Nursing Management of the Critically Ill Exam Solutions
Course Introduction
This course focuses on the advanced nursing care and management of critically ill patients across various care settings, including intensive care units. Students will explore pathophysiological concepts related to critical illness, evidence-based assessment and intervention strategies, and the use of specialized equipment and technologies. The course emphasizes the development of clinical judgment, rapid decision-making, and interdisciplinary collaboration while addressing ethical and legal considerations. Emphasis is placed on holistic patient and family-centered care, management of complex health problems, and the application of leadership principles in critical care 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) Which core competency for interprofessional practice can be described as working with individuals of other professions to maintain a climate of mutual respect and shared values?
A) Interprofessional teamwork and team-based care
B) Values and ethics for interprofessional practice
C) Interprofessional communication
D) Roles and responsibilities for collaborative practice
Answer: B
Q2) Which professional organization administers critical care certification exams for registered nurses?
A) State Board of Registered Nurses
B) National Association of Clinical Nurse Specialist
C) Society of Critical Care Medicine
D) American Association of Critical-Care Nurses
Answer: D
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Chapter 2: Ethical Issues
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) Which situations are early signs of an ethical dilemma?
A) Disagreements among health care team members
B) Failure to discuss end-of-life issues with patient
C) Aggressive pain management
D) Belief that treatment is harmful
E) Following the patient's advance directive despite family objections
F) Providing hope to the patient's family
Answer: A,B,D
Q2) What is the first step of the ethical decision-making process?
A) Consulting with an authority
B) Identifying the health problem
C) Delineating the ethical problem from other types of problems
D) Identifying the patient as the primary decision maker
Answer: B
Q3) Which statement best describes the concept of paternalism?
A) Encouraging the patient to ambulate after surgery
B) Demanding the patient get out of bed to sit in a chair
C) Following the patient's advance directive despite family objections
D) Administering antibiotics for a viral infection
Answer: B
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Chapter 3: Legal Issues
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A nurse fails to recognize an intubated patient's need for suctioning.The endotracheal tube becomes clogged,and the patient has a respiratory arrest.What type of negligence may be present?
A) Assessment failure
B) Planning failure
C) Implementation failure
D) Evaluation failure
Answer: A
Q2) A patient is admitted with chest pain,and his electrocardiogram shows elevated ST segments.The nurse bases her plan of care on the nursing diagnosis of pneumonia.What type of negligence may be present?
A) Assessment failure
B) Planning failure
C) Implementation failure
D) Evaluation failure
Answer: B
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Chapter 4: Genetic Issues
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) What is a genetic variant that exists in greater than 1% of the population termed?
A) Genetic mutation
B) Genetic polymorphism
C) Genetic deletion
D) Tandem repeat
Q2) Hemophilia A is an inherited disease.Which statements would be determined by the family pedigree regarding hemophilia A?
A) It is an X-linked disorder.
B) Sons have a 50% chance of having hemophilia.
C) It is a Y-linked disorder.
D) Daughters have a 50% chance of being a carrier of the trait.
E) Sons have a 25% chance of having hemophilia.
F) Daughters have a 50% chance of having hemophilia.
Q3) What is an example of direct-to-consumer genomic testing?
A) Genetic testing through amniocentesis
B) Paternity testing from buccal swabs of the child and father
C) Biopsy of a lump for cancer
D) Drug testing using hair follicles
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Chapter 5: Patient and Family Education
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Information on what topic should be included in the educational plan of a patient who is unconscious?
A) Sensations
B) Pathophysiology
C) Rehabilitation
D) Attitudes
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) 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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25 Verified Questions
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Sample Questions
Q1) A patient has been admitted with a severed spinal cord injury at the T level.The patient has been in halo traction with immobilization for the past week.The practitioner has explained to the patient that the spinal cord has been severed and that the patient will not be able to walk again.The patient states,"I can't wait until I can get on my feet and walk again." Which defense mechanism is the patient exhibiting in this statement?
A) Denial
B) Posttraumatic stress disorder (PTSD)
C) Regression
D) Trust
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.
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Chapter 7: Nutrition Alterations and Management
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) 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
Q2) A patient is admitted with acute liver failure and encephalopathy.Which 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) The nursing management plan for a patient at risk for aspiration should include which intervention?
A) Administer intermittent feedings
B) Add thickening agents to the tube feeding solution
C) Suction the patient hourly
D) Elevate the head of the bed 30 to 45 degrees
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9
Chapter 8: Pain and Pain Management
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Sample Questions
Q1) C fibers are small-diameter,unmyelinated fibers that transmit what type of pain?
A) Aching
B) Sharp
C) Prickling
D) Concentrated
Q2) The patient has received ketamine for its analgesic effects.The patient suddenly states,"I feel like I am floating and can see everything you are doing.I am not in control." What is this response called?
A) Hallucination state
B) Guided imagery
C) Dissociative state
D) Adverse event
Q3) Which assessment findings might indicate respiratory depression after opioid administration?
A) Flushed, diaphoretic skin
B) Shallow respirations with a rate of 24 breaths/min
C) Tense, rigid posture
D) Snoring
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10
Chapter 9: Sedation,Agitation,and Delirium Management
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Sample Questions
Q1) A patient is admitted with acute respiratory distress syndrome (ARDS).The patient has been intubated and is mechanically ventilated.The patient is becoming increasingly agitated,and the high-pressure alarm on the ventilator has been frequently triggered.Despite the nurse's actions,the patient continues to be agitated,triggering the high-pressure alarm on the ventilator.Which medication would be appropriate to sedate the patient this time?
A) Midazolam 2 to 5 mg intravenous push (IVP) every 5 to 15 minutes until the patient is no longer triggering the alarm
B) Haloperidol 5 mg IVP stat
C) Propofol 5 mcg/kg/min by IV infusion
D) Fentanyl 25 mcg IVP over a 15-minute period
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
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Chapter 10: End-Of-Life Care
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19 Verified Questions
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Sample Questions
Q1) A patient was admitted to the critical care unit after having a cerebrovascular accident (CVA)and myocardial infarction (MI).The patient has poor activity tolerance,falls in and out of consciousness,and has poor verbal skills.The patient has been resuscitated four times in the past 6 hours.The patient does not have advance directives.Family members are at the bedside.Who should the practitioner approach to discuss decisions of care and possible do-not-resuscitate (DNR)status?
A) Patient
B) Family
C) Hospital legal system
D) Hospital ethics committee
Q2) What is the most common complaint heard from families of dying patients?
A) Poor nursing care
B) Inadequate communication
C) Lack of consistent plan of care
D) Confusion among health care team members
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12
Chapter 11: Cardiovascular Anatomy and Physiology
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Which statement regarding the autonomic nervous system's role in the regulation of heart rate is true?
A) Parasympathetic influences increase heart rate.
B) Sympathetic influences are predominantly present.
C) Parasympathetic influences are only compensatory.
D) Both sympathetic and parasympathetic influences are normally active.
Q2) Which is an example of a physiologic shunt?
A) A ventricular septal defect
B) Blood returning from the inferior vena cava to the right atrium
C) A septal infarct
D) The thebesian vessels returning deoxygenated blood to the left ventricle
Q3) 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
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Chapter 12: Cardiovascular Clinical Assessment
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25 Flashcards
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Sample Questions
Q1) Which statement best describes the purpose of the Allen test?
A) The Allen test assesses the adequacy of blood flow through the ulnar artery.
B) The Allen test evaluates oxygen saturation in the brachial artery.
C) The Allen test assesses the patency of an internal graft.
D) The Allen test determines the size of needle to be used for puncture.
Q2) A patient is admitted with a diagnosis of "rule out myocardial infarction." The patient reports midchest pressure radiating into the jaw and shortness of breath when walking up stairs.What factor influences the amount of history obtained during the admission assessment?
A) Presence of cardiovascular risk factors
B) Prior medical history
C) Presenting symptoms
D) Current medications
Q3) Evaluation of arterial circulation to an extremity is accomplished by assessing which of the following?
A) Homans sign
B) Skin turgor
C) Peripheral edema
D) Capillary refill
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Page 14
Chapter 13: Cardiovascular Diagnostic Procedures
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74 Verified Questions
74 Flashcards
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Sample Questions
Q1) A 55-year-old patient is scheduled for a stress test.What is the estimation of the patient's maximal predicted heart rate?
A) 65 beats/min
B) 155 beats/min
C) 165 beats/min
D) 265 beats/min
Q2) ST segment monitoring for ischemia has gained increasing importance with the advent of thrombolytic therapy.What is the most accurate method for monitoring the existence of true ischemic changes?
A) Biomarkers
B) Echocardiogram
C) 5-lead ECG
D) 12-lead ECG
Q3) What major clinical finding present in a patient with ventricular fibrillation (VF)?
A) Hypertension
B) Bradycardia
C) Diaphoresis
D) Pulselessness
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15
Chapter 14: Cardiovascular Disorders
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34 Verified Questions
34 Flashcards
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Sample Questions
Q1) A patient presents with severe substernal chest pain.The patient exclaims,"This is the most severe pain I have ever felt!" The patient reports that the pain came on suddenly about 2 hours ago and that three sublingual nitroglycerin tablets have not relieved the pain.The 12-lead electrocardiogram (ECG)reveals only the following abnormalities: T-wave inversion in leads I,aVL,V4,and V5; pathologic Q waves in leads II,III,and aVF; ST segment elevation in leads V1,V2,V3,and V4.Which statement is accurate about this patient?
A) This patient has an old lateral wall infarction.
B) This patient is having an inferior wall infarction.
C) This patient is having an acute anterior wall infarction.
D) This patient is having a posterior wall infarction.
Q2) Which clinical manifestations are indicative of left ventricular failure?
A) Cool, pale extremities
B) Jugular venous distention
C) Liver tenderness
D) Weak peripheral pulses
E) Rales
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Page 16
Chapter 15: Cardiovascular Therapeutic Management
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) What is the rationale for administrating a fibrinolytic agent to a patient experiencing acute ST-elevation myocardial infarction (STEMI)?
A) Dilation of the blocked coronary artery
B) Anticoagulation to prevent formation of new emboli
C) Dissolution of atherosclerotic plaque at the site of blockage
D) Restoration of blood flow via lysis of the thrombus
Q2) A patient suddenly develops a wide QRS complex tachycardia.The patient's heart rate is 220 beats/min and regular; blood pressure is 96/40 mm Hg; and respiratory rate is 22 breaths/min,and the patient is awake without complaint except for palpitations.Which of the following interventions would be best to try first?
A) Adenosine 6 mg rapid IV push
B) Lidocaine 1 mg/kg IV push
C) Verapamil 5 mg IV push
D) Digoxin 0.5 mg IV push
Q3) Which finding is a reliable indicator of reperfusion after fibrinolytic therapy?
A) Dysrhythmias
B) Q waves
C) Elevated ST segments
D) Immediate rapid decrease in cardiac biomarkers
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Page 17
Chapter 16: Pulmonary Anatomy and Physiology
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40 Verified Questions
40 Flashcards
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Sample Questions
Q1) What substance do Alveolar type II cells secrete?
A) Trypsin
B) Chyme
C) Amylase
D) Surfactant
Q2) 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%
Q3) The lymphatic system plays which of the following important roles?
A) Ridding lung tissue of excess CO
B) Connecting the thebesian veins to the coronary circulation
C) Removing fluid from the lungs
D) Producing immune responses
E) Removing cell debris from the lungs
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Chapter 17: Pulmonary Clinical Assessment
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30 Verified Questions
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Sample Questions
Q1) A patient is admitted with acute lung failure secondary to emphysema.Percussion of the lung fields will predictably exhibit which tone?
A) Resonance
B) Hyperresonance
C) Tympany
D) Dullness
Q2) The nurse performs inspection of the oral cavity as part of a focused pulmonary assessment to check for evidence of what condition?
A) Hypoxia
B) Dyspnea
C) Dehydration
D) Malnutrition
Q3) The nurse is caring for a patient with respiratory failure.The nurse notes the patient's diaphragmatic excursing is 8 cm.What coexisting conditions could account for this finding?
A) Asthma and emphysema
B) Hepatomegaly and ascites
C) Atelectasis and pleural effusion
D) Pneumonia and pneumothorax
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Page 19
Chapter 18: Pulmonary Diagnostic Procedures
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Sample Questions
Q1) What medication may be included in the preprocedural medications for a diagnostic bronchoscopy?
A) Aspirin for anticoagulation
B) Vecuronium to inhibit breathing
C) Codeine to decrease the cough reflex
D) Cimetidine to decrease hydrochloric acid secretion
Q2) The patient's arterial blood gas (ABG)values on room air are PaO ,40 mm Hg; pH,7.10; PaCO ,44 mm Hg; andHCO ¯,16 mEq/L.What is the interpretation of the patient's ABG?
A) Uncompensated respiratory acidosis
B) Uncompensated metabolic acidosis
C) Compensated metabolic acidosis
D) Compensated respiratory acidosis
Q3) Determination of oxygenation status by oxygen saturation alone is inadequate.What other value must be known?
A) pH
B) PaCO
C)HCO ¯
D) Hemoglobin (Hgb)
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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) Which cause of hypoxemia is the result of blood passing through unventilated portions of the lungs?
A) Alveolar hypoventilation
B) Dead space ventilation
C) Intrapulmonary shunting
D) Physiologic shunting
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 ventilator phase variable initiates the change from exhalation to inspiration?
A) Cycle
B) Trigger
C) Flow
D) Pressure
Q2) Which of the following are complications of endotracheal tubes?
A) Tracheoesophageal fistula
B) Cricoid abscess
C) Tracheal stenosis
D) Tube obstruction
E) Hemorrhage
Q3) The Passy-Muir valve is contraindicated in which patient?
A) A patient who is trying to relearn normal breathing patterns
B) A patient who has minimal secretions
C) A patient with laryngeal or pharyngeal dysfunction
D) A patient who wants to speak while on the ventilator
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Chapter 21: Neurologic Anatomy and Physiology
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Sample Questions
Q1) What is the large opening at the base of the cranium called?
A) Cisterna magna
B) Median foramen
C) Foramen magnum
D) Lateral foramen
Q2) A lack of which two substances can cause disruption in neuronal function and irreversible damage?
A) Oxygen and glucose
B) Protein and insulin
C) Oxygen and protein
D) Protein and glucose
Q3) Which areas of the spinal cord have tenuous blood supply and are especially vulnerable to circulatory embarrassment?
A) C2 to C3
B) C5 to C6
C) T8 to T10
D) L4 to L5
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Chapter 22: Neurologic Clinical Assessment and Diagnostic
Procedures
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49 Verified Questions
49 Flashcards
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Sample Questions
Q1) The nurse is precepting a nursing student.The student asks about testing of extraocular eye movements.What should the nurse tell the student?
A) It tests the pupillary response to light.
B) It tests function of the three cranial nerves.
C) It tests the ability of the eyes to accommodate to a closer moving object.
D) It tests the oculocephalic reflex.
Q2) Indications for the use of electroencephalography (EEG)include
A) cerebral infarct.
B) metabolic encephalopathy.
C) confirmation of brain death.
D) altered consciousness.
E) all head injuries.
Q3) The nurse is caring for a severely head injured comatose patient who is dying.The practitioner asks to be notified when the patient starts to exhibit signs of Cushing reflex.The nurse would call the practitioner when the patient starts to show what signs?
A) Bradycardia, systolic hypertension, and widening pulse pressure
B) Tachycardia, systolic hypotension, and tachypnea
C) Headache, nuchal rigidity, and hyperthermia
D) Bradycardia, aphasia, and visual field disturbances
Page 24
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Chapter 23: Neurologic Disorders and Therapeutic Management
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Sample Questions
Q1) A patient has been admitted post craniotomy for a brain tumor.The nursing management plan should include monitoring the patient for what complication?
A) Diabetes mellitus
B) Fluid retention
C) Intracranial hypotension
D) Surgical hemorrhage
Q2) The extrusion of cerebral tissue through the cranium is what type of herniation?
A) Transcalvarial
B) Uncal
C) Cingulate
D) Transtentorial
Q3) Which nursing intervention will help prevent spikes in intracranial pressure in the post-neurosurgical patient?
A) Keep the head of the bed elevated 45 to 90 degrees.
B) Administer an antiemetic to prevent vomiting.
C) Provide fluid restriction.
D) Help with turn, cough, and deep breathe exercises.
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Page 25
Chapter 24: Kidney Anatomy and Physiology
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Sample Questions
Q1) Which electrolytes are cations?
A) Sodium, potassium, and chloride
B) Sodium, chloride, and bicarbonate
C) Bicarbonate, chloride, and calcium
D) Sodium, potassium, and magnesium
Q2) The following substances,among others,are found in a patient's urine sample: urea,creatinine,sodium,chlorine,potassium,glucose,and bicarbonate ions.Which patient situation could account for this abnormal finding?
A) Blood pressure of 76/30 mm Hg
B) Blood glucose of 456 mg/dL
C) Blood glucose of 40 mg/dL
D) Blood potassium level of 4.1 mEq/L
Q3) What is the functional unit of the kidney called?
A) Bowman capsule
B) Glomerulus
C) Nephron
D) Distal tubule
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Chapter 25: Kidney Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) A patient is admitted in acute heart failure secondary to renal insufficiency.The patient reports that over the past few weeks,his urine output has decreased,and he has developed peripheral edema and ascites.A diagnosis of renal failure is made.The nurse would expect to see elevated values in which laboratory results?
A) Blood urea nitrogen (BUN)
B) Creatinine
C) Glucose
D) Hemoglobin and hematocrit
E) Protein
Q2) Which findings may be present in the patient with significant fluid volume overload?
A) S3 or S4 may develop.
B) Distention of the hand veins will disappear if the hand is elevated.
C) When testing the quality of skin turgor, the skin will not return to the normal position for several seconds.
D) Tachycardia with hypotension may be present.
E) Dependent edema may be present.
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Chapter 26: Kidney Disorders and Therapeutic Management
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Sample Questions
Q1) The nursing management plan for the patient with a urinary drainage catheter would include which interventions to prevent catheter-associated urinary tract infection (CAUTI)?
A) Insert urinary catheters using aseptic techniques.
B) Change the urinary catheter daily.
C) Review the need for the urinary catheter daily and remove promptly.
D) Flush the urinary catheter q8 hours to maintain patency.
E) Avoid unnecessary use of indwelling urinary catheters.
Q2) 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
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28
Chapter 27: Gastrointestinal Anatomy and Physiology
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Sample Questions
Q1) Which layer of the large intestine consists of longitudinal and circular muscles?
A) Serosa layer
B) Muscularis layer
C) Submucosa layer
D) Mucosa layer
Q2) Which organ lies obliquely beneath the cardiac sphincter and above the pyloric sphincter?
A) Esophagus
B) Stomach
C) Duodenum
D) Ileum
Q3) When the ileum is distended,the ileogastric reflex inhibits what process?
A) Gastric absorption
B) Absorption in the jejunum
C) Gastric motility
D) Ileum motility
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Chapter 28: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) A patient was admitted with an abdominal mass.Which assessment technique would the nurse find most useful in detecting this pathologic condition?
A) Percussion
B) Palpation
C) Inspection
D) Auscultation
Q2) A patient has been admitted with ulcerative colitis.Which information from the patient's history would be consistent with this diagnosis?
A) Drug abuse
B) Jewish ancestry
C) Pericardial disease
D) Asian ancestry
Q3) A patient was admitted with pancreatitis.In which order would the nurse perform an assessment of the gastrointestinal system?
A) Inspection, palpation, percussion, auscultation
B) Palpation, percussion, inspection, auscultation
C) Inspection, auscultation, percussion, palpation
D) Palpation, inspection, auscultation, percussion
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Chapter 29: Gastrointestinal Disorders and Therapeutic Management
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Sample Questions
Q1) 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
Q2) 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
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Chapter 30: Endocrine Anatomy and Physiology
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Q1) A patient is brought to the hospital with a major stab wound.After excessive blood loss,the nurse should anticipate what change in the patient's serum osmolality?
A) Increase
B) Decrease
C) Rapid decrease than increase
D) Equal to his or her sodium level
Q2) A patient is receiving total parenteral nutrition (TPN).During rounds the dietitian states that she believes the patient is getting too much glucose.Identify one area in which excess glucose is stored as glycogen.
A) Pancreas
B) Hepatic cells
C) Gallbladder
D) Stomach
Q3) What hormone do the alpha cells of the pancreas secrete?
A) Glucagon
B) Insulin
C) Somatostatin
D) Pancreatic polypeptide hormone
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Chapter 31: Endocrine Clinical Assessment and Diagnostic
Procedures
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Q1) The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes.Which laboratory results would the nurse note confirming this diagnosis?
A) Hemoglobin A C of 3%
B) Absence of ketones in the urine
C) Presence of ketones in the blood
D) Fasting glucose of 105 mg/dL
Q2) A patient has been admitted with abdominal pain.The nurse notes that the patient's fasting blood glucose is 120 mg/dL.Which statement regarding this finding is accurate?
A) This is a normal finding in critically ill patients.
B) This finding is indicative of prediabetes, but another test should be done to confirm.
C) This finding is lower than what the nurse would expect in a patient receiving intravenous fluids.
D) This finding is indicative of diabetic ketoacidosis.
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Chapter 32: Endocrine Disorders and Therapeutic Management
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Q1) Patients discharged with antithyroid medications should be alerted to which potential side effect?
A) Hyperthermia
B) Agranulocytosis
C) Tachypnea
D) Diaphoresis
Q2) A patient with bronchogenic oat cell carcinoma has a drop in urine output.The laboratory reports a serum sodium level of 120 mEq/L,a serum osmolality level of 220 mOsm/kg,and urine specific gravity of 1.035.The nurse suspects the patient may be developing what problem?
A) Diabetes ketoacidosis (DKA)
B) Diabetes insipidus (DI)
C) Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
D) Hyperaldosteronism
Q3) Decreased urine osmolality is a sign of which disorder?
A) Hyperglycemia
B) Diabetes insipidus
C) Thyroid crisis
D) Syndrome of inappropriate secretion of antidiuretic hormone
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Chapter 33: Trauma
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Q1) A patient is admitted with a C5-C6 subluxation fracture.He is able to move his legs better than he can move his arms.The nurse suspects the patient may have which type of injury?
A) Posterior cord syndrome
B) Brown-Séquard syndrome
C) Diffuse axonal injury
D) Central cord syndrome
Q2) A patient developed a hemothorax after a blunt chest trauma.The practitioner inserted a chest tube on the left side,and 1800 mL of blood was evacuated from the chest.The nurse expects that the patient will be taken to surgery for what procedure?
A) Thoracotomy
B) Pericardiocentesis
C) Splenectomy
D) Pneumonectomy
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Chapter 34: Shock,sepsis,and Multiple-Organ Dysfunction Syndrome
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Q1) A nurse is caring for a patient in septic shock due to urinary sepsis.Which pathophysiologic mechanism results in septic shock?
A) Bacterial toxins lead to vasodilation.
B) White blood cells are released to fight invading bacteria.
C) Microorganisms invade organs such as the kidneys and heart.
D) Decreased red blood cell production and fluid loss
Q2) The nurse is caring for a patient with multiple-organ dysfunction syndrome (MODS).The nurse understands that earlier nutritional support is critical for the patient to prevent profound weight loss.Why does this occur in patient MODS?
A) Patient experiences hypometabolism.
B) Patient experiences hypermetabolism.
C) Patient experiences anorexia.
D) Patient has gut dysfunction.
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Chapter 35: Burns
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Q1) Roughly 80% of burns in children are classified as what type of burn?
A) Radiation
B) Chemical
C) Electrical
D) Thermal
Q2) Contracture development leading to impaired physical mobility can occur after a major burn injury.Splints are applied to prevent or correct contractures.Priority nursing interventions concerning this therapy include which action?
A) Daily assessment for proper fit and effectiveness
B) Removal of splints during showers and dressing changes
C) Allowing for frequent breaks from splint use
D) Passive and active range of motion may be used instead of splints
Q3) Which topical antimicrobial agent is commonly used as a broad-spectrum and fights against gram-positive and -negative bacteria?
A) Pure silver
B) Bacitracin
C) Mafenide acetate cream
D) Silver sulfadiazine
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Chapter 36: Organ Donation and Transplantation
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Q1) The Model for End-Stage Liver Disease (MELD)formula is used to calculate risk of 3-month mortality in patients 12 years old or older.What criteria is part of the MELD formula?
A) Whether the patient has undergone hemodialysis at least twice in the past 2 weeks
B) The number of organs in which metastasis has occurred following hepatocellular carcinoma
C) The presence or absence of intractable pruritus
D) The number of hours the patient is expected to live without a transplant
Q2) The nurse is caring for a patient after a lung transplant.Which intervention would be a priority for the nurse?
A) Wean the patient from the ventilator.
B) Maintain hypotensive levels.
C) Start corticosteroid therapy.
D) Initiate pulmonary function studies.
Q3) 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
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Chapter 37: Hematologic and Oncologic Emergencies
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Q1) A patient was admitted with gram-negative sepsis a few days ago.Today the nurse notes continual oozing from intravenous sites and ecchymosis beneath the blood pressure cuff.The patient's platelet count is normal,and international normalized ratio (INR)is elevated.The nurse places highest priority on which treatment goal?
A) Maintain adequate organ perfusion.
B) Suppress antibody response that is destroying platelets.
C) Treat life-threatening metabolic disturbances.
D) Begin hypothermic therapy to prevent cerebral hemorrhage.
Q2) How is the intrinsic coagulation pathway activated?
A) Local blood vessels constrict at the injury site.
B) Damaged subendothelium comes into contact with circulating blood.
C) Tissue factor is released by injured vascular cells.
D) Serotonin and histamine are released.
Q3) What is the most common cause of disseminated intravascular coagulation (DIC)?
A) Sepsis caused by gram-positive organisms
B) Sepsis caused by gram-negative organisms
C) Sickle cell anemia
D) Burns
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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 preeclampsia.The nurse understands that this disorder is characterized by what widespread physiologic changes?
A) Increase in circulating plasma volume
B) Vasospasms in the arterial system
C) Disseminated intravascular coagulation
D) High systemic vascular resistance
Q3) What is the leading cause of cardiac arrest in pregnancy?
A) Sepsis
B) Pregnancy-induced hypertension
C) Hemorrhage
D) Pulmonary embolism
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Page 40
Chapter 39: The Pediatric Patient
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Q1) 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
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 circulating blood volume of a neonate?
A) 40 to 60 mL/kg
B) 75 to 80 mL/kg
C) 80 to 85 mL/kg
D) 65 to 70 mL/kg
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Page 41
Chapter 40: The Older Adult Patient
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Q1) A nurse is teaching an older patient about the signs and symptoms of a myocardial infarction.Which statement by the patient would indicate that the teaching was effective?
A) "The pain in my chest may last a long time."
B) "I will feel like I have an elephant sitting on the center of my chest."
C) "The chest pain will be sharp and over the center of my chest."
D) "The pain may not be severe and may not be in my chest."
Q2) Which factors contribute to diminished wound healing in the older adult?
A) Decreased cytokine production
B) Increased production of growth factor
C) Decreased inflammatory response
D) Decreased glucocorticoid secretion
E) Decreased cell proliferation
Q3) Which age-related changes contribute to a higher risk for myocardial ischemia in an older patient?
A) Increased diastolic filling pressures
B) Decreased intracellular free calcium
C) Thinning of the left ventricular wall
D) Increased myocardial collagen content
E) Increased myocardial oxygen consumption
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Chapter 41: The Perianesthesia Patient
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Q1) 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
Q2) 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
Q3) When a patient emerges in a very restless state,what is the first problem the nurse must suspect?
A) Anxiety
B) Hypoxia
C) Pain
D) Gastric distention
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