Intensive Care Nursing Study Guide Questions
Course Introduction
Intensive Care Nursing is a specialized course designed to equip nursing students and professionals with the knowledge and skills necessary to care for critically ill patients in intensive care settings. The course covers advanced concepts in the assessment, monitoring, and management of patients with life-threatening conditions, emphasizing the use of sophisticated medical technology and interdisciplinary collaboration. Key topics include hemodynamic monitoring, ventilatory support, pharmacological interventions, ethical decision-making, and effective communication with patients' families. Through a combination of theoretical instruction and hands-on clinical experience, students develop the competencies required to provide high-quality, evidence-based care in dynamic and demanding 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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Page 2
Chapter 1: Critical Care Nursing Practice
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Sample Questions
Q1) A patient was admitted to a rural ICU in Montana.Critical care nurses are assisting with monitoring and care of the patient from the closest major city.This is an example of A) telemedicine.
B) tele-ICU.
C) tele-informatics.
D) tele-hospital.
Answer: B
Q2) Designing therapeutic activities that move a patient from one state of health to another is an example of A) a nursing diagnosis.
B) nursing interventions.
C) nursing outcomes.
D) the nursing process.
Answer: B
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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 statement best reflects the concept of allocation of resources within the critical care setting?
A) Limitations of resources force reexamination of goals of critical care for clients.
B) Care is provided equally to all those who need the resources.
C) Equal access is available for those with the same condition or diagnosis.
D) Technologic advances are available to most of those in a given community.
Answer: A
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4
Chapter 3: Legal Issues
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Sample Questions
Q1) Which of the following actions demonstrate the act of battery?
A) Performing CPR on a patient with a DNR order
B) Threatening to punch someone
C) Sexual misconduct
D) Drawing blood without the patient's consent
E) Threatening to restrain a patient for not using his or her call light for mobility assistance
Answer: A,C,D
Q2) A patient received heparin by intravenous infusion.The nurse received an order to increase the heparin infusion rate and obtain a partial thromboplastin time (PTT)in 1 hour.The PTT was drawn correctly and revealed a critically elevated level.The nurse was busy with another patient and failed to report the critical result to the physician within 30 minutes according to the facility's policy.Subsequently,the patient sustained a massive intracerebral bleed.Which of the following best describes the type of negligence the nurse is liable for?
A) Assessment failure
B) Planning failure
C) Implementation failure
D) Evaluation failure
Answer: C
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Page 5
Chapter 4: Genetics and Genomics in Critical Care
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Sample Questions
Q1) To achieve a consistent distance across the width of the DNA strand,the nucleotide base guanine (G)can only be paired with:
A) adenine (A).
B) thymine (T).
C) cytosine (C).
D) sex chromosome X.
Q2) Each chromosome consists of an unbroken strand of DNA inside the nucleus of the cell.This arrangement of human chromosomes is known as:
A) chromatids.
B) karyotype.
C) genomics.
D) histones.
Q3) When a genetic variant exists in greater than 1% of the population,it is considered a A) genetic mutation.
B) genetic polymorphism.
C) genetic deletion.
D) tandem repeat.
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Chapter 5: Patient and Family Education
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Sample Questions
Q1) A patient is scheduled for a cardiac catheterization this afternoon.The nurse wants to provide her with some basic information before going in the room to talk about her specific procedure.Which teaching strategy is most appropriate for this situation?
A) Discussion
B) Demonstration and practice
C) Audiovisual media
D) Written
Q2) The first step of the teaching-learning process involves
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.
Q3) Which of the following statements BEST describes the teaching-learning process?
A) It follows the distinct order of the nursing process, with each step of the process separate and without repetition.
B) It requires formal blocks of learning time that are planned during the shift.
C) It is a continuous activity that occurs during hospitalization and beyond.
D) It ends at the point of discharge.
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Chapter 6: Psychosocial and Spiritual Alterations and Management
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Sample Questions
Q1) An intervention for a patient with learned helplessness is to A) maintain control of the environment.
B) set limits on the behavior.
C) maintain a routine schedule so that the patient can anticipate activities. D) prepare the patient for transfer to the medical floor.
Q2) Psychologic and spiritual interventions have the power to engage a patient's A) hope.
B) fear.
C) will to survive.
D) energy.
E) ability to meet life's challenges.
Q3) A patient with low self-esteem may manifest which of the following behaviors?
A) Refusal to participate in care
B) Feelings that his or her body has betrayed him or her
C) Acceptance and ownership of problems
D) Disruption in the perception of the body
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8
Chapter 7: Sleep Alterations and Management
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Sample Questions
Q1) A patient with mild obstructive sleep apnea (OSA)can expect treatment to consist of
A) medical management with protriptyline.
B) weight loss, elimination of alcohol before bedtime, and side sleeping.
C) immediate use of continuous positive airway pressure (CPAP).
D) surgical intervention with uvulopalatopharyngoplasty (UPPP).
Q2) _____ is used during polysomnography to determine when the patient enters REM sleep.
A) Electrooculography
B) Electromyography
C) Electroencephalography
D) Polysomnography
Q3) _____ is the external element that has the most significant effect on circadian rhythms.
A) Lower body temperature
B) Light
C) Melatonin cycle
D) Background noise
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Chapter 8: Nutrition Alterations and Management
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Sample Questions
Q1) The nutritional alteration most frequently encountered in hospitalized patients is
A) respiratory quotient (RQ).
B) protein-calorie malnutrition.
C) fat-calorie malnutrition.
D) gluconeogenesis.
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.Which of the following dietary restrictions should be maintained for the patient?
A) Fat and magnesium
B) Protein and sodium
C) Carbohydrate and potassium
D) Protein and calcium
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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10
Chapter 9: Pain and Pain Management
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Sample Questions
Q1) Which of the following combinations of drugs has been found to be effective in managing the pain associated with musculoskeletal and soft tissue inflammation?
A) Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids
B) NSAIDs and antidepressants
C) Opioid agonists and opioid antagonists
D) Adjuvants and partial agonists
Q2) Relaxation,distraction,guided imagery,and music therapy are all examples of A) physical techniques for pain management.
B) cognitive-behavioral techniques for pain management.
C) PCA management of pain.
D) equianalgesic management of pain.
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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Chapter 10: Sedation,Agitation,Delirium: Assessment and Management
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Sample Questions
Q1) A patient was admitted into the critical care unit 3 days ago.She has just been weaned from mechanical ventilation.She suddenly becomes confused,seeing nonexistent animals in her room and pulling at her gown.Which of the following interventions are indicated to adequately monitor the patient during haloperidol use?
A) Continuous bispectral index (BIS) monitoring
B) Continuous electrocardiographic (ECG) monitoring
C) Continuous pulse oximetry
D) Continuous electrocardiogram (ECG) monitoring
Q2) Which of the following drugs is used for sedation in patients experiencing withdrawal syndrome?
A) Dexmedetomidine
B) Hydromorphone
C) Diazepam
D) Clonidine
Q3) A major side effect of benzodiazepines is
A) hypertension.
B) respiratory depression.
C) renal failure.
D) phlebitis at the IV site.
Page 12
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Chapter 11: End-Of-Life Issues
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Sample Questions
Q1) According to the Society for Critical Care Medicine,which of the following are among the most important needs of the family of the dying patient?
A) To be helpful
B) To stay informed
C) To achieve a sense of control
D) To vent emotions
E) To be fed, hydrated, and rested
Q2) Family members become dissatisfied and stressed because of a lack of _____ among health care providers.
A) care provided
B) communication
C) patient's prognosis
D) patient's outcome
Q3) Organ donation
A) is a choice only the patient can make for him- or herself.
B) is mandated by legal and regulatory agencies.
C) must be requested by the nurse caring for the dying patient.
D) is controlled by individual institutional policies.
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Chapter 12: Cardiovascular Anatomy and Physiology
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Sample Questions
Q1) Cardiac cells contain _____ and _____,the proteins responsible for their contractile nature.
A) Z-disc, A-band
B) actin, myosin
C) I-band, M-band
D) renin, angiotension-converting enzyme
Q2) The contribution of atrial kick to ventricular filling is approximately A) 10%.
B) 20%.
C) 5%.
D) 45%.
Q3) A patient is admitted to the critical care unit with a diagnosis of acute myocardial infarction.The monitor pattern reveals bradycardia.The patient weight is 70 kg and height is 5 feet,5 inches tall.Based on the above information; occlusion of which coronary artery most likely resulted in bradycardia from sinoatrial node ischemia?
A) Right
B) Left anterior descending
C) Circumflex
D) Dominant
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Page 14
Chapter 13: Cardiovascular Clinical Assessment
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Sample Questions
Q1) An 82-year-old patient is admitted into the critical care unit with a diagnosis of left-sided heart failure related to mitral stenosis.Physical assessment findings reveal tachycardia with an S? and a 3/6 systolic murmur.The grading of a murmur as a 3/6 refers to which of the following characteristics of murmurs?
A) Intensity
B) Quality
C) Timing
D) Pitch
Q2) During a history examination,a patient tells the nurse,"The cardiologist says I have a leaking valve." The nurse documents that the patient has a history of
A) acute mitral regurgitation.
B) aortic insufficiency.
C) chronic mitral regurgitation.
D) pericardial friction rub.
Q3) Which of the following conditions is usually associated with clubbing?
A) Central cyanosis
B) Peripheral cyanosis
C) Carbon monoxide poisoning
D) Acute hypoxemia
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Page 15
Chapter 14: Cardiovascular Diagnostic Procedures
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Sample Questions
Q1) The patient has an HR of 84 beats/min and an SV of 65 mL.Calculate the CO.
A) 149 mL
B) 500 mL
C) 4650 mL
D) 5460 mL
Q2) The blood test used to standardize PT results among clinical laboratories worldwide is known as
A) aPTT.
B) ACT.
C) HDL.
D) INR.
Q3) A patient's CVP reading suddenly increased from 10 to 48 mm Hg.His lungs are clear except for fine rales at the bases.Immediate response should be which of the following?
A) Nothing; this reading is still within normal limits.
B) Place a stat call into the physician.
C) Administer ordered prn Lasix.
D) Check the transducer level.
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Chapter 15: Cardiovascular Disorders
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Sample Questions
Q1) You are teaching a patient with endocarditis about his diagnosis.Which statement below is correct?
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.
Q2) Which classification of dysrhythmia is most common with an inferior wall infarction in the first hour after STEMI?
A) Sinus tachycardia
B) Multifocal PVCs
C) Atrial fibrillation
D) Sinus bradycardia
Q3) Dyspnea with wheezing,a nonproductive cough,and pulmonary crackles that progress to the gurgling sounds of pulmonary edema is described as A) dyspnea.
B) orthopnea.
C) paroxysmal nocturnal dyspnea.
D) cardiac asthma.
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Chapter 16: Cardiovascular Therapeutic Management
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Sample Questions
Q1) In caring for a postoperative cardiovascular patient,the nurse knows that the most frequent cause of a decreased cardiac output is
A) reduced preload.
B) increased afterload.
C) increased contractility.
D) bradycardia.
Q2) Vasopressors are used cautiously with critical care patients because they can cause A) vasoconstriction of the smooth muscles.
B) vasodilation of the smooth muscles.
C) increased afterload of the heart.
D) decreased preload of the heart.
Q3) A patient is being monitored by continuous ECG after placement of a transvenous pacemaker."Loss of capture" is seen on the ECG.Which nursing intervention may correct this situation?
A) Position the patient on the left side.
B) Decrease the milliamperes as ordered.
C) Increase the rate as ordered.
D) Monitor the patient in a different lead.
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18
Chapter 17: Pulmonary Anatomy and Physiology
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Sample Questions
Q1) 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
Q2) Lack of surfactant can cause which of the following conditions?
A) Pulmonary embolus
B) Pulmonary hypertension
C) Pulmonary atelectasis
D) Pulmonary edema
Q3) How much of the basal oxygen consumption is required by the pulmonary system during normal quiet breathing?
A) 10% to 20%
B) 5% to 10%
C) 3% to 5%
D) 1% to 2%
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Chapter 18: Pulmonary Clinical Assessment
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Sample Questions
Q1) A patient presents with chest trauma from an MVA.Upon assessment,the nurse documents that the patient is complaining of dyspnea,shortness of breath,tachypnea,and tracheal deviation to the right.In addition,the client's tongue is blue-gray.Based on the following data,what would the nurse would expect to find?
A) PaO<sub>2</sub> of 88 and PCO<sub>2</sub> of 55
B) Absent breath sounds in all right lung fields
C) Absent breath sounds in all left lung fields
D) Diminished breath sounds in all fields
Q2) Which of the following is an example of a disorder with increased tactile fremitus?
A) Emphysema
B) Pleural effusion
C) Pneumothorax
D) Pneumonia
Q3) Voice sounds such as bronchophony,egophony,and whispering pectoriloquy are increased in
A) pneumonia with consolidation.
B) pneumothorax.
C) asthma.
D) bronchiectasis.
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Page 20
Chapter 19: Pulmonary Diagnostic Procedures
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Sample Questions
Q1) Which of the following ABG values represents uncompensated metabolic acidosis?
A) pH, 7.29; PaCO<sub>2</sub>, 57 mm Hg; HCO<sub>3</sub>-, 22 mEq/L
B) pH, 7.36; PaCO<sub>2</sub>, 33 mm Hg; HCO<sub>3</sub>-, 18 mEq/L
C) pH, 7.22; PaCO<sub>2</sub>, 42 mm Hg; HCO<sub>3</sub>-, 18 mEq/L
D) pH, 7.52; PaCO<sub>2</sub>, 38 mm Hg; HCO<sub>3</sub>-, 29 mEq/L
Q2) On admission,a patient presents as follows: pH,7.38; respiratory rate,24 breaths/min,regular,pursed-lip breathing; PaO<sub>2</sub>,66 mm Hg; heart rate,112 beats/min,sinus tachycardia; PaCO<sub>2</sub>,52 mm Hg; blood pressure,110/68 mm Hg; HCO<sub>3</sub>-,24 mEq/L; and SpO<sub>2</sub>,90% on O<sub>2</sub> 2 L/min
nasal cannula.Which of the following diagnoses would be most consistent with the above arterial blood gas values?
A) Acute pulmonary embolism
B) Acute myocardial infarction
C) Congestive heart failure
D) Chronic obstructive pulmonary disease
Q3) Preprocedural medications for a diagnostic bronchoscopy may include
A) aspirin for anticoagulation.
B) vecuronium to inhibit breathing.
C) codeine to decrease the cough reflex.
D) cimetidine to decrease hydrochloric acid secretion.
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Chapter 20: Pulmonary Disorders
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Sample Questions
Q1) A pneumothorax greater than 15% requires
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 and facilitate re-expansion of the collapsed lung.
D) mechanical ventilation to assist with re-expansion of the collapsed lung.
Q2) Patients with left-sided pneumonia may benefit from placing them in which of the following positions?
A) Reverse Trendelenburg
B) Supine
C) On the left side
D) On the right side
Q3) Supplemental oxygen administration is usually effective in treating hypoxemia related to
A) physiologic shunting.
B) dead space ventilation.
C) hypercapnia with a PaCO<sub>2</sub> of 35 mm Hg.
D) ventilation/perfusion mismatching.
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22
Chapter 21: Pulmonary Therapeutic Management
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Sample Questions
Q1) A patient was admitted to the critical care unit with acute respiratory failure.The patient has been on a ventilator for 3 days and is being considered for weaning.The ventilator high-pressure alarm keeps going off.When you enter the room,the ventilator inoperative alarm sounds.Which of the following criteria would indicate that the patient is not tolerating weaning?
A) A decrease in heart rate from 92 to 80 beats/min
B) An SpO<sub>2</sub> of 92%
C) An increase in respiratory rate from 22 to 38 breaths/min
D) Spontaneous tidal volumes of 300 to 350 mL
Q2) Preset positive pressure used to augment the patient's inspiratory effort is known as
A) positive end-expiratory pressure (PEEP).
B) continuous positive airway pressure (CPAP).
C) pressure control ventilation (PCV).
D) pressure support ventilation (PSV).
Q3) Nursing interventions to limit the complications of suctioning include
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.
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Page 23
Chapter 22: Neurologic Anatomy and Physiology
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Q1) An afferent pathway that carries sensory impulses from the body into the spinal cord is the
A) subarachnoid.
B) spinal nerves.
C) ventral root.
D) dorsal root.
Q2) Damage to the upper portion of the reticular activating system results in which condition?
A) Seizures
B) Diabetes insipidus
C) Apnea
D) Impaired consciousness
Q3) Which of the following structures form(s)the blood-brain barrier?
A) Postsynaptic terminals
B) Pia mater
C) Vascular endothelial cells
D) Myelin sheath
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Page 24
Chapter 23: Neurologic Clinical Assessment and Diagnostic
Procedures
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Q1) Which of the following choices is an acceptable and recommended method of noxious stimulation?
A) Nipple pinch
B) Nail bed pressure
C) Supraorbital pressure
D) Sternal rub
Q2) The difference between electroencephalography and evoked potentials is that evoked potentials
A) record electrical and muscle activity.
B) monitor cerebral blood flow velocity.
C) record impulses generated by sensory stimuli.
D) cannot be used in the assessment of spinal cord injury.
Q3) MRI is superior to CT for which of the following?
A) Brain death determination
B) Detection of central nervous system infection
C) Estimation of intracranial pressure
D) Identification of subarachnoid hemorrhage
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Chapter 24: Neurologic Disorders and Therapeutic Management
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Sample Questions
Q1) A patient is admitted to the critical care unit with an acute head injury after a motor vehicle accident.The patient has a Glasgow Coma Scale score of 6.The patient is intubated and ventilated,and a ventriculostomy is placed with physician orders to keep the ICP less than 15 mm Hg.The patient's ICP continues to rise despite aggressive intervention.Which of the following is an advantage of a ventriculostomy ICP monitoring system?
A) Lower risk of infection
B) Ease of insertion
C) No penetration of brain
D) Access for cerebrospinal fluid drainage and sampling
Q2) A fast-acting,short-duration agent used for breakthrough seizures is
A) lorazepam (Ativan).
B) phenytoin (Dilantin).
C) phenobarbital.
D) midazolam (Versed).
Q3) The stroke patient who has difficulty with speech has
A) expressive aphasia.
B) global aphasia
C) receptive aphasia.
D) apraxia.
Page 26
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Chapter 25: Kidney Anatomy and Physiology
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Q1) The initial filtering of the blood occurs in which structure?
A) The distal tubule
B) The proximal tubule
C) The glomerulus
D) The collecting tubule
Q2) The primary waste product(s)that are measured to determine kidney function is/are
A) urea and creatinine.
B) creatinine.
C) BUN and creatine.
D) BUN, sodium, and potassium.
Q3) Chloride plays a major role in maintaining A) cellular immunity.
B) serum osmolality.
C) bone strength.
D) adenosine triphosphate (ATP).
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Chapter 26: Kidney Clinical Assessment and Diagnostic
Procedures
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Q1) Which of the following auscultatory parameters may exist in the presence of hypovolemia?
A) Hypertension
B) Third or fourth heart sound
C) Orthostatic hypotension
D) Vascular bruit
Q2) 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.
Q3) Percussion of kidneys is usually done to
A) assess the size and shape of the kidneys.
B) detect pain in the renal area.
C) elicit a fluid wave.
D) evaluate fluid status.
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Page 28
Chapter 27: Kidney Disorders and Therapeutic Management
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Q1) An elderly patient is in a motor vehicle accident and sustains a significant internal hemorrhage.Which category of renal failure is the patient at the greatest risk of developing?
A) Intrinsic
B) Postrenal
C) Prerenal
D) Acute tubular necrosis
Q2) Which of the following IV solutions is recommended for treatment of prerenal failure?
A) Dextrose in water
B) Normal saline
C) Albumin
D) Lactated Ringer solution
Q3) Which of the following IV solutions is contraindicated for patients with kidney or liver disease or in lactic acidosis?
A) D5W
B) 0.9% NaCl
C) Lactated Ringer solution
D) 0.45% NaCl
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Chapter 28: Gastrointestinal Anatomy and Physiology
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Q1) Which organ lies obliquely beneath the cardiac sphincter and above the pyloric sphincter?
A) Esophagus
B) Stomach
C) Duodenum
D) Ileum
Q2) Which component of gastric juice is necessary for the breakdown of proteins?
A) HCl
B) Pepsin
C) Intrinsic factor
D) Potassium
Q3) Food is propelled through the esophagus by A) gravity.
B) salivary fluids.
C) cardiac sphincter suction.
D) peristalsis.
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Chapter 29: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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Q1) When assessing the gastrointestinal system,the order of assessment progresses in which of the following ways?
A) Inspection, palpation, percussion, auscultation
B) Palpation, percussion, inspection, auscultation
C) Inspection, auscultation, percussion, palpation
D) Palpation, inspection, auscultation, percussion
Q2) Which of the following findings is considered an abnormal gastrointestinal assessment finding?
A) Visible peristaltic waves
B) Hyper-resonance of the intestine
C) High-pitched gurgling sounds in the small intestine
D) Dull sounds over the liver and spleen
Q3) The patient has just returned from a liver biopsy.The patient should be positioned on the
A) left side for 2 hours.
B) right side for 2 hours.
C) left side for 6 to 8 hours.
D) right side for 6 to 8 hours.
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Chapter 30: Gastrointestinal Disorders and Therapeutic Management
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Q1) Esophagectomy is usually performed for
A) cancer of the proximal esophagus and gastroesophageal junction.
B) cancer of the distal esophagus and gastroesophageal junction.
C) cancer of the pancreatic head.
D) varices of the distal esophagus and gastroesophageal junction.
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) Absorption of Prilosec and Prevacid occurs in the
A) stomach.
B) duodenum.
C) jejunum.
D) cecum.
Q4) A nursing priority for a patient with GI hemorrhage is
A) positioning the patient in a high-Fowler position.
B) airway protection.
C) irrigating the nasogastric tube with iced saline.
D) maintaining venous access so that fluids and blood can be administered.
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Chapter 31: Endocrine Anatomy and Physiology
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Q1) When the brain perceives a stressful or threatening situation,the hypothalamus releases ________________________,which causes the anterior pituitary to release_____________________________.
A) cortisol; androgens.
B) corticotropin-releasing hormone; ACTH
C) ACTH; glucocorticoid hormone
D) ACTH; epinephrine
Q2) 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) Insulin produces hypoglycemia.What other physiologic effect may occur when insulin is given?
A) Polyuria
B) Hypercalcemia
C) Hypokalemia
D) Cellular dehydration
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Page 33
Chapter 32: Endocrine Clinical Assessment and Diagnostic
Procedures
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Q1) A patient with a decreased T? level but an elevated TSH level has A) primary Cushing syndrome.
B) Addison disease.
C) thyrotoxicosis.
D) myxedema.
Q2) The nurse knows that an abnormal response to the ADH test would be
A) a slight increase in urine osmolality.
B) a decrease in urine output.
C) a decrease in serum osmolality.
D) no change in urine osmolality.
Q3) Medications such as salicylates,lithium,and sulfonamides can influence thyroid levels by
A) increasing T?.
B) increasing T? .
C) decreasing T?.
D) decreasing T? .
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Chapter 33: Endocrine Disorders and Therapeutic Management
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Q1) A patient is admitted to the unit with extreme fatigue,vomiting,and headache.This patient has type 1 diabetes but has been on an insulin pump for 6 months.He states,"I know it could not be my diabetes because my pump gives me 24-hour control." The nurse's best response would be
A) "You know a lot about your pump, and you are correct."
B) "You're right. This is probably a virus."
C) "We'll get an abdominal CT and see if your pancreas is inflamed."
D) "We'll check your serum blood glucose and ketones."
Q2) The most common maintenance dose of intravenous insulin for a patient with hyperglycemic hyperosmolar syndrome (HHS)would be
A) 0.1 U/kg/hr.
B) 1.0 U/kg/hr.
C) 2.0 U/kg/hr.
D) 5.0 U/kg/hr.
Q3) Nursing management of a patient with thyrotoxic crisis includes A) providing diversional stimuli.
B) restricting fluids.
C) maintaining a quiet, restful environment.
D) administering thyroid supplements at the same time each day.
Page 35
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Chapter 34: Trauma
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Q1) The majority of falls accounting for traumatic injury occur in what population?
A) Construction workers
B) Adolescents
C) Older adults
D) Young adults
Q2) 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
Q3) When preparing a patient for a diagnostic peritoneal lavage (DPL),the nurse should
A) insert a nasogastric tube and urinary catheter before the procedure.
B) make sure that a computed tomography scan is performed first to rule out abdominal adhesions.
C) know that the test will tell which specific organ has been injured.
D) know that the return of clear fluid from the abdominal cavity means that the patient does not have an injury.
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Page 36
Chapter 35: Shock,sepsis,and Multiple Organ Dysfunction Syndrome
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Q1) Which of the following hemodynamic parameters supports the diagnosis of cardiogenic shock?
A) Increased right atrial pressure
B) Decreased pulmonary artery wedge pressure
C) Increased cardiac output
D) Decreased cardiac index
Q2) Which medication is not recommended in the treatment of shock-related lactic acidosis?
A) Glucose
B) Sodium bicarbonate
C) Vasoconstrictor
D) Large quantity of crystalloids fluids
Q3) Shock syndrome can best be described as a
A) physiologic state resulting in hypotension and tachycardia.
B) generalized systemic response to inadequate tissue perfusion.
C) degenerative condition leading to death.
D) condition occurring with hypovolemia that results in irreversible hypotension.
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Page 37
Chapter 36: Burns
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Q1) 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%
Q2) Which of the following would prevent cross-contamination by direct contact and decrease the risk of infection in the burn-injured patient?
A) Gloves are the only personal protective equipment worn when changing dressings that are in direct contact of body fluids.
B) Family members only have to wear a gown when visiting a patient because masks will increase anxiety in the patient.
C) Changing gloves and hand washing should be done when moving from area to area on the same patient.
D) Sharing of equipment between patients in the same room does not show evidence of cross-contamination.
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Chapter 37: Organ Donation and Transplantation
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Q1) Who determines the medical suitability of the patient for organ donation?
A) The organ procurement organization (OPO) coordinator
B) The patient's family
C) The admitting health care provider
D) The transplant team
Q2) A patient who has received a transplant is being taught about azathioprine.Which statement made by the patient would indicate the teaching was effective?
A) "I will notify my health care provider if my gums start to bleed."
B) "I will make sure to increase the amount of fiber in my diet."
C) "I realize I may have an increase in hair growth."
D) "I know the flulike symptoms will go away as I get used to the drug."
Q3) 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.
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Chapter 38: Hematologic Disorders and Oncologic Emergencies
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Q1) The intrinsic coagulation pathway is activated when
A) local blood vessels constrict at the injury site.
B) damaged endothelium comes into contact with circulating blood.
C) tissue factor is released by injured cells.
D) fibrinogen is converted to fibrin.
Q2) A patient is admitted into the critical care unit with symptoms of a low-grade fever,joint pain,tachycardia,hepatomegaly,photophobia,and an inability to follow commands.The patient is becoming more agitated and complaining of pain.The nurse suspects that the patient has
A) ITP.
B) heparin-induced thrombocytopenia.
C) sickle cell anemia.
D) DIC.
Q3) Common findings in tumor lysis syndrome (TLS)include
A) increased calcium.
B) decreased potassium.
C) dysrhythmias.
D) elevated blood urea nitrogen (BUN) and creatine.
E) edema.
Page 40
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Chapter 39: The Obstetric Patient
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Q1) Severe neonatal disorders associated with toxoplasmosis infections include A) microcephaly.
B) respiratory distress.
C) hydrocephalus.
D) dysrhythmias.
E) visual and hearing impairments.
Q2) The most common obstetric cause of DIC is
A) pre-eclampsia.
B) abruptio placentae.
C) dead fetus syndrome.
D) amniotic fluid embolism.
Q3) The most common cause of obstetric cardiac arrest in pregnancy is A) anesthetic complications.
B) idiopathic peripartum cardiomyopathy.
C) pregnancy-induced hypertension.
D) hemorrhage.
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Chapter 40: The Pediatric Patient
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Q1) Initial treatment for hypoxia,acidosis,or hypothermia is
A) vasopressin.
B) bronchodilators.
C) oxygenation and ventilation.
D) hydration.
Q2) Which of the following drugs is used for weaning from iatrogenic narcotic dependency?
A) Morphine
B) Fentanyl
C) Meperidine
D) Methadone
Q3) Central cyanosis is associated with
A) visible cyanosis but normal arterial oxygen saturation.
B) desaturation of arterial blood.
C) reduced hemoglobin of 15 g/dL.
D) permanent cerebral hypoxia.
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Page 42
Chapter 41: The Older Adult Patient
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Q1) Which medications are considered an alternative to angiotensin-converting enzyme (ACE)inhibitors in older adult hypertension patients with diabetes mellitus and heart failure (HF)?
A) Angiotensin-receptor blockers
B) Beta-blockers
C) Calcium antagonists
D) Direct renin inhibitors
Q2) A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.Age-related changes in myocardial pumping ability may be evidenced by
A) increased contractility.
B) decreased contractility.
C) decreased left ventricle afterload.
D) increased cardiac output.
Q3) Which of the following sounds may be difficult for an older person to hear?
A) Telephone ringing
B) Clothes dryer running
C) Car horn honking
D) Child crying
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Page 43
Chapter 42: The Perianesthesia Patient
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Q1) 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.
Q2) An electrolyte disturbance that can cause delayed arousal in a postoperative patient is
A) hypercalcemia.
B) hyponatremia.
C) hyperkalemia.
D) hypermagnesemia.
Q3) What is the most common cause of hypoxemia?
A) Laryngeal edema
B) Laryngospasm
C) Bronchospasm
D) Ventilation/perfusion mismatching
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