CRITICAL CARE REGISTERED NURSE(CCRN) MULTISYSTEM WITH VERIFIED ANSWERS

The nurse is caring for a child with septicemia. while reviewing the orders, he notes that 2 antibiotics are ordered, on treats gram - organisms and one treats gram + organisms. The cultures have been obtained and the IV has been established, which antibiotic should be given first? a. the antibiotic that treats gram - organisms b. the antibiotic that treats gram + organisms c. they should be given simultaneously d. it does not matter which one is given first as they both need to be administered a. since gram - organisms are the ones that release endotoxins that may lead to multiorgan failure, they need to be treated first. Whic of the following has th emost negative effect on the prognosis of a drowning patient? a. a child that was submerged in cool water for 9 minutes b. a child that received cpr within 8 minutes of drowning c. a child that was submerged in a pool in the summer for 8 minutes d. a child who's initial pH was 7.2 c. being submerged in warm water has a negative prognostic effect. cool water can created a protective hypothermia that allows blood to shunt to the brain and heart. It is imperative to recieve CPR within 10 minutes of drowning. An initial pH greater than 7.1 offers a potentially better prognosis All of the following are potential complications of near drowning except: a. coagulopathy b. pulmonary edema c. HUS. d. seizures C. Drowning can lead to multi organ failure and affect every body system. Although renal failure can result from near drowning, it is not associated with the development of HUS CRITICAL CARE REGISTERED NURSE(CCRN) MULTISYSTEM WITH VERIFIED ANSWERS EXAM The nurse is caring for Cassie, a 3 year old admitted due to drowning. Cassie fell through the ice of the neighborhood pond and required CPR at the scene. Which of the following should be included in Cassie's care? a. anticipate the ventilatory rate to be slightly lower than expected to allow slightly elevated Co2 levels. b. anticipate the use of PEEP with the ventilator settings c. Ensure that o2 delivery is cool and moist d. avoidance of the use of inotropes. B. peep is often needed in a drowining patient to help with o2 delivery. the ventilator settings usually allow for slight to moderate hyperventilation to assist with hypercapnea. Because the child needs to be rewarmed, o2 and IV fluids should be warmed. Inotropes are adminsitered to assist with myocardial contractility that is impaired due to acidosis, hypoxia, and hypothermia. Adult supervision is the most important measure to prevent drowning in children. Of the following which is the most effective preventative measure against back yard drowning? a. pool alarms b. retractable pool covers c. fencing around the pool d. keeping flotation devices on the arms of children when outside C. Although all of the measures listed are helpful, keeping the entire pool surrounded by a fence is the most effective of the measures listed. Which of the following is not how the body responds to sympathetic nervous system activation? a. constiction of blood vessels in kidney b. dilation of blood vessels in skeletal muscle c. dilation of coronary arteries. d. constriction of pupils EXAM d.