Exam (elaborations)
CEN PRACTICE TEST QUESTIONS AND ANSWERS
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CEN PRACTICE TEST QUESTIONS AND ANSWERS
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CEN PRACTICE TEST QUESTIONS AND ANSWERSPreload refers to:
a. The volume of blood entering the left side of the heart
b. The volume of blood entering the right side of the heart
c. The pressure in the venous system that the heart must overcome to pump the blood
d. The pressure in the arterial system that the heart must overcome to pump the blood -
Answers -b. The volume of blood entering the right side of the heart
Preload is the volume of blood that enters the right side of the heart. This volume
stretches the fibers in the heart prior to contraction. Preload is commonly measured as
atrial pressure.
The patient is brought to the ED with an anterior ST-elevation myocardial infarction
(STEMI). You are assessing him for possible administration of fibrinolytics. An absolute
contraindication for this treatment is:
a. The patient's pain is not relieved by medications.
b. Symptoms began 36 hours before arrival.
c. The patient has received aspirin in the last 2 hours.
d. The patient had a previous MI 6 years ago. - Answers -b. Symptoms began 36 hours
before arrival.
Fibrinolytic therapy is generally NOT recommended for patients whose symptoms
began more than 12 hours before arrival. Fibrinolytics should not be given if the onset of
symptoms was more than 24 hours before arrival UNLESS a posterior MI is diagnosed.
In this case, the MI was anterior.
The team is performing CPR on a patient. The rhythm that will respond to an electrical
shock is:
a. Asystole
b. PEA
c. Ventricular fibrillation
d. SVT - Answers -c. Ventricular fibrillation
Ventricular fibrillation and pulseless ventricular tachycardia are the two rhythms that are
considered to be "shockable" cardiac arrest rhythms. Although asystole and PEA are
cardiac arrest rhythms, they will not respond to electrical shock.
When suctioning during a cardiac arrest, suctioning should be limited to which of the
following?
a. Less than 5 seconds
b. Less than 10 seconds
,c. Less than 20 seconds
d. Less than 30 seconds - Answers -b. Less than 10 seconds
According to the 2010 BLS and ACLS guidelines, suctioning for longer than 10 seconds
may result in pulling too much oxygen out of the airways resulting in hypoxemia.
Possible causes of cardiac arrest include all of the following EXCEPT:
a. Hypervolemia
b. Hypoxia
c. Hypokalemia
d. Tension Pneumothorax - Answers -a. Hypervolemia
Common causes of cardiac arrest are known as the H's and T's and include:
hypovolemia (NOT hypervolemia), hypoxia, hydrogen ion excess (acidosis), hypo or
hyperkalemia, hypothermia, tension pneumothorax, tamponade, toxins, and thrombosis
(pulmonary or coronary). Correction of these causes can often reverse a cardiac arrest.
You are providing ventilations using a Bag-mask device. Suddenly, you do not see the
patient's chest rise with the ventilation. You reposition the patient to ensure an open
airway. When you attempt to ventilate, you do not see his chest rise. The most likely
cause of this is:
a. The bag-mask device is faulty
b. Airway obstruction
c. The patient has suffered an MI
d. Cardiac tamponade - Answers -b. Airway obstruction
The nurse should recognize that these signs and symptoms in a teenage boy may be
indicative of testicular torsion. Although all of the treatments may be used, surgery is the
definitive treatment for this condition.
A 24-year-old woman is seen in the emergency department complaining of urinary
frequency, pain with urination and urgency. Vital signs are stable and within normal
limits. When you obtain a urine specimen, you note that it is cloudy and foul smelling.
You should prepare the patient for:
a. Admission for acute renal failure
b. Discharge with antibiotic therapy
c. Admission for lithotripsy
d. Discharge without medications - Answers -b. Discharge with antibiotic therapy
The symptoms of dysuria, urgency and frequency are classic indicators of a urinary tract
infection. Urinary tract infections are very common in women and can almost always be
treated on an outpatient basis with a course of antibiotics.
, A woman is admitted to the ED with complaints of lower abdominal pain, smelly vaginal
discharge, pain with intercourse, and burning with urination. Her vital signs are stable,
and she has no other symptoms. Treatment for this patient will likely include:
a. Hysterectomy
b. Inpatient treatment
c. Antibiotics
d. No treatment is needed - Answers -c. Antibiotics
Given the patient symptoms, the nurse should suspect that the patient has pelvic
inflammatory disease (PID). With early antibiotic treatment, this infection can be treated
on an outpatient basis. Without treatment, the infection can continue and cause scar
tissue that may lead to infertility and ectopic pregnancies.
When evaluating a patient for Acute Renal Failure, it is helpful to use the RIFLE criteria
for classification. This acronym refers to:
a. Risk, Injury, Functional decrease, Loss, and End-Stage kidney disease
b. Risk, Iatrogenic factors, Failure, Labile diabetes, and End-Stage kidney disease
c. Risk, Iatrogenic factors, Failure, Loss, and End-Stage kidney disease
d. Risk, Injury, Failure, Loss, and End-Stage kidney disease - Answers -d. Risk, Injury,
Failure, Loss, and End-Stage kidney disease
ARF can be classified by using Risk, Injury, Failure, Loss and End-stage kidney
disease. Risk is defined as an increased serum creatinine level at 1.5 times normal or
decrease of glomerular filtration rate (GFR) by 25% or decrease in urine output less
than 0.5 cc/kg/hr for more than 6 hours. AFR is defined as Injury when the serum
creatinine level is increased more than 2 times, GFR is decreased by 50% or urine
output is less than 0.5 cc/kg/hr for 12 hours. AFR is defined as Failure when the serum
creatinine level is increased more than 3 times, GFR is decreased by 75% or urine
output is less than 0.3 cc/kg/hr for 24 hours or anuria for 12 hours. AFR is classified as
Loss if there is persistent ARF or if there is a complete loss of kidney function for more
than 4 weeks. End-stage kidney disease is defined as a loss of kidney function for more
than 3 months.
The nurse has assisted in an emergent delivery of an infant in the Emergency
Department. The infant was born 2 weeks before the due date and is small for
gestational age. The nurse documents a thin upper lip, small eye openings, and a
smooth philtrum above the upper lip. This child may be diagnosed with:
a. Vitamin B12 deficiency
b. Folic acid deficiency
c. Fetal alcohol syndrome
d. Diabetes - Answers -c. Fetal alcohol syndrome
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