Nursing Care of the Critically Ill Test Bank
Course Introduction
This course focuses on the principles and practices of nursing care for critically ill patients in acute and intensive care settings. Students will explore the pathophysiology of life-threatening conditions, advanced assessment techniques, and complex interventions required for critically ill individuals. Emphasis is placed on collaborative decision-making, use of specialized equipment, pharmacological management, and evidence-based interventions to support patients with multi-system instability. The course also covers ethical considerations, communication with families, and the psychological impact of critical illness, preparing students to provide comprehensive, compassionate, and safe care in high-pressure environments.
Recommended Textbook
Critical Care Nursing Diagnosis and Management 8th Edition by Linda D. Urden
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41 Chapters
1210 Verified Questions
1210 Flashcards
Source URL: https://quizplus.com/study-set/2075 Page 2
Chapter 1: Critical Care Nursing Practice
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/41299
Sample Questions
Q1) 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) What type of practitioner is instrumental in ensuring care that is evidence based and that safety programs are in place?
A) Clinical nurse specialist
B) Advanced practice nurse
C) Registered nurses
D) Nurse practitioners
Answer: A
Q3) What is the systematic decision-making model used by nurses termed?
A) Nursing diagnosis
B) Nursing interventions
C) Nursing evaluations
D) Nursing process
Answer: D
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Page 3
Chapter 2: Ethical Issues
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/41300
Sample Questions
Q1) A patient's wife has been informed by the practitioner that her spouse has permanent quadriplegia.The wife states that she does not want anyone to tell the patient about his injury.The patient asks the nurse about what has happened.The nurse has conflicting emotions about how to handle the situation.What is the nurse experiencing?
A) Autonomy
B) Moral distress
C) Moral doubt
D) Moral courage
Answer: B
Q2) Truth-telling is an example of what ethical principle?
A) Justice
B) Beneficence
C) Autonomy
D) Nonmaleficence
Answer: C
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Chapter 3: Legal Issues
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41301
Sample Questions
Q1) What element of malpractice is based on the existence of a nurse-patient relationship?
A) Duty
B) Breach
C) Damages
D) Harm caused by the breach
Answer: A
Q2) The ability to practice as a licensed professional nurse is a privilege granted by what entity?
A) Employee contract
B) State legislature
C) State boards of nursing
D) Congress
Answer: B
Q3) Which situation would be considered a failure of proper implementation?
A) Not identifying and analyzing symptoms appropriately
B) Not documenting the patient's response to pain medication
C) Not recognizing a malfunctioning chest tube
D) Not asking the patient about code or no code wishes
Answer: B
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Chapter 4: Genetic Issues
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/41302
Sample Questions
Q1) A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known which of the following?
A) Chromatids
B) Karyotype
C) Genomics
D) Histones
Q2) To achieve a consistent distance across the width of the DNA strand,the nucleotide base guanine (G)can only be paired with what other genetic material?
A) Adenine (A)
B) Thymine (T)
C) Cytosine (C)
D) Sex chromosome X
Q3) A family pedigree is used to determine whether a disease has a genetic component.What does a proband indicate in a family pedigree?
A) The disease being mother related or father related
B) The first person in the family who was diagnosed with the disorder
C) Who in the family is the xy band
D) The disease genotype including locus
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Chapter 5: Patient and Family Education
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41303
Sample Questions
Q1) 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.
Q2) Acute illness disrupts the patient's and family's normal routines and is extremely stressful.What coping mechanisms might the nurse expect the patient and/or family to display?
A) Denial
B) Adaptation
C) Values
D) Anger
E) Disbelief
Q3) In which situation are group discussions most effective as a patient teaching strategy?
A) Patients have a variety of medical diagnoses.
B) Patients are in the acute phase of their illness.
C) Patients are in the hospital only 3 days or less.
D) Patients are at similar stages of adaptation.
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Chapter 6: Psychosocial and Spiritual Alterations and Management
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41304
Sample Questions
Q1) Which intervention should be included in the patient management plan for a patient with powerlessness?
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) A patient is admitted complaining of pain from a femur fracture and is anxious and agitated.The patient is receiving steroids and theophylline for exacerbation of asthma.What disorder should the nurse suspect the patient may be experiencing?
A) Anxiety
B) Low self-esteem
C) Regression
D) Suicidal ideations
Q3) Which medications are commonly used for alcohol withdrawal symptoms?
A) Chlordiazepoxide and folic acid
B) Chlordiazepoxide and lorazepam
C) Lorazepam and promethazine
D) Promethazine and thiamine
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Chapter 7: Nutrition Alterations and Management
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41305
Sample Questions
Q1) The patient is receiving corticosteroid treatment for neurologic alterations.The patient should be routinely monitored for what common complication of this type of therapy?
A) Hyponatremia
B) Hyperalbuminemia
C) Hyperkalemia
D) Hyperglycemia
Q2) 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
Q3) A patient who has sustained a head injury has increased nutritional needs related to what physiologic mechanism?
A) Decreased metabolism as a result of coma
B) Decreased blood sugar from a lack of dietary supplementation
C) Anabolism and wound healing
D) Hypermetabolism and catabolism associated with the injury
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Page 9
Chapter 8: Pain and Pain Management
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/41306
Sample Questions
Q1) The nurse is caring for a patient with a patient-controlled analgesia (PCA).The patient's spouse asks about the advantages of using this type of pain management therapy.What should the nurse say to the spouse?
A) "The method allows the patient to act preemptively by administering a bolus of medication when pain begins."
B) "This method allows the patient to choose between an opioid and a nonopioid medication to control pain."
C) "This method decreases the risk of respiratory depression and other side effects."
D) "This method allows for the rise and fall of the blood level of the opioid."
Q2) Which of the following patients is MOST likely to be experiencing a life-threatening opioid side effect?
A) Patient with respiratory rate of 10 breaths/min who is breathing deeply
B) Patient with a respiratory rate of 8 breaths/min who is snoring
C) Patient with blood pressure of 150/75 mm Hg and heart rate of 102 beats/min
D) Patient with a temperature of 100.5° F who is asleep but easily roused
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Chapter 9: Sedation,Agitation,and Delirium Management
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) A patient has been taking benzodiazepines and suddenly develops respiratory depression and hypotension.After careful assessment,the nurse determines that the patient is experiencing benzodiazepine overdose.What is the nurse's next action?
A) Decrease benzodiazepines to half the prescribed dose.
B) Increase IV fluids to 500 cc/h for 2 hours.
C) Administer flumazenil (Romazicon).
D) Discontinue benzodiazepine and start propofol.
Q2) To achieve ventilator synchrony in a mechanically ventilated patient with acute respiratory distress syndrome (ARDS),which level of sedation might be most effective?
A) Light
B) Moderate
C) Conscious
D) Deep
Q3) What is a major side effect of benzodiazepines?
A) Hypertension
B) Respiratory depression
C) Renal failure
D) Phlebitis
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11
Chapter 10: End-Of-Life Care
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/41308
Sample Questions
Q1) A patient was admitted several weeks ago with an acute myocardial infarction and subsequently underwent coronary artery bypass grafting surgery.Since a cardiac arrest 5 days ago,the patient has been unresponsive.An electroencephalogram shows no meaningful brain activity.After a family conference,the practitioner orders a do-not-resuscitate (DNR)order,and palliative care is begun.How does this affect the patient's treatment?
A) The patient will continue to receive the same aggressive treatment short of resuscitation if he has another cardiac arrest.
B) All treatment will be stopped, and the patient will be allowed to die.
C) All attempts will be made to keep the patient comfortable without prolonging his life.
D) The patient will be immediately transferred to hospice.
Q2) What are the two basic ethical principles underlying the provision of health care?
A) Beneficence and nonmaleficence
B) Veracity and beneficence
C) Fidelity and nonmaleficence
D) Veracity and fidelity
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Chapter 11: Cardiovascular Anatomy and Physiology
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41309
Sample Questions
Q1) Why do many patients with very high heart rates frequently have chest pain and shortness of breath?
A) Patients with heart disease frequently have an anxiety disorder as well.
B) The rapid pounding of the heart in the chest wall causes the physical pain.
C) The heart muscle gets tired from the increased work.
D) The decreased diastolic time decreases oxygen delivery to the myocardium.
Q2) A patient is admitted with a diagnosis of acute myocardial infarction.The monitor pattern reveals bradycardia.Occlusion of which coronary artery most likely resulted in bradycardia from sinoatrial node ischemia?
A) Right
B) Left anterior descending
C) Circumflex
D) Dominant
Q3) Which factors influence stroke volume?
A) Afterload
B) Cardiac output
C) Contractility
D) Heart rate
E) Preload
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Chapter 12: Cardiovascular Clinical Assessment
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41310
Sample Questions
Q1) 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) The presence of a carotid or femoral bruit may be evidence of what anomaly?
A) Left-sided heart failure
B) Blood flow through a partially occluded vessel
C) Early onset of pulmonary embolism
D) Myocardial rupture
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Page 14
Chapter 13: Cardiovascular Diagnostic Procedures
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74 Verified Questions
74 Flashcards
Source URL: https://quizplus.com/quiz/41311
Sample Questions
Q1) 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
Q2) Which blood test standardizes prothrombin time (PT)results among worldwide clinical laboratories?
A) aPTT
B) ACT
C) HDL
D) INR
Q3) Why is mixed venous oxygen saturation (SVO )monitoring helpful in the management of the critically ill patient?
A) It facilitates oxygen saturation monitoring at the capillary level.
B) It can detect an imbalance between oxygen supply and metabolic tissue demand.
C) It assesses the diffusion of gases at the alveolar capillary membrane.
D) It estimates myocardial workload during heart failure and acute pulmonary edema.
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Chapter 14: Cardiovascular Disorders
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/41312
Sample Questions
Q1) The nursing management plan for a patient with angina would include which intervention?
A) Immediate administration of antiplatelet therapy
B) Teaching the patient how to perform the Valsalva maneuver
C) Assessment and documentation of chest pain episodes
D) Administration of prophylactic lidocaine for ventricular ectopy
Q2) Which intervention is an essential aspect of the patient teaching plan for the patient with chronic heart failure?
A) Instructing the patient to call the practitioner prior to dental surgery
B) Stressing the importance of compliance with diuretic therapy
C) Instructing the patient to take nitroglycerin if chest pain occurs
D) Teaching the patient how to take an apical pulse
Q3) A patient has been admitted in hypertensive crisis.Which medication would the nurse expect the practitioner to order for this patient?
A) Digitalis
B) Vasopressin
C) Verapamil
D) Sodium nitroprusside
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Chapter 15: Cardiovascular Therapeutic Management
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/41313
Sample Questions
Q1) Which calcium channel blocker is beneficial in the treatment of patients with coronary artery disease or ischemic stroke?
A) Nifedipine
B) Nicardipine
C) Clevidipine
D) Diltiazem
Q2) A transvenous pacemaker is inserted through the right subclavian vein and threaded into the right ventricle.The pacemaker is placed on demand at a rate of 70.What is the three letter code for this pacing mode?
A) VVI
B) AOO
C) DDD
D) VAT
Q3) What two medications are commonly prescribed at discharge for patients who have had a coronary artery stent placed?
A) Aspirin and prasugrel
B) Aspirin and abciximab
C) Clopidogrel and eptifibatide
D) Tirofiban and tricagrelor
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Chapter 16: Pulmonary Anatomy and Physiology
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40 Verified Questions
40 Flashcards
Source URL: https://quizplus.com/quiz/41314
Sample Questions
Q1) Which factor will increase diffusion of gases across the alveolar capillary membrane?
A) A decrease in the surface area of the membrane
B) An increase in the 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) What is the most important function of type I alveolar epithelial cells?
A) They comprise 90% of total alveolar surface in the lungs for gas exchange.
B) The ability to produce, store, and secrete pulmonary surfactant.
C) The ability to trap foreign particles for auto digestion.
D) The maintenance, repair, and restoration of the mucociliary escalator.
Q3) A patient has sustained a stroke and is no longer able to control his epiglottis.Why should the nurse be concerned about the patient?
A) The patient is at increased risk of aspiration.
B) The patient will need surgery to close his epiglottis.
C) The patient will need a tracheostomy to breathe.
D) The patient is at risk for a pneumothorax.
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Chapter 17: Pulmonary Clinical Assessment
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41315
Sample Questions
Q1) A patient presents with chest trauma from a motor vehicle accident.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 patient's tongue is blue-gray.Based on this assessment data,what additional assessment findings would the nurse expect to find?
A) Kussmaul breathing pattern
B) Absent breath sounds in the right lower lung fields
C) Absent breath sounds in the left lung fields
D) Diminished breath sounds in the right upper lung fields
Q2) A patient is admitted with diminished to absent breath sounds on the right side,tracheal deviation to the left side,and asymmetric chest movement.These findings are indicative of which disorder?
A) Tension pneumothorax
B) Pneumonia
C) Pulmonary fibrosis
D) Atelectasis
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Chapter 18: Pulmonary Diagnostic Procedures
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) Place the steps for analyzing arterial blood gases in the proper order.
1)Assess HCO ¯ level for metabolic abnormalities
2)Assess PaO for hypoxemia
3)Examine PaCO for acidosis or alkalosis
4)Re-examine pH to determine level of compensation
5)Examine pH for acidemia or alkalemia
A) 5, 1, 2, 4, 3
B) 2, 5, 3, 1, 4
C) 1, 2, 4, 3, 5
D) 1, 3, 4, 5, 2
Q2) In a patient who is hemodynamically stable,which procedure can be used to estimate the PaCO levels?
A) PaO /FiO ratio
B) A-a gradient
C) Residual volume (RV)
D) End-tidal CO
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Chapter 19: Pulmonary Disorders
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Which nursing intervention should be used to optimize oxygenation and ventilation in the patient with acute lung failure?
A) Provide adequate rest and recovery time between procedures.
B) Position the patient with the good lung up.
C) Suction the patient every hour.
D) Avoid hyperventilating the patient.
Q2) Patients with left-sided pneumonia may benefit from placing them in which position?
A) Reverse Trendelenburg
B) Supine
C) On the left side
D) On the right side
Q3) Supplemental oxygen administration is usually effective in treating hypoxemia related which situation?
A) Physiologic shunting
B) Dead space ventilation
C) Alveolar hyperventilation
D) Ventilation-perfusion mismatching
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21
Chapter 20: Pulmonary Therapeutic Management
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41318
Sample Questions
Q1) What is the therapeutic blood level for theophylline (Xanthines)?
A) 5 to 10 mg/dL
B) 10 to 20 mg/dL
C) 20 to 30 mg/dL
D) 35 to 45 mg/dL
Q2) A patient was admitted with acute lung failure.The patient has been on a ventilator for 3 days and is being considered for weaning.Which criteria would indicate that the patient is ready to be weaned?
A) FiO 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) 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%
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Chapter 21: Neurologic Anatomy and Physiology
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41319
Sample Questions
Q1) The ability to access cerebrospinal fluid (CSF)by a lumbar puncture is attributable to the flow of CSF in which space?
A) Subdural
B) Subpia
C) Epidural
D) Subarachnoid
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) Substances most likely to pass across the blood-brain barrier have what characteristics?
A) Low pH compared with body fluids
B) Lipid solubility
C) Large particle size
D) A close relation to toxic metabolites
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23
Chapter 22: Neurologic Clinical Assessment and Diagnostic
Procedures
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49 Verified Questions
49 Flashcards
Source URL: https://quizplus.com/quiz/41320
Sample Questions
Q1) The practitioner has ordered a carotid Doppler study for a patient.The patient asks the nurse what the test is for.How should the nurse respond?
A) The test evaluates blood flow in the anterior, middle, or posterior cerebral arteries.
B) The test estimates blood flow velocity thought the carotid arteries.
C) The test assesses arteriovenous circulation in the intracranial space.
D) The test gauges global cerebral blood flow.
Q2) The nurse is caring for a patient who has sustained a traumatic head injury.The practitioner has asked the nurse to test the patient's oculocephalic reflex.What must the nurse verity prior to performing the test?
A) The absence of cervical injury
B) The depth and rate of respiration
C) The patient's ability to swallow
D) The patient's ability to follow a verbal command
Q3) Which procedure is the diagnostic study of choice for acute head injury?
A) Magnetic resonance imaging
B) Computed tomography
C) Transcranial Doppler
D) Electroencephalography
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Chapter 23: Neurologic Disorders and Therapeutic Management
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44 Verified Questions
44 Flashcards
Source URL: https://quizplus.com/quiz/41321
Sample Questions
Q1) The patient has sustained an ischemic stroke involving the left cerebral hemisphere.Which of the following neurologic abnormalities would you expect to see?
A) Aphasia
B) Left visual field defect
C) Difficulty balancing his checkbook
D) Ataxic gait
E) Somnolence
Q2) Which independent nursing measures can assist in reducing increased intracranial pressure (ICP)?
A) Decreasing the ventilator rate
B) Decreasing noxious stimuli
C) Frequent orientation checks
D) Administration of loop diuretics
Q3) Which patient has the best prognosis based on the cause of coma?
A) A 36-year-old man with closed head injury
B) A 50-year-old woman with hepatic encephalopathy
C) A 46-year-old woman with subarachnoid hemorrhage
D) A 72-year-old man with hypertensive intracerebral hemorrhage
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Chapter 24: Kidney Anatomy and Physiology
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25 Flashcards
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Sample Questions
Q1) What are the functions of the kidneys?
A) Formation of urine
B) Blood pressure regulation
C) Erythrocyte destruction
D) Breakdown of prostaglandins
E) Regulation of acid-base balance
Q2) The mobilization of calcium from bone stores is accomplished through the influence of which hormone?
A) Antidiuretic hormone (ADH)
B) Parathyroid hormone (PTH)
C) Thyroid-stimulating hormone (TSH)
D) Erythropoietin
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) A patient has been admitted with acute kidney injury.The nurse knows the most important consideration for evaluating the patient's fluid status is what parameter?
A) Daily weights
B) Urine and serum osmolality
C) Intake and output
D) Hemoglobin and hematocrit levels
Q2) As serum osmolality rises,intravascular fluid equilibrium will be maintained by the release of what substance?
A) Ketones
B) Glucagon
C) Antidiuretic hormone
D) Potassium
Q3) A patient was admitted with acute heart failure a few days ago.Today the patient's urine has a specific gravity of 1.040.What could be the potential cause for this value?
A) Volume overload
B) Volume deficit
C) Acidosis
D) Urine ketones
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Chapter 26: Kidney Disorders and Therapeutic Management
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30 Flashcards
Source URL: https://quizplus.com/quiz/41324
Sample Questions
Q1) A patient is admitted with acute kidney injury (AKI).Which event from the patient's history was the most probable cause of the patient's AKI?
A) Recent computed tomography of the brain with and without contrast
B) Recent bout of acute heart failure after an acute myocardial infarction
C) Twice-daily prescription of Lasix 40 mg by mouth
D) Recent bout of benign prostatic hypertrophy and transurethral resection of the prostate
Q2) What is the recommended nutritional intake of protein to control azotemia in the patient with acute kidney injury?
A) 0.5 to 1.0 g/kg/day
B) 1.2 to 1.5 g/kg/day
C) 1.7 to 2.5 g/kg/day
D) 2.5 to 3.5 g/kg/day
Q3) What is the most common site for short-term vascular access for immediate hemodialysis?
A) Subclavian artery
B) Subclavian vein
C) Femoral artery
D) Radial vein
Page 28
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Chapter 27: Gastrointestinal Anatomy and Physiology
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20 Flashcards
Source URL: https://quizplus.com/quiz/41325
Sample Questions
Q1) 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
Q2) Stimulation of the parasympathetic nervous system produces which effect on the gastrointestinal system?
A) Decreased peristalsis
B) Increased secretion of watery saliva
C) Decreased colonic activity
D) Increased release of gastrointestinal hormones
Q3) What vessel delivers nutrient-rich blood from the gut,pancreas,spleen,and stomach to the liver?
A) Hepatic artery
B) Hepatic vein
C) Portal vein
D) Interlobular veins
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Chapter 28: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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28 Flashcards
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Sample Questions
Q1) Which anatomic structures are found in the left lower quadrant?
A) Distended uterus
B) Cecum and appendix
C) Left ureter
D) Portion of the descending colon
E) Sigmoid colon
Q2) A patient is undergoing a hepatobiliary scan to assess the progression of cirrhosis of the liver.The nurse would anticipate which result?
A) Nonvisualization
B) Little or no uptake
C) Increased uptake
D) Normal uptake
Q3) Which finding 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
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Page 30
Chapter 29: Gastrointestinal Disorders and Therapeutic Management
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Sample Questions
Q1) A patient has been admitted with acute liver failure.Which interventions would the nurse expect as part of the interprofessional collaborative management plan?
A) Benzodiazepines for agitation
B) Pulse oximetry and serial arterial blood gas measurements
C) Insulin drip for hyperglycemia and hyperkalemia
D) Monitoring electrolyte blood levels
E) Assessing for signs of cerebral edema
F) Fever
Q2) A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices.The patient has been started on a vasopressin drip.The nurse would monitor the patient for which side effect of the medication?
A) Constipation
B) Diarrhea
C) Chest pain
D) Bleeding
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Chapter 30: 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; adrenocorticotrophic hormone (ACTH)
C) ACTH; glucocorticoid hormone
D) ACTH; epinephrine
Q2) A patient with thyrotoxicosis has been admitted.What effect of increased T and T levels might the nurse expect to see in this patient?
A) Increased oxygen consumption
B) Decreased basal metabolic rate
C) Decreased cardiac output
D) Increased calcium levels
Q3) A patient is admitted with multiple trauma.Which hormone would the nurse expect to be increased in response to physiologic stress?
A) Mineralocorticoid
B) Corticosteroid
C) Glucocorticoid
D) Cortisol
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Chapter 31: Endocrine Clinical Assessment and Diagnostic
Procedures
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Q1) A patient with thyrotoxicosis is admitted.Which laboratory tests would the nurse expect to be ordered for this patient?
A) Total serum triiodothyronine (TT )
B) Total serum thyroxine (TT )
C) Free urine thyroid stimulating hormone
D) Total urine thyroxine
E) Thyroglobulin (Tg)
F) Free thyroxine (T )
Q2) A patient has been admitted with uncontrolled atrial fibrillation and muscle wasting.The practitioner suspects the patient may have a thyroid disorder.The nurse auscultates a bruit over the thyroid.What does this finding indicate?
A) Normal function
B) Enlargement of the thyroid
C) Hypoplasia of the thyroid
D) Tumor of the thyroid
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Chapter 32: Endocrine Disorders and Therapeutic Management
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Q1) A patient has thyroid storm.The nurse is providing medication instruction for home.The patient asks,"If I have a fever,should I take Tylenol or aspirin?" Which response would be the most appropriate?
A) "Either one is fine because they do not affect the antithyroid medication."
B) "Take Tylenol rather than aspirin because aspirin increases the amount of free thyroid hormone in circulation."
C) "Take aspirin rather than Tylenol because Tylenol increases the amount of free thyroid hormone in circulation."
D) "They both prevent the antithyroid medication from working correctly. I would recommend an NSAID."
Q2) A patient with type 2 diabetes is admitted.He is very lethargic and hypotensive.A diagnosis of hyperglycemic hyperosmolar syndrome (HHS)is given.Which findings support this diagnosis?
A) Decreased serum glucose and increased serum ketones
B) Increased urine ketones and decreased serum osmolality
C) Increased serum osmolality and increased serum potassium
D) Increased serum osmolality and increased serum glucose
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Page 34
Chapter 33: Trauma
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Q1) An unresponsive trauma patient has been admitted to the emergency department.Which statement regarding opening the airway is accurate?
A) Airway assessment must incorporate cervical spine immobilization.
B) Hyperextension of the neck is the only acceptable technique.
C) Flexion of the neck protects the patient from further injury.
D) Airway patency takes priority over cervical spine immobilization.
Q2) A patient with multisystem trauma has been in the critical care unit for 2 days.The patient is still intubated and mechanically ventilated and has a chest tube,urinary drainage catheter,nasogastric tube,and two abdominal drains.The nurse understands that immobility places the patient at risk for developing which complication?
A) Pneumonia
B) Infection
C) Venous thromboembolism
D) Fat embolism syndrome
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Chapter 34: Shock,sepsis,and Multiple-Organ Dysfunction Syndrome
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Q1) A patient has been admitted with septic shock due to urinary sepsis.The practitioner inserts a pulmonary artery (PA)catheter.Which hemodynamic value would the nurse expect to note to support this diagnosis?
A) Cardiac output (CO) of 8 L/min
B) Right atrial pressure (RAP) of 17 mm Hg
C) Pulmonary artery occlusion pressure (PAOP) of 23 mm Hg
D) Systemic vascular resistance (SVR) of 1100 dyne/s/cm-5
Q2) A patient is admitted after she develops disseminated intravascular coagulation (DIC)after a vaginal delivery.The nurse knows that DIC is known to occur in patients with retained placental fragments.What is the pathophysiologic consequence of DIC?
A) Hypersensitivity response to an antigen
B) Excessive thrombosis and fibrinolysis
C) Profound vasodilatation
D) Loss of intravascular volume
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Chapter 35: Burns
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Q1) A patient is admitted after being burned in a house fire.The nurse feels that the patient should be transferred to a burn center.Which factor is most important when determining whether or not to refer a patient to a burn center?
A) The size and depth of burn injury and the burning agent
B) The age and present medical history of the patient
C) The depth of the burn injury and the presence of soot in the sputum
D) The medical history of the patient and the size and depth of the burn injury
Q2) A patient is brought to the emergency department after a house fire.The patient sustained an inhalation injury.The nurse is aware that this injury predisposes the patient to the development of what complication?
A) Tension pneumothorax
B) Adult respiratory distress syndrome (ARDS)
C) Asthma
D) Lung cancer
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) 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 is admitted after a lung transplant.The nurse knows the patient is at risk for developing pneumonia.What parameter would be a priority for the nurse to monitor?
A) Oxygen saturation
B) Chest tube output
C) Intake and output
D) Blood pressure
Q3) The nurse is caring for a patient after a heart transplant.Which finding would the nurse anticipate after cardiac transplantation?
A) Two P waves on the electrocardiogram (ECG)
B) High cardiac output
C) Anginal pain
D) Resting heart rate of 60 to 70 beats/min
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Chapter 37: Hematologic and Oncologic Emergencies
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Q1) The nurse is developing a patient education plan for a patient with sickle cell anemia.Hydroxyurea is the medication used in the treatment of the disorder.The nurse would inform the patient that the hydroxyurea may be 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
Q2) 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
Q3) What is the primary mechanism in the development of tumor lysis syndrome?
A) Destruction of platelets by lymphocytic antibodies
B) Destruction of malignant cells through radiation or chemotherapy
C) Formation of heparin antibodies
D) Damage to the endothelium
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Page 39
Chapter 38: The Obstetric Patient
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Q1) Which obstetric conditions may precipitate disseminated intravascular coagulation (DIC)in an obstetric patient?
A) Abruptio placentae
B) Amniotic fluid embolism
C) Asthma
D) Intracranial hemorrhage
E) Bacterial pneumonia
F) Dead fetus syndrome
Q2) A patient has been admitted with severe preeclampsia.The nurse knows that the patient's treatment plan would include which intervention?
A) Titrating intravenous fluids to maintain urine output greater than 50 mL/h
B) Administering hydralazine to keep the systolic blood pressure less than 120 mm Hg
C) Placing the patient on bed rest to decrease the chance of delivery
D) Administering magnesium sulfate to maintain serum levels of 4 to 7 mEq/L
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Chapter 39: The Pediatric Patient
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Q1) A 4-year-old child is admitted with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.Based on these clinical manifestations,what diagnosis would the nurse anticipate?
A) Status epilepticus
B) Bacterial meningitis
C) Head trauma
D) Septic shock
Q2) Which anatomic and physiologic findings are normal in infants younger than 1 year old?
A) The epiglottis is large and floppy.
B) The basal metabolic rate is lower than that of an adult.
C) The size of the head is smaller compared with the rest of the body.
D) The hormonal and metabolic response to pain is the same as that of an adult.
E) A positive Babinski reflex is a normal finding.
Q3) 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
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Page 41
Chapter 40: The Older Adult Patient
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Q1) A 78-year-old patient has been admitted after an inferior myocardial infarction (MI).The nurse knows that age-related changes in the cardiovascular system coupled with the MI place the patient at risk for what problem?
A) Hypertension
B) Heart failure
C) Ventricular fibrillation
D) Bradycardia
Q2) An older patient is admitted to the hospital with an acute onset of mental changes and recent falls.What is the one of the most common causes of mental changes in older patients?
A) Dementia
B) Infection
C) Stroke
D) Depression
Q3) Which sign or symptom can be a normal assessment finding for an older patient?
A) Asymptomatic dysrhythmias
B) Decreased urine output
C) Increased respiratory effort
D) Difficulty problem solving
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Page 42
Chapter 41: The Perianesthesia Patient
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Q1) What is the most definitive test for detecting malignant hyperthermia (MH)susceptibility?
A) Creatine phosphokinase (CPK) test
B) Ionized calcium test
C) Core temperature reading
D) Skeletal muscle biopsy
Q2) 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
Q3) The nurse is assisting with intubation of a patient.Which depolarizing skeletal muscle relaxant medication would the nurse anticipate being given to the patient?
A) Succinylcholine
B) Pancuronium
C) Mivacurium
D) Rocuronium
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