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Question 1 A patient is a victim of a motor vehicle accident and…
Question 1
A patient is a victim of a motor vehicle accident and has closed chest trauma. As you assess your patient, you notice that he has diminished breath sounds. Your patient is most likely experiencing a:
a. fat embolus. b. hemothorax. c. pneumothorax. d. spinal cord injury.
Question 2
You are caring for a patient with severe sepsis and third-degree heart block. The patient is hypotensive. The treatment for this life-threatening rhythm change includes:
a. Chest compressions b. Defibrillation c. Norepinephrine infusion d. Transcutaneous pacing
Question 3
A patient admitted to the ICU has been diagnosed with blunt abdominal trauma following an altercation. Upon assessment, the patient reports severe pain. Further assessment includes Cullen’s sign, Grey Turner’s sign, and rigid abdomen despite nasogastric tube placement for decompression. The patient is most likely experiencing:
a. Cardiac contusion b. Hemorrhage c. Pancreatitis. d. Pneumothorax
Question 4
Which drug is given first to a patient with pulseless electrical activity (PEA)?
a. Dopamine b. Epinephrine c. Lidocaine d. Norepinephrine
Question 5
What would be the most effective intervention to be ordered to treat a hemodynamically unstable patient with third-degree heart block?
a. Cardioversion b. Atropine sulfate (Atropine) c. Diltiazem (Cardizem) d. Transcutaneous pacing
Question 6
A mechanically ventilated patient from the OR is admitted to the ICU following an MVA. The patient experienced head trauma and blunt trauma to the abdomen. You are assessing this patient and notice that his heart rate is 130-145 per minute in sinus tachycardia; his CVP is 2. The patient remains hypotensive despite the use of vasopressors. The patient has a chest tube connected to wall suction and the TAC is putting out large amounts of bright red blood. You recognize that this patient is most likely experiencing:
a. Anaphylactic shock b. Hypovolemic shock c. Neurogenic shock d. Septic shock
Question 7
The patient diagnosed with acute tubular necrosis (ATN) and experiencing severe dehydration, sepsis, and pneumonia is now in the polyureic stage of ATN. The most important nursing action is to:
a. Administer furosemide and monitor electrolyte levels b. Decrease fluid intake and monitor electrolyte levels c. Monitor electrolyte levels and mental status. d. Monitor electrolyte levels and signs of fluid depletion
Question 8
A patient is experiencing a cardiogenic shock. The nurse understands the goal of treatment focuses on increasing the:
a. Cardiac output b. Central venous pressure c. Heart rate d. Hematocrit
Question 9
The mechanically ventilated patient has increased respiratory rate ranging from 12-24 and oxygen saturation decreased to 90% despite oxygen increase to 100%. The patient assessment reveals basilar crackles that were not previously present, high peak airway pressures, and use of accessory muscles. Arterial blood gas reveals pH 7.50, pCO2 32, and pO2 49. Chest X-ray results are significant for diffuse ground glass opacities. The patient is likely experiencing:
a. Acute respiratory distress syndrome b. Bacterial pneumonia c. Chronic obstructive pulmonary disease d. Pulmonary embolism
Question 10
A patient assessment reveals distended neck veins, pulsus paradoxus, and decreased systolic pressure. This assessment is most consistent with:
a. Cardiac tamponade b. Heart failure c. Hemothorax d. Pulmonary contusion
Question 11
A 46-year-old patient states that he has had weakness in his lower extremities that has worsened in an ascending manner over the past 3 days. The patient also states he is having difficulty breathing. The nurse is most concerned that this patient is at high risk for respiratory failure caused by:
a. CVA b. Guillain-Barré syndrome c. Meningitis d. Myasthenia Gravis
Question 12
A patient is experiencing a change in condition. Your assessment is significant for oliguria, jugular vein distention, and dyspnea on exertion. You review laboratory values and notice that the isoenzymes are not elevated. The most likely explanation is that the patient is experiencing:
a. Anxiety b. Heart failure c. Pericarditis d. Pneumothorax
Question 13
Diabetes insipidus:
a. Involves damage to the anterior pituitary gland. b. Is caused by the excessive secretion of epinephrine. c. Is usually treated with vasopressin d. Occurs in conjunction with hyperglycemia
Question 14
If the pulmonary artery catheter migrates distally and becomes permanently wedged, the patient is at risk for:
a. Asystole b. Endocarditis c. Pneumothorax d. Pulmonary infarction
Question 15
Which sign or symptom would affect a patient’s score on the Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar)?
a. Fever b. Paroxysmal sweats c. Tachycardia d. Vertigo
Question 16
The nurse recognizes that signs and symptoms of diabetic ketoacidosis (DKA) include:
a. Confusion and slow, shallow breathing b. Diaphoresis and absence of urine ketones c. Diaphoresis, excessive urine output, and absence of ketones d. Fruity breath, deep, rapid breathing, and positive ketones
Question 17
The nurse is caring for a patient with alcohol use disorder. The patient has a score of 23 on the Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar). What is the level of withdrawal this patient is experiencing?
a. Extreme b. Mild c. Moderate d. Severe
Question 18
Right atrial pressures are obtained in order to assess:
a. Left atrial function b. Left ventricular function c. Pulmonary artery d. Right ventricular function
Question 19
The patient with a new diagnosis of subarachnoid hemorrhage reports a headache and nausea. Vital signs are as follows: HR 95, RR 16, BP 200/105. You are titrating the nicardipine drip. You are careful to not lower the blood pressure too rapidly because it will result in:
a. acute coronary syndrome. b. dysrhythmia, dizziness, and hypotension. c. renal failure related to hypotension. d. the reduction of cerebral perfusion and ischemia to areas compressed by the injury.
Question 20
To improve renal perfusion many patients with Acute Kidney Injury are treated with __________________.
a. Ace-Inhibitors b. calcium channel blocker c. Vasoconstrictors d. Vasodilators
Question 21
A patient is admitted to the ICU with suspected cervical spinal cord injury following a motor vehicle accident. The most important nursing intervention for this patient is to:
a. Assess his pupils hourly b. Immobilize his head c. Monitor his MAP closely d. Take aspiration precautions
Question 22
A patient has 10% kidney function. The nurse understands that this patient will likely require:
a. Dialysis b. Diuretics c. Fluids d. Nephrostomy tube
Question 23
How do the symptoms of neurogenic shock and hypovolemic shock differ?
a. In hypovolemic shock, capillary refill is brisk b. In hypovolemic shock, there is bradycardia c. In neurogenic shock, capillary refill is delayed d. In neurogenic shock, the skin is warm and dry
Question 24
Preload is defined as the:
a. Amount of blood ejected with each heartbeat b. Pressure in the right atrium c. Stretch produced within the myocardium at the end of diastole d. Volume of blood in the ventricles during systole
Question 25
When treating a patient with Acute Kidney Injury typically this is used to correct fluid overload?
a. bumetanide b. furosemide c. torsemide d. spironolactone
Question 26
A patient has cardiomyopathy and is unstable. You understand that the treatment goal is to improve contractility, reduce preload, and reduce afterload. You anticipate that medication management will include starting:
a. dobutamine and nitroglycerine infusions. b. dobutamine and nitroprusside infusions c. dopamine and furosemide infusions. d. phenylephrine and epinephrine infusions.
Question 27
Alpha-1 receptors produce which physiologic effect?
a. Bronchodilation b. Hypotension c. Vasoconstriction d. Vasodilation
Question 28
What patient parameters should be monitored for the patient receiving ketamine for pain or sedation?
a. Altered mental status and respiratory rate b. Blood pressure and respiratory rate c. Blood pressure, heart rate, and altered mental status d. Oxygen saturation, heart rate, and blood pressure
Question 29
Beta-1 receptors produce which physiologic effect?
a. Bronchodilation b. Increased heart rate and contractility c. Renal and mesenteric vessel dilation d. Vasoconstriction
Question 30
According to the American Nurses Association, the five rights of delegation are:
a. Right clinic, right patient, right day, right task, right instructions b. Right medication, right dose, right time, right person, right task c. Right patient, right hospital, right time, right staff, right task d. Right task, right circumstance, right person, right supervision, right direction and communication
Question 31
What are the characteristics of effective teams?
a. Individual agenda, pluralistic goals, and passive communication b. Instability, passive-aggressive communication, and incongruent goals c. Purpose, goals, cohesion, respect, and effective communication d. Submissive communication, capstone goals, and provisional agendas
Question 32
Which circumstance is the best example of an internal constraint that may lead to moral distress?
a. Fear of legal action b. Lack of administrative support c. Pressure to reduce costs d. Providing end-of-life care
Question 33
Accessing personal and professional resources can help nurses overcome feelings of moral distress. Which action would be an example of this?
a. Attending a debriefing session assigned by one’s nurse manager after a patient dies. b. Calling out sick on one’s next scheduled shift. c. Finding a clinical leader or mentor with whom to share one’s feelings. d. Keeping a journal about one’s feelings.
Question 34
What is the single most important intervention to prevent the spread of infections?
a. Contact precautions b. Glove use c. Hand washing d. Isolation
Question 35
The nurse completes a new patient intake assessment. The patient reports a persistent cough for over 3 weeks, fatigue, and noted weight loss. The nurse suspects:
a. tuberculosis (TB) and should initiate airborne precautions, isolate the patient, and notify the provider immediately. b. pneumonia and should obtain an oral temperature, instruct the patient to wear a surgical or procedure mask, and notify the provider .c. tuberculosis (TB) and should notify the provider immediately, contact the state health department, and isolate the patient. d. pneumonia and should adhere to universal precautions, send the patient to the lab for a sputum sample, and prepare for the patient to be admitted to the hospital.
