Intensive Care Nursing Exam Bank
Course Introduction
Intensive Care Nursing is a specialized course designed to equip students with the advanced knowledge and clinical skills required to care for critically ill patients in intensive care settings. The course covers the principles of critical care, including patient assessment, monitoring, and the management of life-threatening conditions involving major organ systems. Emphasis is placed on evidence-based interventions, use of advanced medical technology, and interdisciplinary collaboration to ensure optimal patient outcomes. Students also develop competencies in crisis management, ethical decision-making, and effective communication with patients, families, and healthcare teams in high-pressure environments.
Recommended Textbook Priorities in Critical Care Nursing 7th Edition by Linda D. Urden
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42 Chapters
1239 Verified Questions
1239 Flashcards
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Chapter 1: Critical Care Nursing Practice
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20 Flashcards
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Sample Questions
Q1) A stepwise decision-making flowchart for a specific care process is known as a(n) A) algorithm.
B) practice guideline.
C) protocol.
D) order set.
Answer: A
Q2) _____ have a broad depth of knowledge and expertise in their specialty area and manage complex clinical and system issues.
A) SCCMs
B) APNs
C) CNSs
D) AACNs
Answer: B
Q3) The systematic decision-making model used by nurses is known as A) a nursing diagnosis.
B) nursing interventions.
C) nursing evaluations.
D) the nursing process.
Answer: D
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Page 3
Chapter 2: Ethical Issues
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Sample Questions
Q1) Ethical decisions are best made by
A) following the guidelines of a framework or model.
B) having the client discuss alternatives with the physician or nurse.
C) prioritizing the greatest good for the greatest number of persons.
D) careful consideration by the Ethics Committee after all diagnostic data are reviewed.
Answer: A
Q2) Which of the following ethical principles is most important when soliciting informed consent from a client?
A) Nonmaleficence
B) Fidelity
C) Beneficence
D) Veracity
Answer: D
Q3) Which of the following is/are criteria for defining an ethical dilemma?
A) An awareness of different options
B) An issue in which only one viable option exists
C) The choice of one option compromises the option not chosen
D) An issue that has different options
Answer: A,C,D
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Page 4
Chapter 3: Legal Issues
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Sample Questions
Q1) Which of the following 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
Q2) Restraining an angry,competent patient against his or her wishes is an intentional tort because the nurse
A) did not document the patient's need for restraints in the nursing notes.
B) failed to get a physician's order for restraints.
C) purposefully restrained the patient against his or her wishes.
D) reassured the patient that the restraints were needed to maintain safety.
Answer: C
Q3) The legal standard of care for a nurse's actions is defined as
A) minimal competency under the Nurse Practice Act.
B) the ability to distinguish what is right or wrong for the patient.
C) the demonstration of satisfactory knowledge of policies and procedures.
D) providing reasonable, prudent care comparable to that of like practitioners.
Answer: D
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Page 5
Chapter 4: Genetics and Genomics in Critical Care
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Sample Questions
Q1) Hemophilia A is an inherited disease.Which statements would be determined by the family pedigree regarding hemophilia A?
A) It is an X-linked disorder.
B) Sons have a 50% chance of having hemophilia.
C) It is a Y-linked disorder.
D) Daughters have a 50% chance of being a carrier of the trait.
E) Sons have a 25% chance of having hemophilia.
F) Daughters have a 50% chance of having hemophilia.
Q2) The Genetic Information Nondiscrimination Act (GINA)of 2008 is an essential piece of legislation designed to prevent:
A) abuse of genetic information in employment and health insurance decisions.
B) genetic counselors from reporting results to the health insurance companies.
C) confidentiality of results.
D) information sharing between biobanks that are studying the same genetic disorders.
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Chapter 5: Patient and Family Education
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Sample Questions
Q1) A 79-year-old patient received a liver transplant 3 days ago.The patient is extubated and hemodynamically stable.His spouse is coming for a visit,and the nurse has some time to discuss immune suppression drug therapy with both of them.The patient is hearing and sight impaired.The spouse brought the patient's hearing aids 2 days ago and will bring the patient's glasses today.Which of the following teaching strategies would be least effective in the ICU setting?
A) Patient education channel
B) Written materials
C) Lecture
D) Discussion
Q2) 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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Chapter 6: Psychosocial and Spiritual Alterations and Management
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Sample Questions
Q1) Patients with an external locus of control
A) believe that they can influence the outcome of their illness.
B) should be forced to take control of their discharge planning.
C) usually start out with an internal locus of control until a major illness occurs.
D) believe that events are related to chance or fate.
Q2) _____ occurs when the critical illness is so severe that the patient or family becomes overwhelmed.
A) Anxiety
B) Spiritual distress
C) Stress overload
D) Hopelessness
Q3) Commonly used medications for withdrawal symptoms include
A) chlordiazepoxide and folic acid.
B) chlordiazepoxide and lorazepam.
C) lorazepam and promethazine.
D) promethazine and thiamine.
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Chapter 7: Sleep Alterations and Management
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Sample Questions
Q1) Which of the following are characteristic of sleep in elderly adults?
A) Insomnia
B) Less sleep required
C) Altered circadian rhythms
D) Higher incidence of sleep apnea
E) Longer periods of non-REM sleep
Q2) The primary determinant in the efficacy of CPAP in patients with OSA is
A) compliance.
B) weight.
C) tonsil size.
D) respiratory effort.
Q3) Which stage of NREM sleep is associated with anabolic processes?
A) N1
B) N2
C) N3
D) N4
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Chapter 8: Nutrition Alterations and Management
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Sample Questions
Q1) The patient's feeding tube is occluded and cannot be flushed.The nurse knows that the best irrigant for feeding tube occlusion is
A) cola.
B) pancreatic enzyme.
C) water.
D) juice.
Q2) A patient is admitted to the critical care unit with severe malnutrition as a result of hepatic failure.A triple-lumen central venous catheter is placed in the right subclavian vein,and TPN is started.On the third day of infusion,the patient develops symptoms of fever and chills.Which of the following complications should be suspected?
A) Air embolism
B) Pneumothorax
C) Central venous thrombosis
D) Catheter-related sepsis
Q3) An effect of malnutrition on respiratory function is
A) decreased surfactant.
B) increased vital capacity.
C) decreased PaCO<sub>2</sub>.
D) tachypnea.
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Page 10
Chapter 9: Pain and Pain Management
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Sample Questions
Q1) The use of PCA infusion pumps allows the patient to
A) act preemptively by administering a bolus of medication when pain begins.
B) choose between the use of opioids or NSAID medication to control pain.
C) decrease the risk of respiratory depression.
D) control pain medication in 2-hour increments.
Q2) C fibers are small-diameter,unmyelinated fibers that transmit what type of pain?
A) C fibers transmit diffuse, dull, aching pain.
B) C fibers conduct the rapid acute pain sensation described as prickling, sharp, and fast.
C) C fibers conduct diffuse, dull, aching pain.
D) C fibers transmit rapid acute pain sensation described as prickling, sharp, and fast.
Q3) The nurse is aware that the use of a pain flow sheet in the critical care setting allows for
A) visible and ongoing pain assessment and management of pain.
B) pain assessment and control in postoperative patients treated in the ICU.
C) evaluation of analgesic treatments.
D) recording vital signs.
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Page 11
Chapter 10: Sedation,Agitation,Delirium: Assessment and Management
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Sample Questions
Q1) Causes of delirium in critically ill patients include
A) hyperglycemia.
B) meningitis.
C) cardiomegaly.
D) pulmonary embolism.
E) alcohol withdrawal syndrome.
F) hyperthyroidism.
Q2) A 56-year-old patient is admitted to the critical care unit with acute respiratory distress syndrome (ARDS).The patient has been intubated and is mechanically ventilated.The patient is becoming increasingly agitated,and the high-pressure alarm on the ventilator has been frequently triggered.After the patient's agitation is controlled,which of the following drugs would be most appropriate for long-term sedation?
A) Morphine 2 mg/hr 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/hr by IV infusion
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Page 12
Chapter 11: End-Of-Life Issues
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Sample Questions
Q1) Hospice care can help families with A) organ donations.
B) aggressive symptom management and family support.
C) writing advance directives and living wills.
D) legal euthanasia.
Q2) Disagreement and distress among physicians,nurse practitioners,and critical care nurses can lead to
A) emotional distress only.
B) ethical distress only.
C) emotional and ethical distress.
D) pessimistic opinions of care.
Q3) Which of the following are considerations when making the decision to allow family at the bedside during resuscitation efforts?
A) The patient's wishes
B) Experience of the staff
C) The family's need to participate in all aspects of the patient's care
D) State regulatory issues
E) Seeing the resuscitation may confirm the impact of decisions made or delayed
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Chapter 12: Cardiovascular Anatomy and Physiology
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Sample Questions
Q1) Which of the following values reflects a normal cardiac output at rest?
A) 2.5 L/min
B) 5.8 L/min
C) 7.3 L/min
D) 9.6 L/min
Q2) Which of the following factors influence stroke volume?
A) Afterload
B) Cardiac output
C) Contractility
D) Heart rate
E) Preload
Q3) The outermost layer of the artery that helps strengthen and shape the vessel is the A) tunica.
B) intima.
C) adventitia.
D) media.
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Chapter 13: Cardiovascular Clinical Assessment
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Sample Questions
Q1) The purpose of the Allen test is to
A) assess adequate blood flow through the ulnar artery.
B) occlude the brachial artery and evaluate hypoxemia to the hand.
C) test the patency of an internal graft.
D) determine the size of needle to be used for puncture.
Q2) A sudden increase in left atrial pressure,acute pulmonary edema,and low cardiac output,caused by the ventricle contracting during systole,are all characteristics of A) acute mitral regurgitation.
B) aortic insufficiency.
C) chronic mitral regurgitation.
D) pericardial friction rub.
Q3) An assessment finding of pulsus alternans may indicate evidence of A) left-sided heart failure.
B) jugular venous distention.
C) pulmonary embolism.
D) myocardial ischemia.
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15
Chapter 14: Cardiovascular Diagnostic Procedures
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Sample Questions
Q1) Which of the following findings would be indicative reasons to abort an exercise stress test?
A) Ventricular axis of +90
B) Increase in blood pressure
C) Inverted U wave
D) ST segment depression or elevation
Q2) When performing a 12-lead ECG,how many wires are connected to the patient?
A) 3
B) 5
C) 10
D) 12
Q3) Which of the following conditions can cause an artificial increase in the PAOP/PCWP?
A) Aortic regurgitation
B) Aortic stenosis
C) Mitral stenosis
D) Mitral regurgitation
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Chapter 15: Cardiovascular Disorders
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Sample Questions
Q1) The nurse should anticipate which of the following as the most common complication after an MI?
A) Pulmonary edema
B) Cardiogenic shock
C) Dysrhythmias
D) Deep vein thrombosis
Q2) Which of the following cholesterol values indicates a heightened risk for the development of CAD?
A) Total cholesterol level of 170 mg/dL
B) HDL cholesterol level of 30 mg/dL
C) Triglyceride level of 120 mg/dL
D) LDL cholesterol level >190 mg/dL
Q3) Clinical manifestations of right-sided heart failure include
A) elevated central venous pressure and sacral edema.
B) pulmonary congestion and jugular venous distention.
C) hypertension and chest pain.
D) liver tenderness and pulmonary edema.
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Chapter 16: Cardiovascular Therapeutic Management
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Sample Questions
Q1) The patient is 12 hours postoperative for a CABG.The patient's vital signs include: T
103° F,HR 112,RR 22,BP 134/78 mm Hg,and O<sub>2</sub> sat 94% on 3L/NC.The nurse suspects that the patient has developed
A) infection and notifies the physician immediately.
B) infection, which is common postoperatively, and monitors the patient's condition.
C) cardiac tamponade and notifies the physician immediately.
D) delirium caused by the elevated temperature.
Q2) Which calcium channel blocker is easily titrated and beneficial in treating hypertension in patients with CAD or CVA?
A) Nifedipine (Procardia)
B) Nicardipine (Cardene)
C) Clevidipine (Cleviprex)
D) Diltiazem (Cardizem)
Q3) The predominant form of percutaneous coronary intervention (PCI)is
A) Rotablator.
B) stents.
C) directional coronary atherectomy (DCA).
D) balloon angioplasty (PTCA).
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18
Chapter 17: Pulmonary Anatomy and Physiology
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Sample Questions
Q1) A patient is admitted to the critical care unit with an acute exacerbation of chronic emphysema.Respirations are 28 breaths/min.A pulmonary artery catheter is in place.Pulmonary artery systolic (PAS)is 38 mm Hg with a pulmonary artery mean (PAM)of 22 mm Hg.Blood gases reveal an uncompensated respiratory acidosis.The patient's work effort for breathing is increased related to the effect of emphysema,which is
A) increased lung compliance.
B) decreased lung recoil.
C) increased chest wall compliance.
D) widespread atelectasis.
Q2) Which of the following factors will increase diffusion of gases across the alveolar capillary membrane?
A) A decrease in surface area of the membrane
B) An increase in thickness of the membrane
C) An increase in the driving pressure of the gas
D) A decrease in the solubility coefficient of the gas
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19
Chapter 18: Pulmonary Clinical Assessment
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Sample Questions
Q1) Voice sounds such as bronchophony,egophony,and whispering pectoriloquy are increased in
A) pneumonia with consolidation.
B) pneumothorax.
C) asthma.
D) bronchiectasis.
Q2) Which of the following 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.
Q3) Why would the nurse perform an inspection of the oral cavity during a complete pulmonary assessment?
A) To provide evidence of hypoxia
B) To provide evidence of dyspnea
C) To provide evidence of dehydration
D) To provide evidence of nutritional status
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Chapter 19: Pulmonary Diagnostic Procedures
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Sample Questions
Q1) A patient is admitted with signs and symptoms of a pulmonary embolus (PE).The diagnostic test most conclusive to determine this diagnosis is a(n)
A) ABG.
B) bronchoscopy.
C) pulmonary function test.
D) V/Q scan.
Q2) A patient is admitted with acute respiratory failure attributable to pneumonia.Smoking history reveals that the patient smoked two packs of cigarettes a day for 25 years,stopping 10 years ago.ABG values on the current ventilator settings are pH,7.37; PaCO<sub>2</sub>,50 mm Hg; and HCO<sub>3</sub>-,27 mEq/L.Chest radiograph reveals a large right pleural effusion.Intrapulmonary shunting value of 35% indicates
A) normal gas exchange of venous blood.
B) an abnormal finding indicative of a shunt-producing disorder.
C) a serious and potentially life-threatening condition.
D) metabolic alkalosis.
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21
Chapter 20: Pulmonary Disorders
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Sample Questions
Q1) A patient was admitted to the critical care unit after a left pneumonectomy.The patient is receiving 40% oxygen via a simple facemask.The morning chest radiography study reveals right lower lobe pneumonia.After eating breakfast,the patient suddenly vomits and aspirates.Which test would the nurse expect the health care provider to order to identify the infectious pathogen?
A) CBC with differential
B) Wound culture of surgical site
C) Sputum Gram stain and culture
D) Urine specimen
Q2) Which of the following findings confirms the diagnosis of a PE?
A) Low-probability V/Q scan
B) Negative pulmonary angiogram
C) High-probability V/Q scan
D) Absence of vascular markings on the chest radiograph
Q3) The two most common causes of hospital-acquired pneumonia in the United States are
A) Staphylococcus aureus and Pseudomonas aeruginosa
B) Escherichia coli and Haemophilus influenzae
C) methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa
D) Klebsiella spp. and Enterobacter spp.
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Chapter 21: Pulmonary Therapeutic Management
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Sample Questions
Q1) Patient safety precautions when working with oxygen involve
A) observation for signs of oxygen-introduced hyperventilation.
B) restriction of smoking.
C) removal of all oxygen devices when eating to prevent aspiration.
D) administration of oxygen at the nurse's discretion.
Q2) A patient was admitted to the critical care unit with acute respiratory failure.The patient has been on a ventilator for 3 days and is being considered for weaning.The ventilator high-pressure alarm keeps going off.When you enter the room,the ventilator inoperative alarm sounds.Which of the following criteria would indicate that the patient is ready to be weaned?
A) FiO<sub>2</sub> greater than 50%
B) Rapid shallow breathing index less than 105
C) Minute ventilation greater than 10 L/min
D) Vital capacity/kg greater than or equal to 15 mL
Q3) The correct procedure for selecting an oropharyngeal airway is to:
A) measure from the tip of the nose to the ear lobe.
B) measure from the mouth to the ear lobe.
C) measure from the tip of the nose to the middle of the trachea.
D) measure the airway from the corner of the patient's mouth to the angle of the jaw.
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Page 23
Chapter 22: Neurologic Anatomy and Physiology
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Sample Questions
Q1) Stimulation of this nerve will elicit the gag reflex.
A) Glossopharyngeal
B) Facial
C) Spinal accessory
D) Hypoglossal
Q2) Which of the following structures form(s)the blood-brain barrier?
A) Postsynaptic terminals
B) Pia mater
C) Vascular endothelial cells
D) Myelin sheath
Q3) Control of the rate of respirations occurs in the
A) apneustic center.
B) pneumotaxic center.
C) reticular activating system.
D) midbrain.
Q4) Which lobe of the brain deals primarily with sensory function?
A) Frontal lobe
B) Temporal lobe
C) Occipital lobe
D) Parietal lobe
Page 24
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Chapter 23: Neurologic Clinical Assessment and Diagnostic
Procedures
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Q1) Postprocedural care of a patient undergoing a water-based contrast myelogram should include which of the following interventions?
A) Maintain the patient flat in bed for 4 to 6 hours.
B) Observe the puncture sight every 15 minutes for 2 hours for signs of bleeding.
C) Keep the patient's head elevated 30 to 45 degrees for 8 hours.
D) Administer a sedative to keep the patient from moving around.
Q2) Successful completion of digital subtraction angiography requires what participation on the part of the patient?
A) Responding appropriately to various commands
B) Repositioning at appropriate intervals
C) Remaining motionless
D) Holding inspiration during imaging
Q3) Identify the sites for monitoring ICP.
A) Intraventricular space
B) Epidural space
C) Jugular veins
D) Subdural space
E) Parenchyma
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Chapter 24: Neurologic Disorders and Therapeutic Management
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Q1) The osmotic diuretic that has been most effective in the reduction of increased ICP is A) mannitol.
B) furosemide (Lasix).
C) urea.
D) glycerol.
Q2) Thrombolytic therapy with recombinant tissue plasminogen activator (rtPA)is now recommended for the management of ischemic stroke if administration can be instituted within how many hours of onset of stroke symptoms?
A) 1
B) 4
C) 6
D) 10
Q3) One of the earliest and most important signs of increased ICP is A) Cushing triad.
B) decerebrate posturing (abnormal extension).
C) a decrease in the level of consciousness.
D) an increase in pupillary size.
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Page 26
Chapter 25: Kidney Anatomy and Physiology
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Q1) The following substances,among others,are found in a urine sample: urea,creatinine,sodium,chlorine,potassium,glucose,and bicarbonate ions.Which of the following could account for this abnormal finding?
A) Blood pressure of 76/30 mm Hg
B) Blood glucose of 456 mg/dL
C) Blood glucose of 36 mg/dL
D) Blood potassium level of 4.1 mEq/L
Q2) The substance most responsible for maintaining the colloid osmotic pressure is
A) intravascular plasma proteins.
B) intracellular potassium.
C) extracellular sodium.
D) interstitial potassium.
Q3) Which of the following is most indicative of renal failure?
A) Elevated blood-urea-nitrogen
B) Congestive heart failure
C) Peripheral edema
D) Elevated creatinine
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Chapter 26: Kidney Clinical Assessment and Diagnostic Procedures
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Q1) The patient complains of a metallic taste and loss of appetite.The nurse is concerned that the patient has developed
A) glycosuria.
B) proteinuria.
C) myoglobin.
D) uremia.
Q2) A patient is admitted to the critical care unit in congestive 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.A diagnosis of renal failure is made.Which of the following diagnostic tests would give 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 27: Kidney Disorders and Therapeutic Management
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Q1) The patient is a gravida 6,para 1.She is admitted after a cesarean section after an amniotic embolus.Her heart rate (HR)is more than 150 beats/min with a systolic BP less than 80 mm Hg.Her temperature is 38°C,and her condition has caused her to develop prerenal azotemia.The patient was fluid resuscitated through a double-lumen catheter,which was placed into her right femoral access,and started on vasopressors with a fair response (BP,80/50 mm Hg; HR,122 beats/min).Because of her diagnosis and a concern regarding fulminating sepsis,the patient was begun on CVVH.Why would this therapy be chosen for this patient?
A) Hyperdynamic patients can better tolerate abrupt fluid and solute changes.
B) It is the treatment of choice for patients with diminished renal perfusion who are unresponsive to diuretics.
C) It is indicated for patients who require large-volume removal for severe uremia or critical acid-base imbalances.
D) It is indicated for hemodynamically unstable patients, who are often intolerant of the abrupt fluid and solute changes that can occur with hemodialysis.
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Chapter 28: Gastrointestinal Anatomy and Physiology
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Q1) An important role of saliva is that it
A) washes away bacteria.
B) provides the body's main source of potassium.
C) contains hydrochloric acid for breakdown of protein.
D) stimulates the sympathetic nervous system.
Q2) Which component of gastric juice is necessary for the breakdown of proteins?
A) HCl
B) Pepsin
C) Intrinsic factor
D) Potassium
Q3) The liver receives nutrient-rich blood from the gut,pancreas,spleen,and stomach from the
A) hepatic artery.
B) hepatic vein.
C) portal vein.
D) intralobular veins.
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Chapter 29: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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Q1) A 78-year-old patient was admitted to the critical care unit with cirrhosis of the liver.A hepatobiliary scan is performed to assess the progression of the patient's cirrhosis.Which of the following results is expected?
A) Nonvisualization
B) Little or no uptake
C) Increased uptake
D) Normal uptake
Q2) When assessing the abdomen,how long must the nurse listen to the abdomen to be able to accurately chart that bowel sounds are absent?
A) 30 seconds in each quadrant
B) 1 minute
C) 3 minutes
D) 5 minutes
Q3) Identify anatomic structures that are found in the right lower quadrant.
A) Sigmoid colon
B) Portion of the ascending colon
C) Portion of the descending colon
D) Distended bladder
E) Enlarged uterus
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Chapter 30: Gastrointestinal Disorders and Therapeutic Management
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Q1) A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.The patient is preparing for discharge.Nursing intervention should include
A) diabetes management.
B) alcohol cessation program.
C) frequency of hemoccult testing.
D) frequency of PT and PTT testing.
Q2) Which of the following disorders is the leading cause of upper GI hemorrhage?
A) Stress ulcers
B) Peptic ulcers
C) Nonspecific erosive gastritis
D) Esophageal varices
Q3) A patient has a Salem sump to lower intermittent suction.Nursing interventions include
A) prevention of esophageal erosion and stricture.
B) prevention of dry mouth.
C) prevention of ulceration of the nares.
D) irrigating the tube every 4 hours or as ordered by the health care provider.
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Chapter 31: Endocrine Anatomy and Physiology
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Q1) ADH works primarily at the A) liver.
B) pancreas.
C) stomach.
D) kidneys.
Q2) The gland called the "master gland" that has the most influence over all areas of body functioning is the A) hypothalamus.
B) pancreas.
C) thyroid.
D) pituitary.
Q3) Identify major functions of the thyroid hormones.
A) Increase the rate of glucose used by the cells
B) Decrease fat metabolism
C) Increase the body's demand for vitamins
D) Decrease cardiac output
E) Stimulate bone resorption
F) Increase serum cholesterol levels
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Chapter 32: Endocrine Clinical Assessment and Diagnostic
Procedures
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Q1) A patient is admitted to the critical care unit with critical hypotension,hyperkalemia,hyponatremia,and hypoglycemia.The most likely cause of this is
A) myxedema.
B) diabetes insipidus.
C) addisonian crisis.
D) Cushing syndrome.
Q2) A nurse auscultates a bruit over the thyroid and knows that this indicates A) normal function.
B) enlargement of the thyroid.
C) hypoplasia of the thyroid.
D) tumor of the thyroid.
Q3) The nurse knows that a serum osmolality of 378 mOsm/kg indicates a patient who is A) overhydrated.
B) normal.
C) dehydrated.
D) hypokalemic.
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Chapter 33: Endocrine Disorders and Therapeutic Management
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Q1) While a patient with SIADH is receiving hypertonic saline,the nurse assesses for signs that the saline must be stopped.These signs would include A) decreased CVP and decreased PAP.
B) bradycardia and thirst.
C) hypotension and wheezing.
D) hypertension and lung crackles.
Q2) Patients with myxedema are at high risk for any surgical procedure because of A) decrease cardiac output.
B) overhydration.
C) thrombocytopenia.
D) respiratory failure.
Q3) A patient is very lethargic.Vital signs include a blood pressure of 110/95 mm Hg and heart rate of 40 beats/min.The nurse would suspect A) hypothyroidism.
B) Cushing syndrome.
C) Addison disease.
D) thyrotoxic crisis.
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Chapter 34: Trauma
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Q1) Which of the following physiologic changes caused by aging is the most likely contributor to the high mortality rate in older trauma patients compared with younger trauma patients?
A) Deterioration of cerebral and motor skills
B) Poor vision and hearing
C) Diminished pain perception
D) Limited cardiovascular physiologic reserve in the elderly
Q2) Which mechanisms caused by circulating myoglobin can lead to the development of kidney failure?
A) Dark tea-color urine
B) Decreased renal perfusion
C) Cast formation with tubular obstruction
D) Administration of diuretics
E) Rapid screening for serum creatine kinase level
F) Toxic effects of myoglobin in the kidney tubules
Q3) The AVPU is a way for the nurse to quickly assess a patient's
A) respiratory status.
B) circulatory status.
C) pain status.
D) level of consciousness.
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Chapter 35: Shock,sepsis,and Multiple Organ Dysfunction Syndrome
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Q1) A patient has been on the medical floor for 1 week after a vaginal hysterectomy.A urinary catheter was inserted.Complete blood cell count results have revealed escalating white blood cell counts.The patient is transferred to the critical care unit when her condition deteriorates.Septic shock is diagnosed.The medical management of the patient's condition is aimed toward
A) limiting fluids to minimize the possibility of congestive 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.
Q2) A vasoconstrictor used to treat shock is
A) adrenaline.
B) Nipride.
C) Dobutrex.
D) adenosine.
Q3) Which of the following drugs promotes bronchodilation and vasoconstriction?
A) Solu-Medrol
B) Gentamicin
C) Atropine
D) Epinephrine
Page 37
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Chapter 36: Burns
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Q1) From the surface inward,identify in the correct order the five layers of the skin:
1)Stratum granulosum
2)Stratum corneum
3)Stratum germinativum
4)Stratum lucidum
5)Stratum spinosum
A) 2, 4, 1, 5, 3
B) 2, 4, 5, 1, 3
C) 4, 2, 5, 1, 3
D) 4, 5, 1, 3, 2
Q2) A patient involved in a house fire is brought by ambulance to your emergency department.He is breathing spontaneously but appears agitated.He does not respond appropriately to questions.You assume he has inhaled carbon monoxide and has carbon monoxide (CO)poisoning.Your first action is to
A) ask the physician to order a STAT chest radiograph to rule out a pneumothorax.
B) apply a pulse oximeter to one of his unburned fingers.
C) call the local hyperbaric chamber to check on its availability.
D) administer 100% high-flow oxygen via a nonrebreathing mask.
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Chapter 37: Organ Donation and Transplantation
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Q1) After a urinary diversion pancreatic transplant,the nurse must anticipate which order?
A) Continuous bladder irrigation
B) Intermittent insulin injections
C) Removal of the nasogastric tube as soon as the patient is alert
D) Daily hematocrit and hemoglobin levels.
Q2) The Model for End-Stage Liver Disease (MELD)formula is used to
A) calculate risk of 3-month mortality in patients 12 years old or older.
B) calculate risk of 3-month mortality in patients 11 years or younger.
C) calculate risk of 6-month mortality in patient 18 years or older.
D) calculate risk of 6-month mortality in patient 17 years or younger.
Q3) Which of the following would indicate that a newly transplanted liver is not functioning properly?
A) Increased serum glucose
B) Low aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
C) Elevated prothrombin time
D) Decreased blood urea nitrogen and creatinine
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Chapter 38: Hematologic Disorders and Oncologic Emergencies
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Q1) A patient was admitted to the critical care unit with gram-negative sepsis 5 days ago.Today there is continual oozing from his intravenous sites,and ecchymosis of the skin is noted beneath his automatic blood pressure cuff.On his laboratory work,his platelets are normal,and his international normalized ratio is elevated.The primary treatment goal for this patient is to
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.
Q2) The high-risk period for developing HIT is
A) 5 to 10 hours after initiation of heparin.
B) 5 to 14 hours after initiation of heparin.
C) 5 to 14 days after initiation of heparin.
D) 30 to 60 days after initiation of heparin.
Q3) Hydroxyurea is increased by what dosage until the maximum of 35 mg/kg is reached?
A) 5 mg/kg every 4 weeks
B) 10 mg/kg every 8 weeks
C) 5 mg/kg every 12 weeks
D) 15 mg/kg every 15 weeks
Page 40
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Chapter 39: The Obstetric Patient
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Q1) Which animal is the host for the protozoan Toxoplasma gondii?
A) Cattle
B) Pigs
C) Sheep
D) Cats
Q2) The mnemonic tone,tissue,trauma,and thrombosis refers to potential causes of A) hypoxia.
B) abruptio placentae.
C) postpartum hemorrhage (PPH).
D) trauma.
Q3) Which of the following physiologic changes are common in pregnant women?
A) Circulating blood volume decreases by 20% as it is diverted to the placenta.
B) Oxygen consumption increases to accommodate the fetus's needs.
C) Respiratory tidal volumes decrease because of the elevated diaphragm.
D) Gastric motility decreases because of displacement of gastrointestinal structures by the enlarged uterus.
E) The glomerular filtration rate increases as cardiac output rises.
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Chapter 40: The Pediatric Patient
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Q1) 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
Q2) What is the daily fluid requirement for a 60-kg child?
A) 2600 mL/m² per day
B) 1500 mL/m² per day
C) 2400 mL/m² per day
D) 3000 mL/m² per day
Q3) A 4-year-old child is admitted to the critical care unit with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.Nursing management for this patient would include
A) measuring and documenting head circumference.
B) allowing the patient's siblings to visit.
C) isolating the patient during initial antibiotic treatment and for 24 hours thereafter.
D) administering anticonvulsant medications every 6 hours.
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Chapter 41: The Older Adult Patient
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Q1) Nurses should be alert for immune deficiencies in older patients because of which of the following?
A) Nutritional deficiencies
B) Presence of chronic illnesses
C) Insertion of invasive devices
D) Decreased total lung capacity
E) Increased peristaltic action in the esophagus
Q2) Age-related pulmonary changes that may affect this patient include
A) increased tidal volumes.
B) weakening of intercostal muscles and the diaphragm.
C) improved cough reflex.
D) decreased sensation of the glottis.
Q3) The focus on the relief of suffering,in all of its dimensions,is referred to as A) aggressive care
B) advance directives
C) hospice care
D) palliative care
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Chapter 42: The Perianesthesia Patient
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Q1) Causes of a postoperative fever include
A) medication reactions.
B) hypotension.
C) blood transfusion reaction.
D) pulmonary emboli.
E) atelectasis.
Q2) A patient emerges from general anesthesia screaming,shouting,and thrashing
wildly.The nurse identifies this reaction as
A) emergence hallucination.
B) normal.
C) emergence hyperactivity.
D) emergence delirium.
Q3) The most definitive test for detecting malignant hyperthermia (MH)susceptibility is a(n)
A) creatine phosphokinase (CPK) test.
B) ionized calcium test.
C) core temperature reading.
D) skeletal muscle biopsy.
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