NCIV - Comprehensive Exam Questions

D (on anti coagsfor 6-12 mo after)

A nurse has taken on the care of a client who had a coronary artery stent placed yesterday. When reviewing the client's daily medication administration record, the nurse should anticipate administering what drug? a) Acetaminophen b) Dipyridamole c) Ibuprofen d) Clopidogrel

C

Which are characteristics of autonomic dysreflexia? a) severe hypotension, tachycardia, nausea, flushed skin b) severe hypertension, tachycardia, blurred vision, dry skin c) severe hypertension, slow heart rate, pounding headache, sweating d) severe hypotension, slow heart rate, anxiety, dry skin

B

A RN on a cardiac unit is caring for a pt on telemetry. The RN recognizes that the HR is 46 bpm and notifies the MD. Which of the following prescriptions might the MD order? a) Defib b) Pacemaker c) Synchronized cardioversion d) IV lidocaine

B (Pelvic injury = high RF bleed - iliac arteries)

A client arrived at the emergency department after suffering multiple physical injuries including a fractured pelvis from a vehicular accident. Upon assessment, the client is incoherent, pale, and diaphoretic. With vital signs as follows: temperature of 97°F (36.11° C), blood pressure of 60/40 mm Hg, heart rate of 143 beats/minute, and a respiratory rate of 30 breaths/minute. The client is mostly suffering from which of the following shock? A. Distributive B. Hypovolemic C. Obstructive D. Cardiogenic

A (remember CHOP acronym for L sided HF)

A client with a myocardial infarction (MI) develops pulmonary crackles and dyspnea. A chest X-ray shows evidence of pulmonary edema. What type of MI did this client have? a) anterior. b) posterior. c) lateral. d) inferior.

E, F

A patient has pancreatitis. The client's ABGs reveal met acidosis. Which s/s are expected? a) Tachycardia b) HTN c) Bounding pulses d) Hyperreflexia e) Dysrhythmia f) Tachypnea

C (while A & D show improvement, they do not necessarily indicate perfusion. C indicates perfusion as the kidneys need blood supply to perform their fxn)

A patient who is in hypovolemic shock has the following clinical signs: Heart rate 120 beats/minute, blood pressure 80/55 mmHg and urine output 20ml/hr. After administering an IV fluid bolus, which of these signs if noted by the healthcare provider is the best indication of improved perfusion? A. Heart rate drops to 100 beats/minute B. Right atrial pressure increases. C. Urine output increases to 30mL/hour D. Systolic blood pressure increases to 85 mmHg.

C (hyperthermia!)

A patient with increased ICP has the following vital signs: blood pressure 99/60, HR 65, Temperature 101.6 'F, respirations 14, oxygen saturation of 95%. ICP reading is 21 mmHg. Based on these findings you would? A. Administered PRN dose of a vasopressor B. Administer 2 L of oxygen C. Remove extra blankets and give the patient a cool bath D. Perform suctioning

D

A pt is exhibiting s/s of acute heart failure. What med is not a priority? a) Dobutamine b) Lanoxin c) Lasix d) Lovenox

C (relative hypovolemia)

A pt w/ a spinal cord injury is admitted to the ICU. The nurse notes significant orthostatic hypotension. What is the most likely cause? a) Increased sympathetic stim b) Obstructive shock, r/t hematoma of spinal cord c) Hypovolemia, distributive shock d) Incomplete spinal cord lesion

B, E

An ED nurse is assessing a 71-year-old female client for a suspected MI. When planning the assessment, the nurse should be cognizant of what signs and symptoms of MI that are particularly common in female clients? Select all that apply. a) Anxiety b) Indigestion c) Shortness of breath d) Chest pain e) Nausea

A, C, E

Clinical manifestations of neurogenic shock include which of the following? Select all that apply. a) Bradycardia b) Tachycardia c) Venous pooling in the extremities d) Profuse bilateral sweating e) Warm skin

D (occurs within first 8 hours)

Following a serious thermal burn, which complication will the nurse take action to prevent first? a) Renal failure b) Tissue hypoxia c) Infection d) Hypovolemia

A, B, D, F

In a spinal cord injury, neurogenic shock develops due to loss of the autonomic nervous system functioning below the level of the lesion. Which of the following indicators of neurogenic shock would the nurse expect to find? Select all that apply. a) Hypotension b) Hypothermia c) Diaphoresis d) Tachypnea e) Tachycardia f) Venous pooling

C, D, E, F, G, H

One of your patients begins to vomit large amounts of bright red blood. The patient is taking Warfarin. You call a rapid response. Which assessment findings indicate this patient is developing hypovolemic shock? Select all that apply: A. Temperature 104.8 'F B. Heart rate 40 bpm C. Heart rate 140 bpm D. Anxiety, restlessness E. Urinary output 15 mL/hr F. Blood pressure 70/56 G. Pale, cool skin H. Weak peripheral pulses I. Blood pressure 220/106

C

Organ failure associated with multiple organ dysfunction syndrome (MODS) usually begins in which organ? a) Liver b) Brain c) Lungs d) Kidneys

A, D, E, F

Select all the signs and symptoms that occur with increased ICP: A. Decorticate posturing B. Tachycardia C. Decrease in pulse pressure D. Cheyne-stokes E. Hemiplegia F. Decerebrate posturing

True

T or F: Valvular dx are most common in the mitral or aortic valve

Fixed

What will pupils be like with very high ICP?

B

Which of the following is not a manifestation of Cushing's triad (Cushing reflex)? a) Irregular respiration b) Tachycardia c) Widening pulse pressure d) Hypertension

D

Which of the following is the preferred IV fluid for burn resuscitation? a) D5W b) Total parenteral nutrition (TPN) c) Normal saline (NS) d) Lactated Ringer's (LR)

A, C, E (C = increased RF fat embolism)

Which of the following pt's are RF a PE? (SATA) a) Pt who has BMI of 30 b) Female pt postmenopausal c) Pt w/ fractured femur d) Pt who is a marathon runner e) Pt w/ chronic A fib

D (increases thoracic pressure = increased ICP)

While positioning a patient in bed with increased ICP, it important to avoid? A. Midline positioning of the head B. Placing the HOB at 30-35 degrees C. Preventing flexion of the neck D. Flexion of the hips

B, D, E, F, I

You're assessing your patient with cardiogenic shock, what signs and symptoms do you expect to find in this condition? Select all that apply: A. Warm, flushed skin B. Prolonged capillary refill C. Urinary output >30 mL/hr D. Systolic blood pressure <90 mmHg E. Crackles in lung fields F. Dyspnea G. Decreased BUN and creatinine H. Strong peripheral pulses I. Chest pain

D

A client arrives at the emergency department who suffered multiple injuries from a head-on car collision. Which of the following assessment should take the highest priority to take? A. Unequal pupils B. Irregular pulse C. Ecchymosis in the flank area D. A deviated trachea

A (240/24 = 10 mL/hr = K+ builds up)

A client develops acute renal failure (ARF) after receiving IV therapy with a nephrotoxic antibiotic. Because the client's 24-hour urine output totals 240 mL, the nurse suspects that the client is at risk for a) Cardiac Arrhythmia b) Paraesthesia c) Dehydration d) Pruritus

B

A client has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this client? a) Chest pain b) Bleeding at the implantation site c) Malignant hyperthermia d) Bradycardia

C

A client in the ICU has a central venous pressure (CVP) line placed. The CVP reading is 10 mm Hg. To what condition does the nurse correlate the CVP reading? a) Reduction in preload b) Left-sided heart failure c) Right-sided heart failure d) Hypovolemia

A

A client is admitted to the ICU after a motor vehicle accident. On the second day of the hospital admission, the client develops acute kidney injury. The client is hemodynamically unstable, and renal replacement therapy is needed to manage the client's hypervolemia and hyperkalemia. Which of the following therapies will the client's hemodynamic status best tolerate? a) Peritoneal dialysis b) Hemodialysis c) Continuous venovenous hemodialysis (CVVHD) d) Plasmapheresis

C (key: hemodynamically unstable)

A client is admitted to the ICU after a motor vehicle accident. On the second day of the hospital admission, the client develops acute kidney injury. The client is hemodynamically unstable, and renal replacement therapy is needed to manage the client's hypervolemia and hyperkalemia. Which of the following therapies will the client's hemodynamic status best tolerate? a) Peritoneal dialysis b) Hemodialysis c) Continuous venovenous hemodialysis (CVVHD) d) Plasmapheresis

D (remember, never normal to have chest pain)

A client reports midsternal chest pain radiating down his left arm. The nurse notes that the client is restless and slightly diaphoretic, and measures a temperature of 99.6 °F (37.6 °C); a heart rate of 102 beats/minute; regular, slightly labored respirations at 26 breaths/minute; and a blood pressure of 150/90 mm Hg. What assessment is the nurse's highest priority? a) anxiety b) cardiac output c) body temperature d) acute pain

A

A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to a) avoid caffeinated beverages. b) request sublingual nitroglycerin. c) apply supplemental oxygen. d) lie down and elevate the feet.

A, B, D

A client who had coronary artery bypass surgery is exhibiting signs of heart failure. What medications will the nurse anticipate administering for this client? Select all that apply. a) inotropic agents b) diuretics c) nitroprusside d) digoxin e) amlodipine

C

A client with a T4-level spinal cord injury (SCI) reports severe headache. The nurse notes profuse diaphoresis of the client's forehead and scalp and suspects autonomic dysreflexia. What is the first thing the nurse will do? a) Notify the physician. b) Lay the client flat. c) Place the client in a sitting position. d) Apply antiembolic stockings.

B (have a high amount of acid so want to keep the base!)

A client with a diagnosis of respiratory acidosis is experiencing renal compensation. What function does the kidney perform to assist in restoring acid-base balance? a) Sequestering free hydrogen ions in the nephrons b) Returning bicarbonate to the body's circulation c) Returning acid to the body's circulation d) Excreting bicarbonate in the urine

B

A client with myasthenia gravis is receiving continuous mechanical ventilation. When the high-pressure alarm on the ventilator sounds, what should the nurse do? a) Check for an apical pulse. b) Suction the client's artificial airway. c) Increase the oxygen percentage. d) Ventilate the client with a handheld mechanical ventilator.

A, B, D

A critical care nurse is caring for a client with a hemodynamic monitoring system in place. For what complications should the nurse assess? Select all that apply. a) Infection b) Air embolism c) Bronchospasm d) Pneumothorax e) Atelectasis

C, E (Remember wheezing is a good sign in an acute asthma attack)

A nurse in the ED is caring for a pt who is experiencing an acute asthma attack. Which of the following assessments indicates that the resp status is declining? (SATA) a) SaO2 95% b) Wheezing c) Retraction of sternal muscles d) Pink mucous membranes e) Tachycardia

D

A nurse is admitting a pt who has complete heart block as demonstrated by the EKG. HR is 34 bpm, BP 83/48 mmHg. The pt is lethargic and unable to complete sentences. Which of the following actions should the nurse perform first? a) Transport the pt to cardiovascular lab b) Prepare pt for permanent packemaker insertion c) Obtain an informed consent form for a pacemaker d) Apply transcutaneous pacemaker pads

B, D, E (Expect tachypnea and hypotension)

A nurse is assessing a pt who has a PE. Which of the following s/s should the nurse expect? (SATA) a) Bradypnea b) Pleural friction rub c) HTN d) Petechiae e) Tachycardia

A

A nurse is caring for a client diagnosed with Guillain-Barré syndrome. The client states, "It's getting harder to take a deep breath." Which action by the nurse is most appropriate? a) Call the physician and prepare for intubation. b) Explain the progression of the syndrome. c) Assess lung sounds. d) Encourage the client to cough.

A

A nurse is caring for a client who has had an automatic cardiac defibrillator implanted. What instructions should the nurse provide to the client? a) Avoid devices with a magnetic field. b) Use digital cellular telephones. c) Avoid driving for at least 3 months. d) Avoid using microwave ovens.

A, C

A nurse is caring for a pt following insertion of a temporary venous pacemaker via femoral artery that is set as a VVI pacemaker rate of 70/min. Which of the following findings should the nurse report to the provider? (Select all that apply) a) Cool and clammy foot w/ cap refill 5 seconds b) Observed pacing spike followed by a QRS complex c) Persistent hiccups d) HR 84/min e) BP 104/62 mmHg

B (Remember, this & PEEP = weaning modes)

A nurse is caring for a pt who is receiving mechanical ventilation and is on pressure support ventilation (PS) mode. Which of the following statements indicates understanding of PS? a) It keeps the alveoli open to pv atelectasis b) It allows preset pressure delivered during spontaneous ventilation c) It guarantees minimal minute ventilator d) It delivers a preset vent rate and tidal volume to a client

C (ABC framework)

A nurse is reviewing rx for a pt who has acute SOB and diaphoresis. The pt states "I am anxious. I can't get enough air!" VS are HR 117 bpm, RR 38, T 101.2 (F) and BP 100/54. Which of the following is the nurse's priority? a) Notify MD b) Administer heparin via IV infusion c) Admin O2 d) Obtain CT

D

A patient comes to the emergency department with reports of chest pain after using cocaine. The nurse assesses the patient and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing? a) Sinus bradycardia b) Ventricular tachycardia c) Normal sinus rhythm d) Sinus tachycardia

C (A is for ventricular, B for brady, D for atrial)

A patient has had several episodes of recurrent tachydysrhythmias over the last 5 months and medication therapy has not been effective. What procedure should the nurse prepare the patient for? a) Insertion of an ICD b) Insertion of a permanent pacemaker c) Catheter ablation therapy d) Maze procedure

C

A patient is experiencing hyperventilation and has a PaCO2 level of 52. The patient has an ICP of 20 mmHg. As the nurse you know that the PaCO2 level will? A. cause vasoconstriction and decrease the ICP B. promote diuresis and decrease the ICP C. cause vasodilation and increase the ICP D. cause vasodilation and decrease the ICP

Subarachnoid

A patient states they have the "worse h/a of my life" - it comes on sudden and severe. What kind of hematoma might this indicate?

C

A patient who experienced a cerebral hemorrhage is at risk for developing increased ICP. Which sign and symptom below is the EARLIEST indicator the patient is having this complication? A. Bradycardia B. Decerebrate posturing C. Restlessness D. Unequal pupil size

C (ABGs show resp acidosis w/ hypoxia. So want to increase breathing + PEEP allows more O2 in)

A pt has the following ABGs: pH 7.12, pCO2 50, HCO3 24, PO2 59. What vent settings would the nurse anticipate changing based on these results? a) Increase PEEP, decrease FiO2 b) Increase RR, decrease tidal vol c) Increase RR, increase PEEP d) Increase tidal volume, increase sedation

B (Think MONA, with nitro being priority followed by morphine)

A pt has worsening chest pain after 3 NTG (nitroglycerin) are given. What should the nurse do next? a) Admin another NTG and elevate the HOB b) Call the MD and considering admin morphine c) Place O2 and continue to monitor d) Obtain repeat cardiac enzymes and make NPO

D (indicates SOB)

A pt is admitted with HF. What pt statement indicates that FVO was occurring at home? a) "I eat 6 meals a day when I am hungry" b) "My best time of day is AM" c) "My food tastes bland w/o salt" d) "I cut back on going up the steps during the day"

B (high lactate = met acidosis)

A pt is admitted with a serum lactate of 8.0. What ABG result would the nurse anticipate? a) ph 7.52, paCO2 44, HCO3 32 b) pH 7.23, paCO2 37, HCO3 18 c) pH 7.31, paCO2 54, HCO3 21 d) pH 7.50, paCO2 32, HCO3 24

A

A pt was in a MVC. CXR reveals a pneumothorax. Pt c/o chest pain and difficulty breathing. Which acid base imbalance should the RN expect? a) Resp acidosis b) Normal c) Met Acidosis d) Met Alk

C (allows optimal draining of venous blood from cerebral cavity = decreased cerebral contents = decreased ICP)

After assessing that a pt has a new fixed/dilated pupil, what should the RN do next to initiate management of herniation synd? a) Hyperventilate pt to 25 breaths/min b) Prep pt for transport to CT scan c) ensure HOB elevated to at least 30 deg d) Admin mannitol, 1g/kg, using an inline filter

B (full thickness burns involve innervation - loss of feeling)

An explosion of a fuel tanker has resulted in melting of clothing on the driver and extensive full-body burns. The client is brought into the emergency department alert, denying pain, and joking with the staff. Which is the best interpretation of this behavior? a) The paramedic administered high doses of opioids during transport. b) The client has experienced extensive full-thickness burns. c) The client is in hypovolemic shock. d) The client has experienced partial-thickness burns.

A, C, E (remember HCO3 will be low so met acidosis)

Based on the pathophysiologic changes that occur as renal failure progresses, the nurse identifies the following indicators associated with the disease. Select all that apply. a) Hyperkalemia b) Metabolic alkalosis c) Anemia d) Hyperalbuminemia e) Hypocalcemia

C (All other choices are from HEAD acronym = R sided HF)

The nurse is assessing a client with left-sided heart failure. What assessment finding is expected? a) pitting edema of the legs b) ascites c) air hunger d) jugular vein distention

D

The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker? a) Date and time of insertion b) Location of the generator c) Model number d) Pacer rate

C

The nurse is caring for a client in shock who is deteriorating. The nurse is infusing IV fluids and giving medications as ordered. What type of medications is the nurse most likely giving to this client? a) Hormone antagonist drugs b) Antimetabolite drugs c) Adrenergic drugs d) Anticholinergic drugs

C (r.t hypoxia) (D - redding, like when you exercise)

The nurse is caring for a client who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output? a) Increased blood pressure b) Bounding peripheral pulses c) Changes in level of consciousness d) Skin flushing

A, B, C

The nurse is caring for a client who has just been intubated and started on mechanical ventilation in the intensive care unit. The nurse recognizes that it is possible to inadvertently intubate the right lung only. What nursing assessment and monitoring is required to determine if this complication has occurred? Select all that apply. a) Auscultate both sides of the chest b) Mark the endotracheal tube at the corner of the mouth and nose c) Monitor for both high and low pressure alarms d) Apply suctioning to clear the airway e) Re-set the ventilator rate as needed

B

The nurse is caring for a client who has terminal lung cancer and is unconscious. Which assessment finding would most clearly indicate to the nurse that the client's death is imminent? a) Increased swallowing b) Mottling of the lower limbs c) Bowel incontinence d) Slow, steady pulse

B

The nurse is caring for a dying client in a hospice setting. The family is unsure whether to go home for rest or spend the night with the client. Which body system would the nurse assess to provide the first data on decline? a) Central nervous system b) Cardiovascular system c) Respiratory system d) Gastrointestinal system

0.5

The nurse is caring for a patient that has developed oliguria. Oliguria is defined as urine output less than ___________mL/kg/hr

C (@ RF OH)

The nurse is planning care for the client in neurogenic shock. Which of the following actions would be least helpful in minimizing the effects of vasodilation below the level of the injury? A. Monitoring vital signs before and during position changes B. Using vasopressor medications as prescribed C. Moving the client quickly as one unit D. Applying Teds or compression stockings.

C

The nurse is planning discharge teaching for a client with a newly inserted permanent pacemaker. What is the priority teaching point for this client? a) Start lifting the arm above the shoulder right away to prevent chest wall adhesion. b) Avoid cooking with a microwave oven. c) Avoid exposure to strong electromagnetic fields d) Avoid walking through store and library antitheft devices.

A, C, D, E (B - remember, arterial in nature)

The nurse providing care for a client post PTCA knows to monitor the client closely. For what complications should the nurse monitor the client? Select all that apply. a) Retroperitoneal bleeding b) Venous insufficiency c) Bleeding at the insertion site d) Arterial occlusion e) Abrupt closure of the coronary artery

A

The nurse should monitor a client receiving mechanical ventilation for which of the following complications? a) Gastrointestinal hemorrhage b) Immunosuppression c) Increased cardiac output d) Pulmonary emboli

-Ventilated-Devastating dx-Brain dead or meet criteria for Donation after Circulatory Death (DCD)

What are the required criteria to be an organ donor (think hospital)?

A

What dx may be present in a pt's hx who now has a dx of mitral valve stenosis? a) Rheumatic fever b) Chicken pox c) Meningitis d) Pneumonia

-Type of transplant: higher risk with kidneys-Timeline: occurs within first week

What factors are associated w/ developing acute rejection (old and new do not get along)?

C (would increase CO2, D is good idea but not most important)

What interventions would you anticipate being most helpful to the client in acute resp failure? A) Increase IV rate B) Prepare for Intubation C) Increase Sedation D) Obtain CXR

B

What is the treatment of choice for ventricular fibrillation? a) Implanted defib b) Immediate bystander CPR c) Just call the doctor and wait d) Atropine

C (Nitro = RF hypotension)

When administering SL Nitroglycerin, what is the most important parameter to assess? a) Pulse b) Temp c) BP d) Cardiac rhythm

A, C, E (expect tenderness @ site)

Which assessments should a nurse perform when caring for a client following a cardiac catheterization? Select all that apply. a) Palpate the pulse in different locations. b) Palpate the insertion site for tenderness. c) Inspect pressure dressing for signs of bleeding. d) Inspect the color in every extremity. e) Monitor BP and pulse frequently.

C (hypovolemic shock has a WIDENED pulse pressure, while cardiogenic has a NARROW pulse pressure)

Which characteristic often distinguishes cardiogenic shock from hypovolemic shock? A. Tachycardia. B. Increased respiratory rate. C. Narrow pulse pressure. D. Oliguria.

A, B, D, E

Which clients are @ RF developing ARDS (SATA)? a) Pt who experienced near-drowning event b) Pt following CABG surgery c) Pt who has hgb 15.1 d) Pt w/ dysphagia e) Pt with acute drug toxicity

C (Cushing's triad - RF herniation)

Which of the following BP changes alerts the nurse to increased ICP, and should be reported immediately? a) Gradual increase b) Rapid drop followed by gradual increase c) Widened pulse pressure d) Rapid fluctuation

A, D, E, H (NOT cold extremities because blood is pooling)

You receive a patient in the ER who has sustained a cervical spinal cord injury. You know this patient is at risk for neurogenic shock. What hallmark signs and symptoms, if experienced by this patient, would indicate the patient is experiencing neurogenic shock? Select all that apply: A. Blood pressure 69/38 B. Heart rate 170 bpm C. Blood pressure 250/120 D. Heart rate 29 E. Warm and dry extremities F. Cool and clammy extremities G. Temperature 104.9 'F H. Temperature 95 'F

B, C, E, F, G

You're providing education to a patient, who has a severe peanut allergy, on how to recognize the signs and symptoms of anaphylactic shock. Select all the signs and symptoms associated with anaphylactic shock:* A. Hyperglycemia B. Difficulty speaking C. Feeling dizzy D. Hypertension E. Dyspnea F. Itchy G. Vomiting and Nausea H. Fever I. Slow heart rate

A, B, C, E (W/ sepsis, our goal for blood sugar is under 180, E: Part of tx is fluids so CVP shouldn't be abnormally low)

Your patient is receiving aggressive treatment for septic shock. Which findings demonstrate treatment is NOT being successful? Select all that apply:* A. MAP (mean arterial pressure) 40 mmHg B. Urinary output of 10 mL over 2 hours C. Serum Lactate 15 mmol/L D. Blood glucose 120 mg/dL E. CVP (central venous pressure) less than 2 mmHg

Cancel the test (already know there is a problem with the heart)

Your patient is scheduled for a stress test when the lab calls and informs you that their troponin and other heart enzymes are elevated. What should you do regarding the test?

B, C, D (A - would STOP the infusion)

Your patient is started on an IV antibiotic to treat a severe infection. During infusion, the patient uses the call light to notify you that she feels a tight sensation in her throat and it's making it hard to breathe. You immediately arrive to the room and assess the patient. While auscultating the lungs you note wheezing. You also notice that the patient is starting to scratch the face and arms, and on closer inspection of the face you note redness and swelling that extends down to the neck and torso. The patient's vital signs are the following: blood pressure 89/62, heart rate 118 bpm, and oxygen saturation 88% on room air. You suspect anaphylactic shock. Select all the appropriate interventions for this patient:* A. Slow down the antibiotic infusion B. Call a rapid response C. Place the patient on oxygen D. Prepare for the administration of Epinephrine

B

Your patient's blood pressure is 72/56, heart rate 126, and respiration 24. The patient has a fungal infection in the lungs. The patient also has a fever, warm/flushed skin, and is restless. You notify the physician who suspects septic shock. You anticipate that the physician will order what treatment FIRST?* A. Low-dose corticosteroids B. Crystalloids IV fluid bolus C. Norepinephrine D. 2 units of Packed Red Blood Cells

A, C

Your patient, who is post-op from a gastrointestinal surgery, is presenting with a temperature of 103.6 'F, heart rate 120, blood pressure 72/42, increased white blood cell count, and respirations of 21. An IV fluid bolus is ordered STAT. Which findings below indicate that the patient is progressing to septic shock? Select all that apply:* A. Blood pressure of 70/34 after the fluid bolus B. Serum lactate less than 2 mmol/L C. Patient needs Norepinephrine to maintain a mean arterial pressure (MAP) greater than 65 mmHg despite fluid replacement D. Central venous pressure (CVP) of 18