Critical Care Concepts and Practice
Practice Questions
Course Introduction
Critical Care Concepts and Practice provides an in-depth exploration of the principles, skills, and decision-making processes essential for managing critically ill patients. The course covers the pathophysiology of major organ dysfunction, advanced monitoring techniques, pharmacological interventions, and evidence-based approaches to mechanical ventilation, fluid management, and infection control. Students engage with case studies and simulations to develop clinical reasoning and interdisciplinary teamwork skills, preparing them to deliver high-quality care in intensive and emergency care environments. Emphasis is placed on ethical considerations, patient-centered communication, and the integration of current research into clinical practice.
Recommended Textbook
Critical Care Nursing Diagnosis and Management 8th Edition by Linda D. Urden
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41 Chapters
1210 Verified Questions
1210 Flashcards
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2
Chapter 1: Critical Care Nursing Practice
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/41299
Sample Questions
Q1) What considerations are taken into account in evidence-based nursing practice?
A) Clinical expertise of the nurse
B) Availability of staff and facility equipment
C) Research evidence on the topic
D) Patient knowledge of the disease
E) Patient preference regarding care
Answer: A,C,E
Q2) What type of therapy is an option to conventional treatment?
A) Alternative
B) Holistic
C) Complementary
D) Individualized
Answer: A
Q3) What is the stepwise decision-making flowchart for a specific care process named?
A) Algorithm
B) Practice guideline
C) Protocol
D) Order set
Answer: A
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Page 3
Chapter 2: Ethical Issues
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19 Flashcards
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Sample Questions
Q1) What is the first step of the ethical decision-making process?
A) Consulting with an authority
B) Identifying the health problem
C) Delineating the ethical problem from other types of problems
D) Identifying the patient as the primary decision maker
Answer: B
Q2) A patient's wife has been informed by the practitioner that her spouse has permanent quadriplegia.The wife states that she does not want anyone to tell the patient about his injury.The patient asks the nurse about what has happened.Based on which ethical principles does the nurse answer the patient's questions?
A) Veracity
B) Justice
C) Autonomy
D) Nonmaleficence
Answer: C
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Chapter 3: Legal Issues
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25 Flashcards
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Sample Questions
Q1) Which actions by a nurse demonstrate the act of battery?
A) Performing cardiopulmonary resuscitation (CPR) on a patient with a do-not-resuscitate (DNR) order
B) Threatening to punch someone
C) Sexual misconduct with a patient
D) Drawing blood without the patient's consent
E) Threatening to restrain a patient for not using his or her call light for mobility assistance
Answer: A,C,D
Q2) What is the best action a nurse could take to prevent allegations of malpractice?
A) Carrying malpractice insurance
B) Clarifying orders with the nursing supervisor
C) Delegating care to nursing assistants
D) Providing care according to standards of practice
Answer: D
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Chapter 4: Genetic Issues
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20 Flashcards
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Sample Questions
Q1) What was the Genetic Information Nondiscrimination Act (GINA)of 2008 designed to prevent from happening?
A) Abuse of genetic information in employment and health insurance decisions
B) Genetic counselors from reporting results to the health insurance companies
C) Mandatory genetics testing of all individuals with certain diseases
D) Information sharing between biobanks that are studying the same genetic disorders
Q2) What was the goal of the Human Genome Project?
A) Identifying haplotype tags
B) Exposing untaggable SNPs and recombination hot spots
C) Producing a catalog of human genome variation
D) Mapping all the human genes
Q3) Prader-Willi syndrome (PWS)is a rare genetic disorder in which genes on chromosome 15 (q11.2-13)are deleted.What type of disorder is PWS?
A) Chromosome disorder
B) Mitochondrial disorder
C) Complex gene disorder
D) Multifactorial disorder
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Chapter 5: Patient and Family Education
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Sample Questions
Q1) A patient is scheduled for a cardiac catheterization this afternoon.The nurse wants to provide her with some basic information before going in the room to talk about her specific procedure.Which teaching strategy is most appropriate for this situation?
A) Discussion
B) Demonstration and practice
C) Audiovisual media
D) Written
Q2) In which situation are group discussions most effective as a patient teaching strategy?
A) Patients have a variety of medical diagnoses.
B) Patients are in the acute phase of their illness.
C) Patients are in the hospital only 3 days or less.
D) Patients are at similar stages of adaptation.
Q3) How should a nurse respond when a patient asks if he or she is going to die?
A) Avoid the question by leaving the room.
B) Defer the question to the physician.
C) Answer honestly and sensitively with information that is understandable and in simple terms.
D) Speak with the family first before answering the patient.
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Page 7
Chapter 6: Psychosocial and Spiritual Alterations and Management
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Sample Questions
Q1) A patient with low self-esteem may manifest which behaviors?
A) Refusal to participate in care
B) Feelings that his or her body has betrayed him or her
C) Acceptance and ownership of problems
D) Disruption in the perception of the body
Q2) A patient tells his family,"I don't know why I was placed on this earth just to suffer from cancer all my life.I just want to die." What psychosocial issue is the patient experiencing?
A) Lost control
B) Spiritual distress
C) Anxiety
D) Powerlessness
Q3) Which statement regarding regression as a coping mechanism for critical care patients is accurate?
A) It is necessary to some degree to allow staff to administer care.
B) It indicates deterioration of the physical state.
C) It is adaptive when the patient calls every 15 minutes, even for trivial matters.
D) It is best avoided to ensure successful recovery.
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Chapter 7: Nutrition Alterations and Management
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) What is the rationale for careful intake and output for patients with pulmonary alterations?
A) Fluid retention occurs with tachypnea.
B) Hemodilution may cause deleterious hypernatremia.
C) Fluid volume excess can lead to right-sided heart failure.
D) Excessive fluid losses may lead to dehydration and hypovolemic shock.
Q2) A patient is mechanically ventilated and is receiving enteral nutrition via a nasogastric tube.Which intervention should be included the patient's plan of care to prevent clogging of the feeding tube?
A) Flush the tube with gastric juice every 8 hours.
B) Obtain an order for a prokinetic agent to stimulate gastric emptying.
C) Irrigate the tube with water before and after administration of any medication.
D) Add crushed medications to the enteral feeding formula.
Q3) What type of diet would be appropriate for a patient with hypertension after a myocardial infarction?
A) Three meals a day with two snacks
B) Low-protein diet
C) Low-salt, low-cholesterol diet
D) High-carbohydrate diet
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Page 9
Chapter 8: Pain and Pain Management
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Sample Questions
Q1) Which statement accurately describes the duration of acute pain?
A) Acute pain is associated with the injury to the joints and lasts about 9 months.
B) Acute pain is associated with the healing process and should not exceed 6 months.
C) Acute pain is persistent pain of more than 6 months after the healing process.
D) Acute pain is associated with damage to the nervous system and is of infinite duration.
Q2) Which statement best describes the concept of pain?
A) Pain is an uncomfortable experience present only in the patient with an intact nervous system.
B) Pain is an unpleasant experience accompanied by crying and tachycardia.
C) Pain is activation of the sympathetic nervous system from an injury.
D) Pain is whatever the patient experiencing it says it is, occurring when that patient says it does.
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10
Chapter 9: Sedation,Agitation,and Delirium Management
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Sample Questions
Q1) What are the risk factors for delirium?
A) Hypertension, alcohol abuse, and benzodiazepine administration
B) Coma, hypoxemia, and trauma
C) Dementia, hypertension, and pneumonia
D) Coma, alcohol abuse, hyperglycemia
Q2) A patient was admitted 5 days ago and has just been weaned from mechanical ventilation.The patient suddenly becomes confused,seeing nonexistent animals in the room and pulling at the bedding.What parameter should be monitored while the patient is haloperidol?
A) Sedation level
B) QTc-interval
C) Oxygen saturation level
D) Brain waves
Q3) What is the major advantage of using propofol as opposed to another sedative for short-term sedation?
A) Fewer side effects
B) Slower to cross the blood-brain barrier
C) Shorter half-life and rapid elimination rate
D) Better amnesiac properties
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Page 11
Chapter 10: End-Of-Life Care
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19 Flashcards
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Sample Questions
Q1) The patient's condition has deteriorated to the point where she can no longer make decisions about her own care.Which nursing interventions would be most appropriate?
A) Obtain a verbal do-not-resuscitate (DNR) order from the practitioner.
B) Continue caring for the patient as originally ordered because she obviously wanted this.
C) Consult the hospital attorney for recommendations on how to proceed.
D) Discuss with the family what the patient's wishes would be if she could make those decisions herself.
Q2) Disagreement and distress among practitioners,nurse practitioners,and critical care nurses can lead to what issue?
A) Moral indignation
B) Ethical resentment
C) Moral distress
D) Interprofessional anguish
Q3) What is the most common complaint heard from families of dying patients?
A) Poor nursing care
B) Inadequate communication
C) Lack of consistent plan of care
D) Confusion among health care team members
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Page 12
Chapter 11: Cardiovascular Anatomy and Physiology
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A patient presents with atrial fibrillation,a heart rate of 156 beats/min,and a blood pressure of 124/76 mm Hg.The practitioner orders diltiazem,a calcium channel blocker,to be given slowly by intravenous push.Why did the practitioner choose this medication to treat this patient's atrial tachyarrhythmia?
A) Diltiazem decreases the calcium influx into the atrioventricular (AV) nodal tissue and decreases the speed of impulse conduction.
B) Diltiazem increases the calcium influx into the AV nodal tissue and decreases the speed of impulse conduction.
C) Diltiazem decreases the calcium influx into the myocardial tissue and decreases the strength of heart contraction.
D) Diltiazem increases the calcium influx into the myocardial tissue and decreases the strength of heart contraction.
Q2) What is the name of outermost layer of an artery?
A) Tunica
B) Intima
C) Adventitia
D) Media
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Page 13
Chapter 12: Cardiovascular Clinical Assessment
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Sample Questions
Q1) A patient is admitted with left-sided heart failure related to mitral stenosis.Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur.The grading of a murmur as a 3/6 refers to which characteristics of the murmur?
A) Intensity
B) Quality
C) Timing
D) Pitch
Q2) Which statement best describes the purpose of the Allen test?
A) The Allen test assesses the adequacy of blood flow through the ulnar artery.
B) The Allen test evaluates oxygen saturation in the brachial artery.
C) The Allen test assesses the patency of an internal graft.
D) The Allen test determines the size of needle to be used for puncture.
Q3) A patient is admitted with left-sided heart failure related to mitral stenosis.Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur.Which statement about an S3 is accurate?
A) It is normal for a person this age.
B) It is synonymous with a ventricular gallop.
C) It is only heard during systole.
D) It is best heard best with the diaphragm of the stethoscope.
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Page 14
Chapter 13: Cardiovascular Diagnostic Procedures
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74 Flashcards
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Sample Questions
Q1) Which criteria are representative of the patient in normal sinus rhythm?
A) Heart rate, 64 beats/min; rhythm regular; PR interval, 0.10 second; QRS, 0.04 second
B) Heart rate, 88 beats/min; rhythm regular; PR interval, 0.18 second; QRS, 0.06 second
C) Heart rate, 54 beats/min; rhythm regular; PR interval, 0.16 second; QRS, 0.08 second
D) Heart rate, 92 beats/min; rhythm irregular; PR interval, 0.16 second; QRS, 0.04 second
Q2) Which serum lipid value is a significant predictor of future acute myocardial infarction (MI)in persons with established coronary artery atherosclerosis?
A) High-density lipoprotein (HDL)
B) Low-density lipoprotein (LDL)
C) Triglycerides
D) Very-low-density lipoprotein
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15
Chapter 14: Cardiovascular Disorders
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34 Verified Questions
34 Flashcards
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Sample Questions
Q1) A patient is admitted for palliative care for end-stage heart failure.What is the nurse's primary goal when caring for this patient?
A) To reverse heart failure with the use of diuretics
B) To increase activity tolerance
C) To manage symptoms and relieve pain
D) To increase cardiac output related to alteration of contractility
Q2) A patient was admitted 3 days ago with an acute myocardial infarction (MI).The patient complains of fatigue,not sleeping the past two nights,and change in appetite.Based on these findings the nurse suspects the patient may be experiencing which problem?
A) Angina
B) Anxiety
C) Depression
D) Endocarditis
Q3) Which statement regarding the difference between stable and unstable angina is accurate?
A) Stable angina responds predictably well to nitrates.
B) Stable angina is not precipitated by activity.
C) Stable angina has a low correlation to coronary artery disease (CAD).
D) Stable angina is a result of coronary artery spasm.
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Chapter 15: Cardiovascular Therapeutic Management
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Sample Questions
Q1) When analyzing the electocardiogram (ECG)strip of the patient with a pacemaker,the nurse notices there is a spike before each QRS complex.What is this phenomenon indicative of?
A) 60-cycle electrical interference; check equipment
B) Pacing artifact; the pacemaker is sensing and capturing
C) Electrical artifact; the pacemaker is not sensing
D) Patient movement; check electrodes
Q2) Which signs and symptoms would indicate successful reperfusion after administration of a fibrinolytic agent?
A) Gradual decrease in chest pain
B) Intermittent, multifocal premature ventricular contractions
C) Rapid resolution of ST elevation
D) Rapid rise in creatine kinase MB fraction
Q3) The possibility of microshock when handling a temporary pacemaker can be minimized by which intervention?
A) Decreasing the milliamperes
B) Wearing gloves
C) Positioning the patient on the left side
D) Wearing rubber-soled shoes
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Page 17
Chapter 16: Pulmonary Anatomy and Physiology
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Sample Questions
Q1) Which factor will result in a shift of the oxyhemoglobin dissociation curve to the left?
A) Increased PaCO
B) Increased pH
C) Increased temperature
D) Increased 2,3-DPG
Q2) What substance do Alveolar type II cells secrete?
A) Trypsin
B) Chyme
C) Amylase
D) Surfactant
Q3) Oxygen saturation of left atrial blood is normally between 96% and 99%.What is the explanation for less than 100% saturation?
A) As blood passes to the alveolar-capillary membrane, a predicted percentage of hemoglobin will not bind with oxygen.
B) During normal respiration, the majority of alveoli are not expanded.
C) Venous blood from the bronchial circulation is returned to the left atrium.
D) A small amount of blood leaks from the right atrium to the left atrium with each ventricular contraction.
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18
Chapter 17: Pulmonary Clinical Assessment
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Sample Questions
Q1) Which conditions will commonly reveal breath sounds with inspiration greater than expiration on assessment?
A) Normal lung
B) Bronchiectasis
C) Emphysema
D) Acute bronchitis
E) Diffuse pulmonary fibrosis
Q2) A patient is admitted with acute lung failure secondary to emphysema.Percussion of the lung fields will predictably exhibit which tone?
A) Resonance
B) Hyperresonance
C) Tympany
D) Dullness
Q3) Which statement describes the major difference between tachypnea and hyperventilation?
A) Tachypnea has increased rate; hyperventilation has decreased rate.
B) Tachypnea has decreased rate; hyperventilation has increased rate.
C) Tachypnea has increased depth; hyperventilation has decreased depth.
D) Tachypnea has decreased depth; hyperventilation has increased depth.
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Chapter 18: Pulmonary Diagnostic Procedures
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Sample Questions
Q1) A patient has the following arterial blood gas (ABG)values: pH,7.20; PaO ,106 mm Hg; pCO ,35 mm Hg; andHCO ¯,11 mEq/L.What symptom would be most consistent with the ABG values?
A) Diarrhea
B) Shortness of breath
C) Central cyanosis
D) Peripheral cyanosis
Q2) What risk factors need to be considered when preparing a patient for a thoracentesis?
A) Coagulation defects
B) Unstable hemodynamics
C) Pleural effusion
D) Uncooperative patient
E) Empyema
Q3) Which blood gas parameter is the acid-base component that reflects kidney function?
A) pH
B) PaO
C) PaCO
D) HCO ¯
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Chapter 19: Pulmonary Disorders
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Sample Questions
Q1) What condition develops when air enters the pleural space from the lung on inhalation and cannot exit on exhalation?
A) Tension pneumothorax
B) Sucking chest wound
C) Open pneumothorax
D) Pulmonary interstitial empyema
Q2) A patient was admitted with acute lung failure secondary to pneumonia.What is the single most important measure to prevent the spread of infection between staff and patients?
A) Place the patient in respiratory isolation.
B) Ensure everyone is using proper hand hygiene.
C) Use personal protective equipment.
D) Initiate prompt administration of antibiotics.
Q3) What two pathogens are most frequently associated with ventilator-associated pneumonia?
A) Staphylococcus aureus and Pseudomonas aeruginosa
B) Escherichia coli and Haemophilus influenzae
C) Acinetobacter baumannii and Haemophilus influenzae
D) Klebsiella spp. and Enterobacter spp.
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Page 21
Chapter 20: Pulmonary Therapeutic Management
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Sample Questions
Q1) A patient with acute lung failure has been on a ventilator for 3 days and is being considered for weaning.When entering the room,the ventilator inoperative alarm sounds.What action should the nurse take FIRST?
A) Troubleshoot the ventilator until the problem is found.
B) Take the patient off the ventilator and manually ventilate.
C) Call the respiratory therapist for help.
D) Silence the ventilator alarms until the problem is resolved.
Q2) Which statement describes the assist-control mode of ventilation?
A) It delivers gas at preset volume, at a set rate, and in response to the patient's inspiratory efforts.
B) It delivers gas at a preset volume, allowing the patient to breathe spontaneously at his or her own volume.
C) It applies positive pressure during both ventilator breaths and spontaneous breaths.
D) It delivers gas at preset rate and tidal volume regardless of the patient's inspiratory efforts.
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22
Chapter 21: Neurologic Anatomy and Physiology
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Sample Questions
Q1) Stimulation of what nerve will elicit the gag reflex?
A) Glossopharyngeal
B) Facial
C) Spinal accessory
D) Hypoglossal
Q2) What percentage of the body's total resting cardiac output is used by the brain?
A) 5%
B) 10%
C) 20%
D) 40%
Q3) Which of these substances are examples of small-molecule transmitters?
A) Acetylcholine
B) Glucose
C) Norepinephrine
D) Dopamine
E) Epinephrine
F) GABA receptors
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Chapter 22: Neurologic Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) The nurse is precepting a new graduate nurse.The new graduate asks about testing the oculovestibular reflex.What should the nurse tell the new graduate?
A) The test should not be performed on an unconscious patient because of the risk of aspiration.
B) An abnormal response is manifested by conjugate, slow, tonic nystagmus, deviating toward the irrigated ear.
C) This test should be included in the nursing neurologic examination of a patient with a head injury.
D) This test is one of the final clinical assessments of brainstem function.
Q2) Indications for the use of electroencephalography (EEG)include
A) cerebral infarct.
B) metabolic encephalopathy.
C) confirmation of brain death.
D) altered consciousness.
E) all head injuries.
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Chapter 23: Neurologic Disorders and Therapeutic Management
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Sample Questions
Q1) A patient has been experiencing drowsiness,confusion,and slight focal deficits for several days.The initial noncontract computed tomography (CT)findings are negative.The patient is being prepared for a lumbar puncture.What appearance does the nurse anticipate that the cerebrospinal fluid (CSF)would look?
A) Cloudy
B) Bloody
C) Xanthochromic
D) Clear
Q2) A male patient post right-sided stroke is experiencing hemiagnosia.This is evidenced by which finding?
A) The patient only reads the right side of the newspaper.
B) The patient refuses to acknowledge the left side of his body.
C) The patient is hyperresponsive when approached on the right side.
D) The patient attempts to comb his hair with a toothbrush.
Q3) What is a pathologic consequence of an unruptured cerebral aneurysm?
A) It shunts blood away from the surrounding tissues.
B) It leaks blood into the subarachnoid space.
C) It causes damage the middle layer of the arterial wall.
D) It places pressure on the surrounding tissues.
Page 25
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Chapter 24: Kidney Anatomy and Physiology
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Sample Questions
Q1) Chloride plays a major role in maintaining what physiologic process?
A) Cellular immunity
B) Serum osmolality
C) Bone strength
D) Adenosine triphosphate (ATP)
Q2) What is the primary function of aldosterone?
A) Excretion of potassium through the renal tubules
B) Control of sodium and water
C) Regulation of bicarbonate
D) Reabsorption of sodium and potassium
Q3) A patient has been admitted with a severe kidney infection.The nurse suspects the patient has damage to the glomerular membrane.Which substance in the urine would confirm the nurse's suspicion?
A) Creatinine
B) Bicarbonate ions
C) Sodium
D) Albumin
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Chapter 25: Kidney Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) When calculating the anion gap,what is the predominant cation?
A) Sodium
B) Potassium
C) Chloride
D) Bicarbonate
Q2) A patient has been on complete bed rest for 3 days.The practitioner has left orders to get the patient out of bed for meals.The patient complains of feeling dizzy and faint while sitting at the bedside.The nurse suspects that the patient is experiencing what problem?
A) Orthostatic hypertension
B) Orthostatic hypotension
C) Hypervolemia
D) Electrolyte imbalance
Q3) As serum osmolality rises,intravascular fluid equilibrium will be maintained by the release of what substance?
A) Ketones
B) Glucagon
C) Antidiuretic hormone
D) Potassium
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Chapter 26: Kidney Disorders and Therapeutic Management
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Sample Questions
Q1) An alert and oriented patient presents with a pulmonary artery occlusion pressure (PAOP)of 4 mm Hg,blood pressure of 88/50 mm Hg,cardiac index of 1.8,and urine output of 15 mL/h.The patient's blood urea nitrogen (BUN)is 44 mg/dL and creatinine is 3.2 mg/dL.Lungs are clear to auscultation with no peripheral edema noted.Which treatment would the nurse expect the practitioner to order?
A) Lasix 40 mg intravenous push
B) 0.9% normal saline at 125 mL/h
C) Dopamine 15 mcg/kg/min
D) Transfuse 1 U of packed red blood cells
Q2) A patient with acute kidney injury has a potassium level of 6.9 mg/dL.The patient has had no urine output in the past 4 hours despite administration of Lasix 40 mg intravenous push.To correct the hyperkalemia the patient is given 50 mL of 50% dextrose in water and 10 U of regular insulin intravenous push.A repeat potassium level 2 hours later shows a potassium level of 4.5 mg/dL.What order would the nurse expect now?
A) Sodium Kayexalate 15 g PO
B) Nothing; this represents a normal potassium level
C) Lasix 40 mg IVP
D) 0.9% normal saline at 125 mL/h
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Chapter 27: Gastrointestinal Anatomy and Physiology
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Sample Questions
Q1) What is the name of the portion of the stomach that connects the antrum to the duodenum?
A) Fundus
B) Body
C) Cardiac orifice
D) Pylorus
Q2) Which component of gastric juice is necessary for the breakdown of proteins?
A) Hydrochloric acid (HCl)
B) Pepsin
C) Intrinsic factor
D) Potassium
Q3) The pancreas has both exocrine and endocrine properties.Which substances are produced by the exocrine function?
A) Gastrin
B) Trypsin
C) Amylase
D) Lipase
E) Insulin
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29
Chapter 28: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) A patient has been admitted with ulcerative colitis.Which information from the patient's history would be consistent with this diagnosis?
A) Drug abuse
B) Jewish ancestry
C) Pericardial disease
D) Asian ancestry
Q2) A patient was admitted with an abdominal mass.Which assessment technique would the nurse find most useful in detecting this pathologic condition?
A) Percussion
B) Palpation
C) Inspection
D) Auscultation
Q3) A patient was admitted with pancreatitis.In which order would the nurse perform an assessment of the gastrointestinal system?
A) Inspection, palpation, percussion, auscultation
B) Palpation, percussion, inspection, auscultation
C) Inspection, auscultation, percussion, palpation
D) Palpation, inspection, auscultation, percussion
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Chapter 29: Gastrointestinal Disorders and Therapeutic Management
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Sample Questions
Q1) A patient was admitted with acute pancreatitis.The nurse understands that pancreatitis occurs as a result of what pathophysiologic mechanism?
A) Uncontrolled hypoglycemia caused by an increased release of insulin
B) Loss of storage capacity for senescent red blood cells
C) Premature activation of inactive digestive enzymes, resulting in autodigestion
D) Release of glycogen into the serum, resulting in hyperglycemia
Q2) The nurse is caring for a patient with acute liver failure.The practitioner asks the nurse to assess the patient for asterixis.How should the nurse assess for this symptom?
A) Inflate a blood pressure cuff on the patient's arm.
B) Have the patient bring the knees to the chest.
C) Have the patient extend the arms and dorsiflex the wrists.
D) Dorsiflex the patient's foot.
Q3) How would the nurse administer sucralfate through a gastric tube?
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
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Page 31
Chapter 30: Endocrine Anatomy and Physiology
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Q1) A patient with thyrotoxicosis has been admitted.What effect of increased T and T levels might the nurse expect to see in this patient?
A) Increased oxygen consumption
B) Decreased basal metabolic rate
C) Decreased cardiac output
D) Increased calcium levels
Q2) A patient has been admitted after a craniotomy.The patient starts to exhibit changes in the level of antidiuretic hormone (ADH).The nurse knows that ADH works primarily affects which organ?
A) Liver
B) Pancreas
C) Stomach
D) Kidneys
Q3) The release of hormones by the pituitary gland is under the control which part of the brain?
A) Cerebellum
B) Occipital lobe
C) Temporal lobe
D) Hypothalamus
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Page 32
Chapter 31: Endocrine Clinical Assessment and Diagnostic
Procedures
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Q1) A patient has been admitted with abdominal pain.The nurse notes that the patient's fasting blood glucose is 120 mg/dL.Which statement regarding this finding is accurate?
A) This is a normal finding in critically ill patients.
B) This finding is indicative of prediabetes, but another test should be done to confirm.
C) This finding is lower than what the nurse would expect in a patient receiving intravenous fluids.
D) This finding is indicative of diabetic ketoacidosis.
Q2) A patient was admitted with asthma who has been on steroids for a long time.The nurse knows that this patient is at risk of developing secondary Cushing syndrome.What would be the cause of this condition?
A) Pharmacologic glucocorticoids
B) Pharmacologic mineralocorticoids
C) Cortisol
D) Aldosterone
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Chapter 32: Endocrine Disorders and Therapeutic Management
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Q1) A patient in diabetic ketoacidosis (DKA)is comatose with a temperature of 102.2°
F.The nurse suspects the patient may have which secondary disorder?
A) Head injury
B) Hypothalamus infarction
C) Infection
D) Heat stroke
Q2) An older patient presents with a serum glucose level of 900 mg/dL,hematocrit of 55%,and no serum ketones.Immediate attention must be given to which intervention?
A) Evaluating clotting factors
B) Fluid administration
C) Insulin administration
D) Sodium replacement
Q3) A patient is presenting with signs of diabetes insipidus (DI).Which findings would confirm this diagnosis?
A) Hyperosmolality and hypernatremia
B) Hyperosmolality and hyponatremia
C) Hypoosmolality and hypernatremia
D) Hypoosmolality and hyponatremia
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Chapter 33: Trauma
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Q1) Older trauma patients have a higher mortality than younger trauma patients.The nurse understands that this fact is probably related to what physiologic change?
A) Deterioration of cerebral and motor skills
B) Poor vision and hearing
C) Diminished pain perception
D) Limited physiologic reserve
Q2) A nurse and a nursing student are discussing management of the trauma patient.The nurse asks the student what the AVPU method is used for during the primary survey.Which response would indicate the new graduate nurse understood the information?
A) Used to assess respiratory status
B) Used to assess circulatory status
C) Used to assess pain status
D) Used to assess level of consciousness
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Chapter 34: Shock,sepsis,and Multiple-Organ Dysfunction Syndrome
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Q1) An elderly patient is admitted with pneumonia.This morning the patient is febrile,tachycardic,tachypneic,and confused.The nurse suspects the patient may be developing what problem?
A) Sepsis
B) Delirium
C) Adult respiratory distress syndrome
D) Acute kidney injury
Q2) A patient has been admitted with septic shock related to tissue necrosis.The nurse knows the initial goal for medical management for this patient is which intervention?
A) Limiting fluids to minimize the possibility of heart failure
B) Finding and eradicating the cause of infection
C) Discontinuing invasive monitoring as a possible cause of sepsis
D) Administering vasodilator substances to increase blood flow to vital organs
Q3) A nurse is caring for a patient in septic shock due to urinary sepsis.Which pathophysiologic mechanism results in septic shock?
A) Bacterial toxins lead to vasodilation.
B) White blood cells are released to fight invading bacteria.
C) Microorganisms invade organs such as the kidneys and heart.
D) Decreased red blood cell production and fluid loss
Page 36
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Chapter 35: Burns
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Q1) A nurse is caring for a patient who was burned 2 weeks ago.The nurse knows the patient has entered the next phase of healing,which is characterized by rapid synthesis of collagen.What phase is the patient in?
A) Wound phase
B) Inflammatory phase
C) Proliferative phase
D) Maturation phase
Q2) Contracture development leading to impaired physical mobility can occur after a major burn injury.Splints are applied to prevent or correct contractures.Priority nursing interventions concerning this therapy include which action?
A) Daily assessment for proper fit and effectiveness
B) Removal of splints during showers and dressing changes
C) Allowing for frequent breaks from splint use
D) Passive and active range of motion may be used instead of splints
Q3) What are the goals of the rehabilitation phase of burn management?
A) Recuperation and healing physically and emotionally
B) Hydrotherapy and splinting
C) Reverse wound isolation and surgical grafting
D) Bed rest and splinting
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Page 37
Chapter 36: Organ Donation and Transplantation
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Q1) A patient with liver failure manifested by portal hypertension and ascites is hospitalized and waiting for a liver transplant.Which order should the nurse question?
A) Low-sodium diet
B) Low-protein diet
C) ABO typing
D) Human leukocyte antigen tissue typing
Q2) The organ procurement organization coordinator writes orders to initiate standard donor care.Which interventions are parts of standard donor care?
A) Continue administration of osmotic agents and diuretics.
B) Maintain head of bed at 30 to 40 degrees elevation.
C) Continue routine pulmonary suctioning and side-to-side body positioning.
D) Warming blanket to maintain body temperature above 36.5° C.
E) Maintain mean arterial pressure less than 70 mm Hg.
Q3) Who determines the medical suitability of the patient for organ donation?
A) The organ procurement organization (OPO) coordinator
B) The patient's family
C) The admitting health care provider
D) The transplant team
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Chapter 37: Hematologic and Oncologic Emergencies
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Q1) Hospital-acquired anemia is an increasing problem in critically ill patients.Which nursing interventions can be most beneficial in preventing this problem?
A) Administering fluids and inotropic agents to optimize blood pressure
B) Using blood salvage devices
C) Obtaining smaller blood samples through the use of pediatric blood tubes and point-of-care testing
D) Decreasing afterload through the use of vasodilators
Q2) Place these pathophysiologic mechanisms of disseminated intravascular coagulation (DIC)in the order in which they occur.
1)Activation of the fibrinolytic system
2)Breakdown of thrombi; spontaneous hemorrhage
3)Consumption of coagulation factors; failure of regulatory mechanisms
4)Endothelial damage; release of tissue factor
5)Thrombin formation; clots form along epithelial walls
A) 4, 5, 3, 1, 2
B) 4, 1, 3, 2, 5
C) 5, 1, 2, 4, 3
D) 2, 3, 1, 5, 4
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Page 39
Chapter 38: The Obstetric Patient
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Sample Questions
Q1) A patient who is 30-weeks pregnant is admitted with severe asthma.The nurse understands that sufficient fetal oxygenation requires what minimum level of maternal oxygenation?
A) PaO greater than 100 mm Hg
B) PaO greater than 70 mm Hg
C) Oxygen saturation of 100%
D) Oxygen saturation greater than 70%
Q2) A multiparous woman was admitted at 36 weeks' gestation for nausea,vomiting,and severe epigastric pain.The fetal heart rate was normal.Severe preeclampsia was diagnosed.The patient is placed on a magnesium sulfate drip of 3 g/h.After an hour the patient has a seizure.The nurse notifies the practitioner.What order would the nurse anticipate?
A) Administer another 2- to 4-g bolus of magnesium sulfate.
B) Increase the magnesium drip at a rate of 1 to 2 g/h.
C) Prepare the patient for immediate delivery of the baby.
D) Prepare for intubation and mechanical ventilatory support.
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Chapter 39: The Pediatric Patient
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Q1) A 3-month-old infant presents with vomiting and diarrhea.The infant appears to be drowsy; his pulse rate is 180 beats/min; and he has had a dry diaper for the past 3 hours.The nurse suspects the patient has developed which condition?
A) Mild dehydration
B) Moderate dehydration
C) Desiccation
D) Severe dehydration
Q2) What are the causes of status epilepticus in children?
A) High fever
B) Encephalitis
C) Metabolic disorders
D) Meningitis
E) Gradual weaning of anticonvulsant drugs
Q3) What is the pathophysiologic characteristic of a left-to-right shunt resulting from a congenital heart defect?
A) Decreased pulmonary blood flow
B) Mixed lesions with variable clinical symptoms
C) Increased pulmonary blood flow
D) Obstruction of blood flow to the ventricles
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Chapter 40: The Older Adult Patient
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Sample Questions
Q1) Which sign or symptom would be a normal assessment finding for an older patient?
A) Inability to remember what was eaten yesterday
B) An increase in resting heart rate
C) Hypoactive bowel sounds
D) Brisk papillary response to light
Q2) A 68-year-old patient was admitted after an inferior myocardial infarction (MI).Dopamine 3 mcg/kg/min has been ordered for this patient.What nursing implications should be considered when administering this medication to an older patient?
A) No changes are noted in older patients with this drug.
B) Drug effect is enhanced by increased receptor site action.
C) Increased breakdown by liver hepatocytes occurs, increasing dosage requirements.
D) Drug metabolism and detoxification are slowed, increasing the risks of drug toxicity.
Q3) Which sound may be difficult for an older person to hear?
A) Telephone ringing
B) Clothes dryer running
C) Car horn honking
D) Child crying
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Chapter 41: The Perianesthesia Patient
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Sample Questions
Q1) The nurse is caring for a postoperative patient who is snoring and has stridor,nostril flaring,and intercostal retractions.The nurse knows that these findings are clinical manifestations of what problem?
A) Angina
B) Airway obstruction
C) Pain
D) Oversedation
Q2) The patient's body temperature is 33° C.The patient is shivering and the nurse needs to initiate which interventions?
A) Cover the patient with warm blankets.
B) Apply heat lamps.
C) Provide fluid and blood warming.
D) Apply supplemental oxygen.
E) Provide a thermal mattress.
Q3) Which stage of general anesthesia is known as surgical anesthesia?
A) Stage I
B) Stage II
C) Stage III
D) Stage IV
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