MS3 Final Exam Questions
When administering propofol over an extended period, what laboratory value should the nurse routinely monitor? a. Serum triglyceride level b. Sodium and potassium levels c. Platelet count d. Acid-base balance
A. serum triglyceride level
. Why do women have higher mortality rates from acute myocardial infarction (MI) than men? a. Women wait longer to seek medical care. b. Women have more risk factors for coronary artery disease than men. c. Women have a higher risk of coronary spasm than men. d. Women have smaller hearts than men.
A. women wait longer to seek medical care
A new-onset myocardial infarction (MI) can be recognized by what electrocardiogram (ECG) change? a. Q waves b. Smaller R waves c. Widened QRS d. ST segment elevation
D. ST segment elevation
Which combinations of drugs have been found to be effective in managing the pain associated with musculoskeletal and soft tissue inflammation? a. Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids b. NSAIDs and antidepressants c. Opioid agonists and opioid antagonists d. Adjuvants and partial agonists
A. nonsteroidal anti-inflammatory drugs (NSAIDS) and opioids
Which mechanisms responsible for a myocardial infarction (MI)? (Select all that apply, one, some, or all.) a. Coronary artery thrombosis b. Plaque rupture c. Coronary artery spasm near the ruptured plaque d. Preinfarction angina e. Hyperlipidemia
A, B, C
Nursing management of the patient with acute lung failure includes which interventions? (Select all that apply, one, some, or all.) a. Positioning the patient with the least affected side up b. Providing adequate rest between treatments c. Performing percussion and postural drainage every 4 hours d. Controlling fever e. Pharmaceutical medications to control anxiety
A, B, D, E
Which statements are true regarding pain assessment and management? (Select all that apply, one, some, or all.) a. The single most important assessment tool available to the nurse is the patient's self-report. b. The only way to assess pain in patients unable to verbalize because of mechanical ventilation is through observation of behavioral indicators. c. The concept of equianalgesia uses morphine as a basis for dosage comparison for other medications. d. Transcutaneous electrical nerve stimulation and application of heat or cold therapy stimulate the nonpain sensory fibers. e. Meperidine, a synthetic form of morphine, is much stronger and is given at lower doses at less frequent intervals.
A, C, D
Which complications can result from prolonged deep sedation? (Select all that apply, one, some, or all.) a. Pressure ulcers b. Thromboembolism c. Diarrhea d. Nosocomial pneumonia e. Delayed weaning from mechanical ventilation f. Hypertension
A,B,D,E
A patient is admitted with a diagnosis of acute myocardial infarction. The monitor pattern reveals bradycardia. Occlusion of which coronary artery most likely resulted in bradycardia from sinoatrial node ischemia? a. Right b. Left anterior descending c. Circumflex d. Dominant
A. Right
What disease process would a Ventilation-perfusion (V/Q) scans be ordered to evaluate? a. Pulmonary emboli b. Acute myocardial infarction c. Emphysema d. Acute respiratory distress syndrome
A. pulmonary emboli
Which diagnostic criteria is indicative of mild adult respiratory distress syndrome (ARDS)? a. Radiologic evidence of bibasilar atelectasis b. PaO2/FiO2 ratio less than or equal to 200 mm Hg c. Pulmonary artery wedge pressure greater than 18 mm Hg d. Increase in static and dynamic compliance
B. PaO2/FiO2 ratio less than or equal to 200mm Hg
What is the preferred initial treatment of an acute myocardial infarction? a. Fibrinolytic therapy b. Percutaneous coronary intervention (PCI) c. Coronary artery bypass surgery (CABG) d. Implanted Cardioverter defibrillator (ICD)
B. Percutaneous coronary intervention (PCI)
What are the causes of delirium in critically ill patients? (Select all that apply, one, some, or all.) a. Hyperglycemia b. Meningitis c. Cardiomegaly d. Pulmonary embolism e. Alcohol withdrawal syndrome f. Hyperthyroidism
B, E, F
Which calcium channel blocker is beneficial in the treatment of patients with coronary artery disease or ischemic stroke? a. Nifedipine b. Nicardipine c. Clevidipine d. Diltiazem
B. Nicardipine
What are the neural processes of encoding and processing noxious stimuli associated with pain? a. perception b. nociception c. transduction d. transmission
B. nociception
The nurse is caring for a patient with left-sided heart failure. The nurse suspects the patient is developing pulmonary edema. Which finding would confirm the nurse's suspicions? a. Pulmonary crackles b. Peripheral edema c. Pink, frothy sputum d. Elevated central venous pressure
C. pink frothy sputum
A patient is admitted with a diagnosis of "rule out myocardial infarction." The patient reports midchest pressure radiating into the jaw and shortness of breath when walking up stairs. When inspecting the patient, the nurse notes that the patient needs to sit in a high Fowler position to breathe. The nurse suspects the patient may be experiencing what problem? a. Pericarditis b. Anxiety c. Heart failure d. Angina
C. Heart failure
Which noninvasive imaging technique is useful in diagnosing complications of a myocardial infarction (MI)? a. 12-lead ECG b. CT c. MRI d. Echocardiography
C. MRI
A patient is admitted with a diagnosis of "rule out myocardial infarction." The patient reports midchest pressure radiating into the jaw and shortness of breath when walking up stairs. What factor influences the amount of history obtained during the admission assessment? a. Presence of cardiovascular risk factors b. Prior medical history c. Presenting symptoms d. Current medications
C. Presenting symptoms
What are the two scales that are recommended for assessment of agitation and sedation in adult critically ill patients? a. Ramsay Scale and Riker Sedation-Agitation Scale (SAS) b. Ramsay Scale and Motor Activity Assessment Scale (MAAS) c. Riker Sedation-Agitation Scale (SAS) and the Richmond Agitation-Sedation Scale (RASS) d. Richmond Agitation-Sedation Scale (RASS) and Motor Activity Assessment Scale (MAAS)
C. Riker Sedation-agitation scale (SAS) and the Richmond Agitation- Sedation Scale (RASS)
A patient in diabetic ketoacidosis would exhibit what alteration to the pulmonary system? a. Breathe faster to increase pH b. Breathe slower to increase pH c. Breathe faster to decrease pH d. Breathe slower to decrease pH
C. breathe faster to decrease PH
After a myocardial infarction, a patient presents with an increasing frequency of premature ventricular contractions (PVCs). The patient's heart rate is 110 beats/min, and electrocardiogram (ECG) indicates a sinus rhythm with up to five unifocal PVCs per minute. The patient is alert and responsive and denies any chest pain or dyspnea. What action should the nurse take next? a. Administer lidocaine 100 mg bolus IV push stat. b. Administer Cardizem 20 mg IV push stat. c. Notify the physician and monitor the patient closely. d. Nothing; PVCs are expected in this patient.
C. notify the physician and monitor the patient closely
Which statement about coronary artery disease (CAD) is accurate? a. There is a low correlation between modifiable risk factors and CAD. b. The onset of CAD occurs in middle age women sooner than men of the same age. c. There is an association between development of specific risk factors and CAD. d. The lower the C-reactive protein level, the higher the risk for a coronary event.
C. there is an association between development of specific risk factors and CAD
A patient with coronary artery disease (CAD) is admitted with chest pain. The patient is suddenly awakened with severe chest pain. Three nitroglycerin sublingual tablets are administered 5 minutes apart without relief. A 12-lead electrocardiograph (ECG) reveals nonspecific ST segment elevation. The nurse suspects the patient may have which disorder? a. Silent ischemia b. Stable angina c. Unstable angina d. Prinzmetal angina
C. unstable angina
The patient has a heart rate (HR) of 84 beats/min and a stroke volume (SV) of 65 mL. Calculate the cardiac output (CO). a. 149 mL b. 500 mL c. 4650 mL d. 5460 mL
D. 5460
A patient is admitted after a positive exercise treadmill test with a diagnosis of coronary artery disease (CAD) and stable angina. Radiographic tests show that the patient has blockage in the left main coronary artery and four other vessels. The nurse anticipates that the patient's treatment plan will include what treatment or procedure? a. Medical therapy b. PCI c. TAVR d. CABG
D. CABG
Which value, when elevated, places the patient at lowest risk for coronary artery disease (CAD)? a. Very-low-density lipoproteins (VLDLs) b. Triglycerides c. Low-density lipoproteins (LDLs) d. High-density lipoproteins (HDLs)
D. High-density lipoproteins (HDLS)
Which laboratory value indicates a heightened risk for the development of coronary artery disease (CAD)? a. Total cholesterol level of 170 mg/dL b. HDL cholesterol level of 30 mg/dL c. Triglyceride level of 120 mg/dL d. LDL cholesterol level >190 mg/dL
D. LDL Cholesterol level >190mg/dl
A patient complains of pain at his incision site. The nurse is aware that four processes are involved in nociception. In what order do the processes occur? a. Transmission, perception, modulation, and transduction b. Perception, modulation, transduction, and transmission c. Modulation, transduction, transmission, and perception d. Transduction, transmission, perception, and modulation
D. Transduction, transmission, perception, and modulation
A patient is admitted with signs and symptoms of a pulmonary embolus (PE). What diagnostic test is most conclusive to determine this diagnosis? a. ABG b. Bronchoscopy c. Pulmonary function test d. V/Q scan
D. V/Q scan
A patient has been admitted with the diagnosis of acute respiratory distress syndrome (ARDS). Arterial blood gasses (ABGs) revealed an elevated pH and decreased PaCO2. The patient is becoming fatigued, and the provider orders a repeat ABG. Which set of results would be indicative of the patient's current condition? a. Elevated pH and decreased PaCO2 b. Elevated pH and elevated PaCO2 c. Decreased pH and decreased PaCO2 d. Decreased pH and elevated PaCO2
D. decreased pH and elevated PaCO2
Which statement best describes pain? a. pain is an uncomfortable experience present only in the patient with an intact nervous system b. pain is an unpleasant experience accompanied by crying and tachycardia c. pain is activation of the sympathetic nervous system from an injury d. pain is whatever the patient experiencing it says it is, occurring when that patient says it does
D. pain is whatever the patient experiencing it says it is, occurring when the patient says it does
A patient was admitted in acute lung failure. The patient is receiving 40% oxygen via a simple facemask. The morning chest radiography study reveals right lower lobe pneumonia. Which test would the nurse expect the practitioner to order to identify the infectious pathogen? a. CBC with differential b. Wound culture of surgical site c. Sputum Gram stain and culture d. Urine specimen
c. Sputum Gram stain and culture
A patient was admitted 3 days ago with an acute myocardial infarction (MI). The patient complains of fatigue, not sleeping the past two nights, and change in appetite. Based on these findings the nurse suspects the patient may be experiencing which problem? a. Angina b. Anxiety c. Depression d. Endocarditis
c. depression
A patient has acute lung failure. What nursing intervention should the nurse use to optimize oxygenation and ventilation? a. Provide adequate rest and recovery time between procedures. b. Position the patient with the good lung up. c. Suction the patient every hour. d. Avoid hyperventilating the patient.
a. Provide adequate rest and recovery time between procedures.
What are the most common presenting signs and symptoms associated with a pulmonary embolism (PE)? a. Tachycardia and tachypnea b. Hemoptysis and evidence of deep vein thromboses c. Apprehension and dyspnea d. Right ventricular failure and fever
a. Tachycardia and tachypnea
A patient has acute lung failure. What nursing intervention should the nurse use to optimize oxygenation and ventilation? a. Provide adequate rest and recovery time between procedures. b. Position the patient with the good lung up. c. Suction the patient every hour. d. Avoid hyperventilating the patient.
a. provide adequate rest and recovery time between procedures
For which sign or symptom does a patient with acute lung failure require a bronchodilator? a. Excessive secretions b. Bronchospasms c. Thick secretions d. Fighting the ventilator
b. Bronchospasms
A patient was admitted with acute lung failure secondary to pneumonia. What is the single most important measure to prevent the spread of infection between staff and patients? a. Place the patient in respiratory isolation. b. Ensure everyone is using proper hand hygiene. c. Use personal protective equipment. d. Initiate prompt administration of antibiotics.
b. Ensure everyone is using proper hand hygiene.
What is the major hemodynamic consequence of a massive pulmonary embolus? a. Increased systemic vascular resistance leading to left heart failure b. Pulmonary hypertension leading to right heart failure c. Portal vein blockage leading to ascites d. Embolism to the internal carotids leading to a stroke
b. Pulmonary hypertension leading to right heart failure
Which statement accurately describes the duration of acute pain? a. Acute pain is associated with the injury to the joints and lasts about 9 months. b. Acute pain is associated with the healing process and should not exceed 6 months. c. Acute pain is persistent pain of more than 6 months after the healing process. d. Acute pain is associated with damage to the nervous system and is of infinite duration.
b. acute pain is associated with the healing process and should not exceed 6 months
Depending on the patient's risk for the recurrence of pulmonary embolism (PE), how long may a patient remain on warfarin once they are discharged from the hospital? a. 1 to 3 months b. 3 to 6 months c. 3 to 12 months d. 12 to 36 months
c. 3 to 12 months
Which therapeutic measure would be the most effective in treating hypoxemia in the presence of intrapulmonary shunting associated with acute respiratory distress syndrome (ARDS)? a. Sedating the patient to blunt noxious stimuli b. Increasing the FiO2 on the ventilator c. Administering positive-end expiratory pressure (PEEP) d. Restricting fluids to 500 mL per shift
c. Administering positive-end expiratory pressure (PEEP)
Which finding confirms the diagnosis of a pulmonary embolism (PE)? a. Low-probability ventilation-perfusion (V/Q) scan b. Negative pulmonary angiogram c. High-probability V/Q scan d. Absence of vascular markings on the chest radiograph
c. High-probability V/Q scan
Patients with left-sided pneumonia may benefit from placing them in what position? a. Reverse Trendelenburg b. Supine c. On the left side d. On the right side
d. On the right side
