Advanced Practice Nursing in Critical Care
Mock Exam
Course Introduction
This course provides an in-depth examination of the principles and practices essential for advanced practice nurses working in critical care settings. Emphasizing clinical decision-making, pathophysiology, pharmacology, and evidence-based interventions, students will develop comprehensive assessment and management skills for acutely and critically ill patients across the lifespan. Topics include hemodynamic monitoring, mechanical ventilation, multisystem organ failure, advanced pharmacotherapeutics, and collaborative interprofessional care. Ethical and legal considerations in critical care, leadership, and communication within high-acuity environments are also explored. The course integrates simulation and case-based learning to prepare nurses for advanced roles in critical care environments.
Recommended Textbook
Priorities in Critical Care Nursing 7th Edition by Linda D. Urden
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42 Chapters
1239 Verified Questions
1239 Flashcards
Source URL: https://quizplus.com/study-set/2074
Page 2
Chapter 1: Critical Care Nursing Practice
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Prayer,guided imagery,and massage are all examples of A) alternative therapy.
B) holistic care.
C) complementary care.
D) individualized care.
Answer: C
Q2) The systematic decision-making model used by nurses is known as A) a nursing diagnosis.
B) nursing interventions.
C) nursing evaluations.
D) the nursing process.
Answer: D
Q3) Designing therapeutic activities that move a patient from one state of health to another is an example of A) a nursing diagnosis.
B) nursing interventions.
C) nursing outcomes.
D) the nursing process.
Answer: B
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Page 3
Chapter 2: Ethical Issues
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20 Flashcards
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Sample Questions
Q1) The difference between withholding treatment and withdrawing treatment is that the decision to withhold treatment
A) is used when it has been determined that there is no hope for success from the onset of care.
B) reflects surrendering hope after all options have been unsuccessful.
C) requires a court order.
D) is an economical decision not a moral or ethical decision.
Answer: A
Q2) The Code of Ethics for Nursing provides a framework for the nurse in ethical decision making and
A) is usurped by state or federal laws.
B) allows the nurse to focus on the good of society rather than the uniqueness of the client.
C) was recently adopted by the American Nurses Association.
D) provides society with a set of expectations of the profession.
Answer: D
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4
Chapter 3: Legal Issues
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A nurse fails to recognize an intubated patient's need for nasotracheal suctioning.The endotracheal tube becomes clogged,and the patient has a respiratory arrest.Which of the following best describes the type of negligence the nurse may be liable for?
A) Assessment failure
B) Planning failure
C) Implementation failure
D) Evaluation failure
Answer: A
Q2) During transport to the operating room for mitral valve replacement,a patient with a signed consent form says that she does not want to go through with the surgery and asks to be returned to her room.The best response from the nurse is:
A) "The operating room is prepared; let's not keep the surgeon waiting."
B) "You have the right to cancel surgery, but it could be weeks before you are rescheduled."
C) "You sound frightened; tell me what you are thinking."
D) "Your preoperative medications will have you feeling more relaxed in a minute; it will be OK."
Answer: C
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Page 5
Chapter 4: Genetics and Genomics in Critical Care
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Hemophilia A is an inherited disease.Which statements would be determined by the family pedigree regarding hemophilia A?
A) It is an X-linked disorder.
B) Sons have a 50% chance of having hemophilia.
C) It is a Y-linked disorder.
D) Daughters have a 50% chance of being a carrier of the trait.
E) Sons have a 25% chance of having hemophilia.
F) Daughters have a 50% chance of having hemophilia.
Q2) A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known as:
A) chromatids.
B) karyotype.
C) genomics.
D) histones.
Q3) An example of direct-to-consumer genomic testing is:
A) genetic testing through amniocentesis.
B) paternity testing from buccal swabs of the child and father.
C) biopsy of a lump for cancer.
D) drug testing using hair follicles.
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Page 6
Chapter 5: Patient and Family Education
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) _____ often occur(s)during the initial ICU visit by the family.
A) Sensory deprivation
B) Discharge teaching
C) Repeated questioning
D) Stress and anxiety
Q2) According to Malcolm Knowles' andragogy,which of the following are characteristics of the adult learner?
A) Autonomy
B) Experience
C) Instructor-driven assessments
D) Peer-directed motivation
E) Individualism
Q3) Identify which of the following questions a nurse could use to obtain assessment information.
A) "How can we help you today?"
B) "Can you tell me why you take each medication?"
C) "Are you in pain?"
D) "Are these people your main support system?"
E) "How well do you understand the directions?"
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Page 7
Chapter 6: Psychosocial and Spiritual Alterations and Management
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Anxiety can cause emotional changes in the A) hypothalamus.
B) limbic system.
C) cerebral cortex.
D) pituitary gland.
Q2) Which of the following concepts supports patients and helps them endure the physical and psychological insults of their critical illness?
A) Regression
B) Denial
C) Hope
D) Trust
Q3) A patient is admitted into the ICU with the diagnosis of gunshot wound to the head,suicide attempt.While the patient is in the ICU the nurse's interventions should include
A) limiting interaction with the patient due to antisocial behaviors exhibited by the suicidal attempt.
B) ignoring the patient's need to talk about the incident.
C) validating the patient's worth and self-esteem.
D) discontinuing any psychotropic medications.
Page 8
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Chapter 7: Sleep Alterations and Management
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) REM sleep comprises what percent of the sleep cycle?
A) 70% to 75%
B) 45% to 65%
C) 15% to 20%
D) 20% to 25%
Q2) Interventions to help with circadian synchronization include
A) opening the window blinds.
B) encouraging the patient to take frequent naps during the day.
C) administering sedatives at bedtime.
D) keeping the patient awake during the early morning hours.
Q3) The patient has been in the critical care unit for 3 weeks and has been on the intraaortic balloon pump for the past 3 days.The patient's condition has been serious,and hourly assessments and vital signs have been necessary.The nursing staff has noted that the patient has been unable to achieve sleep for more than 30 minutes at a time.The patient has been given diazepam (Valium)prn.Which techniques may assist in assessing the patient's sleep pattern?
A) Correlating sleep time with vital signs
B) Documenting sleep periods of more than 90 minutes
C) Assessing degree of arousal on hourly checks
D) Observing the length of NREM sleep periods
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Chapter 8: Nutrition Alterations and Management
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) A patient is admitted to the critical care unit with severe malnutrition as a result of hepatic failure.A triple-lumen central venous catheter is placed in the right subclavian vein,and TPN is started.Which of the following dietary restrictions should be maintained for the patient?
A) Fat and magnesium
B) Protein and sodium
C) Carbohydrate and potassium
D) Protein and calcium
Q2) A patient is admitted to the critical care unit with severe malnutrition as a result of hepatic failure.A triple-lumen central venous catheter is placed in the right subclavian vein,and TPN is started.On the third day of infusion,the patient develops symptoms of fever and chills.Which of the following complications should be suspected?
A) Air embolism
B) Pneumothorax
C) Central venous thrombosis
D) Catheter-related sepsis
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Chapter 9: Pain and Pain Management
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Sample Questions
Q1) Which of the following assessment findings might indicate respiratory depression after opioid administration?
A) Flushed, diaphoretic skin
B) Shallow respirations with a rate of 24 breaths/min
C) Tense, rigid posture
D) Snoring
Q2) The patient is admitted to the CCU with hemodynamic instability and an allergy to morphine.The nurse anticipates that the physician will order which medication for severe pain?
A) Hydromorphone
B) Codeine
C) Fentanyl
D) Methadone
Q3) C fibers are small-diameter,unmyelinated fibers that transmit what type of pain?
A) C fibers transmit diffuse, dull, aching pain.
B) C fibers conduct the rapid acute pain sensation described as prickling, sharp, and fast.
C) C fibers conduct diffuse, dull, aching pain.
D) C fibers transmit rapid acute pain sensation described as prickling, sharp, and fast.
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Page 11
Chapter 10: Sedation,Agitation,Delirium: Assessment and Management
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Sample Questions
Q1) A 56-year-old patient is admitted to the critical care unit with acute respiratory distress syndrome (ARDS).The patient has been intubated and is mechanically ventilated.The patient is becoming increasingly agitated,and the high-pressure alarm on the ventilator has been frequently triggered.The nurse's first intervention for this patient would be to
A) administer midazolam 5 mg by intravenous push immediately.
B) assess the patient to see if a physiologic reason exists for his agitation.
C) obtain a stat arterial blood gas level; his agitation indicates he is becoming increasingly hypoxic.
D) apply soft wrist restraints to keep him from pulling out the endotracheal tube.
Q2) A patient has been taking benzodiazepines and suddenly develops respiratory depression and hypotension.After careful assessment,the nurse determines that the patient is experiencing benzodiazepine overdose.What is the nurse's next step?
A) Decrease benzodiazepines to half the prescribed dose.
B) Increase IV fluids to 500 cc/hr for 2 hours.
C) Administer flumazenil (Romazicon).
D) Discontinue benzodiazepine and start propofol.
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Page 12
Chapter 11: End-Of-Life Issues
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Recommendations for creating a supportive atmosphere during withdrawal discussions include
A) telling the family when and where the procedure will occur.
B) beginning the conversation by inquiring about the emotional state of the family.
C) ending the conversation by inquiring about the emotional state of the family.
D) recommendations that the family not be present when the procedure occurs.
Q2) Disagreement and distress among physicians,nurse practitioners,and critical care nurses can lead to
A) emotional distress only.
B) ethical distress only.
C) emotional and ethical distress.
D) pessimistic opinions of care.
Q3) _____ is a powerful influence when the decision-making process is dealing with recovery or a peaceful death.
A) Hope
B) Religion
C) Culture
D) Ethics
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Chapter 12: Cardiovascular Anatomy and Physiology
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Which of the following factors influence stroke volume?
A) Afterload
B) Cardiac output
C) Contractility
D) Heart rate
E) Preload
Q2) Which step of impulse conduction is most conducive to atrial kick?
A) The firing of the sinoatrial node, which results in atrial depolarization
B) The conduction delay at the AV node, allowing time for filling
C) Conduction through the bundle of His, enhancing ventricular depolarization
D) Conduction to the Purkinje fibers, allowing for ventricular contraction
Q3) The contribution of atrial kick to ventricular filling is approximately
A) 10%.
B) 20%.
C) 5%.
D) 45%.
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14
Chapter 13: Cardiovascular Clinical Assessment
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) _____ are created by the turbulence of blood flow through a vessel caused by constriction of the blood pressure cuff.
A) Korotkoff sounds
B) Pulse pressures
C) Murmurs
D) Gallops
Q2) An 82-year-old patient is admitted into the critical care unit with a diagnosis of left-sided heart failure related to mitral stenosis.Physical assessment findings reveal tachycardia with an S? and a 3/6 systolic murmur.The nurse knows that the presence of an S? heart sound is
A) normal for a person this age.
B) a ventricular gallop.
C) a systolic sound.
D) heard best with the diaphragm of the stethoscope.
Q3) Heart murmurs are characterized by which of the following criteria?
A) Intensity
B) Location
C) Quality
D) Pitch
E) Pathologic cause
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Chapter 14: Cardiovascular Diagnostic Procedures
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75 Verified Questions
75 Flashcards
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Sample Questions
Q1) When comparing a portable chest radiograph taken in an intensive care unit bed with one taken with the patient upright in the radiology department,one significant difference is that the
A) portable chest radiograph is usually clearer.
B) one in the intensive care unit is considered a posterior view.
C) portable chest radiograph magnifies some thoracic structures and decreases the sharpness of the structures.
D) departmental chest radiograph enlarges some thoracic structures.
Q2) A patient's CVP reading suddenly increased from 10 to 48 mm Hg.His lungs are clear except for fine rales at the bases.Immediate response should be which of the following?
A) Nothing; this reading is still within normal limits.
B) Place a stat call into the physician.
C) Administer ordered prn Lasix.
D) Check the transducer level.
Q3) The value of SVO<sub>2</sub> monitoring is to determine A) oxygen saturation at the capillary level.
B) an imbalance between oxygen supply and metabolic tissue demand.
C) the diffusion of gases at the alveolar capillary membrane.
D) the predicted cardiac output for acute pulmonary edema.
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Page 16
Chapter 15: Cardiovascular Disorders
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) An essential aspect of teaching that may prevent recurrence of heart failure is
A) notifying the physician if a 2-lb weight gain occurs in 24 hours.
B) compliance with diuretic therapy.
C) taking nitroglycerin if chest pain occurs.
D) assessment of an apical pulse.
Q2) A 66-year-old patient is admitted to the critical care unit with a diagnosis of acute inferior MI.A 12-lead electrocardiogram (ECG)is done to validate the area of infarction.For the above patient,which leads on the ECG would correlate with an inferior wall MI?
A) II, III, aVF
B) V5 to V?, I, aVL
C) V? to V?
D) V? to V?
Q3) Which of the following clinical manifestations is usually the first symptom of peripheral arterial disease (PAD)?
A) Cramping when walking
B) Thrombophlebitis
C) Pulmonary embolism
D) Cordlike veins
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17
Chapter 16: Cardiovascular Therapeutic Management
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Sample Questions
Q1) A patient is being monitored by continuous ECG after placement of a transvenous pacemaker."Loss of capture" is seen on the ECG.Which nursing intervention may correct this situation?
A) Position the patient on the left side.
B) Decrease the milliamperes as ordered.
C) Increase the rate as ordered.
D) Monitor the patient in a different lead.
Q2) Adenosine (Adenocard)is an antidysrhythmic agent given primarily to A) convert supraventricular tachycardias.
B) act as a second-line drug for premature ventricular contractions (PVCs).
C) treat AV blocks.
D) coarsen ventricular fibrillation so that defibrillation is effective.
Q3) The patient is 12 hours postoperative for a CABG.The patient's vital signs include: T 103° F,HR 112,RR 22,BP 134/78 mm Hg,and O<sub>2</sub> sat 94% on 3L/NC.The nurse suspects that the patient has developed
A) infection and notifies the physician immediately.
B) infection, which is common postoperatively, and monitors the patient's condition.
C) cardiac tamponade and notifies the physician immediately.
D) delirium caused by the elevated temperature.
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Page 18
Chapter 17: Pulmonary Anatomy and Physiology
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40 Verified Questions
40 Flashcards
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Sample Questions
Q1) A patient has sustained a stroke.The speech therapist tells you that the patient cannot control his epiglottis.You know that this patient
A) is at increased risk of aspiration.
B) will need surgery to close his epiglottis.
C) will need a tracheostomy to breathe.
D) is at risk for a pneumothorax.
Q2) The primary functions of the pulmonary system are
A) gas exchange and the movement of air in and out of the lungs.
B) gas exchange and the transfer of oxygen to the tissues.
C) the movement of blood in and out of the lungs and the removal of body waste products.
D) gas exchange and the prevention of infections.
Q3) Which pleura adheres to the lungs?
A) Parietal
B) Visceral
C) Intrapleural
D) Surfactant
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19
Chapter 18: Pulmonary Clinical Assessment
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Sample Questions
Q1) While conducting a physical assessment,you note that the patient's breathing is rapid and shallow.This type of breathing pattern is known as
A) hyperventilation.
B) tachypnea.
C) obstructive breathing.
D) bradypnea.
Q2) Which of the following lung sounds would be most likely heard in a client experiencing an asthma attack?
A) Coarse rales
B) Pleural friction rub
C) Fine crackles
D) Expiratory wheezes
Q3) The creation of sound waves across the body surface to determine abnormal densities is known as
A) inspection.
B) palpation.
C) percussion.
D) auscultation.
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Chapter 19: Pulmonary Diagnostic Procedures
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) A patient presents moderately short of breath and dyspneic.A chest radiographic examination reveals a large right pleural effusion with significant atelectasis.The physician or nurse practitioner would be most likely to order which of the following procedures?
A) Thoracentesis
B) Bronchoscopy
C) Ventilation/perfusion (V/Q) scan
D) Repeat chest radiograph
Q2) On admission,a patient presents as follows: pH,7.38; respiratory rate,24 breaths/min,regular,pursed-lip breathing; PaO<sub>2</sub>,66 mm Hg; heart rate,112 beats/min,sinus tachycardia; PaCO<sub>2</sub>,52 mm Hg; blood pressure,110/68 mm Hg; HCO<sub>3</sub>-,24 mEq/L; and SpO<sub>2</sub>,90% on O<sub>2</sub> 2 L/min
nasal cannula.Which of the following diagnoses would be most consistent with the above arterial blood gas values?
A) Acute pulmonary embolism
B) Acute myocardial infarction
C) Congestive heart failure
D) Chronic obstructive pulmonary disease
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Chapter 20: Pulmonary Disorders
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25 Flashcards
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Sample Questions
Q1) Patients with left-sided pneumonia may benefit from placing them in which of the following positions?
A) Reverse Trendelenburg
B) Supine
C) On the left side
D) On the right side
Q2) According to the National Association of Medical Direction of Respiratory Care
Consensus Panel prolonged mechanical ventilation has been defined as
A) "the need for >=30 consecutive days of mechanical ventilation for >=8 hours per day"
B) "the need for >=15 consecutive days of mechanical ventilation for >=12 hours per day"
C) "the need for >=21 consecutive days of mechanical ventilation for >=6 hours per day"
D) "the need for >=40 consecutive days of mechanical ventilation for >=4 hours per day"
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22
Chapter 21: Pulmonary Therapeutic Management
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Sample Questions
Q1) A patient was admitted to the critical care unit with acute respiratory failure.The patient has been on a ventilator for 3 days and is being considered for weaning.The ventilator high-pressure alarm keeps going off.When you enter the room,the ventilator inoperative alarm sounds.Which of the following criteria would indicate that the patient is not tolerating weaning?
A) A decrease in heart rate from 92 to 80 beats/min
B) An SpO<sub>2</sub> of 92%
C) An increase in respiratory rate from 22 to 38 breaths/min
D) Spontaneous tidal volumes of 300 to 350 mL
Q2) Which route for ETT placement is used in an emergency?
A) Orotracheal
B) Nasotracheal
C) Nasopharyngeal
D) Trachea
Q3) Indications to support a pneumonectomy are
A) lesions confined to a single lobe.
B) bronchiectasis.
C) unilateral tuberculosis.
D) lung abscesses or cyst.
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Page 23
Chapter 22: Neurologic Anatomy and Physiology
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Sample Questions
Q1) Neuronal function is driven by A) nodes of Ranvier.
B) saltatory conduction.
C) repolarization-depolarization cycles.
D) depolarization-repolarization cycles.
Q2) Which statement best describes the role of neuroglial cells?
A) They are fewer in number than neurons.
B) They provide support to the neuron in nutrients and structural formation.
C) They protect the CNS from nonmetabolic primary neoplasms.
D) They produce a steady supply of neurotransmitters.
Q3) Obstructive hydrocephalus can occur in the presence of
A) blockage in the arachnoid villi.
B) malformation of the falx cerebelli.
C) blockage of CSF flow in the ventricular system.
D) increased production of CSF with poor outlet.
Q4) Cranial nerves IX,X,XI,and XII are located in which section of the brainstem?
A) Midbrain
B) Pons
C) Medulla oblongata
D) Reticular formation
Page 24
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Chapter 23: Neurologic Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) A patient is admitted to the critical care unit with a subdural hematoma.The GCS is used to assess his level of consciousness.Which statement is true concerning the GCS?
A) It provides data about level of consciousness only.
B) It is considered equivalent to a complete neurologic examination.
C) It is a sensitive tool for evaluation of an altered sensorium.
D) It is the most critical assessment parameter to account for possible aphasia.
Q2) Which type of ICP monitoring device has the most accurate ICP measurement and provides access to CSF for sampling?
A) Subarachnoid bolt or screw
B) Subdural or epidural catheter
C) Intraventricular catheter
D) Fiberoptic transducer tipped catheter
Q3) Which of the following denotes the most serious prognosis?
A) Decorticate posturing
B) Decerebrate posturing
C) Absence of Babinski reflex
D) GCS score of 14
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Page 25
Chapter 24: Neurologic Disorders and Therapeutic Management
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Sample Questions
Q1) Causes of metabolic coma include A) trauma.
B) ischemic stroke.
C) drug overdose.
D) intracerebral hemorrhage.
Q2) Which nursing interventions will help prevent sharp spikes in ICP and surgical hemorrhage?
A) Keep the head of the bed elevated 45 to 90 degrees.
B) Administer an antiemetic to prevent vomiting.
C) Provide fluid restriction.
D) Help with turn, cough, and deep breathe exercises.
Q3) Corneal epithelial breakdown in the coma patient is prevented by instillation of saline or methylcellulose lubricating eyedrops every
A) 2 hours.
B) 4 hours.
C) 8 hours.
D) 12 hours.
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Page 26
Chapter 25: Kidney Anatomy and Physiology
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Sample Questions
Q1) Chloride plays a major role in maintaining A) cellular immunity.
B) serum osmolality.
C) bone strength.
D) adenosine triphosphate (ATP).
Q2) The following substances,among others,are found in a urine sample: urea,creatinine,sodium,chlorine,potassium,glucose,and bicarbonate ions.Which of the following could account for this abnormal finding?
A) Blood pressure of 76/30 mm Hg
B) Blood glucose of 456 mg/dL
C) Blood glucose of 36 mg/dL
D) Blood potassium level of 4.1 mEq/L
Q3) When renin eventually stimulates angiotensin II,the adrenal glands then secrete A) aldosterone.
B) potassium.
C) ADH.
D) vasopressin.
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Chapter 26: Kidney Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) A patient has been on complete bed rest for 3 days.The health care provider has ordered for the patient to sit at the bedside for meals.The patient complains of feeling dizzy and faint while sitting at the bedside.The nurse anticipates that the patient is experiencing
A) orthostatic hypertension.
B) orthostatic hypotension.
C) hypervolemia.
D) electrolyte imbalance.
Q2) Differentiating ascites from distortion caused by solid bowel contents in the distended abdomen is accomplished by
A) assessing for bowel sounds in four quadrants.
B) palpation of the liver margin.
C) measuring abdominal girth.
D) the presence of a fluid wave.
Q3) When calculating the anion gap,the predominant cation is A) sodium.
B) potassium.
C) chloride.
D) bicarbonate.
28
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Chapter 27: Kidney Disorders and Therapeutic Management
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Sample Questions
Q1) A patient has been hospitalized for a subtotal gastrectomy.After the procedure,an infection developed that eventually had to be treated with gentamicin,an aminoglycoside antibiotic.After 3 days of administration,oliguria occurred,and subsequent laboratory values indicated elevated blood-urea-nitrogen and creatinine levels.The patient is transferred to the critical care unit with acute tubular necrosis.The patient is in the oliguric/anuric phase of acute tubular necrosis.Which statement best describes this phase?
A) It is the period of time from insult until cell injury. A decrease in glomerular filtration rate (GFR) results and disrupts the integrity of the tubular epithelium.
B) It is characterized by an increase in GFR in which the kidneys can clear volume and not solutes.
C) It is referred to as the maintenance phase and lasts 5 to 8 days in a nonoliguric patient and 10 to 16 days in an oliguric patient.
D) Renal function slowly returns to normal with a GFR at 70% to 80%.
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29
Chapter 28: Gastrointestinal Anatomy and Physiology
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Sample Questions
Q1) The innermost layer of the stomach that allows for expansion and secretion of gastric juice is the
A) serosa.
B) muscularis.
C) submucosa.
D) mucosa.
Q2) Stimulation of the parasympathetic nervous system produces which of the following effects on the gastrointestinal system?
A) Decreased peristalsis
B) Increased secretion of watery saliva
C) Decreased colonic activity
D) Increased release of gastrointestinal hormones
Q3) Which layer of the large intestine consists of longitudinal and circular muscles?
A) Serosa layer
B) Muscularis layer
C) Submucosa layer
D) Mucosa layer
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30
Chapter 29: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) Which test would be used to assess blood vessels and blood flow in the body?
A) CT scan
B) MRI
C) MRA
D) MRCP
Q2) Which assessment technique is most useful in detecting abdominal pathologic conditions?
A) Percussion
B) Palpation
C) Inspection
D) Auscultation
Q3) Potential complications of an endoscopy include
A) perforation of the GI tract.
B) hemorrhage.
C) oversedation.
D) constipation.
E) aspiration.
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Page 31
Chapter 30: Gastrointestinal Disorders and Therapeutic Management
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Sample Questions
Q1) To administer sucralfate through a gastric tube it should be
A) crushed and mixed with 10 mL of water.
B) dissolved in 10 mL of water to form a slurry.
C) mixed in 15 mL of water to form a solution.
D) administered as a whole pill with a 35-mL water flush.
Q2) Which of the following is a potential cause for acute liver failure?
A) Ischemia
B) Hepatitis A, B, C, D, E, non-A, non-B, non-C
C) Acetaminophen toxicity
D) Wilson disease
E) Reye syndrome
F) Diabetes
Q3) Verification of feeding tube placement includes
A) auscultation for position.
B) aspiration of stomach contents.
C) x-ray study for confirmation.
D) gastric pH measurement.
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Page 32
Chapter 31: Endocrine Anatomy and Physiology
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Sample Questions
Q1) When the brain perceives a stressful or threatening situation,the hypothalamus releases ________________________,which causes the anterior pituitary to release_____________________________.
A) cortisol; androgens.
B) corticotropin-releasing hormone; ACTH
C) ACTH; glucocorticoid hormone
D) ACTH; epinephrine
Q2) A patient is admitted to the critical care unit after sustaining a head injury.Based on the injury,it is determined that there is a decrease in ADH.Which of the patient's symptoms would alert the medical team to a possible decrease in ADH?
A) Rapidly escalating hypertension
B) Massive diuresis
C) Pulmonary edema
D) Hyperkalemia
Q3) The endocrine system helps maintain equilibrium throughout the body via A) control of smooth muscle.
B) control of skeletal muscle.
C) hormones.
D) neuronal control.
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Page 33
Chapter 32: Endocrine Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) The patient weighed 62 kg on admission yesterday.Today the patient weighs 60 kg.The nurse knows this reflects a fluid loss of
A) 1 L.
B) 2 L.
C) 4 L.
D) 10 L.
Q2) When preparing the patient for a serum ADH level,the nurse must withhold
A) insulin and furosemide.
B) morphine and carbamazepine.
C) Lanoxin and potassium.
D) heparin and beta-blockers.
Q3) Clinical signs and symptoms of Cushing syndrome include A) hirsutism.
B) rounded face.
C) hypotension.
D) decreased libido.
E) scleroderma.
F) fatigue and weakness.
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Chapter 33: Endocrine Disorders and Therapeutic Management
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Sample Questions
Q1) Nursing management of a patient with thyrotoxic crisis includes A) providing diversional stimuli.
B) restricting fluids.
C) maintaining a quiet, restful environment.
D) administering thyroid supplements at the same time each day.
Q2) The onset of seizures in the patient with DI indicates A) increased potassium levels.
B) hyperosmolality.
C) severe dehydration.
D) toxic ammonia levels.
Q3) The patient's temperature is 93° F rectally.The most appropriate intervention with this patient would be to
A) give aggressive therapy that includes warm peritoneal lavage.
B) allow the patient to maintain this body temperature to decrease oxygen demands.
C) use warming blankets to slowly warm the patient.
D) wait until the patient shivers to start warming.
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Chapter 34: Trauma
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Sample Questions
Q1) The nursing care plan of a patient with a diffuse axonal injury (DAI)would involve which of the following considerations?
A) Neurologic assessments should be performed only once a shift.
B) The patient will need a computed tomography scan for definitive diagnosis of the injury.
C) Blood pressure and temperature elevations are common.
D) The patient is at risk for volume overload because of syndrome of inappropriate antidiuretic hormone.
Q2) Motor vehicle crashes (MVCs)and falls are the greatest cause of A) spinal shock.
B) blunt thoracic trauma.
C) maxillofacial injuries
D) penetrating thoracic injuries.
Q3) When opening the airway of an unresponsive trauma patient in the emergency department,which of the following considerations is correct?
A) Airway assessment must incorporate cervical spine immobilization.
B) Hyperextension of the neck is the only acceptable technique.
C) Flexion of the neck protects the patient from further injury.
D) Airway patency takes priority over cervical spine immobilization.
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Page 36
Chapter 35: Shock,sepsis,and Multiple Organ Dysfunction Syndrome
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Sample Questions
Q1) Which of the following clinical manifestations is not suggestive of systemic inflammatory response syndrome (SIRS)?
A) Temperature of 37.5° C
B) Heart rate of 95 beats/min
C) Respiratory rate of 24 breath/min
D) White blood cell (WBC) count of 15,000 cells/mm3
Q2) Shock syndrome can best be described as a
A) physiologic state resulting in hypotension and tachycardia.
B) generalized systemic response to inadequate tissue perfusion.
C) degenerative condition leading to death.
D) condition occurring with hypovolemia that results in irreversible hypotension.
Q3) Which of the following hemodynamic parameters supports the diagnosis of cardiogenic shock?
A) Increased right atrial pressure
B) Decreased pulmonary artery wedge pressure
C) Increased cardiac output
D) Decreased cardiac index
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Page 37
Chapter 36: Burns
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Sample Questions
Q1) A patient is brought to the emergency department after a house fire.He fell asleep with a lit cigarette,and the couch ignited.TBSA burn is estimated at 25% deep partial-thickness burns to areas of the chest,back,and left arm and 20% full-thickness burns to the right arm,right upper leg,and areas on the face.The nurse should have a high suspicion for myoglobinuria with which type of burn injury?
A) Chemical burn
B) Tar burn
C) Electrical burn
D) Carbon monoxide poisoning
Q2) Using the "rule of nines," calculate the percent of injury in an adult who was injured as follows: the patient sustained partial and full-thickness burns to half of his left arm,his entire left leg,and his perineum.
A) 28%
B) 23.5%
C) 45.5%
D) 16%
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Chapter 37: Organ Donation and Transplantation
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Sample Questions
Q1) The most common viral infection in transplant recipients is
A) Aspergillus.
B) Candida.
C) cytomegalovirus (CMV).
D) Pneumocystis jiroveci.
Q2) Which of the following federal laws regulate the medical and surgical therapy involved with organ transplantation?
A) Omnibus Budget Reconciliation Act
B) Uniform Anatomical Gift Act
C) Hospital Conditions of Participation-Organ Donations
D) Medical Examiner Laws
E) Uniform Determination of Death Act
Q3) A patient who has received a transplant is being taught about azathioprine.Which statement made by the patient would indicate the teaching was effective?
A) "I will notify my health care provider if my gums start to bleed."
B) "I will make sure to increase the amount of fiber in my diet."
C) "I realize I may have an increase in hair growth."
D) "I know the flulike symptoms will go away as I get used to the drug."
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Chapter 38: Hematologic Disorders and Oncologic Emergencies
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Sample Questions
Q1) Type 2 heparin-induced thrombocytopenia is characterized by A) formation of thrombi, causing vessel occlusion.
B) spontaneous epistaxis.
C) elevated prothrombin times.
D) massive peripheral ecchymoses.
Q2) Which of the following platelet counts would be most indicative of a diagnosis of ITP?
A) 28,000/mm3
B) 35,000/mm3
C) 72,000/mm3
D) 110,000/mm3
Q3) Which of the following would be appropriate for treating hypocalcemia?
A) Calcium gluconate
B) Insulin
C) Sodium bicarbonate
D) Dialysis
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Chapter 39: The Obstetric Patient
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Sample Questions
Q1) Which of the following conditions may precipitate DIC in an obstetric patient?
A) Abruptio placentae
B) Anaphylactoid syndrome of pregnancy
C) Acute respiratory distress syndrome
D) Intracranial hemorrhage
E) Bacterial pneumonia
F) Septic abortion
Q2) A 35-year-old multiparous woman was admitted to the hospital at 36 weeks' gestation for nausea,vomiting,and severe epigastric pain.On admission,her vital signs were as follows: pulse,90 beats/min; blood pressure,165/100 mm Hg; respiratory rate,18 breaths/min; and temperature,99.4° F.The patient reported blurred and double vision and a severe headache.The fetal heart rate was normal.She was placed on bed rest.Urine analysis revealed proteinuria.Her vital signs 6 hours later were as follows: pulse,88 beats/min; blood pressure,185/105 mm Hg; respirations,16 breaths/min; and temperature,98.4° F.The fetal heart rate was normal.Severe pre-eclampsia was diagnosed.Treatment goals of severe pre-eclampsia include
A) maintaining maternal blood pressure greater than 140/90 mm Hg.
B) delaying delivery of the fetus as long as possible.
C) preventing maternal seizures, which may compromise fetal oxygenation.
D) limiting fluid intake to avoid postpartum edema.
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Chapter 40: The Pediatric Patient
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Sample Questions
Q1) The initial setting on a manual defibrillator for a patient older than 1 year is
A) 100 joules.
B) 360 joules.
C) 2 joules/kg.
D) 4 joules/kg.
Q2) Optimal treatment of a pediatric patient with status asthmaticus includes which of the following?
A) Placing the patient in the knee-chest position
B) Extending the neck to promote opening of the airway
C) Giving humidified oxygen
D) Giving ?-adrenergic therapy
E) Giving corticosteroids
Q3) The nurse is caring for a 6-month-old infant who has had an apparent life-threatening event (ALTE).The nurse is aware that treatment of the infant after ALTE will include all of the following EXCEPT
A) prone positioning.
B) supine positioning.
C) nasal continuous positive airway pressure.
D) continuous gavage feedings.
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Page 42
Chapter 41: The Older Adult Patient
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Sample Questions
Q1) The focus on the relief of suffering,in all of its dimensions,is referred to as
A) aggressive care
B) advance directives
C) hospice care
D) palliative care
Q2) Which medications are considered an alternative to angiotensin-converting enzyme (ACE)inhibitors in older adult hypertension patients with diabetes mellitus and heart failure (HF)?
A) Angiotensin-receptor blockers
B) Beta-blockers
C) Calcium antagonists
D) Direct renin inhibitors
Q3) A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.When caring for this patient,the nurse will give increased attention to skin integrity because of the
A) thickening of the epidermal skin layer.
B) loss of sebaceous glands.
C) increased fragility from loss of protective subcutaneous layers.
D) decreased melanocyte production.
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Page 43
Chapter 42: The Perianesthesia Patient
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Sample Questions
Q1) Nursing management of a postoperative patient who is experiencing prolonged vomiting includes
A) withholding all pain medication until the nausea has subsided.
B) removing the nasogastric tube.
C) inserting an oral airway.
D) increasing intravenous fluids.
Q2) A patient emerges from general anesthesia screaming,shouting,and thrashing wildly.The nurse identifies this reaction as
A) emergence hallucination.
B) normal.
C) emergence hyperactivity.
D) emergence delirium.
Q3) Which stage of general anesthesia begins with the initiation of an anesthetic agent and ends with loss of consciousness?
A) Stage I
B) Stage II
C) Stage III
D) Stage IV
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