Prophecy Trauma ICU Exam A v2

The INITIAL dose of atropine for a conscious adult experiencing symptomatic bradycardia is:

0.5 mg IVP

Motor speech and articulation of speech is located in which region of the brain?

Broca's area

An adult male client was admitted to the trauma service after an MVC. During his stay, the patient suffers an acute MI. He is attached to a cardiac monitor and has an IV catheter in place. His cardiac rhythm has been NSR with occasional PVCs. The nurse notes a sudden change on the cardiac monitor screen to a very irregular, chaotic-looking pattern. The client appears to be sleeping. The primary action on the part of the nurse is to:

Check the client's ECG electrodes.

When administering adenosine in an adult patient for treatment of PSVT, how would you administer the medication?

IV push over 1-2 seconds followed by a rapid saline bolus

When starting a patient's PIV you always keep the following in mind:

avoid areas of flexion

The primary effect of atropine sulfate is to:

block parasympathetic impulses

A trauma patient crushed his chest on the steering wheel and you suspect cardiac tamponade. Cardiac tamponade is defined as:

blood or fluid in the pericardial sac causing an inadequate cardiac output

A pregnant woman's hypervolemic state:

can mask extent of blood loss after injury

Which of the following IV push medications requires cardiac monitoring?

cardizem (diltiazem)

Which of the following is NOT a function of angiotensin II?

causes vasodilation

What is a common finding in a patient recovering from a frontal lobe injury?

change in personality

Which of the following is an appropriate indication for transcutaneous cardiac pacing?

complete heart block with pulmonary edema

Pulmonary contusion is a common injury in the pediatric trauma patient. Which of the following physiologic or anatomic factors contributes to this injury in children?

compliant, flexible ribs

Elevated intra-abdominal hypertension can cause which of the following:

compresses the vena cava, reducing blood flow to the heart, leading to reduced cardiac output and further decrease in blood flow to kidneys and intestines

Whenever there is an increase in carbon dioxide levels, the pH will:

decrease

Diltiazem hydrochloride (cardizem) is used to treat angina because it:

decreases afterload

Which type of sedation is contraindicated for the patient with increased lipids?

diprivan

The #1 cause of traumatic death in the elderly is:

falls

Lipid emulsions provide a major caloric source by providing:

fat

After a radial art line is removed, direct pressure should generally be applied to the artery:

for 5-10 minutes

Calcium chloride/calcium gluconate, insulin with D50 and sodium bicarb are all pharmacologic agents recommended for the emergency treatment of:

hyperkalemia

Pain leads to multiple physiologic adverse effects on the body. Which of the following physical findings could be the result of pain?

hyperthermia leading to metabolism depression

The nurse is caring for a person who is admitted in acute renal failure. The appearance of the U wave on the ECG should alert the nurse to check lab values for:

hypokalemia

Which of the following assessment findings are indicative of spinal or neurogenic shock?

hypotension and bradycardia

Seizure activity without impaired consciousness that is usually confined to a restricted area of the brain and may include twitching of an arm/leg is a:

simple partial

"Noted obstruction of the trachea or larynx" is the definition that correlates with what pulmonary term?

stridor

Indications for use of an external cardiac pacemaker include:

symptomatic complete heart block

A patient has an MRI ordered. The nurse would educate the patient that the procedure will take approx. 30-45 minutes to complete, they need to lie as still as possible during the procedure, and which of the following:

the machine will make loud, banging noises.

What would be an acceptable CPP in a traumatic brain injured patient?

50-80 mmHg

Narcan (naloxone) IV push can be administered every:

2-3 minutes

On a chest x-ray, the tip of a correctly placed endotracheal tube appears:

3-5 cm above the carina

What is the general acceptable amount of output (mLs of urine) per hour in an adult?

30

What is the normal value of PAWP?

4-12 mmHg

A client had a right-sided craniotomy due to an SDH. What neurological findings are consistent with this injury?

Left sided weakness with right visual disturbance.

You are caring for a patient with hypovolemic shock. After insertion of a PA catheter, you have the following information: BP 80/68 mmHg CVP 2 mmHg PA 20/7 mmHg PCWP 4 mmHg CI = 2.1 L/min/m2 PVR 250 dynes/sec/cm5 SVR 1700 dynes/sec/cm-5 Based on the above information, you know the PRIORITY treatment is to:

Replace volume to increase preload, thus increasing CI & BP

For the following ABG values, please interpret the acid-base abnormality: pH = 7.56 PaCO2 = 24 mmHg HCO3 = 23 mEq/L

Respiratory alkalosis

Your patient has a serum sodium of 162 and a serum osmolality of 330. What pathological condition do you suspect?

SIADH

Which medication is administered for treatment of acute ischemic stroke?

activase (alteplase tPa)

Your patient's PEEP has just been increased. A sign that the patient is NOT tolerating this change is:

a decrease in cardiac output

The MOST common cause of cardiogenic shock is:

acute myocardial infarction (AMI)

Seizures can occur in the acute care setting secondary to:

alcohol withdrawal

Signs and symptoms of cardiac tamponade include distant heart sounds, decreased BP, and

increased CVP

A hypertensive patient is started on nitroprusside (nipride), and his O2 sat decreases to 90%. ABGs are drawn and show a PaO2 of 60 mmHg and an O2 sat of 90%. What is the mechanism for this change?

intrapulmonary shunt

The development of ketones in DKA are secondary to:

lipolysis or fat breakdown

The abdominal organ MOST susceptible to injury in blunt trauma is the:

liver

Sedation and analgesia in the head injured population is used mainly for:

prevention of secondary brain injury