Critical Exam #1 EAQ

Second Degree AV Block

1 or more P waves are not conducted to the ventricles and therefore not followed by a QRS

The Synergy Model 8 competencies

1. collaboration 2. clinical judgement 3. advocacy and moral agency 4. clinical inquiry 5. caring practices 6. facilitation of learning 7. systems thinking 8. cultural competency

Which collaborative action would the nurse anticipate when caring for a client with pneumonia whose arterial blood gases are pH 7.24, PaCO2 60, HCO3 20, PaO2 54, O2 sat 88%? A. O2 at 6L/minute by nasal cannula B. Nebulized albuterol treatment C. Intubation and mechanical ventilation D. sodium bicarbonate intravenously

C. Intubation and mechanical ventilation

Ventricular fibrillation

A rapid, feeble twitching/quivering of the ventricles. It has an irregular sawtooth configuration with unidentifiable PR intervals and QRS complexes

The ABG for 3-month-old infant with diarrhea showed that the pH is 7.30, PCO2 35, and HCO3 17. Which would the nurse conclude has developed? A. Metabolic Acidosis B. Metabolic Alkalosis C. Respiratory Acidosis D. Respiratory Alkalosis

A. Metabolic Acidosis

P wave conduction

Atrial depolarization

Which ABG result for a client who is receiving mechanical ventilation using the pressure support ventilation mode indicates that the client is hyperventilating? A. pH 7.28 B. HCO3 24 C. PaO2 60 D. PaCO2 30

D. PaCO2 30

Which part of the ECG represents depolarization of the ventricles? A. P wave B. T wave C. PR interval D. QRS interval

D. QRS interval

Respiratory Alkalosis

Hyperventilation

First Degree AV Block

P and QRS waves are consistent in shape. A P wave precedes every QRS complex and the PR interval is greater than 0.20 seconds

Ventricular Tachycardia

Rate of 140-200 bpm. QRS complexes are wide and bizarre

Third Degree AV Block

The QRS has no relationship with P waves

Diltiazem

Used to treat rapid atrial fibrillation.

T wave conduction

Ventricular repolarization

A client's ABG pH 7.52, PCO2 32, HCO3 24. Which does the nurse identify as a possible cause of these results? A. Airway obstruction B. Inadequate nutrition C. Prolonged gastric suction d. Excessive mechanical ventilation

d. Excessive mechanical ventilation

Atrial Flutter

sawtooth atrial waves at a rate of about 300bpm

After noting that a client in the clinic has an irregularly irregular pulse rhythm at a rate of 88 bpm the nurse will anticipate further testing for which possible dysrhythmia? A. A fib B. V tach C. Complete heart block D. SVT

A. A fib

Which client in the ICU would the nurse assess FIRST? A. Client with increasingly labored respiratory effort after aspiration of gastric contents 2 days ago B. Client who is receiving positive pressure mechanical ventilation after an accidental opioid overdose C. Client who has pneumocystis and has intravenous antibiotic and antiretroviral medications due

A. Client with increasingly labored respiratory effort after aspiration of gastric contents 2 days ago

Which nurse competencies are elements of the Synergy Model of care delivery? A. Collaboration B. Care planning C. Communication D. Clinical judgement E. Cultural competency

A. Collaboration D. Clinical judgement E. Cultural competency

Which finding will the nurse expect when analyzing the cardiac rhythm for a client with first degree AV block? A. Every P wave is conducted to the ventricles B. Some P waves are conducted to the ventricles C. There are no P waves visible on the rhythm strip

A. Every P wave is conducted to the ventricles

When ABG results for an alert client who is in the PACU after abdominal surgery are pH 7.37, PaCO2 42, HCO3 25, PaO2 65, SaO2 90%, which action would the nurse take? A. Increase the oxygen flow rate B. prepare to transfer client out of PACU C. Insert oropharyngeal airway

A. Increase the oxygen flow rate

The RN is teaching a group of nursing students about the characteristics of a good team player and states, "A good team player should work with determination and refuse to stop until the goal has been accomplished." Which characteristic is the RN describing? A. Tenacity B. Selflessness C. Dependability D. Collaboration

A. Tenacity

Which criteria indicate that a client on a cardiac monitor is in sinus rhythm? A. The PR interval are relatively consistent B. One P wave precedes each QRS complex C. The ST segment is higher than the PR interval D. Four to eight complexes occur in a 6-second strip

A. The PR interval are relatively consistent B. One P wave precedes each QRS complex

A client is intubated and receiving mechanical ventilation The nurse reports to the client's room when the ventilator alarms. Which nursing action indicates that the ventilator was signaling a high-pressure alarm? A. The nurse removes secretions by suctioning B. The nurse lowers the setting of tidal volume C. The nurse checks that tubing connections are secure

A. The nurse removes secretions by suctioning

A client who has had a MI suddenly develops a HR of 120 bpm which action would the nurse take first? A. offer reassurance B. check the blood pressure C. Call for an ECG D. activate rapid response team

B. Check the blood pressure

Which result would the nurse expect to see on the ECG tracing monitor when a client with diabetic ketoacidosis and a potassium of 5.4? A. Abnormal P waves and depressed T waves B. Peaked T waves and widened QRS complexes C. Abnormal Q waves and prolonged ST segments

B. Peaked T waves and widened QRS complexes

Which finding for a client who has a diagnosis of paroxysmal atrial fibrillation is most important to report quickly to the HCP? A. Irregular heartbeats B. Right arm weakness C. Client report of palpitations

B. Right arm weakness

When admitting a client with syncope and the ECG rhythm, which medication will the nurse anticipate administering? -- Bradycardia A. Digoxin B. Enalapril C. Atropine

C. Atropine

Which diagnosis is a client most likely to have who has an ABG report indicating pH 7.25, PCO2 35, HCO3 20? A. Panic attack B. Persistent vomitting C. DKA

C. DKA

The nurse is caring for a client with the following ABG values PO2 89, PCO2 35, pH 7.37. These findings indicate that the client is experiencing which condition? A. Respiratory Alkalosis B. Poor oxygen perfusion C. Normal acid-base balance

C. Normal acid-base balance

Which action would the nurse anticipate taking when a client develops Third Degree AV Block with a HR of 30 bpm? A. Assist with rapid defibrillation B. Prepare for synchronized cardioversion C. Obtain the transcutaneous pacemaker

C. Obtain the transcutaneous pacemaker

The nurse is caring for a client whose mechanical ventilator settings include the use of PEEP. This treatment improves oxygenation primarily through which mechanism of action? A. Providing more oxygen to lung tissue B. Forcing pressure into lung tissue which improves gas exchange C. Opening collapsed alveoli and keeping them open

C. Opening collapsed alveoli and keeping them open

A client with COPD has a ABG pH 7.25, PCO2 60. These results require nursing attention because they indicate which condition? A. Metabolic Acidosis B. Metabolic Alkalosis C. Respiratory Acidosis D. Respiratory Alkalosis

C. Respiratory Acidosis

When a client's cardiac rhythm strips shows more P waves than QRS complexes and there is no relationship between the atria and the ventricles, how would the nurse document the rhythm? A. Second degree AV block Mobitz I (Wenkebach) B. Second degree AV block MObitz II C. Third degree Av block

C. Third degree AV block

When caring for a sedated client who is being mechanically ventilated, which action will the nurse take first when the low flow alarm is persistently sounding? A. Adjust the alarm settings B. Notify the respiratory therapist C. Ventilate manually and call for assistance D. Check all connections and ventilator tubing

C. Ventilate manually and call for assistance

When a client's rhythm strip shows that the P and QRS waves are consistent with a P wave preceding every QRS complex and a PR interval of 0.26 seconds how would the nurse interpret the rhythm? A. complete heart block B. Normal sinus rhythm C. first degree AV block D. second degree AV block

C. first degree AV block

ET intubation and positive-pressure ventilation are instituted because of a client's deteriorating respiratory status. Which is an important nursing intervention? A. Facilitate verbal communication B. Prepare the client for emergency surgery C. Maintain sterility of vent system D. Assess the client's response to the mechanical ventilation

D. Assess the client's response to the mechanical ventilation

Which arterial blood gas value would indicate diabetic ketoacidosis? A. Increased pH B. Decreased PO2 C. Increased PCO2 D. Decreased HCO3

D. Decreased HCO3