FINAL QUIZZES AND KAHOOT
How much bolus fluid would a child weighing 18 kg receive? A. 60 B. 180 C. 360 D. 500
B, C
Which of the following relates to the concept of contractility? (Select all that apply) A. Ejection Fraction B. Right Atrial Pressure C. Cardiac Index D. Central Venous Pressure E. Stroke Volume
A, C, E
A cell or group of cells that can initiate a cascade of electrical activity in the heart has what property? A. Automaticity B. Ectopy C. Independence D. Automatism
A.
Resistance or pain with flexion of hip and knee A. Opisthotonic position B. Brudzinski sign C. Kernig's sign
C.
Which of the following are interventions to reduce risk for VAP (select all that apply) A. Hand washing B. Closed in-line suctioning every 4 hours C. Turn the patient's sedation off at least once a shift D. Administer omeprazole E. Administer Lovenox SQ F. Trendelenberg positioning
A, C, D, E
Which of the following is a normal CPP value? A. 20 B. 40 C. 80 D. 0
C.
What is the significance of a high serum lactate level? A. Decreased cardiac contractility B. Kidney failure C. Active Infection D. Hypoperfusion
D.
According to the Joseph article, a NICU nurse caring for a patient in a volume targeted ventilator mode should monitor for (select all that apply) A. nasal obstruction B. Inadvertent extubation C. Leaks around the endotracheal tube D. Purulent secretions and fever
B, C, D
What is the purposes of dialysis? SELECT ALL THAT APPLY A. Dialysis cures kidney disease B. Dialysis corrects fluid and electrolyte imbalances C. Dialysis removes waste products D. Dialysis can be used to treat drug overdoses
B, C, D
Same pediatric patient does not improve with airway adjustment. HR 65 and RR 8. What next? A. Start CPR B. Rescue breathing using BVM C. Panic D. Call for help
B, D
In the first phase of rehydration, how much NS does a child with normal BP and no history receive? A. 10 mL/kg B. 20 mL/kg C. 250 cc D. 500 cc
B.
Involuntary flexion of hips and knees when head is flexed A. Opisthotonic position B. Brudzinski sign C. Kernig's sign
B.
Patient becomes lethargic and BP 78/44. The nurse anticipates? A. Start CPR B. Synchronized cardioversion C. Adenosine D. Defibrillation
B.
SIMV Vt:500, RR:10, PEEP:5, FiO2: 30%. What happens if the patient takes an 11th breath? A. the Vt is guaranteed to be 500 B. it will be whatever volume the patient determines C. the patient can't take an 11th breath D. it will be supported by a PS of 10
B.
The BEST way to assess if a patient is hypovolemic would be to measure... A. The amount of blood in the right ventricle B. The pressure in the right atrium C. The heart rate D. Skin Turgor
B.
The Cerebrospinal Fluid (CSF) of a patient with bacterial meningitis will have? A. increased glucose, elevated WBC, and decreased protein B. Decreased glucose, elevated WBC, and increased protein C. increased glucose, slight WBC, and increased protein D. decreased glucose, normal WBC, and slight protein
B.
An 8yr old post sedation procedure develops snoring sounds and HR is 75. The RN should do 1st? A. Call a Rapid Response B. Use a bag valve mask C. Open airway D. No action needed
C.
What is the hourly maintenance fluid amount for a child weighing 14 kg? A. 50 B. 100 C. 200 D. 1200
A.
Which hemodynamic measurement involves assessing the pressure near the right atrium? A. CVP B. LAP C. SVR D. PVR
A.
A nurse is monitoring a patient with spinal cord injury. The nurse reviews the arterial blood gas (ABG) reports and notifies the health care provider that the patient may need mechanical ventilation. Which blood gas abnormality would have led the nurse to this opinion? Select all that apply. A. pH = 7.27 B. PaCO2= 55 mm Hg C. PaO2 = 80 mm Hg D. HCO3 = 26 mm Hg
A, B
A patient with chronic kidney disease is advised to undergo peritoneal dialysis (PD). What advantages of PD over hemodialysis should the nurse explain to the patient? Select all that apply. A. It can be performed at home B. The equipment setup is simple C. The procedure is simple D. A special water system is required E. There is no risk for infection
A, B, C
Which of the following are true about shock? (Select all that apply) A. Regardless of the category of shock, it will result in hypoperfusion B. Shock causes cells to shift into anaerobic metabolism C. All categories of shock will ultimately lead to low blood pressure if there is no intervention D. All categories of shock will ultimately lead to tachycardia if there is no intervention
A, B, C
Which of the following are appropriate for assessing pain in a nonverbal patient? (Select all that apply) A. Assess facial expression B. Assess Temperature C. Assess changes in heart rate D. Assess resistance to passive movement of the arms
A, B, D
Which of the following is true about Continuous Renal Replacement (CRRT). SELECT ALL THAT APPLY. A. It is indicated for hemodynamically unstable patients B. A trained ICU nurse can run it. C. Hypotension is common D. Anticoagulation is needed to prevent clotting.
A, B, D
Which of the following relate to the concept of "preload" (select all that apply) ? A. A patient with diarrhea who has a CVP of 1 B. A patient with renal failure who has missed dialysis for the past week with a RAP of 22 C. A patient with heart failure with an ejection fraction of 30% D. A patient with heart failure with a CVP of 20 E. This measure can be read using a central line
A, B, D, E
Select all that apply to meningitis management techniques in the acute stage: A. Droplet Isolation B. Reduce environmental stimulus C. Physical Therapy D. Contact Isolation E. Fluid restriction F. Rocking to comfort infant G. IV antibiotics
A, B, D, E, G
Which of the following TRUE regarding a Living Will? SELECT ALL THAT APPLY A. Allows an individual to describe specific healthcare directives and medical wishes to healthcare providers and caregivers. B. Becomes effective once the patient enters the hospital. C. Trumps Medical Power of Attorney if there is conflict D. Once effective, it controls healthcare decisions
A, C, D
A nurse is caring for a patient with a diagnosis of pulmonary edema. On admission, the patient's arterial blood gas (ABG) analysis revealed a :PaO2 of 50 mm Hg, and a PaCO2 of 25 mm Hg. The patient has been in the hospital for 15 days. A recent ABG analysis reveals a PaO2 of 90 mm Hg, a PaCO2 of 42 mm Hg, and a pH of 7.4. What do these measurements indicate? A. The patient has shown improvement. B. The patient should be intubated immediately C. The patient will develop respiratory failure D. The patient has shown no signs of improvement
A.
AC: Vt:500, RR:10, PEEP:5, FiO2: 30%. What happens if the patient takes an 11th breath? A. the Vt is guaranteed to be 500 B. it will be whatever volume the patient determines C. the patient can't take an 11th breath D. it will be supported by a PS of 10
A.
According to the Monro Kellie Hypothesis, which of the following is true? A. If the volume of the brain increases, the blood and/or CSF must decrease B. If the volume of the blood increases, the CSF and/or blood vessels must decrease C. If the volume of the CSF increases, the volume of the neurons and/or skull must decrease D. If the volume of the brain increases, the volume of the blood and CSF must also increase
A.
How would the nurse interpret the following Arterial Blood Gas? pH: 7.52 PaCO2: 47 mmHg HCO3: 36 mEq/L A. Partially compensated metabolic alkalosis B. Compensated metabolic acidosis C. Partially compensated respiratory alkalosis D. Uncompensated respiratory acidosis
A.
Hypovolemic shock causes hypoperfusion of the cells due to which of the following? A. Low intravascular volume B. Ineffective filling and/or pumping by the heart C. Obstructed venous return to the heart D. Massive vasodilation causes reduced venous blood return to the heart
A.
Neck and head hyperextended to relieve pain A. Opisthotonic position B. Brudzinski sign C. Kernig's sign
A.
The nurse is assessing a patient with Diabetic Ketoacidosis who is using Kussmaul's respirations. The nurse realizes the body is compensating for primary metabolic acidosis with: A. respiratory alkalosis B. metabolic alkalosis C. respiratory acidosis
A.
The nurse is evaluating a patient's arterial blood gases. Which value of partial pressure of carbon dioxide (PaCO2) in arterial blood indicates a compensatory response in metabolic alkalosis? A. 47 mm Hg B. 44 mm Hg C. 33 mm Hg D. 40 mm Hg
A.
The nurse is interpreting her client's Arterial Blood Gas values. What acid base balance is present? PH: 7.55 PaCO2: 21 HCO3: 10 A. Partially compensated respiratory alkalosis B. Partially compensated metabolic alkalosis C. Partially compensated respiratory acidosis D. Uncompensated metabolic alkalosis
A.
The nurse notes that an advance directive is in the client's medical record. Which of the following statements does BEST represents the description of what an advance directive is? A. A collection of legal documents empowering you to spell out your end-of-life decisions and medical care if you become unable to communicate your wishes due to terminal illness or incapacity B. A written document stating that all comfort measures associated with pain control and symptom management are carried out, but the natural physiologic progression to death is not delayed or interrupted. C. A written physician order instructing health care providers not to attempt CPR. D. A written document of patient wishes to specify the patient's wish to be allowed to die without heroic or extraordinary measures.
A.
The patient is alert and vital signs 85/55, HR 200. The RN anticipates the next action to be? A. Amiodarone B. Adenosine C. Epinephrine D. Atropine
A.
The patient is alert and vital signs 87/55, HR 200. The RN anticipates the next action to be? A. Vagal Maneuvers B. Synchronized cardioversion C. Defibrillation D. Medication
A.
Which of the following is a contraindication for using CRRT on a patient? A. If the patient has life threatening manifestations of uremia B. If the patient is unable to tolerate a rapid removal of fluid C. If the patient has any type of acid base balance. D. If the patient has a large amount of uremia toxins and hypervolemia
A.
Which of the following is a normal ICP value? A. 9 B. 23 C. 30 D. -6
A.
Which of the following is an appropriate scale to assess level of sedation in an ICU patient? A. Ramsay Sedation Scale B. ICUOPT Sedation Scale C. COPT Scale D. Wong Baker Sedation Scale
A.
Your patient has the following Ventilator settings and ABG. Ventilator Settings: SIMV: RR: 16 Vt: 500mL FiO2: 50% PEEP: 7cmH20 ABG: pH: 7.49; CO2: 29; HCO3: 22; PaO2: 89 Which of the following changes in the ventilator would the nurse anticipate? A. Turn down the respiratory rate setting- B. Turn up the respiratory rate setting C. Turn up the FiO2 D. Change the mode to AC-
A.
How do the kidneys respond to acid base disturbances? Select all that apply. A. adjusting PaCo2 levels B. excreting bicarbonate C. reabsorbing Hydrogen (H+) D. producing phosphate buffers
B, C
Your 17 year old ICU patient is on the ventilator and appears to be in pain. She is moving in bed, has a grimace on her face, and her respiratory rate is elevated. She is looking at you with a panicked face and is trying to reach her endotracheal tube with her hand. Which of the following could be considered appropriate nursing actions? (Select all that apply) A. Continue assessing the patient without intervention, these are normal responses to being on the ventilator B. Talk to the patient. Attempt to determine the cause of her discomfort. Explain where she is and the purpose of the tube in her throat. C. Turn her continuous Propofol drip rate down D. Dim the lights in the room, ask that her mother sit next to her and hold her hand
B, D
Which of the following relates to the concept of preload? (Select all that apply) A. Cardiac Output B. Right Atrial Pressure C. Percentage of blood left in the ventricle after systole D. Central Venous Pressure E. Ventricular Stretch before Systole
B, D, E
20 kg child is mildly dehydrated, taking POs. How much fluid should he take over 4-6 hours? A. 500 B. 1000 C. 1500 D. 2000
B.
A 61 year old male is receiving Pancuronium, Fentanyl, and Propofol while on the ventilator. You assess the patient's Train of Four and see the patient's hand twitch four times. Which of the following is the most appropriate nursing action? A. Turn down the Pancuronium B. Turn up the Pancuronium C. Turn off the Pancuronium D. Leave the Pancuronium at this rate
B.
A 94 year old male patient was admitted two days ago with a UTI. He has a serum lactate of 8 mmol/L, a temperature of 39 degrees C, a CVP of 1mmHg, and a blood pressure of 90/50. Which of the following is an appropriate nursing action at this time? A. Await physician orders B. Ask the patient and family about what they hope to happen during their time in the ICU C. Place the patient on palliative care immediately D. Meet with the physician privately about goals of patient care
B.
A patient has an anterior wall STEMI. Which is the best treatment for this patient? A. oxygen B. PCI C. TpA D. nitroglycerin
B.
A patient in SIMV is in resp. alkalosis. What can be changed on the ventilator to address this? A. increase PPEP B. decrease RR C. increase FiO2 D. change mode to AC
B.
A patient is in respiratory acidosis. What can be changed on the ventilator to address this? A. decrease PEEP B. increase Vt C. decrease RR D. increase FiO2
B.
A patient is just admitted to the hospital following a spinal cord injury at the level of T4. A priority of nursing care for the patient is monitoring for A. return of reflexes B. bradycardia with hypoxemia C. effects of sensory deprivation D. fluctuations in body temperature
B.
A patient on which ventilator mode MUST be able to trigger breaths AND provide WOB A. SIMV B. CPAP C. PS D. PC
B.
A patient with septic shock caused by a UTI presents with a blood pressure of 87/35. Which of the following medications should be initiated first? A. Epinephrine B. Norepinephrine C. Midazolam D. Phenylephrine
B.
A patient with septic shock has the following lab values today: Blood sample from 0800 Serum lactate: 5mmol/L Serum Sodium: 140 Blood glucose: 220 Blood sample from 1600 Serum lactate: 4.6 mmol/L Serum Sodium: 142 Blood glucose: 190 Which of the following orders should the nurse anticipate? A. IV Furosemide (lasix) 40mg stat B. Begin insulin sliding scale C. Administer Metoprolol (Lopressor ) 5mg IV D. Begin lisinopril 40mg PO/per feeding tube BID
B.
A young adult is hospitalized after an accident that resulted in a complete transection of the spinal cord at the level of C7. The nurse informs the patient that after rehabilitation, the level of function that is most likely to occur is the ability to A. breathe with respiratory support. B. drive a vehicle with hand controls. C. ambulate with long-leg braces and crutches. D. use a powered device to handle eating utensils.
B.
Acute Coronary Syndrome includes all of the following, except A. unstable angina B. stable angina C. STEMI D. NSTEMI
B.
Applying what you learned in the Joseph article, decisions on how to change ventilator settings in a NICU patient would NOT be influenced by which of the following factors? A. Requiring increasing amounts of vasopressor therapy B. A low cardiac output C. diagnosis of pulmonary fibrosis D. family support
B.
Before beginning hemodialysis, the nurse weighs the patient and then compares this weight to the patient's last postdialysis weight. What is the purpose of this assessment? A. To ensure that the patient eating a proper diet B. To determine the amount of fluid to remove from the patient C. To ensure the patient is drinking enough water D. There is no particular purpose for this assessment.
B.
CPAP: PEEP:5, FiO2: 30%. What happens if the patient takes a breath? A. the Vt is guaranteed to be 500 B. it is up to the patient to provide all WOB C. the patient can't take a breath on their own D. it will be supported by a PS of 10
B.
Calculate this patient's CPP and determine what nursing intervention is indicated MAP: 50 ICP: 7 A. CPP is 43, measures to reduce ICP are indicated B. CPP is 43, measures to increase MAP are indicated C. CPP is 57, measures to reduce ICP are indicated D. CPP is 57, measures to increase MAP are indicated
B.
Cardiogenic shock causes hypoperfusion of the cells due to which of the following? A. Low intravascular volume B. Ineffective filling and/or pumping by the heart C. Obstructed venous return to the heart D. Massive vasodilation causes reduced venous blood return to the heart
B.
Chest pain that goes away with rest would be called? A. unstable angina B. stable angina C. STEMI D. NSTEMI
B.
From the UC San Diego Medical Center video. Which of the following is true? A. The patient was not on a ventilator by the end of the video B. The respiratory therapist educated the patient's family member about the spontaneous breathing trial C. The nurse put the patient's contacts in to help her see while she was walking D. The patient needed the help of the primary physician to walk safely
B.
In septic shock, which part of the immune response causes a decrease in blood pressure? A. Profound infection B. Vasodilation and capillary permeability C. Severe hypovolemia D. Diminished neurological response
B.
The nurse provides care for a patient with respiratory alkalosis. What arterial blood gas results correspond to this condition? A. pH 7.46, pCO2 44 mm Hg, PO2 95 mm Hg, and HCO3 - 36 mEq/L B. pH 7.52, pCO2 24 mm Hg, PO2 85 mm Hg, and HCO3 - 24 mEq/L C. pH 7.30, pCO2 35 mm Hg, PO2 70 mm Hg, and HCO3 - 20 mEq/L D. pH 7.27, pCO2 70 mm Hg, PO2 80 mm Hg, and HCO3 - 26 mEq/L
B.
What is the hourly maintenance fluid amount for an infant weighing 5 kg? A. 5 B. 21 C. 250 D. 500
B.
What is the minimum urine output for an adolescent? A. 2 mL/kg/hr B. 30 mL/hr C. 1 mL/kg.hr D. unknown
B.
Which of the following is NOT a likely sign of pain in a patient who cannot verbally communicate with you? A. Eyes clenched shut when turning the patient B. Decreased respiratory rate C. Patient resists bending of her elbow when you try to contract her arm D. Heart rate of 120 in a 54 year old male
B.
Which of the following is an accurate definition of septic shock? A. An exaggerated allergic response to an allergen B. A systemic inflammatory response initiated by an infection C. Massive vasodilation caused by a neurologic injury D. Poor perfusion caused by ineffective cardiac pumping ability
B.
Which of the following is most consistent with diabetes insipidus? A. Fluid volume overload with hypernatremia B. Fluid volume deficit with hypernatremia C. Fluid volume overload with hyponatremia D. Fluid volume deficit with hyponatremia
B.
Which of the following is the most accurate reflection of blood being pumped out of the heart relative to the patient's size? A. Cardiac Output (CO) B. Cardiac Index (CI) C. Ejection Fraction (EF) D. Stroke Volume
B.
Which of the following is true about the stages of shock? A. Signs of organ decompensation such as oliguria or jaundice are evident in the initial stage B. Patients may experience tachycardia in the compensatory stage C. Patients typically become more lucid in the progressive stage, signifying their progress toward improved perfusion D. Patient prognoses typically improve as they progress to stages 3 and 4
B.
Which of the following is true regarding arteriovenous fistulas (AVF)? A. The arteriovenous fistulas (AVF) may be used the same day it is placed. B. It is created with in the arm as an anastomosis of an artery and a vein C. It is made by attaching a synthetic material to form a bridge between the artery and vein D. If a bruit is heard at the arteriovenous fistulas (AVF) site, it is no longer functional.
B.
Which of the following oral fluids would be most appropriate for a child with dehydration? A. orange juice B. pedialyte C. gatorade D. chicken broth
B.
Which of the following patients most likely needs to be sedated? A. A 24 year old male reporting 9/10 pain admitted after a motor vehicle accident with a fractured right humerus. B. A 45 year old female admitted status post gunshot wound to the abdomen. She has just undergone abdominal surgery and is coming to the ICU on a ventilator C. A 92 year old male admitted to the telemetry unit who is recovering from a right hip replacement surgery with no complications (post-op day 3) D. A 64 year old male admitted to the ICU with atrial fibrillation and a large deep vein thrombosis in his right femoral vein
B.
Which of the following would be an appropriate intervention by the nurse to reduce pain for a nonverbal patient who is fidgeting in bed? A. Change medication order from tylenol to fentanyl drip B. Increase the fentanyl drip per protocol and have a family member help you play music from the patient's cell phone C. Increase the patient's propofol drip rate within the parameters listed on the protocol D. Decrease the patient's propofol drip rate within the parameters listed on the protocol
B.
You connect the cardiac monitor and see SVT. The next action is? A. Start cpr B. Check patient C. Apply oxygen D. Prepare cardioversion
B.
You notice some abnormalities in your patient's EKG that show some parts of the heart are firing "out of turn" What would you call this? A. Automaticity B. Ectopy C. Cardiac Cycle D. Missed beat
B.
Your patient has a MAP of 70 and an ICP of 20. What is an appropriate nursing intervention? A. Continue to monitor, this is normal B. Take measures to decrease the ICP C. Take measures to decrease the MAP D. Take measures to increase the ICP
B.
Your patient reports chest tightness and is diaphoretic. Which of these do you do first? A. give metorpolol B. get a 12 lead EKG C. ask the patient to bear down D. give TpA
B.
Your patient with an AMI is waiting for a cardiac cath. What should the RN do in the meantime? A. keep the patient awake B. encourage rest to reduce oxygen demand C. prepare the patient for a stress test D. prepare the patient for intubation
B.
A 61 year old male is receiving Pancuronium, Fentanyl, and Propofol while on the ventilator. You walk in the room and the patient's BP is 200/130, heart rate is 154, and the patient is diaphoretic. You look at the ventilator screen and see no issues, you see that the patient's oxygen saturations are 98%. What is the most appropriate nursing action? A. Turn up the Pancuronium B. Turn down the Pancuronium C. Turn up the Propofol D. Turn down the Propofol
C.
A child with suspected meningitis comes into the ED, what is the nurse's first priority? A. Measure head circumference B. Antibiotics C. Contact/Droplet Precautions D. Assess vitals
C.
A patient complains of 9/10 chest "burning." What medication do you give first? A. aspirin B. morphine C. nitroglycerine D. metoprolol
C.
A patient has end-stage kidney disease and is receiving hemodialysis. During dialysis the patient complains of nausea and a headache and appears confused. On examination, the nurse finds that the blood pressure is very low. What is the priority action by the nurse? A. Transfuse blood B. Avoid excess coagulation C. Infuse 0.9% saline solution D. Infuse hypertonic glucose solution
C.
According to the study by Tanois et al. (2014), which group experienced the least amount of unplanned extubations? A. No sedation B. Intermittent sedation C. Continuous sedation with daily interruption D. Continuous Analgesia
C.
Calculate this patient's CPP and determine what nursing intervention is indicated MAP: 72 ICP: 20 A. CPP is 92, measures to reduce ICP are indicated B. CPP is 92, measures to reduce MAP are indicated C. CPP is 52, measures to reduce ICP are indicated D. CPP is 52, measures to reduce MAP are indicated
C.
Distributive shock causes hypoperfusion of the cells due to which of the following? A. Low intravascular volume B. Ineffective filling and/or pumping by the heart C. Obstructed venous return to the heart D. Massive vasodilation causes reduced venous blood return to the heart
C.
During assessment of a patient with a spinal cord injury at the level of T2 at the rehabilitation center, which finding would concern the nurse the most? A. A heart rate of 92 B. A reddened area over the patient's coccyx C. Marked perspiration on the patient's face and arms D. A light inspiratory wheeze on auscultation of the lungs
C.
How should the nurse obtain blood cultures for a patient in septic shock? A. After antibiotics have been administered B. One time, from a peripheral IV C. Two sets of samples (both samples including anaerobic and aerobic) D. This is not a routine practice for a patient with septic shock
C.
How would you measure how well a patient's heart is SQUEEZING? A. Get a chest X-ray and see how big the heart muscle is B. Measure the amount of resistance in the systemic circulation C. Measure the percentage of blood that leaves the ventricle after each beat D. Measure the amount of resistance in the pulmonary circulation
C.
If a 9 year old child's BP was 80/55, how fast would you give the bolus? A. over 20 minutes B. over 60 minutes C. as fast as possible D. whatever the doctor says
C.
In the UC San Diego Medical Center video, the nurse... A. Removes the board with pictures and personal reminders to reduce distress for the patient B. Asks the patient to describe what her pain feels like C. Explains what she is doing with the patient to the patient's family member D. Feeds the patient breakfast with the head of bed at 30 degrees
C.
The dialysis nurse is administering hemodialysis to a patient with chronic kidney failure. For what common complication should the nurse carefully monitor in this patient? A. Pneumonia B. Lower back pain C. Hypotension D. Hernia
C.
The primary care provider wrote a do-not-resuscitate (DNR) order. The nurse recognizes that which applies to the planning of nursing care for this client? A. The client may no longer make decisions regarding his or her own health care. B. The client and family know that the client will most likely die within the next 48 hours. C. The nurses will continue to implement all treatments focused on comfort and symptom management. D. A DNR order from a previous admission is valid for the current admission
C.
What is the difference between a STEMI and an NSTEMI? A. no tissue has died in a NSTEMI B. STEMI is a thrombus, NSTEMI is plaque C. the coronary artery is completely occluded in a STEMI D. STEMI is infarction, NSTEMI is injury
C.
Which of the following are reasons for a HIGH CVP? A. Right heart failure and hypovolemia B. Left heart failure and high systemic vascular resistance C. Right heart failure and hypervolemia D. Dehydration and high afterload
C.
Which of the following is NOT a common problem with most sedative agents? A. Reduced ability to clear pulmonary secretions B. Accumulation of the drug with prolonged infusion which can delay getting the patient off the ventilator C. Increased alertness D. Reduced useful REM sleep
C.
Which of the following is NOT included in the sepsis bundle? A. Obtain blood cultures B. Measure serum lactate level C. Administer Albumin via IV push D. Administer vasopressors to maintain a MAP of at least 65
C.
Which of the following is a risk for this mode: AC, RR 15, Vt 500, PEEP 5, FiO2 40% A. patient won't get any breaths unless they can trigger them B. patient anxiety- patient can't take independent breaths C. volutrauma- forcing in too much volume D. respiratory acidosis
C.
Which of the following is an example of "Source Control" in relation to sepsis? A. Placing a patient on the ventilator B. Administering sedatives C. Removing a foley catheter D. Placing Sequential Compression Devices (SCDs) on a patient
C.
Which of the following is an example of the fluid of choice for a patient in septic shock? A. Albumin 25% B. TPN C. Lactated Ringers D. Packed Red Blood Cells
C.
Which of the following is the correct formula for calculating CPP? A. SBP-ICP=CPP B. DBP-ICP=CPP C. MAP-ICP=CPP D. MAP+ICP=CPP
C.
Which of the following is the priority of care for a patient actively suffering from an AMI? A. oxygen administration B. accurate patient history C. reperfusion of the myocardium D. bringing the ST segment back to baseline
C.
Which of the following reflects a percentage of blood leaving the left ventricle with one beat? A. Cardiac Output (CO) B. Cardiac Index (CI) C. Ejection Fraction (EF) D. Stroke Volume
C.
Why do we get a 12 lead EKG in a patient with chest pain? A. to reduce myocardial demand B. to increase oxygenation C. to assess where there may be damage in the myocardium D. to assess the percentage the coronary arteries are occluded
C.
Your 92 year old patient who you have been caring for over the past 3 days is alert and awake when you walk in the room. You ask him to sit up so that you can examine his pupils with your penlight. He says "Who are you? I don't remember ordering pizza. My grandmother was here just a minute ago and said we would be having Chinese." He sits up and reluctantly opens his eyes wide as you assess his pupillary response. What is his GCS? A. 8 B. 15 C. 14 D. 12
C.
Your patient has just been intubated with the diagnosis of ARDS. You recognize the following is TRUE about suctioning A. Suctioning is used purely for patient comfort B. Suctioning should be done q2hours on schedule C. Suctioning is appropriate when the patient is showing signs of hypoxia or copious secretions D. Patients on a mechanical ventilator should be able to cough up all of their own secretions- suctioning is only for an emergency
C.
A 55 year old male with a brain tumor is hypoxic and hypercarbic (high CO2), what is he at risk for? A. Decreased ICP due to cerebral vasoconstriction B. Decreased ICP due to cerebral vasodilation C. Increased ICP due to cerebral vasoconstriction D. Increased ICP due to cerebral vasodilation
D.
A 6 year old comes in alert, with shortness of breath, & heart racing. The RN's 1st action is? A. Attempt vagal maneuver B. Prepare medication C. Prepare for cardioversion D. Assessment and vital signs
D.
A nurse is caring for a client who has severe head injuries and is declared brain dead. The transplant coordinator has spoken with the client's family about organ donation. The client's spouse states she is confused and does not know what she should do. Which of the following responses by the nurse is appropriate? A. Most religions support organ donation, so don't let that stand in the way. B. Don't you think you will feel a little better about the situation if you donate your spouse's organs? C. There is such a shortage of organs in this country, so I think you should go ahead and consent to donate your spouse's organs. D. What do you think your spouse would have wanted?
D.
A patient on which ventilator mode MUST have the ability to trigger their own breaths? A. CMV B. SIM C. AC D. PS
D.
A patient with chronic kidney disease is prescribed regular peritoneal dialysis (PD). What should the nurse inform the patient while teaching about PD? A. Avoid protein drinks B. Restrict fluid intake C. Avoid a high protein diet D. Take potassium supplements
D.
According to the Joseph article, the World Health Organization categorizes infants born alive before 37 completed weeks of gestation into which three categories? A. premature, mature, post mature B. small, medium, large C. minimal risk, medium risk, severe risk D. late and moderate preterm, very preterm, extremely preterm
D.
An ICU nurse is caring for a 96-year-old patient that who client who is experiencing multi-organ failure due to septic shock and does not have an advance directive. Who should the nurse except will be responsible for making decisions regarding end-of-life decisions for this client? A. The primary healthcare provider B. The client's nurse C. The client's attorney D. The client's daughter
D.
PS: PS: 10, PEEP:5, FiO2: 30%. What happens if the patient takes a breath? A. the Vt is guaranteed to be 500 B. it is up to the patient to provide all WOB C. the patient can't take a breath on their own D. it will be supported by a PS of 10
D.
The manner in which a potential organ donor's family is approached is important. It is strongly suggested that family be approached only after what has occurred? A. The patient has been pronounced legally dead. B. The family has approached the physician or nurse about possible donation C. It is determined whether the potential donor has signed a uniform donor card. D. The family has acknowledged that their loved one is brain-dead.
D.
The nurse is caring for a patient undergoing peritoneal dialysis. What finding should the nurse report to the primary health care provider that would indicate peritonitis? A. Hyponatremia B. Hyperkalemia C. Oliguria D. Abdominal pain
D.
The nurse teaches a patient with chronic kidney disease about prevention of complications. What should the nurse include in the teaching plan? A. Monitor for proteinuria daily with a urine dipstick. B. Perform self-catheterization every 4 hours to measure urine. C. Adjust sodium intake related to amount of daily urine output. D. Check weight daily and report a gain of greater than 4 pounds.
D.
What is the daily maintenance fluid amount for a child weighing 29 kg? A. 70 B. 600 C. 1500 D. 1680
D.
Which of the following is NOT an appropriate nursing role in the sedated patient? A. Monitor patient's vital signs in response to sedative medication B. Monitor patient's level of sedation according to hospital protocol C. Assess patient for signs of complications of sedation such as immunosuppression D. Determine the most appropriate sedative medication for the patient's condition
D.
Which of the following is a potential cause for hypovolemic shock? A. Acute Myocardial Infarction B. Penicillin allergy C. Spinal Cord Injury at T-2 D. Gastrointestinal bleed
D.
Which of the following is a sign of successful weaning for a patient with ideal weight of 80 kg? A. SR with bigeminal PVCs B. PaCO2: 60 C. Vt of 150 mL D. patient is calm and makes eye contact with you
D.
Which of the following is considered a "lethal dysrhythmia" ? A. Sinus Tachycardia B. 1st degree AV Block C. Junctional Rhythm D. 3rd Degree AV Block
D.
Which of the following most likely describes unstable angina? A. chest pain while mowing the lawn B. shortness of breath and fatigue while vacuuming C. reduced chest tightness after taking nitrates D. waking up to substernal squeezing
D.
Which of the following must be present for a child to be categorized as unstable? A. rapid/thready heart rate B. altered LOC C. mottled skin color D. decreased BP
D.
Which of the following patients should the nurse assess first? A. A 32 year old female admitted with pneumonia with a heart rate of 47. She claims she became ill after running her second marathon in a week. B. A 82 year old male with 1st degree AV block and a PR interval of 0.28. His 6-second EKG strip has 8 R-waves. C. A 11 year old male admitted with a right ulnar fracture in sinus tachycardia, heart rate: 110 D. A 59 year old male with a recent decrease in level of consciousness and bigeminal PVCs. He was admitted yesterday with renal failure
D.
Your patient has a MAP of 90 and an ICP of 25. What is the CPP? Is this normal? A. 115, no, this is too high B. 115, yes this is normal C. 65, no this is too high D. 65, yes this is normal
D.
Your patient has had 10cc urine output over the past 2 hours, has a low serum osmolality of 155 and her sodium level is 115. Which of the following statements most pertains to this patient? A. She has diabetes insipidus and needs an IV bolus of 1000cc 0.9%NS B. She has SIADH and needs an IV bolus of 1000 cc 0.9%NS C. She has diabetes insipidus and needs 40mg Furosemide IV D. She has SIADH and needs 40mg Furosemide IV
D.
Your patient has the following Ventilator settings and ABG. What is the most appropriate collaborative intervention? Ventilator Settings: AC: RR: 11 Vt: 500mL FiO2: 50% PEEP: 5cmH20 ABG: pH: 7.52; CO2: 29; HCO3: 24; PaO2: 109 Your patient's RR is 35, O2sats are 100%, and appears somewhat anxious. A. Increase the respiratory rate B. Turn up the respiratory rate setting C. Turn up the FiO2 D. Increase sedation drip rate
D.
Your patient has the following Ventilator settings and ABG. What is the most appropriate ventilator change? Ventilator Settings: AC: RR: 11 Vt: 600mL FiO2: 80% PEEP: 7cmH20 ABG: pH: 7.59; CO2: 24; HCO3: 22; PaO2: 119 Your patient's RR is 20, O2sats are 100%, and appears somewhat anxious. A. Turn down the respiratory rate setting- B. Turn up the respiratory rate setting C. Turn up the FiO2 D. Change the mode to SIMV
D.
Your patient has the following Ventilator settings and ABG. What is the most appropriate ventilator change? Ventilator Settings: Pressure Support mode: PS: 10cmH20 FiO2: 40% PEEP: 7cmH20 ABG: pH: 7.19; CO2: 59; HCO3: 22; PaO2: 40 A. Turn up the respiratory rate setting- B. Turn down the PEEP C. Turn down the FiO2 D. Change the mode to AC-
D.
Your patient is on a Vecuronium drip, a Fentanyl drip and a Propofol drip. When assessing train of four, your patient has a 4 twitch response. Which of the following is an appropriate nursing action A. Turn down the Propofol B. Turn up the Propofol C. Turn down the Pancuronium D. Turn up the Pancuronium
D.
Because the donation and transplantation process requires donation agencies to review confidential patient information, the nurse should ensure the donation agency follows HIPAA guidelines. True or false?
False
In the UC San Diego Medical Center video, the nurse uses the CAM ICU scale to assess the patient's sedation. True or false
False
