Critical Care Nursing
Mock Exam
Course Introduction
Critical Care Nursing is designed to equip students with the advanced knowledge and clinical skills necessary for the care of critically ill patients in high-acuity settings. The course focuses on the systematic assessment and management of patients experiencing life-threatening conditions, including respiratory failure, shock, sepsis, and multi-organ dysfunction. Emphasis is placed on the use of advanced technology, evidence-based practices, and interdisciplinary collaboration to optimize patient outcomes. Students will explore ethical and legal aspects of critical care, develop critical thinking and decision-making abilities, and learn to provide holistic support to patients and their families within the critical care environment.
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) 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
Q2) What is the systematic decision-making model used by nurses termed?
A) Nursing diagnosis
B) Nursing interventions
C) Nursing evaluations
D) Nursing process
Answer: D
Q3) Prayer,guided imagery,and massage are all examples of what type of treatment?
A) Alternative therapy
B) Holistic care
C) Complementary care
D) Individualized care
Answer: C
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Page 3
Chapter 2: Ethical Issues
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) The nurse is using the SFNO approach to case analysis to facilitate ethical decision making.What justification criteria may be used to help explain the reasons for selection of one option over another?
A) Effectiveness
B) Usefulness
C) Legal ramifications
D) Economics
Answer: A
Q2) Which situations are early signs of an ethical dilemma?
A) Disagreements among health care team members
B) Failure to discuss end-of-life issues with patient
C) Aggressive pain management
D) Belief that treatment is harmful
E) Following the patient's advance directive despite family objections
F) Providing hope to the patient's family
Answer: A,B,D
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Chapter 3: Legal Issues
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) What element of malpractice is based on the existence of a nurse-patient relationship?
A) Duty
B) Breach
C) Damages
D) Harm caused by the breach
Answer: A
Q2) What elements or criteria must be present for negligence cases to go forward?
A) Duty to another person
B) Acknowledgement of wrong doing
C) Harm that would not have occurred in the absence of the breach
D) Breach of duty
E) Damages that have a monetary value
Answer: A,C,D,E
Q3) Which situation would be considered a failure of proper implementation?
A) Not identifying and analyzing symptoms appropriately
B) Not documenting the patient's response to pain medication
C) Not recognizing a malfunctioning chest tube
D) Not asking the patient about code or no code wishes
Answer: B
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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 patients would be candidates for genetic testing for long QT syndrome (LQTS)?
A) Patients with prolonged QT interval during a cardiac and genetic work-up
B) Family history of positive genotype and negative phenotype
C) Patients diagnosed with torsades de pointes
D) Family history of sudden cardiac death
E) Family history of bleeding disorders
F) Family history of obesity
Q2) A family pedigree is used to determine whether a disease has a genetic component.What does a proband indicate in a family pedigree?
A) The disease being mother related or father related
B) The first person in the family who was diagnosed with the disorder
C) Who in the family is the xy band
D) The disease genotype including locus
Q3) Why are monozygotic twins separated at birth used to study the effects of genetics versus environment?
A) They share an identical genome.
B) They have different sex chromosomes.
C) They have mirror chromosomes.
D) They have identical health issues.
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Chapter 5: Patient and Family Education
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) 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.
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) When writing goals and outcomes,what should be incorporated in the outcome statement?
A) An action oriented intervention list
B) An observable verb
C) The objectives for the nurse
D) The length of the education session
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Page 7
Chapter 6: Psychosocial and Spiritual Alterations and Management
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25 Flashcards
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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) A patient has been admitted with a severed spinal cord injury at the T level.The patient has been in halo traction with immobilization for the past week.The practitioner explains to the patient that the spinal cord has been severed and that the patient will not be able to walk again.The patient becomes overtly hostile to everyone.What psychosocial concept is the patient demonstrating?
A) Regression
B) Loss of autonomy
C) Ineffective coping
D) Hope
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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) Two types of protein-caloric malnutrition are kwashiorkor and marasmus.What physiologic changes are associated with Kwashiorkor?
A) Weight loss and muscle wasting
B) Low levels of serum proteins, low lymphocyte count, and hair loss
C) Elevated serum albumin and increased creatinine excretion in the urine
D) Hyperpigmentation and a hard, easily palpated liver margin
Q2) A patient is admitted with severe malnutrition.A central venous catheter is placed in the right subclavian vein and total parenteral nutrition (TPN)is started.For which complication should the patient be evaluated immediately after insertion of the catheter?
A) Pneumothorax
B) Hypoglycemia
C) Central venous thrombosis
D) Pulmonary aspiration
Q3) 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.
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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) 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
Q2) What are the neural processes of encoding and processing noxious stimuli associated with pain called?
A) Perception
B) Nociception
C) Transduction
D) Transmission
Q3) Why use a specific pain intensity scale in the critical care unit?
A) It eliminates the subjective component from the assessment.
B) It focuses on the objective component of the assessment.
C) It provides consistency of assessment and management.
D) It provides a way to interpret physiologic indicators.
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Chapter 9: Sedation,Agitation,and Delirium Management
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which intervention is an effective nursing strategy to decrease the incidence of delirium?
A) Restriction of visitors
B) Early nutritional support
C) Clustering of nursing care activities
D) Bedrest
Q2) A patient is admitted with acute respiratory distress syndrome (ARDS).The patient has been intubated and is mechanically ventilated.The patient had become very agitated and required some sedation.After the patient's agitation is controlled,which medications would be most appropriate for long-term sedation?
A) Morphine 2 mg/h continuous IV drip
B) Haloperidol 15 mcg/kg/min continuous IV infusion
C) Propofol 5 mcg/kg/min by IV infusion
D) Lorazepam 0.01 to 0.1 mg/kg/h by IV infusion
Q3) 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
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Page 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) In caring for a patient receiving palliative care,antiemetics are used in the treatment of what problem?
A) Dyspnea
B) Nausea and vomiting
C) Anxiety
D) Edema
Q2) 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.
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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12
Chapter 11: Cardiovascular Anatomy and Physiology
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) 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 atrioventricular (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
Q2) An echocardiogram reveals an ejection fraction of 55%.On the basis of this information,how would the patient's cardiac function be described?
A) Adequate
B) Mildly decreased
C) Moderately decreased
D) Severely decreased
Q3) A patient reports feeling dizzy after standing quickly.Which finding could provide a clue regarding the cause?
A) Hemoglobin level of 14.0 g/dL and hematocrit level of 42.3%
B) Poor skin turgor with extended tenting
C) Supine blood pressure of 146/93 mm Hg
D) Resting heart rate of 96 beats/min
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Page 13
Chapter 12: Cardiovascular Clinical Assessment
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41310
Sample Questions
Q1) 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.
Q2) Heart murmurs are characterized by which criteria?
A) Intensity
B) Location
C) Quality
D) Pitch
E) Pathologic cause
Q3) Evaluation of arterial circulation to an extremity is accomplished by assessing which of the following?
A) Homans sign
B) Skin turgor
C) Peripheral edema
D) Capillary refill
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14
Chapter 13: Cardiovascular Diagnostic Procedures
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74 Verified Questions
74 Flashcards
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Sample Questions
Q1) Why is the measurement of the QT interval important?
A) It facilitates rhythm identification and is best assessed in Lead II.
B) It helps differentiate myocardial ischemia from infarction.
C) An increasing QT interval increases the risk of torsades de pointes.
D) A decreasing QT interval increases the risk of torsades de pointes.
Q2) Which blood test standardizes prothrombin time (PT)results among worldwide clinical laboratories?
A) aPTT
B) ACT
C) HDL
D) INR
Q3) 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) In the acute phase after ST segment elevation myocardial infarction (STEMI),fibrinolytic therapy is used in combination with heparin to recanalize the coronary artery.What dosage is the initial heparin bolus?
A) 60 units/kg maximum 5000 units
B) 30 units/kg maximum 3000 units
C) 25 units/kg maximum of 2500 units
D) 12 units/kg maximum of 1000 units
Q2) A patient is admitted with hypertrophic cardiomyopathy.The nurse would expect the medical management of this patient to include which intervention?
A) Administration of beta-blockers
B) Administration of positive inotropes
C) Plans for intensive exercise regimen
D) Plans for an aortic valve replacement
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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Page 16
Chapter 15: Cardiovascular Therapeutic Management
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35 Verified Questions
35 Flashcards
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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) Through what mechanism does enalapril decrease blood pressure?
A) Direct arterial vasodilation
B) Block the conversion of angiotensin I to angiotensin II
C) Increase fluid excretion at the loop of Henle
D) Peripheral vasoconstriction and central vasodilation.
Q3) Which of the following statements regarding beta-blockers is correct?
A) They increase heart rate and are contraindicated in tachydysrhythmias.
B) They result in bronchospasm and should not be used in patients with chronic obstructive pulmonary disease (COPD).
C) They increase cardiac output and help with left ventricular failure.
D) They are helpful in increasing atrioventricular node conduction and are used in heart blocks.
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Chapter 16: Pulmonary Anatomy and Physiology
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40 Verified Questions
40 Flashcards
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Sample Questions
Q1) What anatomic regions are considered physiologic dead space?
A) Respiratory bronchiole and unperfused alveoli
B) Trachea and perfused alveoli
C) Trachea and unperfused alveoli
D) Trachea and mainstem bronchi
Q2) If a patient sustained an injury to the apneustic center in the lower pons area,in which area should the nurse most expect the patient to exhibit problems?
A) Respiratory rate
B) Triggering exhalation
C) Respiratory rhythm
D) Depth of respiration
Q3) What is the main function of the conducting airways?
A) Gas exchange
B) Cool the inhaled air
C) Remove moisture from inhaled air
D) Prevent the entry of foreign material
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18
Chapter 17: Pulmonary Clinical Assessment
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) The nurse is performing a pulmonary assessment on a patient with acute bronchitis.Which finding is unexpected?
A) Rasping productive cough
B) Decreased tactile fremitus
C) Resonant percussion tones
D) Crackles and wheezes
Q2) While palpating a patient's lungs the nurse notes fremitus over the patient's trachea but not the lung periphery.What do these findings indicate?
A) Bilateral pleural effusion
B) Bronchial obstruction
C) A normal finding
D) Apical pneumothorax
Q3) 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
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Page 19
Chapter 18: Pulmonary Diagnostic Procedures
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30 Flashcards
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Sample Questions
Q1) A patient presents with absent lung sounds in the left lower lung fields,moderate shortness of breath,and dyspnea.The nurse suspects pneumothorax and notifies the practitioner.Orders for a STAT chest radiography and reading are obtained.Which finding best supports the nurse's suspicions?
A) Blackness in the left lower lung area
B) Whiteness in the left lower lung area
C) Blunted costophrenic angles
D) Elevated left hemidiaphragm
Q2) On admission,a patient presents with a respiratory rate of 24 breaths/min,pursed-lip breathing,heart rate of 96 beats/min in sinus tachycardia,and a blood pressure of 110/68 mm Hg.The patient's arterial blood gas (ABG)values on room air are PaO ,70 mm Hg; pH,7.38; PaCO ,52 mm Hg; andHCO ¯ ,34 mEq/L.What 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 19: Pulmonary Disorders
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Patients with left-sided pneumonia may benefit from placing them in which position?
A) Reverse Trendelenburg
B) Supine
C) On the left side
D) On the right side
Q2) 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
Q3) Which cause of hypoxemia is the result of blood passing through unventilated portions of the lungs?
A) Alveolar hypoventilation
B) Dead space ventilation
C) Intrapulmonary shunting
D) Physiologic shunting
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21
Chapter 20: Pulmonary Therapeutic Management
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30 Flashcards
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Sample Questions
Q1) Which interventions minimize the complications associated with suctioning an artificial airway?
A) Hyperoxygenate the patient prior to the start of the procedure
B) Hyperoxygenate the patient after each pass of the suction catheter
C) Limit the duration of each suction pass to 20 seconds
D) Instill 5 to 10 mL of normal saline to facilitate secretion removal
E) Use intermittent suction to avoid damaging tracheal tissue
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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Chapter 21: Neurologic Anatomy and Physiology
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) Which lobe of the brain deals primarily with sensory function?
A) Frontal lobe
B) Temporal lobe
C) Occipital lobe
D) Parietal lobe
Q2) Obstructive hydrocephalus can occur in the presence of what abnormality?
A) Blockage in the arachnoid villi
B) Malformation of the falx cerebelli
C) Blockage of cerebrospinal fluid (CSF) flow in the ventricular system
D) Increased production of CSF
Q3) The primary functions of which lobe are hearing,speech,behavior,and memory?
A) Frontal lobe
B) Temporal lobe
C) Occipital lobe
D) Parietal lobe
Q4) Which structure(s)form(s)the blood-brain barrier?
A) Postsynaptic terminals
B) Pia mater
C) Vascular endothelial cells
D) Myelin sheath
23
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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 severely head injured comatose patient who is dying.The practitioner asks to be notified when the patient starts to exhibit signs of Cushing reflex.The nurse would call the practitioner when the patient starts to show what signs?
A) Bradycardia, systolic hypertension, and widening pulse pressure
B) Tachycardia, systolic hypotension, and tachypnea
C) Headache, nuchal rigidity, and hyperthermia
D) Bradycardia, aphasia, and visual field disturbances
Q2) The nursing is caring for a comatose patient with a brain tumor.When the nurse touches the palm of the patient's hand,the patient grasps the nurse's hand.What is this sign indicative of?
A) There is damage to the brainstem.
B) It's a normal finding.
C) The patient is getting better.
D) Cortical damage is present.
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
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Sample Questions
Q1) A patient has been admitted with an ischemic stroke.The patient received recombinant tissue plasminogen activator (rtPA)in the emergency department.The nurse checks the medication administration record to make sure the patient does not have which medications for the next 24 hours?
A) Aspirin
B) Sodium nitroprusside
C) Warfarin
D) Labetalol
E) Any antiplatelet drugs
Q2) Which nursing diagnosis has the highest priority in the nursing management plan for a patient with Guillain-Barré syndrome?
A) Imbalanced nutrition: less than body requirements related to lack of exogenous nutrients or increased metabolic demand
B) Acute pain related to transmission and perception of cutaneous, visceral, muscular, or ischemic impulses
C) Risk for aspiration
D) Ineffective breathing pattern related to musculoskeletal fatigue or neuromuscular impairment
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Chapter 24: Kidney Anatomy and Physiology
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Sample Questions
Q1) The mobilization of calcium from bone stores is accomplished through the influence of which hormone?
A) Antidiuretic hormone (ADH)
B) Parathyroid hormone (PTH)
C) Thyroid-stimulating hormone (TSH)
D) Erythropoietin
Q2) Stimulation from what receptors will cause contraction of the detrusor muscle of the bladder?
A) Bladder wall and ureters
B) Bladder wall and urethra
C) Ureters and urethra
D) Urethra and bladder neck
Q3) The following substances,among others,are found in a patient's urine sample: urea,creatinine,sodium,chlorine,potassium,glucose,and bicarbonate ions.Which patient situation 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 40 mg/dL
D) Blood potassium level of 4.1 mEq/L
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Page 26
Chapter 25: Kidney Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) 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
Q2) A patient is admitted in acute heart failure secondary to renal insufficiency.The patient reports that over the past few weeks,his urine output has decreased,and he has developed peripheral edema and ascites.Which diagnostic tests would provide the best information about the internal kidney structures,such as the parenchyma,calyces,pelvis,ureters,and bladder?
A) Kidney-ureter-bladder (KUB)
B) Intravenous pyelography (IVP)
C) Renal ultrasonography (ECHO)
D) Renal angiography
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Chapter 26: Kidney Disorders and Therapeutic Management
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30 Verified Questions
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Sample Questions
Q1) A patient was admitted with an infection that had to be treated with an aminoglycoside antibiotic.After a few days the patient developed oliguria and elevated blood urea nitrogen and creatinine levels.The patient's vital signs are stable.The nurse would anticipate the practitioner ordering which dialysis method for this patient?
A) Peritoneal dialysis
B) Hemodialysis
C) Continuous renal replacement therapy
D) Intermittent ultrafiltration
Q2) 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
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28
Chapter 27: Gastrointestinal Anatomy and Physiology
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Sample Questions
Q1) Which component of gastric juice is necessary for the breakdown of proteins?
A) Hydrochloric acid (HCl)
B) Pepsin
C) Intrinsic factor
D) Potassium
Q2) 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
Q3) Which statements are correct regarding epithelial cells of the gastric mucosa?
A) They prevent diffusion of hydrogen into the mucosa.
B) They secrete bicarbonate to neutralize hydrogen ions.
C) They have the ability to increase blood flow to facilitate removal of toxic metabolites.
D) They break down prostaglandins.
E) They are impervious to alcohol and aspirin.
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Chapter 28: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/41326
Sample Questions
Q1) A patient was admitted with pancreatitis.Which laboratory value would the nurse expect the practitioner order to confirm this diagnosis?
A) Bilirubin
B) Amylase
C) Lactate dehydrogenase
D) Ammonia
Q2) What is the most common location for a male to have a hernia?
A) Femoral
B) Umbilical
C) Inguinal
D) Abdominal
Q3) Upon auscultation,the nurse hears borborygmi.The nurse suspects the patient may be developing which problem?
A) A complete ileus
B) Early intestinal obstruction
C) Abnormality of blood flow
D) Peritonitis
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Page 30
Chapter 29: Gastrointestinal Disorders and Therapeutic Management
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Sample Questions
Q1) A patient is admitted with a severe head injury.The nurse knows that critically ill patients are at risk for gastrointestinal hemorrhage due to stress-related mucosal disease.The nurse would monitor the patient for which signs and symptoms?
A) Metabolic acidosis and hypovolemia
B) Decreasing hemoglobin and hematocrit
C) Hyperkalemia and hypernatremia
D) Hematemesis and melena
Q2) 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
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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Chapter 30: Endocrine Anatomy and Physiology
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Q1) A patient is brought to the hospital with a major stab wound.After excessive blood loss,the nurse should anticipate what change in the patient's serum osmolality?
A) Increase
B) Decrease
C) Rapid decrease than increase
D) Equal to his or her sodium level
Q2) A patient is admitted with a traumatic head injury.The patient starts to exhibit signs of a decrease in antidiuretic hormone (ADH).What is the function of ADH?
A) Control blood pressure
B) Regulate fluid balance
C) Normalize potassium levels
D) Maintain homeostasis
Q3) Which anatomic structure has influence over all areas of body functioning?
A) Hypothalamus
B) Pancreas
C) Thyroid
D) Pituitary
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Chapter 31: Endocrine Clinical Assessment and Diagnostic
Procedures
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Q1) A patient has been admitted with a brain mass.The practitioner suspects it might be a pituitary tumor and orders a computed tomography (CT)scan.What area of brain should be scanned to confirm this diagnosis?
A) Frontal lobe
B) Base of the skull
C) Temporal lobe
D) Anterior fossa
Q2) A patient is admitted with Cushing syndrome.Which findings would the nurse expect to note as confirming this diagnosis?
A) Hirsutism
B) Rounded face
C) Hypotension
D) Decreased libido
E) Scleroderma
F) Fatigue and weakness
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Page 33
Chapter 32: Endocrine Disorders and Therapeutic Management
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Q1) A patient is admitted with diabetic ketoacidosis (DKA).The patient presents with dry,cracked lips and is begging for something to drink.What reply would be the nurse's best response?
A) "We can't give you anything to drink until we get your blood sugar under control."
B) "You can have one cup of coffee without sugar."
C) "You can drink anything you want as long as it's sugar free."
D) "You can drink as much water has you can handle."
Q2) The nurse understands that the onset of seizures in the patient with diabetes insipidus (DI)is indicative of which situation?
A) Increased potassium levels
B) Hyperosmolality
C) Severe dehydration
D) Toxic ammonia levels
Q3) Which finding is expected in the patient with hypothyroidism?
A) Increased T
B) Anemia
C) Decreased thyroid stimulating hormone
D) Hyperglycemia
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Chapter 33: Trauma
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Q1) A patient with multisystem trauma has been in the intensive care unit (ICU)for 6 days.The patient is still intubated and mechanically ventilated and has a chest tube,urinary drainage catheter,nasogastric tube,and two abdominal drains.The patient's vital signs include blood pressure (BP),92/66 mm Hg; heart rate (HR),118 beats/min; temperature (T),38.7° C; and central venous pressure (CVP),5 mm Hg.What is the most likely cause of this hemodynamic picture?
A) Septic shock
B) Hemorrhagic shock
C) Cardiogenic shock
D) Neurogenic shock
Q2) A patient with a Le Fort III facial fracture has been admitted to the critical care unit.Which statements is true regarding this type of facial fracture?
A) It is frequently associated with cerebrospinal fluid leaks.
B) It is not as severe as Le Forte I and II injuries.
C) The patient's airway is not usually compromised.
D) It is associated with a low risk for hemorrhagic shock.
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35
Chapter 34: Shock,sepsis,and Multiple-Organ Dysfunction Syndrome
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Q1) A patient has been admitted with hypovolemic shock due to traumatic blood loss.Which nursing measure can best facilitate the administration of large volumes of fluid?
A) Inserting a large-diameter peripheral intravenous catheter
B) Positioning the patient in the Trendelenburg position
C) Encouraging the patient to drink at least 240 mL of fluid each hour
D) Administering intravenous fluids under pressure with a pressure bag
Q2) The nurse is caring for a patient with systemic inflammatory response syndrome (SIRS)due to pneumonia.What is SIRS due to infection called?
A) Infectivity
B) Anaphylaxis
C) Sepsis
D) Acute respiratory distress syndrome (ARDS)
Q3) A patient with a known penicillin allergy develops anaphylactic shock after a dose of ampicillin was given in error.Which medication would the nurse administer first?
A) Methylprednisolone
B) Gentamicin
C) Atropine
D) Epinephrine
Page 36
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Chapter 35: Burns
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Q1) A patient is admitted to the burn unit with extensive burns after a house fire.The patient's vital signs and physical exam include a heart rate of 140 beats/min,a urine output of 25 mL/h,and clear lung sounds.The nurse knows that the patient's symptoms are most likely attributable to what cause?
A) Blood loss associated with burns and pain
B) Hemodynamic stability related to adequate fluid resuscitation.
C) Overresuscitation related to overestimation of the burn area involved
D) Underresuscitation because of probable wound conversion
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 36: Organ Donation and Transplantation
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Q1) A nurse is preparing a patient for a liver transplant.The patient asks which stage of the procedure is the longest and most difficult.What would the nurse tell the patient?
A) Stage 1-recipient hepatectomy
B) Stage 2-vascular anastomoses
C) Stage 3-biliary anastomosis
D) Stage 4-induction therapy
Q2) Rejection that occurs within hours after the transplantation and results in immediate graft failure is referred to as what type of rejection?
A) Acute
B) Intermediate
C) Chronic
D) Hyperacute
Q3) The nurse is caring for a patient with a pancreas transplant.Which statement made by the patient indicates the need for further teaching?
A) "I no longer need to monitor my blood glucose levels."
B) "I will need to have periodic pancreas biopsies."
C) "I may feel the urge to urinate frequently."
D) "I will give urine samples to monitor for rejection."
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Chapter 37: Hematologic and Oncologic Emergencies
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Q1) The nurse is caring for a patient with type 2 heparin-induced thrombocytopenia (HIT).The nurse understands that this disorder has which characteristic?
A) Formation of thrombi
B) Spontaneous epistaxis
C) Elevated prothrombin times
D) Massive peripheral ecchymoses
Q2) A patient was admitted with gram-negative sepsis a few days ago.Today the nurse notes continual oozing from intravenous sites and ecchymosis beneath the blood pressure cuff.The patient's platelet count is normal,and international normalized ratio (INR)is elevated.The nurse places highest priority on which treatment goal?
A) Maintain adequate organ perfusion.
B) Suppress antibody response that is destroying platelets.
C) Treat life-threatening metabolic disturbances.
D) Begin hypothermic therapy to prevent cerebral hemorrhage.
Q3) What is the most common cause of disseminated intravascular coagulation (DIC)?
A) Sepsis caused by gram-positive organisms
B) Sepsis caused by gram-negative organisms
C) Sickle cell anemia
D) Burns
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Page 39
Chapter 38: The Obstetric Patient
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Q1) 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
Q2) Which statement regarding pregnancy and asthma is accurate?
A) Progesterone causes smooth muscle relaxation, which can worsen asthma symptoms.
B) Poorly controlled asthma has been associated with an increased incidence of spontaneous abortion.
C) A decrease in peak expiratory flow rate (PEFR) of more than 20% of the patient's personal best requires a visit to the emergency room.
D) It is estimated that approximately two thirds of patients will have worsening of asthma symptoms.
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Chapter 39: The Pediatric Patient
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Sample Questions
Q1) What are the normal cerebral perfusion pressure values for a child?
A) 30 to 50 mm Hg
B) 40 to 60 mm Hg
C) Values are unknown
D) 60 to 100 mm Hg
Q2) A 5-year-old boy has been admitted with severe asthma.His initial PaCO was 30 mm Hg.One hour later his PaCO is 45 mm Hg,and 1 hour after that,his PaCO is 56 mm Hg.Which intervention would the nurse anticipate being ordered by the practitioner?
A) High-dose steroids
B) Chest percussion and vibration
C) Fluid resuscitation with normal saline
D) Intubation and mechanical ventilation
Q3) What is the circulating blood volume of a neonate?
A) 40 to 60 mL/kg
B) 75 to 80 mL/kg
C) 80 to 85 mL/kg
D) 65 to 70 mL/kg
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Chapter 40: The Older Adult Patient
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Q1) An older patient is admitted to the hospital with an acute onset of mental changes and recent falls.What is the one of the most common causes of mental changes in older patients?
A) Dementia
B) Infection
C) Stroke
D) Depression
Q2) 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
Q3) Which factors contribute to diminished wound healing in the older adult?
A) Decreased cytokine production
B) Increased production of growth factor
C) Decreased inflammatory response
D) Decreased glucocorticoid secretion
E) Decreased cell proliferation
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Chapter 41: The Perianesthesia Patient
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Q1) The nurse is assisting with intubation of a patient.Which depolarizing skeletal muscle relaxant medication would the nurse anticipate being given to the patient?
A) Succinylcholine
B) Pancuronium
C) Mivacurium
D) Rocuronium
Q2) What are the causes of a postoperative fever?
A) Medication reactions
B) Hypotension
C) Blood transfusion reaction
D) Pulmonary emboli
E) Atelectasis
Q3) The coughing maneuver in which a patient takes a deep breath and then performs multiple coughs on exhalation of that breath is known as what type of cough?
A) Serial
B) Cascade
C) Sustained maximal
D) Deep
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