quizzes

The nurse is providing postoperative education to a heart transplant patient's family. When asked about detecting rejection, which answer by the nurse is most appropriate? Select one: a. "Endomyocardial biopsies will be performed weekly for the first 6 weeks after surgery." b. "Increased shortness of breath most likely indicates immediate, acute rejection of the heart." c. "As time passes, the more biopsies that are performed, the more reliable the results become." d. "Biopsies of the heart are done every 6 months after the day of the transplant surgery

"Endomyocardial biopsies will be performed weekly for the first 6 weeks after surgery."

Your patient weighs 60 kg and has a 40% TBSA burn injury. Fluid resuscitation orders are for 4 mL/kg/% burn of a lactated Ringer's solution. What volume will be infused during the first 8 hours? Select one: a. 2,400 mL b. 4,800 mL c. 3,600 mL d. 9,600 mL

4,800 mL

The nurse is caring for a patient diagnosed with NSTEMI. Assessment findings include a blood pressure of 86/40 mm Hg, heart rate of 125 beats/min, respiratory rate 35 breaths/min, and oxygen saturation (SpO2) of 90% on a 50% venturi mask. Results from a recent cardiac catheterization include a cardiac output (CO) of 1.7 L/min. The nurse questions which of the following physician's order? Select one: a. Titrate supplemental oxygen to achieve a SpO2 > 94%. b. Administer furosemide (Lasix) 20 mg intravenously. c. Infuse 500 mL 0.9% normal saline over 1 hour. d. Obtain arterial blood gas and serum electrolytes.

Administer furosemide (Lasix) 20 mg intravenously.

The nurse is caring for a mechanically ventilated patient following bilateral lung transplantation. When planning the care of this patient, what is the priority nursing intervention? Select one: a. Endotracheal suctioning as needed b. Frequent side to side repositioning c. Sequential compression stockings d. Thirty-degree elevation of head of bed

a. Endotracheal suctioning as needed

A patient is admitted after collapsing at the end of a summer marathon. She is lethargic, with a heart rate of 110 beats/min, respiratory rate of 30 breaths/min, and a blood pressure of 78/46 mm Hg. The nurse anticipates administering which therapeutic intervention? Select one: a. Lactated Ringer's bolus b. Packed red blood cells c. Human albumin infusion d. Hypotonic saline solution

a. Lactated ringer's bolus

The nurse is caring for a patient in cardiogenic shock experiencing chest pain. Hemodynamic values assessed by the nurse include a cardiac index (CI) of 2.5 L/min/m2, heart rate of 70 beats/min, and a systemic vascular resistance (SVR) of 2200 dynes/sec/cm-5. Upon review of physician orders, which order is most appropriate for the nurse to initiate? Select one: a. Nitroglycerin infusion titrated at a rate of 5-10 mcg/min as needed for chest pain b. Dobutamine (Dobutrex) infusion at a rate of 2-20 mcg/kg/min as needed for CI < 2 L/min/m2 c. Furosemide (Lasix) 20 mg intravenous (IV) every 4 hours as needed for CVP > 20 mm Hg d. Dopamine (Intropin) infusion at a rate of 5-10 mcg/kg/min to maintain a systolic BP of at least 90 mm Hg

a. Nitroglycerin infusion titrated at a rate of 5-10 mcg/min as needed for chest pain

The nurse assesses morning lab results for a postoperative day 1 liver transplant recipient. Lab results noted by the nurse include aspartate transaminase (AST) 365 U/L; alanine aminotransferase (ALT) 400 U/L; and serum glucose of 85 mg/dL. What is the best action by the nurse? Select one: a. Notify the provider of liver enzyme results. b. Treat hypoglycemia with 50 mL 5% dextrose. c. Prepare to administer IV insulin infusion. d. Repeat the liver enzyme results in 4 hours.

a. Notify the provider of liver enzyme results.

You've admitted a patient to the telemetry unit from the emergency department. The patient is having premature ventricular contractions (PVCs). Your greatest concern, as the nurse, should be: Select one: a. The proximity of the R wave within the PVC to the T wave of the next normal beat. b. Whether or not the QRS complex within each one of the PVCs is greater than 0.12 seconds. c. The fact that the PVCs are occurring, because they are so rare. d. The number of PVCs per minute is decreasing.

a. The proximity of the R wave within the PVC to the T wave of the next normal beat. Yes, this is called the R-on-T phenomenon and can put the patient at risk for a dangerous cardiac rhythm.

The patient is admitted to the unit with the diagnosis of rhabdomyolysis. The patient is started on intravenous (IV) fluids and IV mannitol. Because mannitol is an osmotic diuretic, the nurse should: Select one: a. assess the patient's lungs. b. give extra doses prior to giving radiological contrast agents. c. decrease IV fluids once the diuretic has been administered. d. assess the patient's hearing.

a. assess the patient's lungs

A patient being cared for in the ICU before organ donation shows increased PVCs on the cardiac monitor What medication does the nurse prepare to administer first? Select one: a. Esmolol b. Normal saline c. Nitroprusside d. Dobutamine

a. esmolol

The patient is admitted with complaints of general malaise and fatigue, along with a decreased urinary output. The patient's urinalysis shows coarse, muddy brown granular casts and hematuria. The nurse determines that the patient has: Select one: a. intrarenal disease, probably acute tubular necrosis. b. a urinary tract infection. c. acute kidney injury from a prerenal condition. d. acute kidney injury from postrenal obstruction.

a. intrarenal disease, probably acute tubular necrosis.

You are an RN caring for a 76-year old male patient on the telemetry unit. Your patient is a retired biology teacher who inquires about his cardiac rhythm. He has many questions about the connection between the heart's anatomy and electrical conductivity. You explain to your patient that one of the functions of the atrioventricular (AV) node is to: Select one: a. slow the impulse arriving from the SA node. b. send the impulse to the SA node. c. allow for ventricular filling during systole. d. pace the heart if the ventricles fail.

a. slow the impulse arriving from the SA node.

The nurse is caring for a patient who has a Glasgow Coma Scale (GCS) score of 3. Discussions have been held with the family about withdrawing life support. Which statement by the nurse best describes requirements that must be met to sustain Centers for Medicare and Medicaid Services (CMS) Conditions of Participation? Select one: a. "The charge nurse will notify the local Organ Procurement Organization once the patient has been pronounced brain dead." b. "I need to notify the local Organ Procurement Organization of my patient's impending death." c. "I need the physician to evaluate my patient's suitability for organ donation." d. "I will contact the provider to obtain informed consent for organ donation."

b. "I need to notify the local Organ Procurement Organization of my patient's impending death."

A 53-year-old, 80-kg patient is admitted to the cardiac surgical intensive care unit after cardiac surgery. Four hours after admission to the surgical intensive care unit at 4 PM, the patient has stable vital signs and normal arterial blood gases (ABGs) and is placed on a T-piece for ventilatory weaning. During the nurse's 7 PM (1900) assessment, the patient is restless, heart rate has increased to 110 beats/min, respirations are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sinus tachycardia with 10 premature ventricular contractions (PVCs) per minute. The nurse suctions the patient and obtains pink, frothy secretions. Loud crackles are audible throughout lung fields. The nurse notifies the physician, who orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. In communicating with the physician, which statement best indicates that the nurse understands what is likely to be occurring with the patient? Select one: a. "May we have an order for cardiac enzymes? This patient is exhibiting signs of a myocardial infarction." b. "My assessment indicates potential fluid overload." c. "The patient is having frequent PVCs that are compromising the cardiac output." d. "The patient is having a hypertensive crisis; what medications would you like to order?"

b. "My assessment indicates potential fluid overload."

The nurse is caring for a patient in cardiogenic shock who is being treated with an intraaortic balloon pump (IABP). The family inquires about the primary reason for the device. What is the best statement by the nurse to explain the IABP? Select one: a. "The machine will beat for the damaged heart with every beat until it heals." b. "The action of the machine will improve blood supply to the damaged heart." c. "The machine will remain in place until the patient is ready for a heart transplant." d. "The machine will help cleanse the blood of impurities that might damage the heart."

b. "The action of the machine will improve blood supply to the damaged heart."

The patient's serum creatinine level is 0.7 mg/dL. The expected BUN level should be: Select one: a. 10-20 mg/dL. b. 7-14 mg/dL. c. 1-2 mg/dL. d. 20-30 mg/dL.

b. 7-14 mg/dL

The transplant clinic coordinator is evaluating relatives of a patient with end-stage renal disease, whose blood type is A positive, for suitability as a living donor for kidney transplantation. Which family member best qualifies for evaluation? Select one: a. A 70-year-old mother, with a history of sinus infections; blood type A positive b. A 35-year-old female with a history of food allergies; blood type O negative c. A 65-year-old brother with a history of hypertension; blood type A positive d. A 14-year-old son, otherwise healthy with no history; blood type B negative

b. A 35-year-old female with a history of food allergies; blood type O negative

The nurse is caring for a patient in the critical care unit who, after being declared brain dead, is being managed by the OPO transplant coordinator. Thirty minutes into the shift, assessment by the nurse includes a blood pressure 75/50 mm Hg, heart rate 85 beats/min, and respiratory rate 12 breaths/min via assist/control ventilation. The oxygen saturation (SpO2) is 99% and core temperature 93.8° F. Which provider prescription should the nurse implement first? Select one: a. Draw arterial blood gas every 4 hours until surgery. b. Begin phenylephrine (Neo-Synephrine) for systolic BP <90 mm Hg. c. Obtain basic metabolic panel every 4 hours until surgery. d. Apply forced-air warming device to keep temperature ³96.8° F

b. Begin phenylephrine (Neo-Synephrine) for systolic BP <90 mm Hg.

The nurse has just completed an infusion of a 1000 mL bolus of 0.9% normal saline in a patient with severe sepsis. One hour later, which laboratory result requires immediate nursing action? Select one: a. Sodium140 mEq/L b. Lactate 6 mmol/L c. Potassium3.8 mEq/L d. Creatinine 1.0 mg/dL

b. Lactate 6 mmol/L

The charge nurse of a transplant unit is reviewing the clinical course of several transplant patients being cared for in the unit. Which patient assessed by the charge nurse requires immediate action? Select one: a. Heart transplant recipient, 1 day post-op with a cardiac output of 4 L/min b. Liver transplant recipient, 2 days post-op with a serum creatinine of 3.7 mg/dL c. Renal transplant recipient, 1 day post-op with a 3/10 pain level d. Lung transplant recipient, 1 day post-op with a productive cough

b. Liver transplant recipient, 2 days post-op with a serum creatinine of 3.7 mg/dL

The nurse is caring for a patient in the early stages of septic shock. The patient is slightly confused and flushed, with bounding peripheral pulses. Which hemodynamic values is the nurse most likely to assess? Select one: a. High pulmonary artery occlusive pressure and high cardiac output b. Low systemic vascular resistance and high cardiac output c. High systemic vascular resistance and low cardiac output d. Low pulmonary artery occlusive pressure and low cardiac output

b. Low systemic vascular resistance and high cardiac output

The nurse has been administering 0.9% normal saline intravenous fluids as part of early goal-directed therapy protocols in a patient with severe sepsis. To evaluate the effectiveness of fluid therapy, which physiological parameters would be most important for the nurse to assess? Select one: a. Oral temperature and capillary refill b. Right atrial pressure and urine output c. Breath sounds and capillary refill d. Blood pressure and oral temperature

b. Right atrial pressure and urine output

any critically ill patients experience anxiety. The nurse can reduce anxiety with which approach? a. Explain the unit routine. "Mr. J., assessments are done every 4 hours; patients are bathed on the night shift around 5:00 AM; family members are permitted to visit you after the physicians make their morning rounds. They can spend the day. Lights are out every night at 10:00 PM." b. State, "Mr. J., it's time to turn you. I am going to ask another nurse to come in and help me. We will turn you to your left side. During the turn, I'm going to inspect the skin on your back and rub some lotion on your back. This should help to make you feel better." c. Suction Mr. J.'s endotracheal tube immediately when he starts to cough. Tell him, "Mr. J., your tube needs suctioned; you should feel better after I'm done." d. Ask family members to limit their visitation to 2-hour periods in morning, afternoon, and evening. You know that this is the best approach to ensure uninterrupted rest time for the patient. Tell the patient, "Mr. J., your family is in the waiting room. They will be permitted to come in at 2:00 PM after you take a short nap."

b. State, "Mr. J., it's time to turn you. I am going to ask another nurse to come in and help me. We will turn you to your left side. During the turn, I'm going to inspect the skin on your back and rub some lotion on your back. This should help to make you feel better."

The nurse is starting to administer a unit of packed red blood cells (PRBCs) to a patient admitted in hypovolemic shock secondary to hemorrhage. Vital signs include blood pressure 60/40 mm Hg, heart rate 150 beats/min, respirations 42 breaths/min, and temperature 100.6° F. What is the best action by the nurse? Select one: a. Notify the physician of the patient's heart rate. b. Titrate rate of blood administration to patient response. c. Notify the physician of the elevated temperature. d. Administer blood transfusion over at least 4 hours.

b. Titrate rate of blood administration to patient response.

An elderly gentleman with a history of coronary artery disease drives himself to the emergency department. He is diaphoretic and complains of severe chest pain. The emergency department nurse knows that the initial drug recommended at the onset of acute myocardial infarction (AMI) to reduce platelet aggregation is: Select one: a. morphine b. aspirin c. warfarin d. nitroglycerin e. oxygen

b. aspirin

You are the nurse caring for a postoperative patient with chronic obstructive pulmonary disease (COPD). Which assessment will be a cue that your patient is developing postoperative pneumonia (choose the best answer)? Select one: a. Bradycardia b. Change in sputum characteristics c. Hypoventilation d. Pursed-lip breathing

b. change in sputum characteristics

A patient is admitted to the progressive care unit with a diagnosis of community-acquired pneumonia. The patient has a history of chronic obstructive pulmonary disease and diabetes. A set of arterial blood gases obtained on admission without supplemental oxygen shows pH 7.35; PaCO2 55 mm Hg; bicarbonate 30 mEq/L; PaO2 58 mm Hg. These blood gases reflect: Select one: a. hypoxemia and compensated metabolic alkalosis. b. hypoxemia and compensated respiratory acidosis. c. normal oxygenation and compensated metabolic alkalosis. d. normal oxygenation and uncompensated respiratory acidosis.

b. hypoxemia and compensated respiratory acidosis.

While caring for a patient with a small bowel obstruction, the nurse assesses a heart rate of 110, blood pressure of 90/50 and urine output of 10 mL over 2 hours. The nurse anticipates which therapeutic intervention? Select one: a. Diuretics b. Intravenous fluids c. Negative inotropic agents d. Vasopressors

b. intravenous fluids

In calculating the glomerular filtration rate (GFR) results for women, the creatinine clearance is usually: Select one: a. multiplied by 1.15. b. multiplied by 0.85. c. the same as for men. d. greater than that for men.

b. multiplied by 0.85

The patient is diagnosed with an acute myocardial infarction (AMI) and admitted to the coronary care unit. Three days later the nurse is concerned that the patient may have a papillary muscle rupture. Which new assessment finding may indicate a papillary muscle rupture? Select one: a. Gallop rhythm b. Murmur c. S1 heart sound d. S3 heart sound Feedback

b. murmur

The nurse is assessing a patient with a new arteriovenous fistula, but does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable. The nurse should: Select one: a. reassess the patient in an hour. b. notify the provider immediately. c. apply warm packs to the fistula site and reassess. d. raise the arm above the level of the patient's heart.

b. notify the provider immediately

Continuous venovenous hemodialysis is used to: Select one: a. remove fluids and solutes through the process of convection. b. remove plasma water and solutes by adding dialysate. c. remove plasma water in cases of volume overload. d. combine ultrafiltration, convection and dialysis

b. remove plasma water and solutes by adding dialysate.

The transplant clinic nurse is conducting a pretransplant education session for patients being evaluated for liver transplantation. Which statement by the nurse provides the best explanation of the numeric system used to classify the severity of a patient's liver disease? Select one: a. "A score is calculated that ranges between 6 and 40, with the lower score being more serious." b. "The calculated score represents the patient's risk of death within 1 year of diagnosis." c. "A score is calculated based upon kidney function, clotting time, and bilirubin levels." d. "There are currently no exceptions to the MELD score calculation for severity of disease."

c. "A score is calculated based upon kidney function, clotting time, and bilirubin levels."

he nurse is caring for a renal transplant recipient in the postanesthesia care unit. Blood pressure is 125/70 mm Hg; heart rate is 115 beats/min; respiratory rate is 24 breaths/min; oxygen saturation (SpO2) is 95% on 3 L/min of oxygen via nasal cannula; temperature is 97.8° F; and the central venous pressure (CVP/RAP) is 2 mm Hg. What is the best action by the nurse? Select one: a. Assess the patient for pain; administer pain medications as ordered. b. Increase supplemental oxygen to 100% non-rebreather mask; notify physician. c. Administer fluid replacement therapy; monitor intake and output closely d. Apply thermal warming blanket; administer all fluids through warming device.

c. Administer fluid replacement therapy; monitor intake and output closely

A patient who is undergoing withdrawal of mechanical ventilation appears anxious and agitated. The patient is on a continuous morphine infusion and has an additional order for lorazepam (Ativan) 1 to 2 mg IV as needed (prn). The patient has received no lorazepam (Ativan) during this course of illness. What is the most appropriate nursing intervention to control agitation? a. Increase the rate of the morphine infusion by 50%. b. Request an order for a paralytic agent. c. Administer lorazepam (Ativan) 1 mg IV now. d. Administer fentanyl (Duragesic) 25 mg IV bolus.

c. Administer lorazepam (Ativan) 1 mg IV now. Yes, lorazepam is an anxiolytic, and is appropriate for treating anxiety. Pain medications, such as fentanyl and morphine, treat pain. A paralytic is inappropriate for a patient who is being removed from the ventilato

You are receiving a patient from the cardiac cath lab. The transfer RN reports that the patient's cardiac output was measured at 2.6 L/min. Which of the following physician orders will be of the highest priority? Select one: a. Apply 50% oxygen via venture mask. b. Insert an indwelling urinary catheter. c. Begin a dobutamine (Dobutrex) infusion. d. Perform a blood draw to obtain troponin and other cardiac enzyme levels

c. Begin a dobutamine (Dobutrex) infusion.

A family member of a gravely ill child approaches the child's nurse and states, "We want to donate our child's organs." What is the best action by the nurse? Select one: a. Obtain family consent to withdraw life support.Notify the organ procurement organization (OPO). b. Consult the hospital's ethics committee for a ruling. c. Notify the organ procurement organization (OPO). d. Arrange a multidisciplinary meeting with physicians.

c. Notify the organ procurement organization (OPO).

The patient is in need of immediate hemodialysis, but has no vascular access. The nurse prepares the patient for insertion of: Select one: a. an arteriovenous fistula. b. a percutaneous tunneled catheter at the bedside. c. a percutaneous catheter at the bedside. d. an arteriovenous graft.

c. a percutaneous catheter at the bedside.

The patient has elevated blood urea nitrogen (BUN) and serum creatinine levels with a normal BUN/creatinine ratio. These levels most likely indicate: Select one: a. hypovolemia. b. increased nitrogen intake. c. acute kidney injury, such as acute tubular necrosis (ATN). d. fluid resuscitation.

c. acute kidney injury, such as acute tubular necrosis (ATN).

An elderly gentleman with a history of coronary artery disease drives himself to the emergency department. He is diaphoretic and complains of severe chest pain. The emergency department nurse knows that the initial drug recommended at the onset of acute myocardial infarction (AMI) to reduce platelet aggregation is: Select one: a. nitroglycerin b. warfarin c. aspirin d. morphine e. oxygen

c. aspirin

The basic underlying pathophysiology of acute respiratory distress syndrome results from: Select one: a. a decrease in the number of white blood cells available. b. damage to the right mainstem bronchus. c. damage to the type II pneumocytes, which produce surfactant. d. decreased capillary permeability.

c. damage to the type II pneumocytes, which produce surfactant.

The nurse is caring for a patient admitted with cardiogenic shock. Hemodynamic readings obtained with a pulmonary artery catheter include a pulmonary artery occlusion pressure (PAOP) of 18 mm Hg and a cardiac index (CI) of 1.0 L/min/m2. What is the priority pharmacological intervention? Select one: a. phenylephrine (Neo-Synephrine) b. sodium nitroprusside (Nipride) c. dobutamine (Dobutrex) d. furosemide (Lasix)

c. dobutamine (Dobutrex) The patient's cardiac index is dangerously low and immediate intervention is required. Dobutamine is a positive inotrope. Its primary action is to increase myocardial contractility and cardiac output. It is indicated in cases of cardiac decompensation. Note that its action arises from stimulation of the beta-1 adrenergic receptors of the heart.

The patient undergoes a cardiac catheterization that requires the use of contrast dyes during the procedure. To detect signs of contrast-induced kidney injury, the nurse should: Select one: a. not be concerned unless urine output decreases. b. evaluate the patient's post void residual volume to detect intrarenal injury. c. evaluate the patient's serum creatinine for up to 72 hours after the procedure. d. obtain an order for a renal ultrasound.

c. evaluate the patient's serum creatinine for up to 72 hours after the procedure.

The American Association of Critical Care Nurses (AACN) Standards for Acute and Critical Care Nursing Practice use what framework to guide critical care nursing practice? Select one: a. Evidence-based practice b. National Patient Safety Goals c. Nursing process d. Healthy work environment

c. nursing process

Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who: Select one: a. has a history of fluid overload as a result of heart failure. b. has a history of controlled hypertension with a blood pressure of 138/88 mm Hg. c. was discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks. d. has been on aminoglycosides for the past 6 days.

c. was discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks.

The patient has just returned from having an arteriovenous fistula placed. The patient asks, "When will they be able to use this and take this other catheter out?" The nurse should reply: Select one: a. "It will take 2 days up to 2 weeks to heal before it can be used." b. "The fistula was made using graft material so it depends on the manufacturer." c. "It can be used immediately so the catheter can come out anytime." d. "The fistula typically will be usable in about 4 to 6 weeks."

d. "The fistula typically will be usable in about 4 to 6 weeks."

The nurse has just completed administration of a 1000-mL bolus of 0.9% normal saline. The nurse assesses the patient to be slightly confused, with a mean arterial blood pressure (MAP) of 50 mm Hg, a heart rate of 110 beats/min, urine output of 10 mL for the past hour, and a central venous pressure (CVP/RAP) of 3 mm Hg. What is the best interpretation of these results by the nurse? Select one: a. More time is needed to assess response. b. Patient response to therapy is appropriate. c. Values are normal for the patient condition. d. Additional interventions are indicated.

d. Additional interventions are indicated.

The nurse is caring for a patient in spinal shock. Vital signs include blood pressure 100/70 mm Hg, heart rate 70 beats/min, respirations 24 breaths/min, oxygen saturation 95% on room air, and an oral temperature of 96.8° F. Which intervention is most important for the nurse to include in the patient's plan of care? Select one: a. Application of 100% oxygen via facemask b. Infusion of IV phenylephrine (Neo-Synephrine) c. Administration of atropine sulfate (Atropine) d. Application of slow rewarming measures

d. Application of slow rewarming measures

The nurse is caring for a patient following insertion of an intraaortic balloon pump (IABP) for cardiogenic shock unresponsive to pharmacotherapy. Which hemodynamic parameter best indicates an appropriate response to therapy? Select one: a. Pulmonary artery diastolic pressure of 26 mm Hg b. Systemic vascular resistance (SVR) of 1600 dynes/sec/cm-5 c. Pulmonary artery occlusion pressure (PAOP) of 22 mm Hg d. Cardiac index (CI) of 2.5 L/min/m2

d. Cardiac index (CI) of 2.5 L/min/m2

Ten minutes following administration of an antibiotic, the nurse assesses a patient to have edematous lips, hoarseness, and expiratory stridor. Vital signs assessed by the nurse include blood pressure 70/40 mm Hg, heart rate 130 beats/min, and respirations 36 breaths/min. What is the priority intervention? Select one: a. Methylprednisolone (Solu-Medrol) 125 mg intravenously b. Diphenhydramine (Benadryl) 50 mg intravenously c. Ranitidine (Zantac) 50 mg intravenously d. Epinephrine 3 to 5 mL of a 1:10,000 solution intravenously

d. Epinephrine 3 to 5 mL of a 1:10,000 solution intravenously

A patient is admitted to the cardiac care unit with an acute anterior myocardial infarction. The nurse assesses the patient to be diaphoretic and tachypneic, with bilateral crackles throughout both lung fields. Following insertion of a pulmonary artery catheter by the physician, which hemodynamic values is the nurse most likely to assess? Select one: a. Low pulmonary artery occlusive pressure and low cardiac output b. Low systemic vascular resistance and high cardiac output c. Normal cardiac output and low systemic vascular resistance d. High pulmonary artery diastolic pressure and low cardiac output

d. High pulmonary artery diastolic pressure and low cardiac output

The patient's potassium level is 7.0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction? Select one: a. Calcium gluconate b. Regular insulin c. Kayexalate with sorbitol d. Kayexalate

d. Kayexalate

The nurse is caring for a patient admitted with hypovolemic shock. The nurse palpates thready brachial pulses but is unable to auscultate a blood pressure. What is the best nursing action? Select one: a. Obtain an electronic blood pressure monitor with digital read-out. b. Record the blood pressure as "not assessable." c. Estimate the systolic pressure as 60 mm Hg. d. Measure the blood pressure via Doppler.

d. Measure the blood pressure via Doppler.

The nurse is caring for a patient who sustained a head injury and is unresponsive to painful stimuli. Which intervention is most appropriate while bathing the patient? Select one: a. Turn the television on to the evening news so that you and the patient can be updated to current events. b. Ask a family member to help you bathe the patient, and discuss the family structure with the family member during the procedure. c. Because she is unconscious, complete care as quickly and quietly as possible. d. Tell the patient the day and time, and that you are bathing her. Reassure her that you are there.

d. Tell the patient the day and time, and that you are bathing her. Reassure her that you are there. talk to the patient. provide orientation and reassurance

The nurse is caring for a 70-kg patient in hypovolemic shock. Upon initial assessment, the nurse notes a blood pressure of 90/50 mm Hg, heart rate 125 beats/min, respirations 32 breaths/min, central venous pressure (CVP/RAP) of 3 mm Hg, and urine output of 5 mL during the past hour. Following physician rounds, the nurse reviews the orders. Which of the following orders will the nurse question? Select one: a. Complete neurological assessment every 4 hours for the next 24 hours. b. Administer acetaminophen (Tylenol) 650-mg suppository prn every 6 hours for pain. c. Administer furosemide (Lasix) 20 mg IV every 4 hours for a CVP > 20 mm Hg. d. Titrate dopamine (Intropin) intravenously for blood pressure < 90 mm Hg systolic.

d. Titrate dopamine (Intropin) intravenously for blood pressure < 90 mm Hg systolic.

The nurse performs a blood draw for the gentleman who arrived in the emergency department with severe chest pain. The nurse is aware that the cardiac enzyme considered to be the most sensitive for detecting myocardial damage is: Select one: a. CK-MB b. Myoglobin c. CK d. Troponin I e. Potassium

d. Troponin I

The nurse is reading the cardiac monitor and notes that the patient's heart rhythm is extremely irregular and there are no discernible P waves. The ventricular rate is 90 beats per minute, and the patient is hemodynamically stable. The nurse realizes that the patient's rhythm is: a. atrial flutter with rapid ventricular response. b. atrial flutter. c. junctional escape rhythm. d. atrial fibrillation.

d. atrial fibrillation irregular rhythm without discernible p-waves is indicative of atrial fibrillation

A nurse is caring for a patient declared brain dead following a car crash in preparation for the harvesting of organs. The patient's urine output was 1050 mL in the last hour. What medication does the nurse prepare to administer? Select one: a. Vasopressin b. Methylprednisolone c. EsmololContinue to monitor for signs of rejection. d. Desmopressin acetate

d. desmopressin acetate

The patient is getting hemodialysis for the second time when he complains of a headache and nausea and, a little later, of becoming confused. The nurse realizes these are symptoms of: Select one: a. a shift in potassium levels. b. hypothermia. c. dialyzer membrane incompatibility. d. dialysis disequilibrium syndrome.

d. dialysis disequilibrium syndrome

You are the nurse who is assessing a newly-admitted patient, diagnosed with left-sided heart failure. Which symptom will you expect to find (most likely)? Select one: a. Dependent edema b. Distended neck veins c. Dyspnea and crackles d. Nausea and vomiting

d. dyspnea and crackles

Your patient is a 63-year-old woman who came to the emergency department complaining of chest pain. A myocardial infarction was ruled out, and pneumonia was diagnosed, but she was placed on the telemetry unit with continuous cardiac monitoring as a precaution. You notice that your patient has a first-degree AV block. Everything else about the rhythm appears normal. You should: Select one: a. prepare to place the patient on a transcutaneous pacemaker. b. give the patient atropine to shorten the PR interval. c. give the patient an antiarrhythmic medication. d. monitor the rhythm and patient's condition. Transcutaneous pacing or medications are not indicated for first-degree AV block.

d. monitor the rhythm and patient's condition. Transcutaneous pacing or medications are not indicated for first-degree AV block. Yes, this patient deserves continued close monitoring on the telemetry unit.

A patient is admitted with an acute myocardial infarction (AMI). The nurse knows that an angiotensin-converting enzyme (ACE) inhibitor should be initiated to reduce the incidence of which process? Select one: a. Myocardial stunning b. Hibernating myocardium c. Tachycardia d. Myocardial remodeling

d. myocardial remodeling

The nurse is managing a donor patient six hours before the scheduled harvesting of the patient's organs. Which assessment finding requires immediate action by the nurse? Select one: a. Pulmonary artery temperature of 97.8° F b. Morning serum blood glucose of 128 mg/dL c. Central venous pressure of 8 mm Hg d. pH 7.30; PaCO2 38 mm Hg; HCO3 16 mEq/L

d. pH 7.30; PaCO2 38 mm Hg; HCO3 16 mEq/L

Continuous renal replacement therapy (CRRT) differs from conventional intermittent hemodialysis in that: Select one: a. it provides faster removal of solute and water. b. a hemofilter is used to facilitate ultrafiltration. c. it does not allow diffusion to occur. d. the process removes solutes and water slowly.

d. the process removes solutes and water slowly.