Advanced Practice Nursing in Critical Care
Exam Questions
Course Introduction
Advanced Practice Nursing in Critical Care is designed to equip graduate-level nursing students with the advanced knowledge and clinical competencies required to manage the complex needs of critically ill patients. The course focuses on comprehensive assessment, rapid decision-making, and evidence-based interventions in critical care settings. Key areas include pathophysiology, pharmacology, advanced patient monitoring, and life-support technologies. Through case studies and simulation experiences, students will develop skills in interdisciplinary collaboration, leadership, and ethical decision-making, preparing them for advanced roles in intensive care units, emergency departments, and specialty critical care environments.
Recommended Textbook
Introduction to Critical Care Nursing 7th Edition by Mary Lou Sole
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21 Chapters
757 Verified Questions
757 Flashcards
Source URL: https://quizplus.com/study-set/1966 Page 2
Chapter 1: Overview of Critical Care Nursing
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/39100
Sample Questions
Q1) Which of the following professional organizations best supports critical care nursing practice?
A) American Association of Critical-Care Nurses
B) American Heart Association
C) American Nurses Association
D) Society of Critical Care Medicine
Answer: A
Q2) The family members of a critically ill patient bring a copy of the patient's living will to the hospital,which identifies the patient's wishes regarding health care.You discuss contents of the living will with the patient's physician.This is an example of implementation of which of the AACN Standards of Professional Performance?
A) Acquires and maintains current knowledge of practice
B) Acts ethically on the behalf of the patient and family
C) Considers factors related to safe patient care
D) Uses clinical inquiry and integrates research findings in practice
Answer: B
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3
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/39101
Sample Questions
Q1) Family members have a need for information.Which interventions best assist in meeting this need?
A) Handing family members a pamphlet that explains all of the critical care equipment
B) Providing a daily update of the patient's progress and facilitating communication with the intensivist
C) Telling them that you are not permitted to give them a status report but that they can be present at 4:00 PM for family rounds with the intensivist
D) Writing down a list of all new medications and doses and giving the list to family members during visitation
Answer: B
Q2) Which intervention is appropriate to assist the patient in coping 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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4
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/39102
Sample Questions
Q1) The nurse is caring for a patient who is declared brain dead and is an organ donor.The following events occur: 1300 Diagnostic tests for brain death are completed.1330 Intensivist reviews diagnostic test results and writes in the progress note that the patient is brain dead.1400 Patient is taken to the operating room for organ retrieval.1800 All organs have been retrieved for donation.The ventilator is discontinued.1810 Cardiac monitor shows flatline.What is the official time of death recorded in the medical record?
A) 1300
B) 1330
C) 1400
D) 1800
E) 1810
Answer: B
Q2) Which of the following organizations requires a mechanism for addressing ethical issues?
A) American Association of Critical-Care Nurses
B) American Hospital Association
C) Society of Critical Care Medicine
D) The Joint Commission
Answer: D
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Page 5
Chapter 4: End-Of-Life Care and Palliative Care in Critical Care Settings
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/39103
Sample Questions
Q1) The family is considering the withdrawal of 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 patient with end-stage heart failure is experiencing considerable dyspnea.Appropriate palliative management of this symptom includes:
A) administration of midazolam (Versed).
B) administration of morphine.
C) an increase in the amount of oxygen being delivered to the patient.
D) aggressive use of inotropic and vasoactive medications to improve heart function.
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Page 6
Chapter 5: Comfort and Sedation
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33 Verified Questions
33 Flashcards
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Sample Questions
Q1) Choose the items that are common to both pain and anxiety.
A) Cyclical exacerbation of one another
B) Require good nursing assessment for proper treatment
C) Response only to real phenomena
D) Subjective in nature
E) Perception may be influenced by prior experience
Q2) In the healthy individual,pain and anxiety:
A) activate the sympathetic nervous system (SNS).
B) decrease stress levels.
C) help remove one from harm.
D) increase performance levels.
E) limit sympathetic nervous system activity.
Q3) The assessment of pain and anxiety is a continuous process.When critically ill patients exhibit signs of anxiety,the nurse's first priority is to
A) administer antianxiety medications as ordered.
B) administer pain medication as ordered.
C) identify and treat the underlying cause.
D) reassess the patient hourly to determine whether symptoms resolve on their own.
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Chapter 6: Nutritional Support
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) A patient is being ventilated and has been started on enteral feedings with a nasogastric small-bore feeding tube.What is the primary reason the nurse must frequently assess tube placement?
A) To assess for paralytic ileus
B) To maintain the patency of the feeding tube
C) To monitor for skin breakdown on the nose
D) To prevent aspiration of the feedings
Q2) A patient,who has a tube feeding,requires a chest x-ray study for evaluation of a cough.To reduce the risk of aspiration,the nurse:
A) helps the radiology technician to position the patient to avoid dislodging the tube.
B) slows the rate of the feedings until placement has been verified.
C) cuts the infusion rate by half.
D) stops feedings 10 to 15 minutes before placing flat to obtain the radiograph.
Q3) Which statement is true about normal function of the gastrointestinal (GI)tract?
A) Failure of the tight junctions allows bacteria to invade the GI tract.
B) The gut lacks protective mechanisms; thus, infection is always a concern.
C) Water is reabsorbed at the beginning of the colon.
D) Without nutritional stimulation, mucosal villi atrophy.
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Chapter 7: Dysrhythmia Interpretation and Management
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59 Verified Questions
59 Flashcards
Source URL: https://quizplus.com/quiz/39106
Sample Questions
Q1) The nurse notices sinus bradycardia on the patient's cardiac monitor.The nurse should
A) give atropine to increase heart rate.
B) begin transcutaneous pacing of the patient.
C) start a dopamine infusion to stimulate heart function.
D) assess for hemodynamic instability.
Q2) The patient is scheduled to have a permanent pacemaker implanted.The patient asks the nurse,"How long will the battery in this thing last?" The nurse should answer,
A) "Life expectancy is about 1 year. Then it will need to be replaced."
B) "Pacemaker batteries can last up to 25 years with constant use."
C) "Battery life varies depending on usage, but it can last up to 10 years."
D) "Pacemakers are used to treat temporary problems, so the batteries don't last long."
Q3) 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) whether the number of PVCs is decreasing.
D) whether the PVCs are wider than 0.12 seconds.
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Chapter 8: Hemodynamic Monitoring
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/39107
Sample Questions
Q1) The nurse is preparing to obtain a right atrial pressure (RAP/CVP)reading.What are the most appropriate nursing actions?
A) Compare measured pressures with other physiological parameters.
B) Flush the central venous catheter with 20 mL of sterile saline.
C) Inflate the balloon with 3 mL of air and record the pressure tracing.
D) Obtain the right atrial pressure measurement during end exhalation.
E) Zero reference the transducer system at the level of the phlebostatic axis.
Q2) The nurse is caring for a mechanically ventilated patient being monitored with a left radial arterial line.During the inspiratory phase of ventilation,the nurse assesses a 20 mm Hg decrease in arterial blood pressure.What is the best interpretation of this finding by the nurse?
A) The mechanical ventilator is malfunctioning.
B) The patient may require fluid resuscitation.
C) The arterial line may need to be replaced.
D) The left limb may have reduced perfusion.
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Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/39108
Sample Questions
Q1) A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min.His spontaneous respirations are 12 breaths/min.He receives a dose of morphine sulfate,and his respirations decrease to 4 breaths/min.What adjustments may need to be made to the patient's ventilator settings?
A) Add positive end-expiratory pressure (PEEP).
B) Add pressure support.
C) Change to assist/control ventilation at a rate of 4 breaths/min.
D) Increase the synchronized intermittent mandatory ventilation respiratory rate.
Q2) A PaCO<sub>2</sub> of 48 mm Hg is associated with
A) hyperventilation.
B) hypoventilation.
C) increased absorption of O<sub>2</sub>.
D) increased excretion of HCO<sub>3</sub>.
Q3) Pulse oximetry measures
A) arterial blood gases.
B) hemoglobin values.
C) oxygen consumption.
D) oxygen saturation.
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Page 11
Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/39109
Sample Questions
Q1) It is determined that the patient needs a transcutaneous pacemaker until a transvenous pacemaker can be inserted.What is the most appropriate nursing intervention?
A) Apply conductive gel to the skin.
B) Provide adequate sedation and analgesia.
C) Recheck leads to make sure that the rhythm is asystole.
D) Set the milliamperes to 2 mA below the capture level.
Q2) During a code,the nurse would place paddles for anterior defibrillation in what locations?
A) Second intercostal space, left sternal border and fourth intercostal space, left midclavicular line
B) Second intercostal space, right sternal border and fourth intercostal space, left midaxillary line
C) Second intercostal space, right sternal border and fifth intercostal space, left midclavicular line
D) Fourth intercostal space, right sternal border and fifth intercostal space, left midclavicular line
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Page 12
Chapter 11: Organ Donation
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/39110
Sample Questions
Q1) 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) Blood type and body size
D) Blood type and donor history
Q2) The nurse is preparing to administer a renal transplant recipient's first dose of mycophenolate mofetil (CellCept).What is the best understanding of this medication by the nurse?
A) It is a calcineurin inhibitor used for induction therapy.
B) It is an antimetabolite used for maintenance therapy.
C) It is an antiproliferative agent used for maintenance therapy.
D) It is an mTOR inhibitor used for maintenance therapy.
Q3) The transplant clinic social worker is completing a social history on a patient with end-stage renal disease who is being evaluated for transplant.Which statement by the patient warrants further action?
A) "I only smoke marijuana on an occasional basis."
B) "I have two sisters who live within two hours of me."
C) "I have attended all of my scheduled dialysis sessions."
D) "My mother's side of the family has a history of cancer."
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Chapter 12: Shock,sepsis,and Multiple Organ Dysfunction Syndrome
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/39111
Sample Questions
Q1) During the initial stages of shock,what are the physiological effects of decreased cardiac output?
A) Arterial vasodilation
B) High urine output
C) Increased parasympathetic stimulation
D) Increased sympathetic stimulation
Q2) Which patient being cared for in the emergency department is most at risk for developing hypovolemic shock?
A) A patient admitted with abdominal pain and an elevated white blood cell count
B) A patient with a temperature of 102° F and a general dermal rash
C) A patient with a 2-day history of nausea, vomiting, and diarrhea
D) A patient with slight rectal bleeding from inflamed hemorrhoids
Q3) The nurse is caring for a patient admitted to the critical care unit 48 hours ago with a diagnosis of severe sepsis.As part of this patient's care plan,what intervention is most important for the nurse to discuss with the multidisciplinary care team?
A) Frequent turning
B) Monitoring intake and output
C) Enteral feedings
D) Pain management
Page 14
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Chapter 13: Cardiovascular Alterations
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37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/39112
Sample Questions
Q1) While instructing a patient on what occurs with a myocardial infarction,the nurse plans to explain which process?
A) Coronary artery spasm.
B) Decreased blood flow (ischemia).
C) Death of cardiac muscle from lack of oxygen (tissue necrosis).
D) Sporadic decrease in oxygen to the heart (transient oxygen imbalance).
Q2) The patient has undergone open chest surgery for coronary artery bypass grafting.One of the nurse's responsibilities is to monitor the patient for which common postoperative dysrhythmia?
A) Second-degree heart block
B) Atrial fibrillation or flutter
C) Ventricular ectopy
D) Premature junctional contractions
Q3) Acute myocardial infarction (AMI)can be classified as which of the following?
A) Angina
B) Nonischemic
C) Non-Q wave
D) Q wave
E) Frequent PVCs
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Page 15
Chapter 14: Nervous System Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/39113
Sample Questions
Q1) The nurse is caring for a patient admitted to the emergency department following a fall from a 10-foot ladder.Upon admission,the nurse assesses the patient to be awake,alert,and moving all four extremities.The nurse also notes bruising behind the left ear and straw-colored drainage from the left naris.What is the most appropriate nursing action?
A) Insert bilateral ear plugs.
B) Monitor airway patency.
C) Maintain neutral head position.
D) Apply a small nasal drip pad.
Q2) The nurse is caring for a patient admitted with a subarachnoid hemorrhage following surgical repair of the aneurysm.Assessment by the nurse notes blood pressure 90/60 mm Hg,heart rate 115 beats/min,respiratory rate 28 breaths/min,oxygen saturation (SpO<sub>2</sub>)99% on supplemental oxygen at 3L/min by cannula,a Glasgow Coma Score of 4,and a central venous pressure (CVP)of 2 mm Hg.After reviewing the provider prescriptions,which order is of the highest priority?
A) Lasix 20 mg intravenous push as needed
B) 500 mL albumin intravenous infusion
C) Decadron 10 mg intravenous push
D) Dilantin 50 mg intravenous push
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Chapter 15: Acute Respiratory Failure
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/39114
Sample Questions
Q1) During rounds,the provider alerts the team that proning is being considered for a patient with acute respiratory distress syndrome.The nurse understands that proning is
A) an optional treatment to improve ventilation.
B) less of a risk for skin breakdown because the patient is face down.
C) possible with minimal help from coworkers.
D) used to provide continuous lateral rotational turning.
Q2) The nurse is caring for a patient with acute respiratory distress syndrome who is hypoxemic despite mechanical ventilation.The provider prescribes a nontraditional ventilator mode as part of treatment.Despite sedation and analgesia,the patient remains restless and appears to be in discomfort.The nurse informs the provider of this assessment and anticipates an order for
A) continuous lateral rotation therapy.
B) guided imagery.
C) neuromuscular blockade.
D) prone positioning.
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Chapter 16: Acute Kidney Injury
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50 Verified Questions
50 Flashcards
Source URL: https://quizplus.com/quiz/39115
Sample Questions
Q1) A normal glomerular filtration rate is
A) less than 80 mL/min.
B) 80 to 125 mL/min.
C) 125 to 180 mL/min.
D) more than 189 mL/min.
Q2) The critical care nurse is responsible for monitoring the patient receiving continuous renal replacement therapy (CRRT).In doing so,the nurse should
A) assess that the blood tubing is warm to the touch.
B) assess the hemofilter every 6 hours for clotting.
C) cover the dialysis lines to protect them from light.
D) use clean technique during vascular access dressing changes.
Q3) The patient's potassium level is 7.0 mEq/L.Besides dialysis,which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?
A) Sodium polystyrene sulfonate
B) Sodium polystyrene sulfonate with sorbitol
C) Regular insulin
D) Calcium gluconate
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18
Chapter 17: Hematological and Immune Disorders
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56 Verified Questions
56 Flashcards
Source URL: https://quizplus.com/quiz/39116
Sample Questions
Q1) In caring for the patient who has a coagulopathy,the nurse should
A) assess fluids for occult blood.
B) observe for oozing and bleeding and remove clots that form.
C) limit invasive procedures.
D) take temperatures rectally to increase accuracy.
E) weigh dressings to assess blood loss.
Q2) Critical to caring for the immunocompromised patient is the understanding that
A) the immunocompromised patient has normal white blood cell (WBC) physiology.
B) the immunosuppression involves a single element or process.
C) infection is the leading cause of death in these patients.
D) immune incompetence is symptomatic even without pathogen exposure.
Q3) The patient is admitted for chemotherapy,but the nurse notices laboratory values indicating that the patient is immunosuppressed.The nurse should
A) place the patient in a single room with a HEPA filtration system.
B) tell staff that hand washing is not recommended when working with this patient.
C) start as many intravenous lines as possible to provide potential antibiotics.
D) avoid the use of antimicrobial soaps when bathing and providing perineal care.
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19
Chapter 18: Gastrointestinal Alterations
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52 Verified Questions
52 Flashcards
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Sample Questions
Q1) The patient is being admitted with GI bleeding.Blood work includes serial hemoglobin and hematocrit levels.The nurse understands that
A) the hematocrit is a direct reflection of quick blood loss.
B) as extravascular fluid enters the vascular space, the hematocrit increases.
C) the hematocrit value does not change substantially during the first few hours.
D) the administration of intravenous fluids has no effect on hematocrit levels.
Q2) The patient is getting neomycin for treatment of hepatic encephalopathy.While the patient is receiving this medication,it is especially important that the nurse
A) evaluate renal function studies daily.
B) give the medication every 12 hours.
C) evaluate liver studies for signs of neomycin-induced damage.
D) obtain stool guaiac tests to ensure that pathogens are being destroyed.
Q3) The patient is admitted with constipation.In anticipation of treatment,the nurse prepares to:
A) give medications that will suppress the autonomic nervous system.
B) provide therapies that will innervate the autonomic nervous system.
C) teach the patient that the submucosa is the innermost part of the gut wall.
D) give medications intravenously because the submucosa has no blood vessels.
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Chapter 19: Endocrine Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/39118
Sample Questions
Q1) 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
Q2) The nurse is assigned to care for a patient who presented to the emergency department with diabetic ketoacidosis.A continuous insulin intravenous infusion is started,and hourly bedside glucose monitoring is ordered.The targeted blood glucose value after the first hour of therapy is
A) 70 to 120 mg/dL.
B) a decrease of 25 to 50 mg/dL compared with admitting values.
C) a decrease of 35 to 90 mg/dL compared with admitting values.
D) less than 200 mg/dL.
Q3) Acute adrenal crisis is caused by
A) acute renal failure.
B) deficiency of corticosteroids.
C) high doses of corticosteroids.
D) overdose of testosterone.
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Chapter 20: Trauma and Surgical Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/39119
Sample Questions
Q1) When providing information on trauma prevention,it is important to realize that individuals age 35 to 54 years are most likely to experience which type of trauma incident?
A) High-speed motor vehicle crashes
B) Poisonings from prescription or illegal drugs
C) Violent or domestic traumatic altercations
D) Work-related falls
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) A patient has been admitted to the emergency department with a massive hemothorax.What action by the nurse takes priority?
A) Place the patient on a cardiac monitor
B) Prepare for rapid intubation
C) Seal the wound with occlusive dressings
D) Start 2 large bore IVs
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Page 22
Chapter 21: Burns
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/39120
Sample Questions
Q1) A 63-year-old patient is admitted with new-onset fever; flulike symptoms; blisters over the arms,chest,and neck; and red,painful oral mucous membranes.The patient should be further evaluated for which possible non-burn-injured skin disorder?
A) Toxic epidermal necrolysis
B) Staphylococcal scalded skin syndrome
C) Necrotizing soft tissue infection
D) Graft-versus-host disease
Q2) 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.
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