Prophecy General ICU RN A v2 Exam with complete solutions

Common complications of massive transfusions are - ANSWER-Dilutional Coagulopathy, DIC, hypothermia, and fibrinolysis ABG pH 7.25, pCO2 40, pO2 90, HCO3 20mEq/L - ANSWER-Metabolic Acidosis Long term use of TPN may lead to: - ANSWER-Liver Failure Which of the following is a potential complication of high PEEP - ANSWER-Pneumothorax What is a common assessment finding for a patient returning from a small bowel resection? - ANSWER-Hypoactive bowel sounds Your patient suddenly becomes diaphoretic, anxious, tachycardic, and has clammy skin. Which of the following would you suspect. - ANSWER-A)*WRONG* Hypoxemia B) Acute MI C) Panic Attack D) Hypoglycemia The staff nurse asks the nursing assistant to check on a patient. The nursing assistant reports back that the patient is experiencing chest pain and is diaphorectic. Which of the following can the staff nurse delegate to the assistant? - ANSWER-A) *WRONG* Calling the physician B) Gathering vitals and assessing the cause for the change in status C) Informing the charge nurse that a patient needs attention D) Obtaining a medication for the nurse to administer to the patient Your patient returned from PACU after surgery and is very drowsy. She attempts to eat a candy bar and begins to choke. The physician is unable to clear the airway. You would expect to prepare for which of the following. emergency procedures? - ANSWER-A) *WRONG* Endotracheal Intubation B) Chest tube insertion C) Tracheostomy D) Bronchoscopy The initial insulin therapy for a patient with acute DKA is usually administered by which route - ANSWER-Intravenous bolus followed by a continuous infusion Screening tests for DIC include: - ANSWER-D-Dimer and FDPs Which of the following hormones is secreted by the hypothalamus in an effort to regulate water balance? - ANSWER-ADH Which of the following IV sedatives would most likely be ordered for a non-intubated patient? - ANSWER-Precedex Your patient is in bed and eating lunch when they begin to cough and gag. Suddenly they become dyspneic and bradycardic with excessive salivation. What do you suspect happened? - ANSWER-Aspiration Which of the following is a response of the cardiovascular system to early sepsis? - ANSWER-Increased cardiac output and reduced systemic vascular resistance Which patient would you expect to be extubated? - ANSWER-Patient is awake, follow commands with RR of 14, FiO2 40%, and PEEP 5 Hypertensive crisis - ANSWER-Nicardipine Your patient sustained a crushed pelvis in a MVC. You notice a pinkish sediment in the urinary catheter tubing and decreased urinary output. Which of the following conditions would you suspect? - ANSWER-Rhabdomyolysis Which class of drugs should be avoided in patients with asthma? - ANSWER-Beta Blockers CAM-ICU is a measure for which condition? - ANSWER-Delirium Which of the following drugs would you expect to administer in a patient diagnosed with myasthenia gravis? - ANSWER-Mestinon ABG pH 7.56, paCO2 24 mmHG, HCO3 23 mEq/L - ANSWER-Respiratory Alkalosis When assessing a chest tube, which of the following indicates a possible air leak - ANSWER-Excessive bubbling in the water chamber Which of the following medications improves contractility, increases stroke volume, and increases cardiac output? - ANSWER-Dobutamine Muffled heart sounds would indicate what condition? - ANSWER-Cardiac tamponade Pain assessment in an unconscious patient - ANSWER-Requires astute assessment skills using multiple approaches Which of the following tests should be performed prior to administering tPA - ANSWER-CT Scan Which of the following classes of drugs are used in an effort to therapeutically decrease venous return and reduce peripheral vascular resistance? - ANSWER-Vasodilators Identify the type of renal failure that results from bilateral obstruction of urine outflow - ANSWER-Post-renal failure A patient exhibits hypotension without an increase in HR is indicative of - ANSWER-Neurogenic Shock Your patient is taking the following medications: Zoloft, Lanoxin, Protonix, lasix, and coumadin. Which medication would you hold for a blood pressure of 80/50? - ANSWER-Lasix A patient was admitted with a hemoglobin of 6, hematocrit of 25, has clammy skin, confusion, and agitation, BP 80/40, HR 145. What type of shock is this? - ANSWER-Hypovolemic The patient is admitted with suspected Guillain-Barre syndrome. The nurse would expect CSF analysis to reveal which of the following to confirm the diagnosis? - ANSWER-CSF protein of 60 mg/dL and WBC 0 cells/mm3 Your patient is receiving IV medications of Nitroglycerin and Verapamil. Which of the following should the nurse observe for during the assessment? - ANSWER-Hypotension CVP measures the pressure in the - ANSWER-right atrium Which lab value is used to determine the severity of sepsis - ANSWER-lactic acid Which of the following hormones is secreted by the thyroid gland? - ANSWER-calcitonin An adrenocorticotropic hormone (ACTH) stimulation test would be ordered for which diagnosis? - ANSWER-Adrenal crisis The most common cause for the patient to file a nursing negligence claim is - ANSWER-Ineffective communication Which medication is a paralytic - ANSWER-Vecuronium 90% of thrombi develop in which area of the body? - ANSWER-Legs Which of the following medications is usually the first to be administered during status epilepticus - ANSWER-Ativan Pt's BP on admission was 110/40, and Hgb was 10.5. The BP is now 80/50 and pt is vomiting coffee ground emesisi. You expect Hgb to be: - ANSWER-8 You note the appearance of a U wave on the ECG tracing of your patient, This would indicate that the nurse check laboratory values for the presence of - ANSWER-Hypokalemia Must be performed prior to A-line insertion - ANSWER-Allen test Diet best for patient with renal failure? - ANSWER-low sodium, low potassium, and moderate protein You're caring for a 49 yo head trauma pt with an ICP line. What is the formula for calculating the CPP? - ANSWER-MAP - ICP Pt presents with fever, chills, cough, SOB and chest pain. Which diagnosis would you anticipate? - ANSWER-Pneumonia CVP normal range - ANSWER-2-8 mmHg Pt presents with stiff neck, headache and fever for the last 24 hr. What condition would you suspect? - ANSWER-Bacterial meningitis Hypotensive crisis, which med would you anticipate giving? - ANSWER-Levophed Hypotonic solution - ANSWER-0.45% NS What pathological condition might you suspect in a patient with a serum sodium of 165 and serum osmolality of 330? - ANSWER-Diabetes Insipidus Med commonly used to decrease ICP - ANSWER-Mannitol ABG 7.35, paCO2 60mmHg, HCO3 38 mEq - ANSWER-Compensated respiratory acidosis Contraindicated for Lorazepam -