Anesthesiology, Intensive Care and Nursing
A client is admitted to the hospital with a possible diagnosis of myocardial infarction. What description of the character of pain should the nurse expect when assessing this client's pain? a) Severe, intense chest pain b) Burning chest pain of short duration c) Mild chest pain, radiating toward the abdomen d) Squeezing chest pain, relieved by nitroglycerin
A
A client is diagnosed with cancer of the larynx. Before a total laryngectomy, an important aspect of preoperative nursing care includes: a) Answering questions b) Having a speech therapist visit c) Teaching postoperative breathing exercises d) Explaining the nature of the surgery to be performed
A
A client who is suspected of having Cushing's syndrome is admitted to the hospital. The nurse plans to monitor this client for: a) Hypokalemia b) Hypovolemia c) Hypocalcemia d) Hyponatremia
A
A nurse is caring for a client who was diagnosed with a myocardial infarction. While caring for the client 2 days after the event, the nurse notices that the client's temperature is elevated. The nurse concludes that this increase in temperature is most likely the result of: a) Tissue necrosis b) Venous thrombosis c) Pulmonary infarction d) Respiratory infection
A
After surgery a client's fever does not respond to antipyretics. The practitioner orders that the client be placed on a hypothermia blanket. The nurse expects that one reaction to hypothermia therapy that should be prevented is: a) Shivering b) Vomiting c) Dehydration d) Hypotension
A
The compensation of alkalosis is a) hypoventilation b) hyperventilation c) low cardiac output d) jaundice
A
The main causes of acidosis are the following, except: a) vomiting b) diabetic ketoacidosis c) uremia d) lactic acidosis
A
The primary responsibility of the nurse when caring for an underwater seal drainage system is to: a) Ensure maintenance of the closed system b) Maintain mechanical suction to the system c) Encourage the client to deep breathe and cough d) Keep the client in the dorsal recumbent position
A
The risk factors of pulmonary embolism are the following, except: a) pneumonia b) malignancy c) bedrest d) 4. previous surgery
A
The signs of right heart failure are the following, except: a) pulmonary edema b) high central venous pressure c) enlarged liver d) pedal edema
A
Multiple Choice ECG diagnosis of myocardial infarction a) ST elevation > 1 mm in the limb leads b) ST elevation > 2 mm in the chest leads c) new onset left bundle branch block d) new onset right bundle branch block
A (A,B,C)
Multiple Choice Signs of chronic alcoholism a) testicular atrophy b) hairless chest c) spider naevus d) cataract
A (A,B,C)
Multiple Choice What kind of drinks are contraindicated six hours before surgery? a) milk b) fruit juice with pulp c) yoghurt d) water
A (A,B,C)
.........................is the gold standard for diagnosis of myocardial infarction a) CKMB b) troponin c) ALAT/ASAT d) lactate dehydrogenase
B
A client has a tracheostomy tube attached to a tracheostomy collar for the delivery of humidified oxygen. The nurse identifies that the client will need suctioning primarily if the: a) Humidified oxygen is saturated with fluid b) Tracheostomy tube interferes with effective coughing c) Inner cannula of the tracheostomy tube irritates the mucosa d) Weaning process increases the amount of respiratory secretions
B
A client is admitted to the emergency department with a stab wound of the chest. What is the priority when the nurse performs a focused assessment of the client's response to this injury? a) Level of pain b) Quality and depth of respirations c) Amount of serosanguineous drainage d) Blood pressure and papillary response
B
A client is diagnosed as having type 2 diabetes, and the practitioner prescribes an oral hypoglycaemic. The nurse should include in the teaching plan that people taking oral hypoglycemics: a) Should not work where food is readily available b) May tend to relax dietary rules on an unconscious level c) Do not need to be concerned about serious complications d) Have less fear of their condition than those who take insulin
B
A client with chronic obstructive pulmonary disease is admitted to the hospital with a tentative diagnosis of pleuritis. When caring for this client the nurse should: a) Administer opioids frequently b) Assess for signs of pneumonia c) Give medication to suppress coughing d) Limit fluid intake to prevent pulmonary edema
B
A nurse anticipates occasional but serious problems with hypoxia among postoperative clients. When caring for a client after surgery, the client reports shortness of breath and chest pain. Which is the most appropriate initial response by the nurse? a) Initiate oxygen via a nasal cannula b) Administer the prescribed morphine c) Prepare the client for endotracheal intubation d) 4. Place a nitroglycerin tablet under the client's tongue
B
If the cardiac output is 5 l/min, the heart rate is 100/min, the stroke volume is a) 500 ml b) 50 ml c) 5 ml d) cannot be calculated
B
Low........................... has high negative predictive value in pulmonary embolism a) troponin b) CKMB c) D-dimer d) 4. bilirubin
B
The jargon PIRO (sepsis) includes the following, except: a) predisposition b) identification c) response d) organ dysfunction
B
The warning sign which should be reported immediately to the medical emergency team: a) respiratory rate 20/min b) systolic blood pressure lower than 70 mmHg c) pulsoxymetry 97 % d) heart rate 92/min
B
We take the blood gas of a 24-y-o woman. ABG results are: pH= 7.33 PaCO2= 25 mmHg HCO3=12 mmol/l PaO2= 89 mmHg The following statement is true: a) the ABG is alkalotic b) the ABG is acidotic c) the pH is neutral d) the pH is erroneous
B
Multiple Choice After stroke you should maintain high a) blood pressure b) respiratory rate c) oxygen saturation d) blood sugar
B (A,C)
Multiple Choice In case of septic shock which of the following drugs should be given? a) crystalloids b) digoxin c) norepinephrine d) furosemid
B (A,C)
Multiple Choice In the case of elective Caesarian section the following drugs should be given before the operation a) H2 antagonist b) midazolam c) sodium citrate d) apple juice
B (A,C)
Multiple Choice Before general anesthesia you should remove the ... of the patient a) nail polish b) mustache c) removable denture d) pacemaker
B (B,D)
A client is to receive an IV antibiotic in 50 mL of 0.9% sodium chloride to be administered over 20 minutes. At what rate should the nurse set the infusion pump? a) 100 mL/hr b) 2.5 mL/hr c) 150 mL/hr d) 120 mL/hr
C
A client who is complaining of severe midsternal pain is brought to the emergency department. The practitioner diagnoses myocardial infarction. Which drug can the nurse expect to be prescribed to control the pain associated with myocardial infarction? a) Xanax b) Demerol c) Morphine d) Lidocain
C
A client with a rigid and painful abdomen is diagnosed with a perforated peptic ulcer. A nasogastric tube is inserted and surgery is scheduled. Before surgery, the nurse should place the client in the: a) Sims position b) Flat-lying position c) Semi-Fowler's position d) Dorsal recumbent position
C
An older adult, who is complaining of fatigue, is admitted to the hospital with a diagnosis of chronic obstructive pulmonary disease (COPD). What should the nurse plan to do to respond to the client's fatigue? a) Provide small, frequent meals b) Encourage pursed-lip breathing c) Schedule nursing activities to allow for rest d) Encourage bed rest until energy level improves
C
Suspected or proven infection +signs of SIRS is a) infection b) local infection c) sepsis d) species
C
The signs of acute renal failure are the following, except: a) creatinine increase b) urea nitrogen increase c) troponin release d) 4. decreased urine output
C
Multiple Choice When can you apply noninvasive ventilation? a) if the patient is unconscious b) cooperating patient with pulmonary edema c) facial trauma patient d) COPD patient with hypoxia
C (B,D)
A 35- year-old male who sustained a closed head injury is being monitored for increased intracranial pressure. Arterial blood gases are obtained and the results include a PCO2 of 33 mm Hg. It is most important for the nurse to: a) Encourage the client to slow his breathing rate b) Auscultate the client's lungs and suction if indicated c) Advise the practitioner that the client needs supplemental oxygen d) Inform the practitioner of the results and continue to monitor for signs of increasing intracranial pressure
D
A client is admitted to the hospital for replacement of the mitral valve. Postoperatively the pulses in the client's legs are assessed frequently by the nurse. The primary purpose of this intervention is to detect: a) Atrial fibrillation b) Postsurgical bleeding c) Arteriovenous shunting d) Peripheral thrombophlebitis
D
A client with the diagnosis of inhalation anthrax is admitted to the intensive care unit. Which category of adaptations is most important for the nurse to make a focused assessment of? a) Mental b) Hydration c) Neurologic d) Respiratory
D
Initial treatment of sepsis includes the following, except.... a) volume resuscitation b) early goal directed therapy c) early antibiotic treatment d) proper identification of the infective agent
D
The signs of left heart failure are the following, except a) low cardiac output b) pulmonary edema c) oliguria d) peptic ulcer
D
The types of hypoxia are the following, except: a) hystotoxic b) hypoxic c) anemic d) metastatic
D
Multiple Choice Indication of heparin (LMWH or unfractionated) in the perioperative period a) pulmonary embolism b) myocardial infarction c) atrial fibrillation d) cataract surgery
D (D)
Multiple Choice Complications of prolonged orotracheal intubation a) sinusitis b) vocal cord injury c) tracheo-oesophageal fistula d) tracheastenosis
E (ALL)
Multiple Choice Contraindication of nitroglycerin administration a) 1.SAP <100 mmHG b) right ventricle infarction c) allergy d) sildenafil (Viagra) in the last 24 hours
E (ALL)
Multiple Choice DC shock cannot be performed, if a) patients has PEA -pulseless electric activity b) patient has asystolia c) patient lies in water d) patient is attached to metal
E (ALL)
Multiple Choice Hepatic coma is characterized by a) jaundice b) coagulation abnormality c) ascites d) encephalopathy
E (ALL)
Multiple Choice Possible complications of spinal anesthesia a) hypotension b) postdural puncture headache c) cardiac arrest d) general toxicity of local anesthetics
E (ALL)
Multiple Choice The following drugs can cause significant reduction in renal function a) NSAID b) aminoglycosids c) furosemid d) contrast dye
E (ALL)
An adult patient generally needs 10-12 ml air for endotracheal tube cuff blowing.
F
An anatomical blind area is the path between respiratory tracts and the alveolar part.
F
An unconscious patient with mechanical ventilation should have oral hygiene not more often than every 6 hours.
F
Noninvasive blood pressure testing facilitates continuous monitoring.
F
Parenteral feeding has advantages over enteral feeding.
F
Taking invasive blood pressure is not reasonable in case of a septic patient.
F
A patient in critical condition has a deteriorating ability to use oxygen.
T
Capnography (EtCO2) is the monitoring of the concentration of CO2 in the respiratory gases, usually presented as a graph of expiratory CO2 plotted against time.
T
Circulation collapse caused by atrial fibrillation requires immediate electrical cardioversion.
T
In case of chest injury, central venous cannulation is necessary on the injured side.
T
Pain results from tissue damage.
T
Profuse diarrhea is characterised by hypothonic hypohydration.
T
The height of a person is not part of the parameters of daily energy needs.
T
The pressure in the central vein gives information about the left ventricle's filling pressure.
T
The pressure in the central vein shows higher values in case of pericardial tamponade.
T