Critical Care Nursing Exam Preparation Guide
Course Introduction
Critical Care Nursing is a specialized course designed to equip nursing students with the knowledge and skills required to care for patients with life-threatening conditions in intensive care settings. The course covers topics such as advanced assessment techniques, hemodynamic monitoring, interpretation of complex clinical data, ventilator management, pharmacology of critical care medications, and the multidisciplinary care of critically ill patients. Emphasis is placed on the rapid recognition and response to changes in patient status, ethical and legal challenges in critical care, communication with families, and the importance of teamwork. Through theoretical instruction and clinical practice, students develop the competence needed to provide high-quality, evidence-based care in intensive care units and other critical care environments.
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
Source URL: https://quizplus.com/study-set/2075 Page 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) Emphasis is on human integrity and stresses the theory that the body,mind,and spirit are interdependent and inseparable.This statement describes which methodology of care?
A) Holistic care
B) Individualized care
C) Cultural care
D) Interdisciplinary care
Answer: A
Q2) What type of practitioner is instrumental in ensuring care that is evidence based and that safety programs are in place?
A) Clinical nurse specialist
B) Advanced practice nurse
C) Registered nurses
D) Nurse practitioners
Answer: A
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Chapter 2: Ethical Issues
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/41300
Sample Questions
Q1) Ethical decisions are best made by performing which action?
A) Following the guidelines of a framework or model
B) Having the patient discuss alternatives with the practitioner or nurse
C) Prioritizing the greatest good for the greatest number of persons
D) Studying by the Ethics Committee after all diagnostic data are reviewed
Answer: A
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.The nurse has conflicting emotions about how to handle the situation.What is the nurse experiencing?
A) Autonomy
B) Moral distress
C) Moral doubt
D) Moral courage
Answer: B
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4
Chapter 3: Legal Issues
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41301
Sample Questions
Q1) A night nurse is notified by the laboratory that the patient has a critical magnesium level of 1.1 mEq/L.The patient has a do-not-resuscitate order.The nurse does not notify the practitioner because of the patient's code status.In doing so,the nurse is negligent for what?
A) Failure to analyze the level of care needed by the patient
B) Failure to respect the patient's wishes
C) Wrongful death
D) Failure to take appropriate action
Answer: D
Q2) In which situation did the nurse disregard the patient's right to privacy?
A) Informing the physician that the patient was verbalizing suicidal thoughts
B) Notifying the health department of a patient's tuberculosis diagnosis
C) Reporting possible dependent-adult abuse to the police
D) Warning a visitor to wear gloves when giving a back rub because the patient is HIV positive
Answer: D
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Chapter 4: Genetic Issues
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which type of genetic disorder occurs when there is an interaction between genetic and environmental factors such as that which occurs with type 2 diabetes?
A) Chromosome
B) Mitochondrial
C) Multifactorial disorders
D) Allele dysfunction
Q2) A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known which of the following?
A) Chromatids
B) Karyotype
C) Genomics
D) Histones
Q3) What is the study of heredity particularly as it relates to the transfer heritable physical characteristics called?
A) Chromatids
B) Karyotype
C) Genetics
D) Histones
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6
Chapter 5: Patient and Family Education
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41303
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) Which statement best describes the efficacy of group discussion as a patient teaching strategy for educating both a patient newly diagnosed with diabetes and a patient who has had the disease for years?
A) It is an efficient use of the nurse's time.
B) It is an efficient use of the patient's time.
C) It is an effective strategy as both patients have identical goals.
D) It is not an appropriate teaching strategy.
Q3) What does the first step of the teaching-learning process involve?
A) Gathering data to assist in the assessment of learning needs
B) Identifying major learning needs for the patient
C) Identifying learning needs related to medical diagnosis
D) Evaluating the effects of prior teaching
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Page 7
Chapter 6: Psychosocial and Spiritual Alterations and Management
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41304
Sample Questions
Q1) Prolonged periods of anxious waiting,disrupted sleep patterns,witnessing emergency interventions,and financial concerns could put family members at risk for developing what problem?
A) Powerlessness
B) Hopelessness
C) Anxiety
D) Posttraumatic stress disorder
Q2) Which statement regarding patients with an external locus of control is true?
A) They believe that they can influence the outcome of their illness.
B) They should be forced to take control of their discharge planning.
C) They usually start out with an internal locus of control until a major illness occurs.
D) They believe that events are related to chance or fate.
Q3) 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
Page 8
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Chapter 7: Nutrition Alterations and Management
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41305
Sample Questions
Q1) Patients with coronary artery disease should be taught about cholesterol.Which situation is most desirable?
A) Low levels of high-density lipoprotein (HDL) cholesterol
B) Low levels of low-density lipoprotein (LDL) cholesterol
C) Hypocholesterolemia
D) Low levels of both HDL and LDL cholesterol
Q2) A patient has a new order for intermittent nasogastric feedings every 4 hours.The nasogastric tube is placed by the nurse.What is the most accurate method for confirming the placement of the tube before initiating the feeding?
A) Obtain radiography of the abdomen
B) Check the pH of fluid aspirated from the tube
C) Auscultate the left upper quadrant of the abdomen while injecting air into the tube
D) Auscultate the right upper quadrant of the abdomen while injecting air into the tube
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Chapter 8: Pain and Pain Management
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) The nurse is caring for a patient with a patient-controlled analgesia (PCA).The patient's spouse asks about the advantages of using this type of pain management therapy.What should the nurse say to the spouse?
A) "The method allows the patient to act preemptively by administering a bolus of medication when pain begins."
B) "This method allows the patient to choose between an opioid and a nonopioid medication to control pain."
C) "This method decreases the risk of respiratory depression and other side effects."
D) "This method allows for the rise and fall of the blood level of the opioid."
Q2) A patient underwent a thoracotomy 12 hours ago and has continuous epidural analgesia with morphine.In addition to respiratory depression,the patient should be monitored for which complications?
A) Urinary retention, undue somnolence, itching, nausea, and vomiting
B) Urinary incontinence, photophobia, headache, and skin rash
C) Apprehension, anxiety, restlessness, sadness, anger, and myoclonus
D) Gastric bleeding, nasal discharge, cerebrospinal fluid leak, and calf pain
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10
Chapter 9: Sedation,Agitation,and Delirium Management
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/41307
Sample Questions
Q1) To achieve ventilator synchrony in a mechanically ventilated patient with acute respiratory distress syndrome (ARDS),which level of sedation might be most effective?
A) Light
B) Moderate
C) Conscious
D) Deep
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 action?
A) Decrease benzodiazepines to half the prescribed dose.
B) Increase IV fluids to 500 cc/h for 2 hours.
C) Administer flumazenil (Romazicon).
D) Discontinue benzodiazepine and start propofol.
Q3) What is a major side effect of benzodiazepines?
A) Hypertension
B) Respiratory depression
C) Renal failure
D) Phlebitis
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11
Chapter 10: End-Of-Life Care
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/41308
Sample Questions
Q1) Which of the following statements about comfort care is accurate?
A) Withholding and withdrawing life-sustaining treatment are distinctly different in the eyes of the legal community.
B) Each procedure should be evaluated for its effect on the patient's comfort before being implemented.
C) Only the patient can determine what constitutes comfort care for him or her.
D) Withdrawing life-sustaining treatments is considered euthanasia in most states.
Q2) What are the two basic ethical principles underlying the provision of health care?
A) Beneficence and nonmaleficence
B) Veracity and beneficence
C) Fidelity and nonmaleficence
D) Veracity and fidelity
Q3) Haloperidol are traditionally been used to managed which symptom?
A) Anxiety
B) Dyspnea
C) Delirium
D) Pain
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12
Chapter 11: Cardiovascular Anatomy and Physiology
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41309
Sample Questions
Q1) Which factors influence stroke volume?
A) Afterload
B) Cardiac output
C) Contractility
D) Heart rate
E) Preload
Q2) A patient is admitted with right- and left-sided heart failure.The nurse's assessment reveals that the patient has 3+ pitting edema on the sacrum,blood pressure of 176/98 mm Hg,and bilateral crackles in the lungs.The patient is experiencing shortness of breath and chest discomfort.On the basis of this information,how would the nurse evaluate the patient's preload status?
A) The patient is hypovolemic and has too little preload.
B) The patient is experiencing congestive heart failure (CHF) and has too little preload.
C) The patient is experiencing heart failure and has too much preload.
D) The patient is hypertensive and the preload is not a factor.
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Chapter 12: Cardiovascular Clinical Assessment
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41310
Sample Questions
Q1) A patient is admitted with a diagnosis of "rule out myocardial infarction." The patient reports midchest pressure radiating into the jaw and shortness of breath when walking up stairs.What factor influences the amount of history obtained during the admission assessment?
A) Presence of cardiovascular risk factors
B) Prior medical history
C) Presenting symptoms
D) Current medications
Q2) A patient is admitted with a diagnosis of "rule out myocardial infarction." The patient reports midchest pressure radiating into the jaw and shortness of breath when walking up stairs.When inspecting the patient,the nurse notes that the patient needs to sit in a high Fowler position to breathe.The nurse suspects the patient may be experiencing what problem?
A) Pericarditis
B) Anxiety
C) Heart failure
D) Angina
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Chapter 13: Cardiovascular Diagnostic Procedures
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74 Verified Questions
74 Flashcards
Source URL: https://quizplus.com/quiz/41311
Sample Questions
Q1) Which of the electrocardiogram (ECG)findings would be positive for an inferior wall myocardial infarction (MI)?
A) ST segment depression in leads I, aVL, and V2 to V4
B) Q waves in leads V1 to V2
C) Q waves in leads II, III, and aVF
D) T-wave inversion in leads V4 to V6, I, and aVL
Q2) What is the major factor influencing the patient's response to atrial flutter?
A) Atrial rate
B) Ventricular response rate
C) PR interval
D) QRS duration
Q3) Which blood test standardizes prothrombin time (PT)results among worldwide clinical laboratories?
A) aPTT
B) ACT
C) HDL
D) INR
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Chapter 14: Cardiovascular Disorders
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/41312
Sample Questions
Q1) The nurse is caring for a patient with left-sided heart failure.The nurse suspects the patient is developing pulmonary edema.Which finding would confirm the nurse's suspicions?
A) Pulmonary crackles
B) Peripheral edema
C) Pink, frothy sputum
D) Elevated central venous pressure
Q2) Which mechanisms responsible for a myocardial infarction (MI)?
A) Coronary artery thrombosis
B) Plaque rupture
C) Coronary artery spasm near the ruptured plaque
D) Preinfarction angina
E) Hyperlipidemia
Q3) The nurse developing a patient education plan for the patient with endocarditis.What information would be included in the plan?
A) Endocarditis is a viral infection that is easily treated with antibiotics.
B) The risk of this diagnosis is occlusion of the coronary arteries.
C) A long course of antibiotics is needed to treat this disorder.
D) Complications are rare after antibiotics have been started.
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Page 16
Chapter 15: Cardiovascular Therapeutic Management
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/41313
Sample Questions
Q1) Which anticoagulant enhances the activity of antithrombin III and does not require activated partial thromboplastin time (aPTT)or activated clotting time (ACT)monitoring?
A) Heparin
B) Enoxaparin
C) Bivalirudin
D) Argatroban
Q2) A transvenous pacemaker is inserted through the right subclavian vein and threaded into the right ventricle.The pacemaker is placed on demand at a rate of 70.What is the three letter code for this pacing mode?
A) VVI
B) AOO
C) DDD
D) VAT
Q3) Noninvasive emergency pacing is best achieved via the use of which type of temporary pacing?
A) Transvenous (endocardial)
B) Epicardial
C) Transthoracic
D) Transcutaneous
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17
Chapter 16: Pulmonary Anatomy and Physiology
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40 Verified Questions
40 Flashcards
Source URL: https://quizplus.com/quiz/41314
Sample Questions
Q1) The lobes are divided into 18 segments.How many are on the right lung?
A) 3
B) 8
C) 10
D) 15
Q2) What is the movement of air into and out of the lungs termed?
A) Ventilation
B) Respiration
C) Diffusion
D) Perfusion
Q3) Which physiologic mechanism is a passive event in a spontaneously breathing patient?
A) Coughing
B) Inhalation
C) Exhalation
D) Yawning
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Page 18
Chapter 17: Pulmonary Clinical Assessment
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41315
Sample Questions
Q1) Which chest wall deformity is characterized by an increase in anteroposterior (AP)diameter with displacement of the sternum forward and the ribs outward?
A) Funnel chest
B) Pigeon breast
C) Barrel chest
D) Harrison's groove
Q2) While conducting a physical assessment on a patient with chronic obstructive pulmonary disease (COPD),the nurse notes that the patient's breathing is rapid and shallow.What is this type of breathing pattern called?
A) Hyperventilation
B) Tachypnea
C) Obstructive breathing
D) Bradypnea
Q3) Which condition is an example of a disorder with increased tactile fremitus?
A) Emphysema
B) Pleural effusion
C) Pneumothorax
D) Pneumonia
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19
Chapter 18: Pulmonary Diagnostic Procedures
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) A patient is admitted with signs and symptoms of a pulmonary embolus (PE).What diagnostic test most conclusive to determine this diagnosis?
A) ABG
B) Bronchoscopy
C) Pulmonary function test
D) V/Q scan
Q2) What medication may be included in the preprocedural medications for a diagnostic bronchoscopy?
A) Aspirin for anticoagulation
B) Vecuronium to inhibit breathing
C) Codeine to decrease the cough reflex
D) Cimetidine to decrease hydrochloric acid secretion
Q3) Which ABG values reflect compensation?
A) pH, 7.26; PaCO , 55 mm Hg;HCO ¯ , 24 mEq/L
B) pH, 7.30; PaCO , 32 mm Hg;HCO ¯ , 18 mEq/L
C) pH, 7.48; PaCO , 30 mm Hg;HCO ¯ , 22 mEq/L
D) pH, 7.38; PaCO , 58 mm Hg;HCO ¯ , 30 mEq/L
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Page 20
Chapter 19: Pulmonary Disorders
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Which therapeutic measure would be the most effective in treating hypoxemia in the presence of intrapulmonary shunting associated with acute respiratory distress syndrome (ARDS)?
A) Sedating the patient to blunt noxious stimuli
B) Increasing the FiO on the ventilator
C) Administering positive-end expiratory pressure (PEEP)
D) Restricting fluids to 500 mL per shift
Q2) What is the medical treatment for a pneumothorax greater than 15%?
A) Systemic antibiotics to treat the inflammatory response
B) An occlusive dressing to equalize lung pressures
C) Interventions to evacuate the air from the pleural space
D) Mechanical ventilation to assist with re-expansion of the collapsed lung
Q3) Nursing management of the patient with acute lung failure includes which interventions?
A) Positioning the patient with the least affected side up
B) Providing adequate rest between treatments
C) Performing percussion and postural drainage every 4 hours
D) Controlling fever
E) Pharmaceutical medications to control anxiety
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Page 21
Chapter 20: Pulmonary Therapeutic Management
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41318
Sample Questions
Q1) What nursing intervention can minimize the complications of suctioning?
A) Inserting the suction catheter no more than 5 inches
B) Premedicating the patient with atropine
C) Hyperoxygenating the patient with 100% oxygen
D) Increasing the suction to 150 mm Hg
Q2) Which statements regarding rotation therapies are accurate?
A) Continuous lateral rotation therapy (CLRT) can be effective for improving oxygenation if used for at least 18 hours/day.
B) Kinetic therapy can decrease the incidence of ventilator-acquired pneumonia in neurologic and postoperative patients.
C) Use of rotational therapy eliminates the need for other pressure ulcer prevention strategies.
D) CLRT helps avoid hemodynamic instability secondary to the continuous, gentle turning of the patient.
E) CLRT has minimal pulmonary benefits for critically ill patients.
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Chapter 21: Neurologic Anatomy and Physiology
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41319
Sample Questions
Q1) A patient with neurologic damage continues with extremely high core body temperature despite interventions to lower temperature.The nurse suspects the patient has sustained damage to which area of the brain?
A) Cerebrum
B) Cerebellum
C) Thalamus
D) Hypothalamus
Q2) Substances most likely to pass across the blood-brain barrier have what characteristics?
A) Low pH compared with body fluids
B) Lipid solubility
C) Large particle size
D) A close relation to toxic metabolites
Q3) A person with a cerebellar lesion will have difficulty with which physiologic mechanism?
A) Breathing
B) Equilibrium
C) Memory
D) Speech
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Page 23
Chapter 22: Neurologic Clinical Assessment and Diagnostic
Procedures
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49 Verified Questions
49 Flashcards
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Sample Questions
Q1) The nurse is caring for a patient with a head injury and observes a rhythmic increase and decrease in the rate and depth of respiration followed by brief periods of apnea.What should the nurse document under breathing pattern?
A) Central neurogenic hyperventilation
B) Apneustic breathing
C) Ataxic respirations
D) Cheyne-Stokes respirations
Q2) While the Glasgow Coma Scale (GCS)is part of the routine neurologic assessment,the nurse knows that it is not a valid measure for certain types of patients.In which patient is the GCS not valid?
A) Patient with hemiplegia
B) Patient with Parkinson disease
C) Patient with dyslexia
D) Patient who is intoxicated
Q3) Which procedure is the diagnostic study of choice for acute head injury?
A) Magnetic resonance imaging
B) Computed tomography
C) Transcranial Doppler
D) Electroencephalography
Page 24
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Chapter 23: Neurologic Disorders and Therapeutic Management
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44 Verified Questions
44 Flashcards
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Sample Questions
Q1) What is the target range for PaCO in the patient with intracranial hypertension?
A) 25 to 30 mm Hg
B) 25 to 35 mm Hg
C) 35 to 40 mm Hg
D) 33 to 37 mm Hg
Q2) Which independent nursing measures can assist in reducing increased intracranial pressure (ICP)?
A) Decreasing the ventilator rate
B) Decreasing noxious stimuli
C) Frequent orientation checks
D) Administration of loop diuretics
Q3) The extrusion of cerebral tissue through the cranium is what type of herniation?
A) Transcalvarial
B) Uncal
C) Cingulate
D) Transtentorial
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25
Chapter 24: Kidney Anatomy and Physiology
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25 Verified Questions
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Sample Questions
Q1) A patient is admitted with severe hypokalemia.On admission the patient's laboratory values are serum K ,2.2 mEq/L; blood urea nitrogen (BUN),15 mg/dL; and creatinine,1.2 mg/dL.Urine output is averaging 45 mL/h.The patient is given a total of 80 mEq of potassium over 4 hours.The potassium level is repeated and the result is K ,2.4 mEq/L.What other information would be beneficial at this time?
A) Magnesium level
B) Repeat creatinine level
C) Calcium level
D) Hemoglobin level
Q2) Which electrolytes are cations?
A) Sodium, potassium, and chloride
B) Sodium, chloride, and bicarbonate
C) Bicarbonate, chloride, and calcium
D) Sodium, potassium, and magnesium
Q3) 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
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Page 26
Chapter 25: Kidney Clinical Assessment and Diagnostic
Procedures
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20 Verified Questions
20 Flashcards
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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 admitted with acute kidney injury.The nurse knows the most important consideration for evaluating the patient's fluid status is what parameter?
A) Daily weights
B) Urine and serum osmolality
C) Intake and output
D) Hemoglobin and hematocrit levels
Q3) A patient was admitted with acute heart failure a few days ago.Today the patient's urine has a specific gravity of 1.040.What could be the potential cause for this value?
A) Volume overload
B) Volume deficit
C) Acidosis
D) Urine ketones
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Page 27
Chapter 26: Kidney Disorders and Therapeutic Management
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) An elderly patient is in a motor vehicle accident and sustains a significant internal hemorrhage.The nurse knows the patient is at risk for developing what type of acute kidney injury (AKI)?
A) Intrinsic
B) Postrenal
C) Prerenal
D) Intrarenal
Q2) A patient with chronic kidney disease was admitted with severe electrolyte disturbances.The patient had been ill and missed several hemodialysis sessions.The patient is disoriented,dizzy,cold,clammy,and complains of severe abdominal cramping.The patient's electrocardiogram appears normal.Which electrolyte disturbance would the nurse suspect the patient may be experiencing?
A) Hyponatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypochloremia
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Chapter 27: Gastrointestinal Anatomy and Physiology
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/41325
Sample Questions
Q1) What vessel delivers nutrient-rich blood from the gut,pancreas,spleen,and stomach to the liver?
A) Hepatic artery
B) Hepatic vein
C) Portal vein
D) Interlobular veins
Q2) Where in the gastrointestinal tract are Bacteroides,Lactobacillus,and Clostridium organisms commonly found?
A) Stomach
B) Small intestine
C) Large intestine
D) Liver
Q3) What is the pH of gastric juices prior to being mixed with food?
A) 1.0
B) 3.0
C) 5.0
D) 7.0
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29
Chapter 28: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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28 Verified Questions
28 Flashcards
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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) Which anatomic structures are found in the left upper quadrant?
A) Stomach
B) Spleen
C) Portion of the transverse and descending colon
D) Head of the pancreas
E) Body of the pancreas
Q3) 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
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Chapter 29: Gastrointestinal Disorders and Therapeutic Management
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41327
Sample Questions
Q1) A patient has been admitted with acute liver failure.Which interventions would the nurse expect as part of the interprofessional collaborative management plan?
A) Benzodiazepines for agitation
B) Pulse oximetry and serial arterial blood gas measurements
C) Insulin drip for hyperglycemia and hyperkalemia
D) Monitoring electrolyte blood levels
E) Assessing for signs of cerebral edema
F) Fever
Q2) A patient was admitted with acute liver failure.The patient is lethargic,confused,and has marked asterixis.The nurse suspects the patient is in what stage of hepatic encephalopathy.
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
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Chapter 30: Endocrine Anatomy and Physiology
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Q1) The nurse is caring for a patient with diabetes insipidus,which is the result of a decrease in antidiuretic hormone (ADH).Which statements regarding the stimulation or inhibition of ADH are accurate?
A) Infection stimulates the release of ADH.
B) Cold stimulates the release of ADH.
C) Emesis stimulates the release of ADH.
D) Opioids inhibit the release of ADH.
E) Hemorrhage inhibits the release of ADH.
F) Pain inhibits the release of ADH.
Q2) 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
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Chapter 31: Endocrine Clinical Assessment and Diagnostic Procedures
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Q1) A patient has been admitted with multiple trauma due to a motor vehicle accident several weeks ago.Given the prolonged critical illness,the nurse knows the patient may no longer secrete adequate amounts of what hormone?
A) Aldosterone
B) Adrenocorticotropic hormone (ACTH)
C) Cortisol
D) Antidiuretic hormone (ADH)
Q2) A nurse is initiating a patient teaching plan for a patient with hypothyroidism.The patient is currently taking salicylates,lithium,and sulfonamides.It is important that the nurse tell the patient that these medications influence thyroid levels.How are thyroid levels affected by these medications?
A) They increase T
B) They increasing T
C) They decrease T
D) They decrease T
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Chapter 32: Endocrine Disorders and Therapeutic Management
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Q1) A patient weighs 140 kg and is 60 inches tall.The patient's blood sugar is being controlled by glipizide.Which topic would be important for the nurse to include in the patient's discharge education plan?
A) Signs of hyperglycemia
B) Proper injection technique
C) Weight loss
D) Increased caloric intake
Q2) The nurse is developing a discharge education plan for a patient with syndrome of inappropriate secretion of antidiuretic hormone (SIADH).Which topic should be included in the plan?
A) Measuring intake and output
B) Encouraging fluids
C) A low-sodium diet
D) Hypothermia management
Q3) The nursing management plan for a patient with thyrotoxicosis would include which intervention?
A) Providing diversional stimuli
B) Restricting fluids
C) Maintaining a quiet, restful environment
Page 34
D) Administering thyroid supplements at the same time each day
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Chapter 33: Trauma
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Q1) A patient is admitted with a severe diffuse axonal injury (DAI)secondary to a motor vehicle crash.The patient's plan of care would involve which nursing action?
A) Perform neurologic assessments once a shift.
B) Obtain a computed tomography (CT) scan every day.
C) Monitor blood pressure and temperature every hour.
D) Initiate warming measures to keep temperature greater than 37.5° C.
Q2) A patient is admitted with a C5-C6 subluxation fracture.He is able to move his legs better than he can move his arms.Nursing care for the patient includes which intervention?
A) Keep the room cool, dark, and quiet.
B) Maintain mean arterial pressure (MAP) at 85 to 95 mm Hg.
C) Elevate the head of the bed 45 degrees.
D) Resuscitate low blood pressure by only using intravenous fluid.
Q3) A patient was admitted after a motor vehicle crash (MVC).The nurse knows that this type of injury is the greatest cause of what type of trauma?
A) Spinal shock
B) Blunt thoracic trauma
C) Maxillofacial injuries
D) Penetrating thoracic injuries
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Page 35
Chapter 34: Shock,sepsis,and Multiple-Organ Dysfunction Syndrome
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Q1) A patient is being admitted from the emergency department (ED)with cardiogenic shock secondary to unstable angina unresponsive to medications.The patient was intubated and ventilated in the ED.Which intervention should the nurse prepare to initiate when the practitioner arrives in the unit?
A) Administration of sodium bicarbonate
B) Rapid infusion of crystalloids
C) Insertion of an intraaortic balloon pump (IABP)
D) Insertion of dialysis catheters for continuous renal replacement therapy (CRRT)
Q2) 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
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Chapter 35: Burns
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Q1) A patient is admitted to the burn unit after an electrocution.The patient sustained extensive burns.The nurse should have a high degree of suspicion for what complication associated with this type of burn injury?
A) Rhabdomyolysis
B) Stress ulcers
C) Pneumothorax
D) Venous thromboembolism
Q2) A patient is admitted after being burned in a car fire.The wound surface is red with patchy white areas that blanch with pressure but no blister formation.What kind of burn would the nurse document in the patient's record?
A) Superficial partial-thickness burn
B) Moderate partial-thickness burn
C) Deep dermal partial-thickness burn
D) Full-thickness burn
Q3) What is a leading cause of death in the hospitalized burn patient?
A) Smoke inhalation
B) Infection
C) Burn shock
D) Renal failure
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Chapter 36: Organ Donation and Transplantation
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Q1) The nurse is teaching a patient about antiviral medications.The patient asks what is the most common viral infection in transplant recipients.What should the nurse tell the patient?
A) Influenza
B) Respiratory syncytial virus
C) Cytomegalovirus (CMV)
D) Parainfluenza
Q2) The nurse is caring for a patient after a heart transplant.Which finding would the nurse anticipate after cardiac transplantation?
A) Two P waves on the electrocardiogram (ECG)
B) High cardiac output
C) Anginal pain
D) Resting heart rate of 60 to 70 beats/min
Q3) The nurse is caring for a patient after a lung transplant.Which intervention would be a priority for the nurse?
A) Wean the patient from the ventilator.
B) Maintain hypotensive levels.
C) Start corticosteroid therapy.
D) Initiate pulmonary function studies.
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Page 38
Chapter 37: Hematologic and Oncologic Emergencies
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Q1) What is the primary mechanism in the development of tumor lysis syndrome?
A) Destruction of platelets by lymphocytic antibodies
B) Destruction of malignant cells through radiation or chemotherapy
C) Formation of heparin antibodies
D) Damage to the endothelium
Q2) The nurse is caring for a patient with type 2 heparin-induced thrombocytopenia (HIT).The nurse knows that pulmonary embolism is a serious complication of HIT.Which findings would alert the nurse to the presence of this complication?
A) Blanching of fingers and toes and loss of peripheral pulses
B) Chest pain, pallor, and confusion
C) Headache, impaired speech, and loss of motor function
D) Dyspnea, pleuritic pain, and rales
Q3) A patient has been admitted with tumor lysis syndrome (TLS).Which laboratory findings would the nurse expect to note to support this diagnosis?
A) Increased calcium
B) Decreased potassium
C) Dysrhythmias
D) Elevated blood urea nitrogen (BUN)
E) Elevated creatine
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Page 39
Chapter 38: The Obstetric Patient
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Q1) What is the most common cause of obstetric cardiac arrest in pregnancy?
A) Anesthetic complications
B) Idiopathic peripartum cardiomyopathy
C) Pregnancy-induced hypertension
D) Hemorrhage
Q2) A patient has been admitted with severe preeclampsia.The nurse knows that the patient's treatment plan would include which goals?
A) Prevention of seizures
B) Decreasing arterial spasms
C) Prompt delivery of the fetus
D) Support of hypotension
E) Administration of broad-spectrum antibiotics
Q3) A patient has been admitted with severe preeclampsia.The nurse knows that the patient's treatment plan would include which intervention?
A) Titrating intravenous fluids to maintain urine output greater than 50 mL/h
B) Administering hydralazine to keep the systolic blood pressure less than 120 mm Hg
C) Placing the patient on bed rest to decrease the chance of delivery
D) Administering magnesium sulfate to maintain serum levels of 4 to 7 mEq/L
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Chapter 39: The Pediatric Patient
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Q1) To establish a patent airway in an infant or child younger than 2 years of age,the nurse would perform which action?
A) Initiate the head-tilt/chin-lift maneuver.
B) Hyperextend the neck and pull the jaw forward.
C) Place a towel under the upper shoulders with the jaw slightly extended into "sniffing" position.
D) Place a folded towel under the head to extend the neck.
Q2) What elements help a child cope successfully with a critical care crisis?
A) An outside support system
B) A resilient personality
C) Another child with the same illness
D) A supportive family
E) A fatalistic practitioner
Q3) Optimal treatment of a pediatric patient with status asthmaticus includes which actions?
A) Placing the patient in the knee-chest position
B) Extending the neck to promote opening of the airway
C) Providing humidified oxygen
D) Administering b-adrenergic therapy
E) Administering corticosteroids
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Chapter 40: The Older Adult Patient
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Q1) Which sign or symptom can be a normal assessment finding for an older patient?
A) Asymptomatic dysrhythmias
B) Decreased urine output
C) Increased respiratory effort
D) Difficulty problem solving
Q2) What is the chemical change in a drug called that renders it active or inactive?
A) Absorption
B) Metabolism
C) Excretion
D) Distribution
Q3) An older patient is started on spironolactone to control hypertension.The nurse knows to monitor for what side effect?
A) Hyperkalemia
B) Irregular heart rate
C) Confusion
D) Pulmonary edema
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Chapter 41: The Perianesthesia Patient
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Q1) Which medication has a direct myocardial depressant effect on the heart?
A) Ketamine
B) Barbiturates
C) Succinylcholine
D) Opioids
Q2) A patient is oversedated after receiving a benzodiazepine.Which medication would the nurse administer to reverse the effects of the medication?
A) Naloxone
B) Neostigmine
C) Fentanyl
D) Flumazenil
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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