FINAL

DOBUTAMINE MATH.

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Hospitalized patient may display certain behavior changes that... some of the changes exhibited may be: A. Auditory hallucinations only B. Delusion, dementia, visual disturbances C. Loss of sense of time E. Drowsiness, confusion, incoherent

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Medications that primarily dilate veins will decrease... A.Tissue oxygenation B.Contractility C.Afterload and Contractility D.Preload

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The nurse is caring for a newly diagnosed septic patient. The patient has a serum acid level of 8 mmol/L and fluid resuscitation has been started. Which of the following indicates that the fluid resuscitation received by the patient is adequate? A. Central venous pressure of 6 mmHg B.Nitrate output of 0.2 mL/kg/hr C. Sev O2 of 60% D. Mean arterial pressure (MAP) of 70 mmHg

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78-year-old man slipped on icy steps 2-weeks ago. He has Plavix for CAD. ?

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PVCs are considered precursor to ventricular tachycardia when... A.Occur at QRS complex B.Occur at the rate more than 6/min C.They have same shape D.Occur with the normal beat

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Which of these patients should be prioritized? a. 30 year old having severe abdominal pain b. 7 year old with blood sugar of 850 c. 20 year old has fruity breath and rapid respirations d. 65 year old with blood sugar mildly thirsty

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A 65-year-old patient came into the ED reporting light headedness, chest pain, and shortness of breath. You finished the assessment, physician enters and orders tests to diagnose the problem. Which test is used to identify arrhythmia? A.Electrocardiogram B.Cardiac stress test C.Echocardiogram D.Troponin levels

A

A Which of the following is a preferred IV solution in burned patients? a. LR b. NS C. D5 d. TPN

A

A patient has been brought to the ED with multiple trauma after a motor vehicle accident. After immediate threats to life have been addressed, the nurse and trauma team should take what action? A)Perform a rapid physical assessment B)Initiate health education C)Perform diagnostic imaging. D)Establish the circumstances of the accident.

A

A patient is admitted with chest pain. The nurse monitors the patient and notifies the physician when the client exhibits: a. Adventitious breath sounds b. Apical rate change from 104 to 80 bpm c. Decrease frequency of PVC of 4/min d. Troponin levels < 0.035 ng/mL

A

A patient is suspected of having a pheochromocytoma and is having diagnostic tests done in the hospital. What symptoms does the nurse recognize as most significant for a patient with this disorder? A. blood pressure varying between 120/86 and 240/130 mmHg B.heart rate of 56-64 bmp C.shivering D.complaints of nausea

A

Client has an intra-aortic balloon pump with contrapulsation catheter in the aorta. This works by: A.Increasing coronary artery flow during diastole B.Reducing left ventricular pressure during diastole C.Increasing left ventricular pressure during diastole D.Reducing aortic pressure during diastole

A

Critical care nurse is taking care of a patient with endotracheal tube on a ventilator. The nurse knows that meticulous airway management of the patient is necessary. What is the main rationales for that? A.Maintain the patent airway B.Preventing the need for suctioning C.Maintaining the sterility of the patient's airway D.Increasing the patient's lung compliance

A

Patient is receiving dopamine for treatment of shock. What is dopamine used for? A. Increased myocardial contraction, increasing blood pressure.

A

The charge nurse in the ED admits a homeless man with a core temperature of 33.2 C (91.7 F). What is the priority intervention? a. Address the patient's hypothermia b. Address the patient's frostbite on his feet C. Address the patient's alcohol indication d. Address the patient's malnutrition

A

The nurse addresses the patient with Hashimoto's Thyroiditis. Which of the following accompanies the disease: A.Numbness and tingling in the fingers B.Bulging eyes C.Palpitations D.Flushed skin

A

The nurse caring for a patient with a dysrhythmia understands that P-wave on an ECG represents which phase of the cardiac cycle? A.Atrial depolarization B.Atrial repolarization C.Ventricular depolarization D.Ventricular repolarization

A

The nurse is admitting a patient with diagnosis of unstable angina. After 12-lead ECG is done, what is indicative of "coronary artery ischemia?" A.ST segment elevation B.Significant Q waves C.Peak T-waves D.Inverted P-waves

A

The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond? A)Recognize that the view of the electrical current changes in relation to the lead placement. B)Recognize that the electrophysiological conduction of the heart differs with lead placement. C)Inform the technician that the ECG equipment has malfunctioned. D)Inform the physician that the patient is experiencing a new onset of dysrhythmia

A

The nurse knows to treat ISADH she will have to monitor patient's I&O because of: A.Restriction of fluid to 500- 1000 cc within 24 hours B.Push fluids greater than 3,000 cc/day C.Administer hypotonic saline IV D.Hematuria

A

The patient in the Neurological Intensive Care Unit (NICU) following a spinal cord injury. Which of the following assessment findings indicate the patient may be experiencing neurogenic shock? A.HR 48 bpm, BP 90/60 mmHg B. Cool, moist skin C. HR 120 bpm, BP 88/55 D. Shortness of breath

A

The patient with Grave's disease is getting radioactive iodine. Why is the therapy given? A.A radioactive iodine is designed to destroy the over functioning thyroid B.High level of radioactivity prohibits contact with... C.It takes 6 to 8 weeks after treatment to experience relief D.Following initial dose, subsequent treatment needs...

A

What is the primary goal of antidysthymic drug therapy for a patient who has been successfully cardioverted? A.Maintain normal sinus rhythm B.Proof of increased cardiac contractility C.Suppression of original dysrhythmia D.Increase in BP

A

When Glucagon is administered for hypoglycemia, it acts by: A.Liberating glucose from hepatic stores of glycogen B.Supplying glycogen to the brain and other organs C.Competing for insulin and blocking the action of tissue D.Providing a glucose substitute for rapid replacement of deficits

A

Which neurotransmitter communicates between muscle and nerve? A.Acetylcholine B.Dopamine C.GABA D.Serotonin

A

Which of the following assessments would indicate the patient is experiencing Thyroid Storm? A.HR 140, temp 39 C, confusion B.HR 80, temp 36.5 C, emotional C.HR 132, temp 37.5 C, agitation D.HR 160, temp 36 C, lethargic

A

You are caring for a patient with spinal cord injuries. What level of injury affects diaphragm? A.C4 B.T10 C.T12 D.T4

A

As the charge nurse, you assign colostomy teaching for a patient scheduled for discharge. The patient's family takes the patient home early and teaching is not performed. Who is responsible for missed teaching? A.Nurse B.charge nurse C. MD

A (Primary) OR B

The positive diagnosis of Myasthenia Gravis can be reached using the following: A. Anticholinesterase level B.MRI C.CT Scan D.Electromyography

A OR E?

A patient has a diagnosis of hypertrophy of the heart muscle, which correlates with cellular adaptation to injury. What findings does the nurse expect to occur? Select all that apply. A. Compromised cardiac output B. Cellular alteration compensatory to some stimulus C. Increased cardiac output D. Decreased cell size E. Muscle mass changes evidence on radiologic examination

A, C, E

Which of the following is a potential cause of PVC? Select all that apply. A.Hypokalemia B.Alkalosis C.Hypovolemia D.Hypomagnesaemia E.Bradycardia

A,D

16. Syndrome of IADH is associated with hyponatremia seen more frequently in... A.. Small lung cancer

A.

Which of the following describes the valves used in replacement surgery? A.Autograft B.Allograft C.Homograft D.Xenograft

A.

A patient is being treated in the ICU for neurogenic shock secondary to a spinal cord injury. Despite aggressive intervention, the patient's mean arterial pressure (MAP) has fallen to 55 mmHg. The nurse should gauge the onset of acute kidney injury by referring to what laboratory findings? Select all that apply: A.BUN levels B.Urine specific gravity C.Alkaline phosphate level D.Creatinine level E.Serum albumin level

A. B. D.

Identify the sequences of nursing management with a patient who has brain/spinal cord injury? Prevent further injury Assess head injury Establish airway Cover hemorrhage

Airway, cover, assess head, prevent

A nurse is caring for a patient with metastatic bone cancer who complains of excessive thirst and frequent urination. The patient's reflexes are hypoactive, and there is some mental confusion. The nurse determines the patient is mostly experiencing: A. Hyperkalemia B. Hypercalcemia C. Hypernatremia D. Hyperphosphatemia

B

A patient is considered in hypertensive crisis with a following criteria: A.The BP is over 160/80 B.Failure of adrenergic drive to lower BP C.Elevated BP along with renal insufficiency D.Reducing aortic pressure during diastole

B

A person suffering from Carbon Monoxide poisoning: A.Presents with severe hypertension B.Appears intoxicated C.Will always present with cherry red skin D.Appears hyperactive

B

An oncology client has been diagnosed with thrombocytopenia following chemotherapy. A priority for this client is to prevent: A.Pain related to spontaneous bleeding B.Trauma related to decreased platelet count C.Tissue integrity loss due to decreased perfusion D.Alteration in nutrition due to anorexia

B

Antihypertensive drug should never be discontinued suddenly because: A.Renal damage B.Accelerated hypertension C.Angina D.Severe hypotension

B

Elevated D-dimer and prolonged PTT may indicate: A.Metastatic liver disease B.DIC disorder C.Hypovolemia D.Pulmonary edema

B

Nurse is asked to evaluate the degree of consciousness of a brain dead patient. Pupils are dilated and don't react to light, arms and legs are extended rigidly. A.Semi-comatose B.Coma C.Brain dead D.Vegetative state

B

Patient working in the chemical factory sustained a chemical burn to his arm. The chemical is white phosphorus. What is the priority intervention? A.Douching a large amount of water B.Brushing off C.Covering the burnt area to be spread D.Applying ice

B

Propylthiouracil (PTU) derivatives are administered to ___ A.Hyperthyroid to prevent thyroid storm B.Hyperthyroid to interfere with the synthesis of the thyroid hormone C.Hyperparathyroid to promote uptake of calcium. D.Hypothyroid to increase the metabolic rate by rebound activities

B

The acute medical nurse is preparing to wean a patient off the ventilator. Which assessment parameter is most important for the nurse to assess? A.Fluid intake for the last 24 hours B.Baseline arterial blood gas (ABG) levels C.Prior outcomes of weaning D. Electrocardiogram (ECG) results

B

The nurse assesses the patient with Cushing's syndrome and recognizes it results from: A.Sodium and water depletion B.Sodium and water retention C.Decrease mineral corticoids secretion D.Decrease glucocorticoid secretion

B

The nurse is working with a newly diagnosed patient with hypothyroidism. Diagnostic tests indicate that the patient's health problem is caused by anterior pituitary dysfunction. Hypothyroidism is a deficiency in: A.TRH B.TSH C.Both of them

B

The nurse would assess a patient with hyperthyroidism for which of the following manifestations? A.Increased weight gain B.Flushed, moist skin C.Menorrhagia D.Bradycardia

B

The patient comes to the ER complaining of vision changes, nausea & vomit, diarrhea. The patient reports he was out spraying pesticides on his farm. What agent is responsible for this? a. Vesicant b. Nerve agent C. Blood agent d. Pulmonary agent

B

What is the primary nursing intervention in a care of patient with burn exceeding 20% A.Prevent infection B.Fluids C.Endotracheal tube placement D.Restrict intake and output

B

Which term refers to injury that occurs when a person is caught in-between as he is compressed by machinery? A.Blunt trauma B.Crush injuries C.Penetrating abdominal injuries D.Intrabdominal injuries

B

You need to delegate task to a nursing assistant. Which of the following criteria to follow: A.Team member preference B.Appropriateness of assignment C.Learning needs of the team members D.Compatibility of the team member and patient

B

A patient has been admitted to the critical care unit with a diagnosis of Thyroid Storm. Patient's immediate care includes: (select all that apply) A.Administer diuretics to prevent fluid overload B.Administer beta blocker to reduce heart rate C.Administer insulin to reduce blood glucose level D.Apply interventions to reduce patient's temperature E.Administer corticosteroids

B, D

A patient reports he was out spraying pesticides on his farm. What agent is responsible for this? A.Vesicant B.Nerve agent C.Blood agent D.Pulmonary agent

B.

Your patient has a history of mediastinal cancer and you suspect SIADH because: A.Sodium 150 mEq/L B.Serum osmolality 220 mEq C.Urine specific gravity 1.010 D.Urine output 2200 mL/24 hr

B.

A 46-year-old male client sustained a closed-head injury 4 hours ago. He now presents to the Emergency Department because he is having difficulty breathing. This is a result of swelling around the: A. cerebrum. B. thalamus. C. medulla oblongata. D. pituitary.

C

A patent receiving burns to his entire back and left arm using the "Rule of 9": A.9% B.18% C. 27% D.16%

C

A patient exhibiting nystagmus, ataxia, unsteady gait and problems. Probably has a lesion in the: A.Frontal lobe B.Temporal C.Cerebellum D.Hypothalamus

C

A patient has thin extremities but obese "truncal area and buffalo hump." Patient also has c/o weakness and disrupted sleep pattern. A.Hyperthyroid B.Grave's disease C.Cushing's syndrome D.Addison's disease

C

After teaching nursing student about substance abuse and their effect, instructor determines that additional teaching is necessary following: A. Substance abuse is widespread occurring B. Substance abuse involves use of alcohol C. Individuals frequently engage in substance abuse to enhance their decision making ability. D. People experiencing substance abuse

C

During assessment the nurse knows that the most frequent sign of Multiple Sclerosis is: A.Depression B.Double vision C.Fatigue D. Pain

C

Etiology risk factors for disseminated intravascular coagulation (DIC) include: A.Shock, renal insufficiency, nausea, vomiting and diarrhea B.Cardiogenic shock, MI, intravascular hemolysis C.Shock, infection, acute leukemia, intravascular hemolysis D.Septicemia, thrombocytopenia

C

For a patient with an endotracheal tube, which action is the most important? A.Turning the patient from side to side B.Monitoring ABG results every 4 hours C.Auscultating lungs for bilateral breath sounds D.Providing frequent oral hygiene

C

High priority nursing diagnosis for the above patient A.Deficit fluid volume r/t fluid shifting B.Impaired urinary elimination r/t renal hypofunction C.Impaired gas exchange r/t progressive respiratory failure D.Ineffective thermal regulation r/t increased metabolic rate

C

Initial first-aid rendered at the scene of the fire includes preventing further tissue damage through heat exposure. Which intervention could contribute to further hypoxia and necrosis, and therefore should be avoided: a. Removal of clothing b. Irrigation of the wound c. Application of ice d. Removal of hair

C

One of the reasons to give Mannitol is to___ A.Diuresis of 500 ml in 12 hours B.Weight loss of 1 kg and serum creatinine of 0.3 C.Improve level of consciousness and normal ICP D.Serum Creatine of 1.2 and normal ICP

C

Patient is admitted to ICU following MVA. She has prior blood infusing. Day 2 ABG are: pH 7.23, PO2 79.5, 90% FiO2, pCO2 50%, BUN 35, Creatine 3.4. Patient is most susceptible to: A.Increased EF (ejection fraction) B.Increased ICP C.Multiple Organ Dysfunction Syndrome (MODS) D.Acute renal failure

C

The initial neurologic symptoms of GBS: A.Absent tendon reflex B.Headache C.Paresthesia of the legs D.Transient hypertension

C

The nurse caring for a young man in need of an anti-inflammatory agent recognizes that taking... will result from the administration of which secretion of the adrenal cortex? A.Androgens B.Norepinephrine C.Glucocorticoids D.Mineral corticoids

C

When obtaining vital signs in a patient with aortic regurgitation the nurse would check for: A.Hypertension B.Hypotension C.Widening pulse pressure D.Tachycardia

C

While assessing the patient, the nurse observes constant bubbling in the water-seal chamber of the patient's closed chest-drainage system. What should the nurse conclude? A. The system is functioning normally B. The patient has a pneumothorax C.The system has air leak D. The chest tube is obstructed

C

Head trauma; brain tumor, or surgical excision of the pituitary gland can lead to what condition? A.Addison's disease B.Cushing's syndrome C.Diabetes Insipidus D.Hypothyroidism

C.

Stroke victim is experiencing memory loss and impaired learning experiences. Which lobe is affected? A.Temporal B.Parietal C.Frontal D.Occipital

C.

The hospital has EOF and the committee is discussing the consequences of the plan. During the post-incidence response of the EOP, what activity will take place? A.Deciding when the facility will go from disaster response to planned action B.Conducting practicing drills for the community and public C.Conducting a critique and debriefing for all involved in the incident D.Replacing the facility's resources

C.

Your client develops SIADH. Part of the medical treatment includes: A.Encourage fluid intake to 3000 cc/day B.Hydrocortisone 100 mg IV daily C.Restrict fluids to 1000 cc/day D.Calcitonin 100 IV/day

C.

A 53-year-old female carrying a load of laundry falls while descending stairs. She regains consciousness but complains of severe headache. No neurological deficits are apparent for hematoma or skull fracture. Based on this finding, what is the probable cause of the headache? A.Sinusitis B.Acute cervical strain C.Cerebral contusion D.Cerebral concussion

D

A client has been diagnosed with lymphoma and complains to the nurse of increasing shortness of breath and difficulty swallowing. The nurse observes that the client has edema with distended jugular veins. The nurse determines that the findings are indicative of: A.Pulmonary embolus B.Cardiac tamponade C.Spinal cord compression D. Superior vena cava syndrome

D

A patient has been diagnosed with Addison's disease. The nurse should ask the patient for which clinical manifestation characteristic? A.Hypertension and hyperglycemia B.Hypothermia and emaciation C.Obesity and hypokalemia D.Hypotension and hyponatremia

D

A patient working in a chemical facility sustains a chemical burn to his arms. The chemical involved was white phosphorus. Which of the following would be the priority nursing action? a) Dousing the area with large amounts of water b) Applying ice to the burned area c) Covering the burned area to prevent further spread d) Brushing off all traces of the chemical from the patient's skin

D

Effective intervention is decreasing absorption of ingested poison using: A.Syrup B.Milk dilution C.Gastric lavage D.Activated charcoal

D

The ICU nurse is caring for a patient in shock and is administering a vasoactive drug. She knows that a vasoactive drug should be administered in what way: A.Gravity infusion B.IV push for faster onset C.Peripheral IV set with needle gauge beginning at 21 D.Central venous line

D

The etiology of Ischemic stroke would include: A.Intracerebral hemorrhage B.Arteriovenous malformation C.Cerebral aneurysm D.Cardiogenic embolus

D

The nurse will become alert to coworker's substance abuse problem most likely due to: A.Request from the individual to work additional shifts B.Person asking to borrow money from others C.Deterioration in work habits D.Individual starts asking for a registry

D

When planning care of patient with Type II DM, the nurse identifies priority: A.Maintain a low carb, high protein diet B.Maintain ideal body weight C.Maintain daily insulin administration D.Prevent complications of insulin therapy

D

Which of the following is considered a vesicant (blistering agents)? a. Sarin b. Hydration cyanide C. Chloride d. Nitrogen mustard

D

Which serum digoxin level would the nurse interpret indicating digoxin toxicity? A.0.6 ng/mL B.1.3 ng/mL C. 2.4 ng/dL D.> 3.0 ng/dL

D

A client with diabetes is in the Emergency Department (ED) because of vomiting, diarrhea, and weight loss of 8 pounds over 2 days. Vital signs taken by the triage indicate the client is in hypovolemic shock. Place the nurse's steps in the correct order: A.Initiate an intravenous (IV) site and prescribed IV fluids B.Collect a stool specimen for culture C.Assess the capillary blood glucose level D. Place the client in the modified Trendelburg position

D. A . C. B.

Calculate the infusion rate of insulin in order to achieve a starting infusion of 5 units/hr. Fluid bag contains 500 ml of 9% and 100 units of regular insulin. A.1 ml/hr B.2 ml/hr C.5 ml/hr D.10 ml/hr E.25 ml/hr

E

When the nurse receives a physician's progress notes for a patient who showed Battle's sign. (know what Battle's sign is) Probably something about "area of ecchymosis (bruising) is seen over the ear is seen in a Basilar skull fracture"

Mastoid bone, basilar skull

Major structure balancing the rapid action of the nervous system with slower hormonal action is the: ____

Hypothalamus.

A nurse witnesses a patient going into pulmonary edema. The patient exhibits respiratory distress but the blood pressure is stable at this time. While waiting for help to arrive, the nurse performs the following actions in which order of priority? Re-check vital signs Call the respiratory therapy department for a vent Places the patient in High Fowler's position Place the patient on pulse oximeter and cardiac monitor Administer the patient's morphine sulfate IV injection as needed Begin the patient's Oxygen at 2 liters by nasal cannula as needed

Position, 02, 0x, VS, Morphine, RT