Intensive Care Nursing
Textbook Exam Questions
Course Introduction
Intensive Care Nursing is a specialized course designed to equip students with the advanced knowledge and clinical skills necessary for the care of critically ill patients. The course focuses on comprehensive assessment, rapid decision-making, and the management of complex health conditions commonly encountered in intensive care units (ICUs). Topics include advanced monitoring, ventilator management, pharmacological therapies, infection control, ethical dilemmas, and multidisciplinary teamwork. Emphasis is placed on evidence-based practices, patient and family-centered care, and strategies for maintaining personal resilience in high-stress environments. Through theoretical study and practical simulation, students prepare to function effectively as key members of the critical care team.
Recommended Textbook
Critical Care Nursing Diagnosis and Management 8th Edition by Linda D. Urden
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41 Chapters
1210 Verified Questions
1210 Flashcards
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Chapter 1: Critical Care Nursing Practice
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) What is the stepwise decision-making flowchart for a specific care process named?
A) Algorithm
B) Practice guideline
C) Protocol
D) Order set
Answer: A
Q2) The concept of diversity encompasses what thoughts and actions?
A) Sensitivity to ethnic differences
B) Openness to different lifestyles
C) Openness to different values
D) Reticence to different beliefs
E) Lack of concern regarding different opinions
Answer: A,B,C
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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Sample Questions
Q1) What is the difference between ethics and morals?
A) Ethics is more concerned with the "why" of behavior.
B) Ethics provides a framework for evaluation of the behavior.
C) Ethics is broader in scope than morals.
D) Ethics concentrates on the right or wrong behavior based on religion and culture values.
Answer: A
Q2) Ethical decisions are best made by performing which action?
A) Following the guidelines of a framework or model
B) Having the patient discuss alternatives with the practitioner or nurse
C) Prioritizing the greatest good for the greatest number of persons
D) Studying by the Ethics Committee after all diagnostic data are reviewed
Answer: A
Q3) Institutional ethics committees (IECs)review ethical cases that are problematic for the practitioner.What is the major function of an IEC?
A) Consultation with purely binding recommendations
B) Support and education to health care providers
C) Conflict resolution for moral dilemmas
D) Recommendations that are binding in all cases
Answer: B
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Chapter 3: Legal Issues
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Sample Questions
Q1) 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
Q2) Which statement best describes the definition of assault?
A) An intentional act that causes the patient to believe that harm may have been done
B) A statement that causes injury to the patient's standing in the community
C) Negligence that results in harm to a spousal relationship
D) An intentional act that brings about harm or offensive contact with the patient
Answer: A
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5
Chapter 4: Genetic Issues
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Sample Questions
Q1) What is the study of all the genetic material within the cell and its impact on biologic and physical characteristics called?
A) Chromatids
B) Karyotype
C) Genomics
D) Histones
Q2) 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.
Q3) What are the studies called that are done on large,extended families who have several family members affected with a rare disease?
A) Genetic association
B) Genetic epidemiology
C) Kinships
D) Phenotypes
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Chapter 5: Patient and Family Education
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Sample Questions
Q1) Which educational content area is appropriate during the first hours of hospitalization?
A) Pathophysiology of the admitting diagnosis
B) Dietary modifications
C) Purpose of bedside equipment
D) Medication side effects
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.
Q3) What are sources of physiologic stress in the acutely ill patient?
A) Hypotension
B) Hypoxemia
C) Fever
D) Neurologic deficits
E) Eupnea
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Chapter 6: Psychosocial and Spiritual Alterations and Management
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Sample Questions
Q1) A patient with low self-esteem may manifest which behaviors?
A) Refusal to participate in care
B) Feelings that his or her body has betrayed him or her
C) Acceptance and ownership of problems
D) Disruption in the perception of the body
Q2) Which statement regarding regression as a coping mechanism for critical care patients is accurate?
A) It is necessary to some degree to allow staff to administer care.
B) It indicates deterioration of the physical state.
C) It is adaptive when the patient calls every 15 minutes, even for trivial matters.
D) It is best avoided to ensure successful recovery.
Q3) Anxiety can cause emotional changes in which part of the brain?
A) Hypothalamus
B) Limbic system
C) Cerebral cortex
D) Pituitary gland
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8
Chapter 7: Nutrition Alterations and Management
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Sample Questions
Q1) Patients with coronary artery disease should be taught about cholesterol.Which situation is most desirable?
A) Low levels of high-density lipoprotein (HDL) cholesterol
B) Low levels of low-density lipoprotein (LDL) cholesterol
C) Hypocholesterolemia
D) Low levels of both HDL and LDL cholesterol
Q2) A patient has a new order for intermittent nasogastric feedings every 4 hours.The nasogastric tube is placed by the nurse.What is the most accurate method for confirming the placement of the tube before initiating the feeding?
A) Obtain radiography of the abdomen
B) Check the pH of fluid aspirated from the tube
C) Auscultate the left upper quadrant of the abdomen while injecting air into the tube
D) Auscultate the right upper quadrant of the abdomen while injecting air into the tube
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Chapter 8: Pain and Pain Management
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Sample Questions
Q1) The patient is sedated and breathing with the use of mechanical ventilation.The patient is unable to communicate any aspects of his pain to the nurse.What tool should the nurse use to assess the patient's pain?
A) FLACC
B) Wong-Baker FACES
C) BIS
D) BPS
Q2) Which combinations of drugs has been found to be effective in managing the pain associated with musculoskeletal and soft tissue inflammation?
A) Nonsteroidal antiinflammatory drugs (NSAIDs) and opioids
B) NSAIDs and antidepressants
C) Opioid agonists and opioid antagonists
D) Adjuvants and partial agonists
Q3) C fibers are small-diameter,unmyelinated fibers that transmit what type of pain?
A) Aching
B) Sharp
C) Prickling
D) Concentrated
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Chapter 9: Sedation,Agitation,and Delirium Management
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Sample Questions
Q1) Which of the following medications is used for sedation in patients experiencing withdrawal syndrome?
A) Dexmedetomidine
B) Hydromorphone
C) Diazepam
D) Clonidine
Q2) A patient was admitted 5 days ago and has just been weaned from mechanical ventilation.The patient suddenly becomes confused,seeing nonexistent animals in the room and pulling at the bedding.What is the medication of choice for treating this patient?
A) Diazepam
B) Haloperidol
C) Lorazepam
D) Propofol
Q3) When administering propofol over an extended period,what laboratory value should the nurse routinely monitor?
A) Serum triglyceride level
B) Sodium and potassium levels
C) Platelet count
D) Acid-base balance
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Chapter 10: End-Of-Life Care
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Sample Questions
Q1) What is a powerful influence when the decision-making process is dealing with recovery or a peaceful death?
A) Hope
B) Religion
C) Culture
D) Ethics
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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Sample Questions
Q1) What is the normal resting membrane potential of a myocardial cell?
A) 10 to 20 mV
B) 30 to 40 mV
C) -20 to -30 mV
D) -80 to -90 mV
Q2) Which structure is the primary or natural pacemaker of the heart?
A) Ventricular tissue
B) Atrioventricular node
C) Sinoatrial node
D) Purkinje fibers
Q3) What is the name of the valve that allows blood flow into pulmonary artery?
A) Aortic
B) Tricuspid
C) Mitral valve
D) Pulmonic valves
Q4) Which phase is the final repolarization phase of the action potential?
A) Phase 1
B) Phase 2
C) Phase 3
D) Phase 4
Page 13
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Chapter 12: Cardiovascular Clinical Assessment
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Sample Questions
Q1) The abdominojugular reflux test determines the presence of which disorder?
A) Right ventricular failure
B) Cirrhosis
C) Liver failure
D) Coronary artery disease
Q2) A patient was admitted 3 days ago with a myocardial infarction.The patient is complaining of increased chest pain when coughing,swallowing,and changing positions.The nurse hears a systolic scratching sound upon auscultation of the apical pulse.Based on the symptoms,the nurse suspects the patient may have developed what condition?
A) Acute mitral regurgitation
B) Aortic insufficiency
C) Chronic mitral regurgitation
D) Pericarditis
Q3) A patient's blood pressure is 90/72 mm Hg.What is the patient's pulse pressure?
A) 40 mm Hg
B) 25 mm Hg
C) 18 mm Hg
D) 12 mm Hg
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Page 14
Chapter 13: Cardiovascular Diagnostic Procedures
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Sample Questions
Q1) After a myocardial infarction,a patient presents with an increasing frequency of premature ventricular contractions (PVCs).The patient's heart rate is 110 beats/min,and electrocardiogram (ECG)indicates a sinus rhythm with up to five unifocal PVCs per minute.The patient is alert and responsive and denies any chest pain or dyspnea.What action should the nurse take next?
A) Administer lidocaine 100 mg bolus IV push stat.
B) Administer Cardizem 20 mg IV push stat.
C) Notify the physician and monitor the patient closely.
D) Nothing; PVCs are expected in this patient.
Q2) What is the formula for calculating mean arterial pressure (MAP)?
A) Averaging three of the patient's blood pressure readings over a 6-hour period
B) Dividing the systolic pressure by the diastolic pressure
C) Adding the systolic pressure and two diastolic pressures and then dividing by 3
D) Dividing the diastolic pressure by the pulse pressure
Q3) Which cardiac biomarker is elevated in decompensated heart failure?
A) Triglycerides
B) Troponin I
C) Troponin T
D) B-type natriuretic peptide (BNP)
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Page 15
Chapter 14: Cardiovascular Disorders
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Sample Questions
Q1) A patient was admitted 3 days ago with an acute myocardial infarction (MI).The patient complains of fatigue,not sleeping the past two nights,and change in appetite.Based on these findings the nurse suspects the patient may be experiencing which problem?
A) Angina
B) Anxiety
C) Depression
D) Endocarditis
Q2) Which description best describes the pain associated with aortic dissection?
A) Substernal pressure
B) Tearing in the chest, abdomen, or back
C) Numbness and tingling in the left arm
D) Stabbing in the epigastric area
Q3) Assessment of a patient with pericarditis may reveal which signs and symptoms?
A) Ventricular gallop and substernal chest pain
B) Narrowed pulse pressure and shortness of breath
C) Pericardial friction rub and pain
D) Pericardial tamponade and widened pulse pressure
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Chapter 15: Cardiovascular Therapeutic Management
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35 Flashcards
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Sample Questions
Q1) Why are vasopressors used cautiously in the treatment of critical care patients?
A) They cause vasoconstriction of the smooth muscles.
B) They cause vasodilation of the smooth muscles.
C) They increase afterload.
D) They decrease preload.
Q2) What is the most common complication of fibrinolytic therapy?
A) Reperfusion chest pain
B) Lethargy
C) Bleeding
D) Heart blocks
Q3) Which signs and symptoms would indicate successful reperfusion after administration of a fibrinolytic agent?
A) Gradual decrease in chest pain
B) Intermittent, multifocal premature ventricular contractions
C) Rapid resolution of ST elevation
D) Rapid rise in creatine kinase MB fraction
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Chapter 16: Pulmonary Anatomy and Physiology
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Sample Questions
Q1) A shift to the left of the oxyhemoglobin dissociation curve would cause which physiologic alteration?
A) Better tissue perfusion
B) Lower SpO
C) Decreased hemoglobin affinity for O
D) Impaired tissue oxygen delivery
Q2) Muscles of exhalation include which of the following?
A) Abdominal
B) Diaphragm
C) External intercostals
D) Internal intercostals
E) Scalene
Q3) Based on the oxyhemoglobin dissociation curve,respiratory acidosis will have which effect?
A) A shifting of the curve to the left
B) Increased oxygen saturation
C) Enhanced oxygen delivery at the tissue level
D) Hypothermia
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18
Chapter 17: Pulmonary Clinical Assessment
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Sample Questions
Q1) A patient is admitted with acute lung failure secondary to chronic obstructive pulmonary disease (COPD).Upon inspection of the patient,the nurse observes that the patient's fingers appear discolored.What does this finding indicate the presence of?
A) Clubbing
B) Central cyanosis
C) Peripheral cyanosis
D) Chronic tuberculosis
Q2) Which statement describes the major difference between tachypnea and hyperventilation?
A) Tachypnea has increased rate; hyperventilation has decreased rate.
B) Tachypnea has decreased rate; hyperventilation has increased rate.
C) Tachypnea has increased depth; hyperventilation has decreased depth.
D) Tachypnea has decreased depth; hyperventilation has increased depth.
Q3) When assessing a patient,the use of observation is referred to as what technique?
A) Inspection
B) Palpation
C) Percussion
D) Auscultation
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Chapter 18: Pulmonary Diagnostic Procedures
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Sample Questions
Q1) On admission,a patient presents with a respiratory rate of 28 breaths/min,heart rate of 108 beats/min in sinus tachycardia,and a blood pressure of 140/72 mm Hg.The patient's arterial blood gas (ABG)values on room air are PaO ,60 mm Hg; pH,7.32; PaCO ,45 mm Hg; andHCO ¯ ,26 mEq/L.What action should the nurse anticipate for this patient?
A) Initiate oxygen therapy.
B) Prepare for emergency intubation.
C) Administer 1 ampule of sodium bicarbonate.
D) Initiate capnography.
Q2) A patient is admitted with signs and symptoms of a pulmonary embolus (PE).What diagnostic test most conclusive to determine this diagnosis?
A) ABG
B) Bronchoscopy
C) Pulmonary function test
D) V/Q scan
Q3) Which ABG values reflect compensation?
A) pH, 7.26; PaCO , 55 mm Hg;HCO ¯ , 24 mEq/L
B) pH, 7.30; PaCO , 32 mm Hg;HCO ¯ , 18 mEq/L
C) pH, 7.48; PaCO , 30 mm Hg;HCO ¯ , 22 mEq/L
D) pH, 7.38; PaCO , 58 mm Hg;HCO ¯ , 30 mEq/L
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Chapter 19: Pulmonary Disorders
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Sample Questions
Q1) A patient has been admitted with the diagnosis of acute respiratory distress syndrome (ARDS).Arterial blood gasses (ABGs)revealed an elevated pH and decreased PaCO .The patient is becoming fatigued,and the practitioner orders a repeat ABG.Which set of results would be indicative of the patient's current condition?
A) Elevated pH and decreased PaCO
B) Elevated pH and elevated PaCO
C) Decreased pH and decreased PaCO
D) Decreased pH and elevated PaCO
Q2) What are the most common presenting signs and symptoms associated with a pulmonary embolism (PE)?
A) Tachycardia and tachypnea
B) Hemoptysis and evidence of deep vein thromboses
C) Apprehension and dyspnea
D) Right ventricular failure and fever
Q3) Which finding confirms the diagnosis of a pulmonary embolism (PE)?
A) Low-probability ventilation-perfusion (V/Q) scan
B) Negative pulmonary angiogram
C) High-probability V/Q scan
D) Absence of vascular markings on the chest radiograph
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Page 21
Chapter 20: Pulmonary Therapeutic Management
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Sample Questions
Q1) Which arterial blood gas (ABG)values would indicate a need for oxygen therapy?
A) PaO of 80 mm Hg
B) PaCO of 35 mm Hg
C) HCO ¯ of 24 mEq
D) SaO of 87%
Q2) What nursing interventions should be included in the nursing management of the patient receiving a neuromuscular blocking agent?
A) Withholding all sedation and narcotics
B) Protecting the patient from the environment
C) Keeping the patient supine
D) Speaking to the patient only when necessary
Q3) Which airway would be the most appropriate for a patient requiring intubation longer than 21 days?
A) Oropharyngeal airway
B) Esophageal obturator airway
C) Tracheostomy tube
D) Endotracheal intubation
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22
Chapter 21: Neurologic Anatomy and Physiology
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Sample Questions
Q1) Which area of the ventricular system is usually cannulated for intracranial pressure monitoring?
A) Frontal horn of the lateral ventricle
B) Aqueduct of Sylvius
C) Foramen of Monro
D) Fourth ventricle
Q2) What is the large opening at the base of the cranium called?
A) Cisterna magna
B) Median foramen
C) Foramen magnum
D) Lateral foramen
Q3) 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
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Chapter 22: Neurologic Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) While the Glasgow Coma Scale (GCS)is part of the routine neurologic assessment,the nurse knows that it is not a valid measure for certain types of patients.In which patient is the GCS not valid?
A) Patient with hemiplegia
B) Patient with Parkinson disease
C) Patient with dyslexia
D) Patient who is intoxicated
Q2) The nurses are admitting a neurologically impaired patient.The patient's family is present.How comprehensive should the initial history be?
A) It should be limited to the chief complaint and personal habits.
B) It should be all-inclusive, including events preceding hospitalization.
C) It should be confined to current medications and family history.
D) It should be restricted to only information that the patient can provide.
Q3) Which nuclear medicine study should the nurse anticipate a practitioner's order for in a patient who is being evaluated for a brain tumor?
A) PET
B) MRI
C) MRA
D) SPECT
Page 24
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Chapter 23: Neurologic Disorders and Therapeutic Management
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Sample Questions
Q1) A right-handed patient has been admitted with an intracerebral hemorrhage.A computed tomography (CT)of the patient's head reveals a large left parietal area bleed.Patient assessment includes temperature (T),98.7° F; pulse (P),98 beats/min and thready; respirations (R),8 breaths/min; and blood pressure (BP),168/100 mm Hg.Initial management of the patient includes which intervention?
A) Placing the patient in the Trendelenburg position
B) Administering an antihypertensive agent
C) Initiating induced hypertensive therapy
D) Intubating and ventilating the patient
Q2) A patient has been told he has a nonencapsulated tumor that has infiltrated the brain tissue.Why type of tumor does the nurse suspect the patient has?
A) Angioma
B) Pituitary adenoma
C) Meningioma
D) Glioma
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Chapter 24: Kidney Anatomy and Physiology
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Sample Questions
Q1) Which factors stimulate the release of antidiuretic hormone (ADH)?
A) Hypovolemia
B) Hypernatremia
C) Hypothermia
D) Opioids
E) Emotional stress
Q2) A patient has been admitted with acute kidney injury.Which serum laboratory values would the nurse expect to be ordered to confirm this diagnosis?
A) Sodium and potassium
B) Creatinine and calcium
C) Blood urea nitrogen (BUN) and creatine
D) Potassium and magnesium
Q3) 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
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26
Chapter 25: Kidney Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) The patient complains of a metallic taste and loss of appetite.The nurse is concerned that the patient has developed what problem?
A) Glycosuria
B) Proteinuria
C) Myoglobin
D) Uremia
Q2) Percussion of kidneys is usually done to assess what parameter?
A) Size and shape of the kidneys
B) Presence of pain in the renal area
C) Presence of a fluid wave
D) Patient's overall fluid status
Q3) A patient was admitted with multiple trauma who has been volume resuscitated.The nurse suspects the patient is fluid overloaded.Which assessment findings would confirm the nurse's suspicion?
A) Venous filling of the hand veins greater than 5 seconds
B) Distended neck veins in the supine position
C) Presence of orthostatic hypotension
D) Presence of a third heart sound
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Chapter 26: Kidney Disorders and Therapeutic Management
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Sample Questions
Q1) To assess whether or not an arteriovenous fistula is functioning,what must the nurse do and why?
A) Palpate the quality of the pulse distal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow.
B) Palpate the quality of the pulse proximal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow.
C) Palpate gently over the site of the fistula to determine whether a thrill is present; listen with a stethoscope over this site to appreciate a bruit to assess the quality of the blood flow.
D) Palpate over the site of the fistula to determine whether a thrill is present; check whether the extremity is pink and warm.
Q2) Which medication is classified as a loop diuretic?
A) Acetazolamide
B) Furosemide
C) Mannitol
D) Metolazone
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Chapter 27: Gastrointestinal Anatomy and Physiology
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Sample Questions
Q1) How is food is propelled through the esophagus?
A) Gravity
B) Salivary fluids
C) Cardiac sphincter suction
D) Peristalsis
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) What is the main function of bile?
A) Emulsify fat globules
B) Serve as a reservoir for bilirubin
C) Maintain triglyceride levels in the blood
D) Aid in detoxification of drugs in the liver
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29
Chapter 28: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) What is the most common location for a male to have a hernia?
A) Femoral
B) Umbilical
C) Inguinal
D) Abdominal
Q2) Preprocedural teaching of a patient undergoing a liver scan should include which instruction?
A) Drink at least 500 mL of fluids before the procedure.
B) Remain flat in bed for 12 hours after the procedure.
C) Stay flat and still during the procedure.
D) Sedation will be provided during the procedure.
Q3) Which anatomic structures 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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Page 30
Chapter 29: Gastrointestinal Disorders and Therapeutic Management
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Sample Questions
Q1) A patient was admitted after a Roux-en-Y gastric bypass (RYGBP).A nursing student asks the nurse what type of surgery an RYGBP is.What would be an appropriate response from the nurse?
A) "It is an esophagectomy performed using the transthoracic approach."
B) "It is an esophagectomy performed using a transhiatal approach."
C) "It is a combination of restrictive and malabsorption types of bariatric surgery."
D) "It is a standard operation for pancreatic cancer."
Q2) A patient is admitted with the diagnosis of acute pancreatitis.The nurse expects which laboratory values to be elevated?
A) Calcium
B) Serum amylase
C) Serum glucose
D) Potassium
E) White blood cells
F) Serum triglycerides
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Chapter 30: Endocrine Anatomy and Physiology
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Q1) A patient with thyrotoxicosis has been admitted.The nurse knows that when levels of T and T are elevated,the pituitary gland inhibits what hormone?
A) Thyroglobulin
B) Thyroid-releasing hormone (TRH)
C) Thyroid-stimulating hormone (TSH)
D) Calcitonin
Q2) A nurse is caring for a patient who is having difficulty maintaining a normal blood sugar level.In the healthy body,how is a normal blood glucose level is maintained?
A) Insulin secretion
B) Cellular metabolism
C) Insulin-to-glucagon ratio
D) Insulin-to-thyroxine ratio
Q3) Decreased insulin and increased glucagon result in what physiologic process?
A) Increased glycogenolysis
B) Decreased fat mobilization
C) Decreased ketosis
D) Increased glycogen storage
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Chapter 31: Endocrine Clinical Assessment and Diagnostic Procedures
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Q1) A patient has been admitted who is suspected of having thyrotoxicosis.Which laboratory findings would confirm this diagnosis?
A) Very low thyroid-stimulating hormone (TSH)
B) Decreased T uptake ratio
C) Increased serum osmolality
D) Decreased urine osmolality
Q2) A nurse is initiating a patient teaching plan for a patient with hypothyroidism.The patient is currently taking salicylates,lithium,and sulfonamides.It is important that the nurse tell the patient that these medications influence thyroid levels.How are thyroid levels affected by these medications?
A) They increase T
B) They increasing T
C) They decrease T
D) They decrease T
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33
Chapter 32: Endocrine Disorders and Therapeutic Management
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Q1) A patient is admitted with diabetic ketoacidosis (DKA).The nurse knows that the dehydration associated with DKA results from which pathophysiologic mechanism?
A) Increased serum osmolality and urea
B) Decreased serum osmolality and hyperglycemia
C) Ketones and potassium shifts
D) Acute renal failure
Q2) As a patient with diabetic ketoacidosis (DKA)receives insulin and fluids,the nurse knows careful assessment must be given to which electrolyte?
A) Potassium
B) Sodium
C) Phosphorus
D) Calcium
Q3) Patients discharged with antithyroid medications should be alerted to which potential side effect?
A) Hyperthermia
B) Agranulocytosis
C) Tachypnea
D) Diaphoresis
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Chapter 33: Trauma
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Q1) The nurse is working on an organization-wide falls prevention project.The nurse understands that the majority of falls accounting for traumatic injury occur in what population?
A) Construction workers
B) Adolescents
C) Older adults
D) Young adults
Q2) During assessment of a new trauma patient,the nurse observes perianal ecchymosis.The nurse suspects the patient has what problem?
A) Pelvic fracture
B) Bladder trauma
C) Rectal laceration
D) Spleen laceration
Q3) A patient was admitted after a motor vehicle crash (MVC).The nurse knows that this type of injury is the greatest cause of what type of trauma?
A) Spinal shock
B) Blunt thoracic trauma
C) Maxillofacial injuries
D) Penetrating thoracic injuries
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Page 35
Chapter 34: Shock,sepsis,and Multiple-Organ Dysfunction Syndrome
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Q1) A patient has developed septic shock.The nurse knows that the clinical manifestations of ischemic hepatitis show up 1 to 2 days after the insult.Which finding would the nurse expect to note to support this diagnosis?
A) Elevated serum creatinine
B) Decreased bilirubin
C) Jaundice
D) Decreased serum transaminase
Q2) A patient is admitted after she develops disseminated intravascular coagulation (DIC)after a vaginal delivery.Which laboratory value would the nurse expect to note to support this diagnosis?
A) Decreased fibrinogen degradation products
B) Decreased D-dimer concentrations
C) Decreased platelet counts
D) Increased serum glucose levels
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Chapter 35: Burns
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Q1) The nursing management plan for a patient with full-thickness burns includes which intervention?
A) Daily replacement of autografts
B) Daily wound care with premedication
C) Weekly wound care until all eschar is debrided
D) Surgical skin grafting within 8 hours of admission
Q2) Using the Parkland formula for fluid resuscitation and your knowledge of injury calculations using the "rule of nines," calculate the estimated fluid requirements during the first 8 hours for a 75-kg patient with full-thickness burns to the anterior chest,perineum,and entire right leg.
A) 2775 mL
B) 5550 mL
C) 8325 mL
D) 11,100 mL
Q3) What is a leading cause of death in the hospitalized burn patient?
A) Smoke inhalation
B) Infection
C) Burn shock
D) Renal failure
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Page 37
Chapter 36: Organ Donation and Transplantation
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Q1) Not every patient with end-stage liver disease is a candidate for receiving a transplant.Which conditions are contraindications to a kidney transplant?
A) Malignancy during the past 5 years
B) Active infectious process
C) Advanced cardiopulmonary disease
D) Recreational drug use
E) Nonadherence to current medical regimen
Q2) Which statement would indicate that a patient who has received an organ transplant understands the teaching about immunosuppressive medications?
A) "My drug dosages will be lower because the medications enhance each other."
B) "I will be less prone to side effects because I will be taking more than one drug."
C) "Lower doses of these medications put me at greater risk for infection."
D) "Taking more than one medication will put me at risk for developing allergies."
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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 has been admitted with sickle cell anemia and is requiring a blood transfusion.The nurse understands that transfusions should be used with caution in this patient because of what complication?
A) Fluid overload
B) Iron overload
C) Vasoocclusive crisis
D) Stroke
Q3) What is the primary mechanism in the development of idiopathic thrombocytopenic purpura (ITP)?
A) Destruction of platelets by lymphocytic antibodies
B) Destruction of malignant cells through radiation or chemotherapy
C) Formation of heparin antibodies
D) Damage to the endothelium
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Page 39
Chapter 38: The Obstetric Patient
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Q1) A patient who is 30-weeks pregnant is admitted with severe asthma.The nurse understands that sufficient fetal oxygenation requires what minimum level of maternal oxygenation?
A) PaO greater than 100 mm Hg
B) PaO greater than 70 mm Hg
C) Oxygen saturation of 100%
D) Oxygen saturation greater than 70%
Q2) What are some of the unique causes of septic shock in pregnant patients?
A) Postpartum pyelonephritis
B) Ectopic pregnancy
C) Chorioamnionitis
D) Septic abortion
E) Postpartum hemorrhage
Q3) A patient is admitted who is pregnant and has Marfan syndrome.The nurse knows that this disorder places the patient at risk for what complication?
A) Stroke
B) Pulmonary embolism
C) Heart failure
D) Aortic dissection
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Page 40
Chapter 39: The Pediatric Patient
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Q1) What is the initial treatment for hypoxia,acidosis,or hypothermia?
A) Vasopressin
B) Bronchodilators
C) Oxygenation and ventilation
D) Hydration
Q2) To establish a patent airway in an infant or child younger than 2 years of age,the nurse would perform which action?
A) Initiate the head-tilt/chin-lift maneuver.
B) Hyperextend the neck and pull the jaw forward.
C) Place a towel under the upper shoulders with the jaw slightly extended into "sniffing" position.
D) Place a folded towel under the head to extend the neck.
Q3) A 3-month-old infant presents with vomiting and diarrhea.The infant appears to be drowsy; his pulse rate is 180 beats/min; and he has had a dry diaper for the past 3 hours.The nurse suspects the patient has developed which condition?
A) Mild dehydration
B) Moderate dehydration
C) Desiccation
D) Severe dehydration
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Page 41
Chapter 40: The Older Adult Patient
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Q1) The nurse recognizes that there are numerous interventions that can decrease the negative physical,functional,and cognitive long-term outcomes associated with critical illness.Identify a few of these interventions.
A) Avoid pharmacologic sleep agents.
B) Focus on planning for home.
C) Use restraints.
D) Use indwelling catheters.
E) Reduce noise at night.
Q2) An older patient is receiving a nephrotoxic medication.Which parameter would be a priority for the nurse to monitor?
A) Electrocardiogram
B) Lung sounds
C) Blood pressure
D) Level of consciousness
Q3) Which sound may be difficult for an older person to hear?
A) Telephone ringing
B) Clothes dryer running
C) Car horn honking
D) Child crying
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Page 42
Chapter 41: The Perianesthesia Patient
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Q1) A postoperative patient is experiencing delayed arousal after a transurethral prostatectomy.To assist with finding the cause,the nurse would assess the patient's laboratory values for which finding?
A) Hypercalcemia
B) Hyponatremia
C) Hyperkalemia
D) Hypermagnesemia
Q2) A postoperative patient has developed laryngeal edema.What medication would the nurse anticipate being administered to the patient?
A) Racemic epinephrine
B) Succinylcholine
C) Albuterol
D) Morphine
Q3) A patient emerges from general anesthesia screaming,shouting,and thrashing wildly.The nurse suspects the patient is experiencing what problem?
A) Emergence hallucination
B) Emergence fever
C) Emergence hyperactivity
D) Emergence delirium
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Page 43