Acute and Critical Care Nursing Exam Review
Course Introduction
Acute and Critical Care Nursing is designed to equip students with the advanced knowledge and clinical skills necessary to care for patients experiencing life-threatening conditions and medical emergencies. The course emphasizes rapid assessment, decision-making, and evidence-based interventions for patients in acute and critical situations across a variety of healthcare settings such as intensive care units, emergency departments, and trauma centers. Students will explore topics including hemodynamic monitoring, mechanical ventilation, pharmacologic management, and advanced life support, alongside considerations for family support and ethical dilemmas. Through theoretical and practical learning experiences, students will enhance their ability to provide high-quality, compassionate care to critically ill patients.
Recommended Textbook
Introduction to Critical Care Nursing 6th Edition by Mary Lou Sole
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21 Chapters
756 Verified Questions
756 Flashcards
Source URL: https://quizplus.com/study-set/2011
Page 2
Chapter 1: Overview of Critical Care Nursing
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/39999
Sample Questions
Q1) Which of the following nursing activities demonstrates implementation of the AACN Standards of Professional Performance? (Select all that apply.)
A) Attending a meeting of the local chapter of the American Association of Critical-Care Nurses in which a continuing education program on sepsis is being taught
B) Collaborating with a pastoral services colleague to assist in meeting spiritual needs of the patient and family
C) Participating on the unit's nurse practice council
D) Posting an article from Critical Care Nurse on management of venous thromboembolism for your colleagues to read
E) Using evidence-based strategies to prevent ventilator-associated pneumonia
F) None of above
Answer: A,B,C,D,E
Q2) The first critical care units were: (Select all that apply.)
A) burn units.
B) coronary care units
C) recovery rooms.
D) neonatal intensive care units.
Answer: B,C
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Chapter 2: Patient and Family Response to the Critical Care Experience
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28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/40000
Sample Questions
Q1) 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?
A) Ask a family member to help you bathe the patient, and discuss the family structure with the family member during the procedure.
B) Because she is unconscious, complete care as quickly and quietly as possible.
C) Tell the patient the day and time, and that you are bathing her. Reassure her that you are there.
D) Turn the television on to the evening news so that you and the patient can be updated to current events.
Answer: C
Q2) Which intervention is appropriate to assist the patient to cope with admission to the critical care unit?
A) Allowing unrestricted visiting by several family members at one time
B) Explaining all procedures in easy-to-understand terms
C) Providing back massage and mouth care
D) Turning down the alarm volume on the cardiac monitor
Answer: B
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Chapter 3: Ethical and Legal Issues in Critical Care Nursing
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23 Verified Questions
23 Flashcards
Source URL: https://quizplus.com/quiz/40001
Sample Questions
Q1) The nurse is caring for a patient with severe neurological impairment following a massive stroke.The physician has ordered tests to determine brain death.The nurse understands that criteria for brain death include: (Select all that apply.)
A) absence of cerebral blood flow.
B) absence of brainstem reflexes on neurological examination.
C) Cheyne-Stokes respirations.
D) flat electroencephalogram.
Answer: A,B,D
Q2) The nurse is caring for a critically ill patient on mechanical ventilation.The physician identifies the need for a bronchoscopy,which requires informed consent.If the physician were to obtain consent from the patient,the patient must be able to:
A) be weaned from mechanical ventilation.
B) have knowledge and competence to make the decision.
C) nod his head that it is okay to proceed.
D) read and write in English.
Answer: B
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Chapter 4: End-Of-Life Care in the Critical Care Unit
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/40002
Sample Questions
Q1) The family is considering withdrawing life-sustaining measures from the patient.The nurse knows that ethical principles for withholding or withdrawing life-sustaining treatments include which of the following?
A) Any treatment may be withdrawn and withheld, including nutrition, antibiotics, and blood products.
B) Doses of analgesic and anxiolytic medications must be adjusted carefully and should not exceed usual recommended limits.
C) Life-sustaining treatments may be withdrawn while a patient is receiving paralytic agents.
D) The goal of withdrawal and withholding of treatments is to hasten death and thus relieve suffering.
Q2) A statement that provides a legally recognized description of an individual's desires regarding care at the end of life is a (an):
A) advance directive.
B) guardianship ad litem.
C) healthcare proxy.
D) power of attorney.
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Chapter 5: Comfort and Sedation
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33 Verified Questions
33 Flashcards
Source URL: https://quizplus.com/quiz/40003
Sample Questions
Q1) The nurse is assessing pain levels in a critically ill patient using the Behavioral Pain Scale.The nurse recognizes ________ as indicating the greatest level of pain.
A) brow lowering
B) eyelid closing
C) grimacing
D) relaxed facial expression
Q2) In the critically ill patient,an incomplete assessment and/or management of pain or anxiety may be hampered by which of the following? (Select all that apply.)
A) Administration of neuromuscular blocking agents
B) Delirium
C) Effective nurse communication and assessment skills
D) Nonverbal patients
Q3) The nurse is concerned that the patient will pull out the endotracheal tube.As part of the nursing management,the nurse obtains an order for:
A) a Posey-type vest.
B) a higher dosage of lorazepam.
C) propofol.
D) soft wrist restraints.
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7
Chapter 6: Nutritional Support
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/40004
Sample Questions
Q1) A patient is receiving enteral feedings and has just vomited 250 mL of milky green liquid.The nurse holds the tube feeding,which had been infusing at 100 mL/hr.The nurse knows that the next action should be:
A) connect the feeding tube to suction.
B) continue the tube feeding.
C) decrease the tube feeding.
D) recheck the residual in 2 hours.
Q2) Which intervention(s)is (are)critical during intravenous lipid administration? (Select all that apply).
A) Assess glucose levels.
B) Change the tubing every 24 hours.
C) Hold lipids when administering antibiotics through the same line.
D) Monitor triglyceride levels.
Q3) Risks of total parenteral nutrition include: (Select all that apply.)
A) diarrhea.
B) elevated blood sugar.
C) infection at the catheter site.
D) volume overload.
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8
Chapter 7: Dysrhythmia Interpretation and Management
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59 Verified Questions
59 Flashcards
Source URL: https://quizplus.com/quiz/40005
Sample Questions
Q1) The patient is having premature ventricular contractions (PVCs).The nurse's greatest concern should be:
A) the proximity of the R wave of the PVC to the T wave of a normal beat.
B) the fact that PVCs are occurring, because they are so rare.
C) if the number of PVCs are decreasing.
D) if the PVCs are wider than 0.12 seconds.
Q2) The QT interval is the total time taken for ventricular depolarization and repolarization.Prolongation of the QT interval:
A) decreases the risk of lethal dysrhythmias.
B) usually occurs when heart rate increases.
C) increases the risk of lethal dysrhythmias.
D) can only be measured with irregular rhythms.
Q3) The patient's heart rhythm shows an inverted P wave with a PR interval of 0.06 seconds.The heart rate is 54 beats per minute.The nurse recognizes the rhythm as a junctional escape rhythm,and understands that the rhythm is due to the:
A) loss of sinus node activity.
B) increased rate of the AV node.
C) increased rate of the SA node.
D) decreased rate of the AV node.
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Page 9
Chapter 8: Hemodynamic Monitoring
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40006
Sample Questions
Q1) The nurse is caring for a patient following insertion of a left subclavian central venous catheter ( CVC ).Which assessment finding 2 hours after insertion by the nurse warrants immediate action?
A) Diminished breath sounds over left lung field
B) Localized pain at catheter insertion site
C) Measured central venous pressure of 5 mm Hg
D) Slight bloody drainage around insertion site
Q2) Following insertion of a pulmonary artery catheter ( PAC ),the physician orders the nurse to obtain a blood sample for mixed venous oxygen saturation ( SvO<sub>2</sub>
).Which action by the nurse best ensures the obtained value is accurate?
A) Zero referencing the transducer at the level of the phlebostatic axis following insertion
B) Calibrating the system with a central venous blood sample and arterial blood gas value
C) Ensuring patency of the catheter using a 0.9% normal saline solution pressurized at 300 mm Hg
D) Using noncompliant pressure tubing that is no longer than 36 to 48 inches and has minimal stopcocks
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Page 10
Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/40007
Sample Questions
Q1) The nurse is assessing the exhaled tidal volume (EVT)in a mechanically ventilated patient.The rationale for this assessment is to:
A) assess for tension pneumothorax.
B) assess the level of positive end-expiratory pressure.
C) compare the tidal volume delivered with the tidal volume prescribed.
D) determine the patient's work of breathing.
Q2) The amount of effort needed to maintain a given level of ventilation is termed: A) compliance.
B) resistance.
C) tidal volume.
D) work of breathing.
Q3) Oxygen saturation (SaO<sub>2</sub>)represents:
A) alveolar oxygen tension.
B) oxygen that is chemically combined with hemoglobin.
C) oxygen that is physically dissolved in plasma.
D) total oxygen consumption.
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Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40008
Sample Questions
Q1) The nurse chooses which method and concentration of oxygen administration until intubation is established in a patient who has sustained a cardiopulmonary arrest?
A) Bag-valve-mask at FiO<sub>2</sub> of 100%
B) Bag-valve-mask at FiO<sub>2</sub> of 50%
C) Mouth-to-mask ventilation with supplemental oxygen
D) Non-rebreather mask at FiO<sub>2</sub> of 100%
Q2) The patient is diagnosed with abrupt onset of supraventricular tachycardia (SVT).The nurse prepares which medication that has a short half-life and is recommended to treat symptomatic SVT?
A) Adenosine
B) Amiodarone
C) Diltiazem
D) Procainamide
Q3) During cardioversion,the nurse would synchronize the electrical charge to coincide with which wave of the ECG complex?
A) P
B) R
C) S
D) T
Page 12
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Chapter 11: Shock, sepsis, and Multiple Organ Dysfunction Syndrome
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/40009
Sample Questions
Q1) 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?
A) Cardiac index (CI) of 2.5 L/min/m²
B) Pulmonary artery diastolic pressure of 26 mm Hg
C) Pulmonary artery occlusion pressure (PAOP) of 22 mm Hg
D) Systemic vascular resistance (SVR) of 1600 dynes/sec/cm-5
Q2) 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?
A) High pulmonary artery diastolic pressure and low cardiac output
B) Low pulmonary artery occlusive pressure and low cardiac output
C) Low systemic vascular resistance and high cardiac output
D) Normal cardiac output and low systemic vascular resistance
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Chapter 12: Cardiovascular Alterations
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37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/40010
Sample Questions
Q1) The patient presents to the ED with sudden severe sharp chest discomfort radiating to his back and down both arms,as well as numbness in his left arm.While taking the patient's vital signs,the nurse notices a 30-point discrepancy in systolic blood pressure between the right and left arm.Based on these findings,the nurse should:
A) contact the physician and report the cardiac enzyme results.
B) contact the physician and prepare the patient for thrombolytic therapy.
C) contact the physician immediately and begin prepping the patient for surgery.
D) give the patient aspirin and heparin.
Q2) The patient's wife is feeling overwhelmed and tells the nurse that she doesn't know if she can manage to cook different dinners for her husband and the rest of the family to satisfy his cholesterol-reducing diet.The nurse tells her:
A) "It will be worth it to have him healthy, won't it?"
B) "The low-cholesterol diet is one from which everyone can benefit."
C) "As long as you change at least a few things in the diet, it will be okay."
D) "You can go on the diet with him, and then just let the children eat whatever they want."
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Chapter 13: Nervous System Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40011
Sample Questions
Q1) The nurse admits a patient to the critical care unit following a motorcycle crash.Assessment findings by the nurse include blood pressure 100/50 mm Hg,heart rate 58 beats/min,respiratory rate 30 breaths/min,and temperature of 100.5°.The patient is lethargic,responds to voice but falls asleep readily when not stimulated.Which nursing action is most important to include in this patient's plan of care?
A) Frequent neurological assessments
B) Side to side position changes
C) Range of motion to extremities
D) Frequent oropharyngeal suctioning
Q2) A patient with a head injury has an intracranial pressure (ICP)of 18 mm Hg.Her blood pressure is 144/90 mm Hg,and her mean arterial pressure (MAP)is 108 mm Hg.What is the cerebral perfusion pressure (CPP)?
A) 54 mm Hg
B) 72 mm Hg
C) 90 mm Hg
D) 126 mm Hg
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15
Chapter 14: Acute Respiratory Failure
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/40012
Sample Questions
Q1) Which of the following acid-base disturbances commonly occurs with the hyperventilation and impaired gas exchange seen in severe exacerbation of asthma?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Q2) A definitive diagnosis of pulmonary embolism can be made by:
A) arterial blood gas (ABG) analysis.
B) chest x-ray examination.
C) pulmonary angiogram.
D) ventilation-perfusion scanning.
Q3) Select the strategies for preventing deep vein thrombosis (DVT)and pulmonary embolus (PE).(Select all that apply.)
A) Graduated compression stockings
B) Heparin or low-molecular weight heparin for patients at risk
C) Sequential compression devices
D) Strict bed rest
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16
Chapter 15: Acute Kidney Injury
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50 Verified Questions
50 Flashcards
Source URL: https://quizplus.com/quiz/40013
Sample Questions
Q1) The nurse is caring for an elderly patient who was admitted with renal insufficiency.The nurse realizes that with advance age often comes declining renal function.An expected laboratory finding for this patient may be:
A) an increased glomerular filtration rate (GFR).
B) a normal serum creatinine level.
C) increased ability to excrete drugs.
D) hypokalemia.
Q2) The patient has elevated blood urea nitrogen (BUN)and serum creatinine levels with a normal BUN/creatinine ratio.These levels most likely indicate:
A) increased nitrogen intake.
B) acute kidney injury, such as acute tubular necrosis (ATN).
C) hypovolemia.
D) fluid resuscitation.
Q3) An advantage of peritoneal dialysis is that:
A) peritoneal dialysis is time intensive.
B) a decreased risk of peritonitis exists.
C) biochemical disturbances are corrected rapidly.
D) the danger of hemorrhage is minimal.
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Chapter 16: Hematological and Immune Disorders
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55 Verified Questions
55 Flashcards
Source URL: https://quizplus.com/quiz/40014
Sample Questions
Q1) A reduction in the number of circulating RBCs or hemoglobin,which leads to inadequate oxygenation of tissues,is known as:
A) polycythemia.
B) anemia.
C) iron deficiency.
D) an increase in hemoglobin.
Q2) The nurse is caring for a patient receiving chemotherapeutic agents,and notices that the patient's neutrophils count is low.The nurse realizes that:
A) the patient has a bacterial infection.
B) a shift to the left is occurring.
C) chemotherapeutic agents alter the ability to fight infection.
D) neutrophils have a long life span and multiply slowly.
Q3) The patient's white blood cell ( WBC )level is 4000 cells/microliter.The differential shows a neutrophil count of 65% and a band level of 5%.The absolute neutrophil count is A) 4000 cells/microliter.
B) 3000 cells/microliter.
C) 2800 cells/microliter.
D) 2600 cells/microliter.
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Chapter 17: Gastrointestinal Alterations
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/40015
Sample Questions
Q1) Nursing priorities for the management of acute pancreatitis include: (Select all that apply.)
A) managing respiratory dysfunction.
B) assessing and maintaining electrolyte balance.
C) withholding analgesics that could mask abdominal discomfort.
D) stimulating gastric content motility into the duodenum.
E) utilizing supportive therapies aimed at decreasing gastrin release.
Q2) When caring for the patient with upper GI bleeding,the nurse assesses for which of the following? (Select all that apply.)
A) Severity of blood loss
B) Hemodynamic stability
C) Vital signs every 30 minutes
D) Signs of hypervolemic shock
E) Necessity for fluid resuscitation
Q3) Pain control is a nursing priority in patients with acute pancreatitis because pain:
A) increases pancreatic secretions.
B) is caused by decreased distention of the pancreatic capsule.
C) decreases the patient's metabolism.
D) is caused by dilation of the biliary system.
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Page 19
Chapter 18: Endocrine Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40016
Sample Questions
Q1) Which of the following would be seen in a patient with myxedema coma?
A) Decreased reflexes
B) Hyperthermia
C) Hyperventilation
D) Tachycardia
Q2) The most significant clinical finding of acute adrenal crisis associated with fluid and electrolyte balance is:
A) fluid volume excess.
B) hyperglycemia.
C) hyperkalemia
D) hypernatremia
Q3) A patient presents to the emergency department with suspected thyroid storm.The nurse should be alert to which of the following cardiac rhythms while providing care to this patient?
A) Atrial fibrillation
B) Idioventricular rhythm
C) Junctional rhythm
D) Sinus bradycardia
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Chapter 19: Trauma and Surgical Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40017
Sample Questions
Q1) Which of the following best defines the term traumatic injury?
A) All trauma patients can be successfully rehabilitated.
B) Traumatic injuries cause more deaths than heart disease and cancer.
C) Alcohol consumption, drug abuse, or other substance abuse contribute to traumatic events.
D) Trauma mainly affects the older adult population.
Q2) Treatment and/or prevention of rhabdomyolysis in at-risk patients includes aggressive fluid resuscitation to achieve urine output of:
A) 30 mL/hr.
B) 50 mL/hr.
C) 100 mL/hr.
D) 300 mL/hr.
Q3) During the treatment and management of the trauma patient,maintaining tissue perfusion,oxygenation,and nutritional support are strategies to prevent:
A) disseminated intravascular coagulation.
B) multisystem organ dysfunction.
C) septic shock.
D) wound infection.
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Chapter 20: Burns
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40018
Sample Questions
Q1) When paramedics notice singed hairs in the nose of a burn patient,it is recommended that the patient be intubated.What is the reasoning for the immediate intubation?
A) Carbon monoxide poisoning always occurs when soot is visible.
B) Inhalation injury above the glottis may cause significant edema that obstructs the airway.
C) The patient will have a copious amount of mucus that will need to be suctioned.
D) The singed hairs and soot in the nostrils will cause dysfunction of cilia in the airways.
Q2) The nurse is providing care to manage the pain of a patient with burns.The physician has ordered opiates to be given intramuscularly.The nurse contacts the physician to change the order to intravenous administration because:
A) intramuscular injections cause additional skin disruption.
B) burn pain is so severe it requires relief by the fastest route available.
C) hypermetabolism limits effectiveness of medications administered intramuscularly.
D) tissue edema may interfere with drug absorption of injectable routes.
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Chapter 21: Solid Organ Transplantation
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40019
Sample Questions
Q1) A patient presents to the outpatient transplant clinic stating,"I would like to donate one of my kidneys." What is the best response by the nurse?
A) "To be a living donor, you must be related to the recipient."
B) "You must be over the age of 30 to be a living donor."
C) "Living donor donation is coordinated by UNOS."
D) "Let us orient you to the process required to become a donor."
Q2) Which statement best describes the lung allocation score (LAS)used to prioritize lung transplant recipients?
A) The LAS is based on lab values, diagnostic tests, and medical diagnosis.
B) Lungs from children and adolescents are offered to adults first.
C) The LAS is limited to candidates under the age of 65 years.
D) The score was developed to estimate 5-year survival rates.
Q3) Which statement best represents appropriate donor-to-recipient criteria for liver transplantation?
A) Blood type and HLA tissue type
B) HLA tissue type and body type
C) Body type and body size
D) Blood type and donor history
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