse working in the intensive care unit (ICU) is caring for a patient in refractory stage of shock. When planning care, which does the nurse anticipate? 1) A subtle change in heart rate 2) A change from aerobic to anaerobic metabolism 3) The development of hyperglycemia 4) The development of cardiac dysrhythmias
2
A patient is admitted for treatment of pericarditis. For which additional health problem should the nurse expect the patient to be evaluated? 1) Asthma 2) Myocardial infarction 3) Infective endocarditis 4) Chronic obstructive pulmonary disease
2
A patient is diagnosed with a subarachnoid hemorrhage caused by a cerebral aneurysm that has a wide neck and tortuous vascular anatomy. For which procedure should the nurse prepare teaching material for this patient? 1) Aneurysm coiling 2) Aneurysm clipping 3) Reinforcing aneurysm wall 4) Evacuation of the hematoma
2
A patient recovering from a hemorrhagic stroke has a blood pressure of 90/50 mm Hg. What action should the nurse take? 1) Increase the head of the bed 2) Notify the health-care provider 3) Place the head in a neutral position 4) Reassess the pressure in 15 minutes
2
A patient with acute respiratory distress syndrome (ARDS) is being weaned from mechanical ventilation. Which nursing action is appropriate for this patient? 1) Increase percentage of oxygen being provided through the ventilator 2) Place in the Fowler position NURSINGTB.COM 3) Provide morning care during the weaning procedures 4) Medicate with morphine for pain as needed
2
A patient with multiple sclerosis is developing speech difficulties. What should the nurse realize as being the reason for this new manifestation? 1) Depression 2) Medications 3) Nerve regeneration 4) Mental status changes
2
The nurse is conducting a primary survey during the emergency assessment. Which nursing action is appropriate during the breathing assessment? 1) Assessing for edema 2) Counting respiratory rate 3) Checking for foreign bodies 4) Monitoring for respiratory distress
2
The nurse is preparing materials for the families of patients who have sustained a stroke. What information should the nurse include to reduce the risk for additional strokes? 1) Heart-healthy diet 2) Smoking cessation 3) Stress management 4) Weight-reduction strategies
2
The nurse is providing care to a patient who is admitted with cardiogenic shock. The nurse administers the prescribed atropine with no results. Which prescription does the nurse anticipate from the health-care provider based on this data? 1) A beta blocker 2) Transcutaneous pacing 3) Cardiac defibrillation 4) A preload reducer
2
The nurse is providing discharge instructions to an older adult patient who is going home after having a total knee replacement. Which will the nurse include in the discharge teaching to decrease the patient's risk for developing a thrombosis or pulmonary embolism? 1) Place pillows under the knees when in bed 2) Use compression stockings 3) Limit ambulation 4) Limit fluids
2
The nurse wants to evaluate a patient's right heart preload. Which approach should be used to obtain this measurement? 1) Zero the arterial line 2) Measure the central venous pressure 3) Measure the pulmonary artery wedge pressure
2
Which is a potentially life-threatening condition found during the primary triage survey that would necessitate priority nursing care? 1) Cystitis 2) Concussion 3) Lacerated arm 4) Fractured femur
2
he nurse caring for a newborn on a ventilator for acute respiratory distress syndrome (ARDS) informs the parents that the newborn is improving. Which data supports the nurse's assessment of the newborn's condition? 1) Increased PCO2 2) Oxygen saturation of 92% 3) Pulmonary vascular resistance increases 4) Less than 1 mL/kg/hour urine output
2
A nurse working in the intensive care unit (ICU) is receiving a patient diagnosed with early septic shock from the emergency department (ED). The nurse will recognize which symptoms associated with this condition? Select all that apply. 1) Shallow respirations 2) Normal blood pressure 3) Warm and flushed skin 4) Lethargic mental status 5) Decreased urine output 6) Rapid and deep respirations
2 3 6 1 4 5 = LATE
A patient is admitted for diagnosis and treatment of ongoing spasticity and flaccidity of the extremities. Which diagnostic test should the nurse expect to be prescribed that will definitively determine this patient's health problem? 1) MRI of the neck 2) CT scan of the head 3) A variety of tests will be ordered to help rule out other causes 4) Analysis of cerebrospinal fluid from a lumbar puncture
3
A patient becomes unresponsive without a palpable pulse despite showing bradycardia on the rhythm strip. What action should the nurse take immediately? Select all that apply. 1) Auscultate heart sounds 2) Begin cardiac compressions 3) Adjust cardiac monitor leads 4) Prepare for chest tube insertion 5) Place epinephrine at the bedside
2 5
A patient is being discharged after treatment for an ischemic stroke. Which medications should the nurse expect to be prescribed for this patient? Select all that apply. 1) Antibiotics 2) Anticoagulant 3) Antihypertensive 4) Antiplatelet therapy 5) Lipid-lowering agent
2345
The nurse is assessing a patient with multiple sclerosis. What should the nurse expect to assess in this patient? Select all that apply. 1) Anxiety 2) Dizziness 3) Double vision 4) Unsteady gait 5) Electric shocks with head movement
2345
A patient with atypical chest pain is prescribed a 12-lead electrocardiogram. What findings would support this patient experiencing an acute myocardial infarction? Select all that apply. 1) Q waves 2) Junctional rhythm 3) ST segment elevation 4) Prolonged PR interval 5) Premature ventricular contractions
245
A patient diagnosed with a pulmonary embolism has a reduction in arterial oxygen saturation level and dyspnea. Which is the priority nursing diagnosis for this patient? 1) Ineffective Tissue Perfusion 2) Anxiety 3) Impaired Gas Exchange 4) Impaired Physical Mobility
3
A patient with multiple sclerosis is admitted for treatment of clinical manifestations. What should the nurse expect to be prescribed for this patient? 1) Corticosteroids 2) Beta interferons 3) Muscle relaxants 4) Immunosuppressive agents
3
A victim of a house fire is brought to the emergency department for burn treatment. What assessment finding indicates that the patient may have an inhalation injury? 1) Coughing 2) Soot on the face 3) Singed facial hair 4) Heart rate 98 bpm
3
The nurse applies oxygen two liters via nasal cannula on a patient with coronary artery disease. What should the nurse explain as being the purpose of the oxygen? 1) Ensures vessel dilation 2) Ensures perfusion to cerebral tissues 3) Supports myocardial oxygen demand 4) Facilitates the metabolism of medications
3
The nurse caring for a patient recovering from an abdominal hysterectomy suspects the patient is experiencing a pulmonary embolism. Which clinical manifestation supports the nurse's suspicion? 1) Nausea 2) Decreased urine output 3) Dyspnea and shortness of breath 4) Activity intolerance
3
The nurse instructs a patient recovering from an acute myocardial infarction on the Life's Simple 7 actions. Which patient statement indicates that additional teaching is required? 1) "I will not smoke." 2) "I will eat a heart healthy-diet." 3) "I will walk for at least 30 minutes three times a week." 4) "I will make sure my blood sugar level stays under 100 mg/dL."
3
The nurse is caring for a patient experiencing an acute myocardial infarction. Which assessment finding indicates a decrease in this patient's cardiac output? 1) Chest pain 2) Restlessness 3) Low urine output 4) ST segment elevation
3
The nurse is concerned that a patient is at high risk for having a stroke. What finding did the nurse use to make this clinical decision? 1) BMI 24.8 2) Heart rate 90 bpm 3) Blood pressure 182/90 mm Hg 4) Pulse oximetry 98% on room air
3
The nurse is evaluating teaching provided to a patient with coronary artery disease. Which patient statement indicates that additional teaching is required? 1) "I will adhere to my smoking cessation plan." 2) "I am to reduce my daily intake of saturated fat." 3) "I can take up to three doses of nitroglycerin 15 minutes apart." 4) "I am to follow the exercise plan for 30 minutes, five days a week."
3
The nurse is preparing teaching for a patient being treated for coronary artery disease. What dietary information should the nurse emphasize? 1) Restrict carbohydrate intake 2) Limit calorie intake to under 1000/day 3) Reduce saturated fat and sodium intake 4) Have the biggest meal of the day for lunch
3
The nurse is providing care to several patients in the emergency department. Which patient would require priority care from the nurse? 1) An adult patient with an ankle sprain 2) An infant with a rash of unknown origin 3) An adult patient with unstable vital signs and chest pain 4) A pediatric patient with multiple fractures following a motor vehicle accident
3
The nurse suspects that a patient is experiencing a hemorrhagic stroke from a ruptured cerebral aneurysm. What assessment finding caused the nurse to make this conclusion? 1) Slurred speech 2) Visual field deficits 3) Sudden severe headache 4) Lower extremity weakness
3
the nurse is preparing medications for a patient experiencing an acute myocardial infarction. Which medication will dilate the patient's coronary blood vessels? 1) Heparin 2) Fibrinolytics 3) Nitroglycerin 4) Beta blockers
3
A patient recovering from a stroke has profound bradycardia. What should the nurse suspect as the cause of this manifestation? 1) Parasympathetic nervous system disruption 2) Irritation of the sympathetic nervous system 3) Shunting of fluid from the cerebral vasculature 4) Alteration in the vasomotor center in the brainstem
4
The nurse is concerned that a patient is demonstrating early signs of hypovolemic shock. Which assessment findings support the nurse's concern? Select all that apply. 1) Rapid weak pulse 2) Normal respirations 3) Normal blood pressure 4) Slight increase in pulse 5) Prolonged capillary refill time
3 4 5
A patient is scheduled for an exercise stress test. For which cardiac health problems is this patient being tested? Select all that apply. 1) Pericarditis 2) Heart failure 3) Valvular disease 4) Infective endocarditis 5) Coronary artery disease
3 5
The nurse is preparing to measure a patient's central venous pressure. In which order should the nurse perform the steps to ensure an accurate reading? (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234) 1) Zero the transducer 2) Ensure tubing is less than 120 cm long 3) Secure the transducer at the phlebostatic axis 4) Ensure transducer and tubing are free from blood and air
3214
A client with amyotrophic lateral sclerosis is prescribed riluzole (Rilutek). What statement indicates additional teaching is required about the effects of this medication? 1) "This will cure my disease." 2) "This will help me stay awake." 3) "This will stop my bladder spasms." 4) "This will increase the progression of my disease."
4
A patient is admitted for a suspected inhalation injury. What should the nurse emphasize when caring for this patient? 1) Increase oral fluids 2) Turn in bed every two hours 3) Monitor strict intake and outputNURSINGTB.COM 4) Deep breathing and coughing every hour
4
A patient is experiencing increasing flaccid upper arms while the lower extremities periodically cramp and contract. On which health problem should the nurse focus when assessing this patient? 1) Brain tumor 2) Spinal cord tumor 3) Multiple sclerosis 4) Amyotrophic lateral sclerosis (ALS)
4
A patient scheduled for surgery is being instructed in leg exercises and the pneumatic compression device. The nurse includes these instructions to decrease which postoperative complication? 1) Infection 2) Delayed wound healing 3) Contractures 4) Deep vein thrombosis
4
A patient with pericarditis asks the nurse to explain the health problem. Which phrase should the nurse use when responding to this patient? 1) Heart cell dysfunction 2) Plaque buildup in vessels 3) Infection of the innermost layer of the heart 4) Inflammation of the tissue surroNunUdRinSg IthNe GheTarBt
4
A victim of a car fire is confused, dizzy, and nauseated. What diagnostic test should be done to determine if this patient is experiencing carbon monoxide poisoning? 1) Chest x-ray 2) Bronchoscopy 3) Pulse oximeter 4) Carboxyhemoglobin level
4
During a home visit the nurse notes that a patient recovering from an acute myocardial infarction has not had medication prescriptions filled at the pharmacy. What should the nurse say in response to this observation? 1) "I don't blame you. I don't like to take medications every day either." 2) "As long as you aren't having any symptoms, delaying the medications is acceptable." 3) "Most people don't like to take medications but try to remember to get the prescriptions filled." 4) "The medications will help treat the effects of your current health problem and prevent any future events."
4
During the initial stage of shock, which clinical manifestation should the nurse monitor for when assessing the patient? 1) Lethargy 2) Hypotension 3) Respiratory alkalosis 4) Subtle changes in heart rate
4
The emergency department nurse is triaging patients. Which patient should be prioritized? 1) An adult patient experiencing mild chest pain 2) An adolescent patient with a possible fractured wrist 3) An older adult patient with a hip fracture who is in pain 4) A school-age patient with asthma presenting with dyspnea
4
The latest blood pressure reading for a patient with a spinal cord injury is 210/140 mm Hg. What action should the nurse take first? 1) Palpate for bladder distention 2) Assess for a bowel impaction 3) Re-measure the blood pressure 4) Raise the head of the bed 45 degrees
4
The nurse is caring for a patient with multiple sclerosis. What should the nurse do to increase venous return, prevent stiffness, and maintain muscle strength and endurance? 1) Administer interferon 2) Administer corticosteroids 3) Turn and reposition every two hours 4) Encourage range-of-motion exercises
4
The nurse is preparing to defibrillate a patient. Which setting should the nurse use for this treatment? 1) 50J 2) 100J 3) 150J 4) 200J
4
The nurse is providing care to a patient diagnosed with hypovolemic shock. Which nursing action is appropriate for this patient during the initial compensatory phase? 1) Placing a cool blanket over the patient 2) Raising the patient's head to a 30-degree angle 3) Positioning the patient in the left-lateral recumbent position 4) Turning the patient's head to one side if no neck injury is suspected
4
The nurse is providing care to several patients in the emergency department. Which patient is the priority when using the three-tiered triage system? 1) A patient with a simple fracture 2) A patient experiencing renal colic 3) A patient with severe abdominal pain 4) A patient with chest pain and diaphoresis
4
The nurse is reviewing orders written for a patient with a new spinal cord injury. Which order should the nurse question before completing? 1) Place on air mattress 2) Insert a nasogastric tube and attach to low suction 3) Insert indwelling urinary catheter; strict intake and output 4) Dexamethasone (Decadron) 10 mg IVP now and repeat in 4 hours
4
Which assessment data related to the patient's airway would indicate the need for priority intervention by the nurse? 1) Eupnea 2) Tachycardia 3) Hypotension 4) Agonal breaths
4
Which nursing action is appropriate when conducting a secondary survey during the emergency assessment? 1) Maintaining privacy 2) Having suction available 3) Giving supplemental oxygen 4) Assigning a nurse to support family members
4
The nurse is evaluating care provided to a patient with burns during the emergent phase. Which data indicates that additional fluid resuscitation is required? 1) Blood pH 7.39 2) Heart rate 112 bpm 3) Blood pressure 110/60 mm Hg 4) Central venous pressure 2 mm Hg
4 Indications of adequate fluid resuscitation include a central venous pressure between 5- 10 mm Hg. A pressure of 2 mm Hg indicates fluid volume deficit. More fluid would be indicated.
The nurse reviews the cardiac electrical cycle with a patient scheduled for pacemaker insertion surgery. In which order should the nurse explain this process? (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234) A. P wave B. T wave C. QRS complex D. Firing of the SA node E. Ventricular contraction F. Ventricular repolarization
413526
In a patient without a central line, which clinical finding does the nurse look for to indicate effective response to treatment in the initial stage of shock? A. Increased urine output B. Increased HR C. Decreased bowel sounds D. Decreased blood pressure
A
The nurse caring for a patient with a closed pneumothorax will monitor closely for which of these complications? A. Tension pneumothorax B. Flail chest C. Cardiac tamponade D. Pulmonary embolus
A
The nurse is caring for patient who came into the ED with a temperature of 105°F (40.6°C). This patient was found at home in an apartment without air conditioning; the current heat wave has temperatures above 100°F (37.8°C) for the last 3 days. Which of the following actions should the nurse plan to take first? A. Apply cooling blankets B. Obtain laboratory specimens C. Establish IV access D. Administer Tylenol
A
The nurse monitors for which clinical manifestations in the patient in compensatory shock? A. Blood pressure within normal limits, oliguria B. Cold extremities, hyperglycemia C. Weak pulses, hypoventilation D. Hypotension, tachycardia
A
The nurse is caring for a patient bitten by a rattlesnake 3 hours prior to admission to the ED. The nurse correlates which of the following clinical manifestations with a venomous snakebite? (Select all that apply.) A. Edema at the site B. Bleeding at the site C. Excessive diuresis D. Dysrhythmias E. Numbness at the site
A B
The nurse understands that __________________ increases as the delivery of oxygen to the tissues falls below the tissues' requirements. (Select all that apply.) A. VO2 B. Oxygen debt C. SvO2 D. PaO2 E. Preload
A B
The nurse should monitor for which clinical manifestations in the patient diagnosed with mild hypothermia? (Select all that apply.) A. Ataxia B. Shivering C. Cardiac dysrhythmias D. Oliguria E. Hypoglycemia
A, B
As the nurse caring for a patient on a cardiac monitor, you understand which of the following steps are necessary to correctly identify the rhythm? (Select all that apply.) A. Determine the rate. B. Determine the regularity. C. Determine if there is a QRS for every P wave. D. Determine if there is a P wave for every QRS. E. Determine if there is a U wave for every QRS.
ABCD
Key patient teaching points for AF include which of the following? (Select all that apply.) A. Medications for HR control B. Bleeding precautions C. Signs and symptoms of AF with RVR D. Cardioversion E. Defibrillation
ABCD
Signs or symptoms of symptomatic ventricular dysrhythmias include which of the following? (Select all that apply.) A. Hypotension B. Dizziness C. Fever D. Shortness of breath E. Hypertension
ABD
While educating a patient about AF, the nurse informs the patient that which of following can be symptoms of AF? (Select all that apply.) A. Shortness of breath B. Hypotension C. Weight loss D. Dizziness E. Sweating
ABDE
A patient has VF. The nurse understands that the most effective treatment besides CPR is which of the following? A. Antiarrhythmics B. Defibrillation C. Ventilation D. Epinephrine
B
The nurse understands tracheal deviation in a newly admitted patient to the emergency department is typically caused by which of the following? A. Hemothorax B. Tension pneumothorax C. Flail chest D. Subcutaneous emphysema
B
The nurse understands which hemodynamic parameters are consistent with hypovolemic shock? A. Decreased cardiac output, decreased systemic vascular resistance, decreased right atrial pressure B. Decreased cardiac output, increased systemic vascular resistance, decreased right atrial pressure C. Decreased cardiac output, increased systemicvascular resistance, increased right atrial pressure D. Decreased cardiac output, decreased systemic vascular resistance, increased right atrial pressure
B
What is one clinical manifestation of obstructive shock? A. Increased urine output B. Muffled breath sounds C. Decreased appetite D. Hyperactive bowel sounds
B
Your patient requires immediate cardioversion, which is defined as which of the following? A. A controlled electrical shock that is triggered by and fires on the P wave B. A controlled electrical shock that is triggered by and fires on the R wave C. A controlled electrical shock that is triggered by and fires on the T wave D. An electrical shock that fires randomly during the cardiac cycle
B
The nurse should monitor for which of the following clinical manifestations in a patient diagnosed with hypothermia? (Select all that apply.) A. Swelling and pain B. Bradycardia C. Arrhythmias D. Alkalosis E. Altered mental status
B C E
A patient comes into the emergency room seeking treatment for radiation burns. What should be considered prior to providing care to this patient? A)Pathway of flow through the body B)Duration of contact with the agent C)Type, dose, and length of exposure D)Temperature to which the skin is heated
C
The nurse understands that the normal conduction pathway for the heart is which of the following? A. AV → SA → Ventricles → Purkinje fibers B. Purkinje fibers → AV → Ventricles → SA C. SA → AV → Ventricles → Purkinje fibers D. Ventricles → Purkinje fibers → SA → AV
C
Which statement by the patient about snake bites indicates the need for further teaching? A. "So I should return immediately if I develop swelling, redness, and an increase in pain." B. "If I have dark or bloody urine, I should seek immediate medical attention." C. "It's okay to pick up a snake right after it died." D. "I should return if I start vomiting or have shortness of breath."
C
The nurse anticipates which of the following in the initial care of a patient with ARDS? A. Inotropic agents B. IV fluids C. Anticoagulants D. Positive-pressure ventilation
D
The nurse understands transcutaneous pacing is necessary for which symptomatic patient? A. Sinus tachycardia B. Sinus rhythm with PACs C. Atrial fibrillation D. Complete heart block
D
Which of the following dysrhythmias requires defibrillation? A. Atrial tachycardia B. Atrial fibrillation C. Ventricular tachycardia with a pulse D. Ventricular fibrillation
D
What is the second step in the sepsis continuum? A. Multiple organ dysfunction syndrome (MODS) B. Sepsis C. Septic shock D. Systemic inflammatory response syndrome (SIRS)
D FIRST IS INFECTION
The nurse understands the following are clinical manifestations of neurogenic shock. (Select all that apply.) A. Tachycardia B. Vasoconstriction C. Tachypnea D. Decreased right atrial pressure E. Bradycardia
D E