What type of medication is to help maintain open alveoli for a patient with ARDs?

What is a part of the physical health of assessment for ARDs?

The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which findings with the nurse expect the note on assessment of this client?

The nurse is caring for a client who is mechanically ventilated and is monitoring for complications of mechanical ventilation. Which assessment finding, if noted by the nurse, indicates the need for follow-up?

The nurse has assisted the health care provider and the anesthesiologist with placement of an endotracheal (ET) tube for a client in respiratory distress. What is the initial nursing action to evaluate proper ET tube placement?

The low-pressure alarm sounds on a ventilator. The nurse assesses the client and then attempts to determine the cause of the alarm. If unsuccessful in determining the cause of the alarm, the nurse should take what initial action?

The nurse is caring for the client requiring positive pressure mechanical ventilation. The client has been resisting the ventilator-assisted breaths, and the client’s BP has been steadily decreasing. Which intervention should the nurse implement?

The nurse is caring for the client whose condition has progressed from an acute lung injury from near-drowning to ARDS. Which intervention should the nurse question with the HCP?

What does the nurse do first when setting up a safe environment for the new client on oxygen?

A client with asthma has pneumonia, is reporting increased shortness of breath, and has inspiratory and expiratory wheezes. All of these medications are prescribed. Which medication should the nurse administer first?

A client is being admitted for pneumonia. The sputum culture is positive for streptococcus, and the client asks about the length of the treatment. On what does the nurse base the answer?

The nurse is caring for a client who is being discharged after recovering from acute respiratory distress syndrome (ARDS). The family asks if the client is out of danger and if normal activities can be resumed. Which of the following will the nurse explain to the client and family?

Which of these nursing actions included in the care of a mechanically ventilated patient with acute respiratory distress syndrome (ARDS) is most appropriate for the RN to delegate to an experienced LPN/LVN working in the intensive care unit?

Which is part of the nursing management for ARDS?

A client is diagnosed with acute renal failure. Which signs and symptoms indicate to the nurse the client is in the recovery period? Select all that apply

A client is diagnosed with acute renal failure is admitted to the ICU, placed on a therapeutic diet. Which is most appropriate?

The nurse in the dialysis center is initiating the morning dialysis run, which client should the nurse see first?

You're developing a nursing care plan for a patient in the diuresis stage of AKI. What nursing diagnosis would you include in the care plan?

A patient with acute renal injury has a GFR of 40 mL/min. Which signs and symptoms below may this patient present with? Select all that apply

A 45 year old male patient is admitted with a massive GI bleed. Which type of acute kidney injury is the patient at risk for?

During the assessment of a patient with an AKI you note that the creatinine is 3 times the normal level. What stage of renal injury is this patient in?

8. During which phase of a AKI is the urine production less the 400 mL per day?

Which labs are used to assess the kidney function? (Select all that apply)

What are some causes of Metabolic Acidosis? SATA

A nurse is working in ED and is assigned to care for the clients in examination rooms 1, 2 and 3. Which pt does the nurse see first after getting this in report?

While educating a group of nursing students about the stages of acute kidney injury, a student asks how long the oliguric stage lasts. You explain to the student this stage can last?

A patient with a kidney stone explains that the pain he is experiencing is intense, sharp, and wavelike that radiates to the scrotum. In addition, he explains it feels like he has to void but a only a small amount of urine is passed. Based on the patient’s signs and symptoms, where may the kidney stone be located?

Renal Papilla

Which patient is experiencing partially compensated respiratory acidosis?

A 60-year old African American patient is newly diagnosed with mild chronic kidney disease (stage 2). She has a history of diabetes, and her current A1C is 8.0%. She asks the nurse whether any of the following factors could have caused this problem. Which factor should the nurse indicate may have influenced the development of CKD?

The nurse has completed client teaching with the hemodialysis client about self-monitoring between hemodialysis treatments. The nurse determines that the client best understands the information if the client states to record daily the:

The nurse is preparing to care for a client receiving peritoneal dialysis. Which of the following would be included in the nursing plan of care to prevent the major complication associated with peritoneal dialysis?

A client newly diagnosed with renal failure has just been started on peritoneal dialysis. During the infusion of the dialysate, the client complains of abdominal pain. Which action by the nurse is appropriate?

A client is undergoing diagnostic tests to rule out a diagnosis of renal disease. The lab results indicate a ratio of BUN to creatinine of 15:1. The nurse determines that this result indicates:

Which statement by a patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective?

Which patient information will the nurse plan to obtain in order to determine the effectiveness of the prescribed calcium carbonate (Caltrate) for a patient with chronic kidney disease (CKD)?

A client with chronic renal failure has completed a hemodialysis treatment. The nurse would use which of the following standard indicators to evaluate the client’s status after dialysis?

The nurse is caring for a client with rule-out ARF. Which condition predisposes the client to developing prerenal failure?

)The client is diagnosed with ARF. Which signs/symptoms indicate to the nurse the client is in the recovery period? Select all that apply.

______________ is solely filtered from the bloodstream via the glomerulus and is NOT reabsorbed back into the bloodstream but is excreted through the urine.

Which assessment finding is commonly found in the oliguric phase of acute kidney injury (AKI)?

Important nursing interventions for the patient with AKI are (select all that apply).

Patients with CKD have an increased incidence of cardiovascular disease related to (select all that apply).

What are the main advantages of peritoneal dialysis compared to hemodialysis?

A client with chronic renal failure has a serum potassium of 6.6 mEq/L. The nurse should anticipate an orde~r for:

The nurse discusses plans for future treatment options with a client with chronic kidney disease. Which treatment should be included in this discussion? Select all that apply.

The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. Which actions should the nurse take? Select all that apply.

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is the priority nursing action?

14)The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse should assess the client during dialysis for which associated manifestations?

The nurse is creating a plan of care for a client with chronic kidney disease and uremia. The nurse is developing interventions to assist in promoting an increased dietary intake while at the same time maintaining necessary dietary restrictions. Which action should the nurse include in the plan of care?

Patients experiencing chest pain with complaints of fatigue or weakness usually are medicated with which of the following types of medication?

Which of the following diagnostic tests would help diagnose a myocardial infarction?

Along with crushing chest pain, what other symptoms would a patient experience?

A patient is complaining of chest pain. You obtain a 12-lead EKG and see ST elevation in leads II, III, AVF. What area of the heart does this represent?

Which of the following EKG changes are abnormal findings that may indicate ischemia or injury to the cardiac muscle found on a 12-lead EKG? (SELECT-ALL-THAT-APPLY)

The nurse is calculating the cardiac output for a client with a heart rate of 88 beats per minute. What other measurements does the nurse need to complete this calculation?

A patient's morning lab work shows a potassium level of 6.3. The patient’s potassium level yesterday was 4.0 The patient was recently started on new medications for treatment of myocardial infarction. What medication below can cause an increased potassium level?

. A patient recovering from a myocardial infarction is complaining of the taste of blood in their mouth. On assessment, you note there is bleeding on the anterior gums. Which medication can cause this?

On an EKG, the lateral view of the heart is represented with leads?

A patient is admitted with chest pain to the ER. The patient has been in the ER for 5 hours and is being admitted to your unit for overnight observation. From the options below, what is the most IMPORTANT information to know about this patient at this time?

Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply:

Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply:*

The patient diagnosed with rule-out myocardial infarction is experiencing chest pain while walking to the bathroom. What action should the nurse implement first?

The client diagnosed with a myocardial infarction is six hours post-right femoral percutaneous transluminal coronary angioplasty (PTCA), also known as balloon surgery. Which assessment data would require immediate intervention by the nurse?

The intensive care department nurse is assessing the client who is 12 hours post-myocardial infarction. The nurse assesses an S3 heart sound. Which intervention should the nurse implement?

The nurse is administering a calcium channel blocker to the client diagnosed with a myocardial infarction. Which assessment data would cause the nurse to question administering this medication?

The client diagnosed with a myocardial infarction asks the nurse, "why do I have to rest and take it easy? My chest doesn't hurt anymore." Which statement would be the nurse's best response?

Your patient’s blood pressure is 72/56, heart rate 126, and respiration 24. The patient has a fungal infection in the lungs. The patient also has a fever, warm/flushed skin, and is restless. You notify the physician who suspects septic shock. You anticipate that the physician will order what treatment FIRST?

A patient is at risk for septic shock when a microorganism invades the body. Which microorganism is the MOST common cause of sepsis?

A patient in septic shock is experiencing hyperglycemia. The patient is started on an insulin drip. A blood glucose goal for this patient would be:

Your patient, who is post-op from a gastrointestinal surgery, is presenting with a temperature of 103.6 'F, heart rate 120, blood pressure 72/42, increased white blood cell count, and respirations of 21. An IV fluid bolus is ordered STAT. Which findings below indicate that the patient is progressing to septic shock? Select all that apply:*

A patient with a fever is lethargic and has a blood pressure of 89/56. The patient’s white blood cell count is elevated. The physician suspects the patient is developing septic shock. What other findings indicate this patient is in the “early” or “compensated” stage of septic shock? Select all that apply:

The physician orders a patient in septic shock to receive a large IV fluid bolus. How would the nurse know if this treatment was successful for this patient?

A patient is on IV Norepinephrine for treatment of septic shock. Which statement is FALSE about this medication?

Your patient, who is post-op from a kidney transplant, has developed septic shock. Which statement below best reflects the interventions you will perform for this patient?

The healthcare provider is caring for a patient who has septic shock. Which of these should the healthcare provider administer to the patient first?

A client has been diagnosed with sepsis. The nurse will most likely find which of the following when assessing this client: Select all that apply:

An intensive care nurse, is assessing a patient with suspected sepsis. Which predisposing factors would expect to be found in the patient with septic shock?

A patient in septic shock has not responded to fluid resuscitation, as evidenced by a decreasing BP and cardiac output. The nurse anticipates the administration of:

The nurse is caring for a patient admitted with a urinary tract infection and sepsis. Which information obtained in the assessment indicates a need for a change in therapy?

When caring for a patient who has just been admitted with septic shock, which of these assessment data will be of greatest concern to the nurse?

Which medication below can be used within the first 24-48 hours of septic shock and provides anti-inflammatory and antithrombotic effects?

Which nurse should be assigned to care for an intubated client who has septic shock as the result of a methicillin-resistant Staphylococcus aureus (MRSA) infection?

A client recovering from an open reduction of the femur suddenly feels light-headed, with increased anxiety and agitation. Which key vital sign differentiates a pulmonary embolism from early sepsis?

A postoperative client is admitted to the intensive care unit with hypovolemic shock. Which nursing action does the nurse delegate to an experienced nursing assistant?

A patient with a fever is lethargic and has a blood pressure of 89/56. The patient’s white blood cell count is elevated. The physician suspects the patient is developing septic shock. What other findings indicate this patient is in the "early" or "compensated" stage of septic shock?

Select all that apply:

The nurse plans to administer an antibiotic to a client newly admitted with septic shock. What action does the nurse take first?

A patient in septic shock receives large amounts of IV fluids. However, this was unsuccessful in maintaining tissue perfusion. As the nurse, you would anticipate the physician to order what NEXT?

A patient who is in shock will be intubated and placed on mechanical ventilation. How should the nurse explain the benefits of these actions to his family?

Select all that apply:

A patient with a severe infection has developed septic shock. The patient’s blood pressure is 72/44, heart rate 130, respiration 22, oxygen saturation 96% on high-flow oxygen, and temperature 103.6 °F. The patient’s mean arterial pressure (MAP) is 53 mmHg. Based on these findings, you know this patient is experiencing diminished tissue perfusion and needs treatment to improve tissue perfusion to prevent organ dysfunction. In regards to the pathophysiology of septic shock, what is occurring in the body that is leading to this decrease in tissue perfusion?

9)Your patient, who is post-op from a gastrointestinal surgery, is presenting with a temperature of 103.6 °F, heart rate 120, blood pressure 72/42, increased white blood cell count, and respirations of 21. An IV fluid bolus is ordered STAT. Which findings below indicate that the patient is progressing to septic shock?

Your patient's blood pressure is 72/56, heart rate 126, and respiration 24. The patient has a fungal infection in the lungs. The patient also has a fever, warm/flushed skin, and is restless. You notify the physician who suspects septic shock. You anticipate that the physician will order what treatment FIRST?*

Your patient, who is post-op from a kidney transplant, has developed septic shock. Which statement below best reflects the interventions you will perform for this patient?

Which patients are at risk for shock related to fluid shifts?

SELECT ALL THAT APPLY:

The nurse is caring for a patient with sepsis. What is a late clinical manifestation of shock?

The nurse is caring for a patient at risk for septic shock from a wound infection. In order to prevent systemic inflammatory response syndrome, the nurse’s priority is to monitor which factor?

The nurse is caring for a patient in septic shock. The nurse notes that the rate and depth of respirations is markedly increased. The nurse interprets this as a possible manifestation of the respiratory system compensating for which condition?

A patient comes into the emergency department with a chemical burn from contact with lye. Assessment and treatment of this patient will be based on what knowledge regarding this type of burn? Select all that apply

A patient, experiencing a burn that is pale and waxy with large flat blisters, asks the nurse about the severity of the burn and how long it will take to heal. With which of the following should the nurse respond to this patient?

A 25-year-old patient is admitted with partial-thickness injuries over 20% of the total body surface area involving both lower legs. The nurse would classify this injury as being what type of burn?

A patient is being evaluated after experiencing severe burns to his torso and upper extremities. The nurse notes edema at the burned areas. Which of the following best describes the underlying cause for this assessment finding?

A patient with a burn injury is prescribed silver nitrate. Which of the following nursing interventions should be included for the patient? Select all that apply

An adult client was burned in an explosion. The burn initially affected the entire face/anterior half of the forehead, upper half of the anterior torso, and circumferential burns to the lower half of both arms. Burned clothing caused subsequent burns to the posterior head and upper half of posterior torso. Using the rule of nines, what would be the extent of the burn injury?

The nurse is preparing to care for a burn client scheduled for an escharotomy procedure for a third-degree circumferential arm burn. The nurse understands that which finding is the anticipated therapeutic outcome of this procedure?

A client is undergoing fluid replacement after a 20% BSA burn obtained 12 hours prior. On assessment, the patient’s vital signs are a BP 90/50, pulse 110, and urine output 20 mL in the last hour. The nurse informs the primary provider and anticipates which prescription?

A patient is brought to the ER with partial-thickness burns to his face, neck, arms, and chest after trying to put out a campfire. Which of the following nursing actions should be instituted? Select all that apply

A nurse is caring for a patient who sustained superficial partial-thickness burns to the anterior portion of her right lower leg and anterior thorax. Which finding does the nurse expect to find during the resuscitation/emergent phase of the burn injury?

The nurse should expect to apply which type of ordered antiseptic to a client with a burn wound, once the area has been cleansed with sterile saline?

Multiple patients arrive in the emergency department from a house fire. Which patient is a priority?

When assessing a patient with a partial-thickness burn, the nurse would expect to find? Select all that apply

A patient is admitted to the emergency department with first- and second-degree burns after being involved in a house fire. Which of the following assessment findings would alert you to the presence of an inhalation injury (select all that apply)?

A patient who has been severely burned in an accident is brought to the emergency department. The physician orders a regimen to begin fluid resuscitation. Which type of fluid would the nurse most likely use as part of fluid resuscitation following a burn injury?

The newly admitted patient has a large burn area on her trunk. The burned area appears red, has blisters, and is very painful. How should this injury be categorized?

Which information obtained by the assessment ensures that the patient's respiratory efforts are currently adequate?

The burned patients family asked at what point will the patient no longer be at increased risk for infection. What is the nurse's best response?

A patient is brought into the emergency department after suffering from third degree burns in an explosion. The patient has burns on approximately 40 percent of his body. The nurse weighs the patient and notes that he weighs 166 lbs. Calculate the volume of IV fluid this patient must receive in the first 24 hours using the Parkland formula.

How do you manage burn blisters? (Select all that apply)

In order for the nurse to correctly classify a burn injury, which of the following does the nurse need to assess? (Select all that apply)

A patient has experienced a burn injury. Which of the following interventions by the nurse is the highest priority at this time?

Which laboratory result obtained on a client 24 hours post-burn injury would the nurse report to the physician immediately?

The nurse is assessing a patient with a burn wound to the back and chest area. Which assessment findings are consistent with a superficial-thickness burn wound (Select all that apply)

The nurse is reviewing arterial blood gas (ABG) results for a patient with 35% TBSA the burn in the resuscitation phase: pH is 7.26; Pco2 is 36 mm Hg; and HCO3 is 19 meq/L. What condition does the nurse suspect the patient has?

A patient was burned on the forearm after tripping and falling against a wood-burning stove. There are currently several small blisters over the burn area. What does the nurse advise the patient to do about the blisters?

On admission to the burn unit, a patient with an approximate 25 % total body surface area (TBSA) burn has the following initial laboratory results: Hct 56%, Hb 17.2 mg/dlm serum K+ 4.8 mEq/L and serum Na+ 135 mEq/L. Which action with the nurse anticipate taking

Which of the following patients will be evaluated for transfer to a burn center? (Select all that apply)

A patient has been brought in to the emergency department with 2nd and 3rd degree burns over 40 percent of his body. Which medications does the nurse anticipate to use for the GI response to the burn injury? (Select all that apply)

The nurse is caring for a client who has just been admitted to the ED after receiving burns to the face and chest. The nurse notes a hoarse cough and black flecks in the sputum. The client suddenly becomes restless and pale. The nurse should suspect?

The nurse is caring for a client who goes into ventricular tachycardia. Which intervention should the nurse implement first?

The client comes to the emergency department saying, "I am having a heart attack." Which question is most pertinent when assessing the client?

The client is 3 hours post-myocardial infarction. Which data would warrant immediate intervention by the nurse?

What is the first intervention for a client experiencing MI?

What is the primary reason for administering morphine to a client with an MI?

A doctor has ordered cardiac enzymes on a patient being admitted with chest pain. You know that _____________ levels elevate 2-4 hours after injury to the heart and is the most regarded marker by providers.

You’re educating a patient about the causes of a myocardial infarction. Which statement by the patient indicates they misunderstood your teaching and requires you to re-educate them?

You note in the patient’s chart that the patient recently had a myocardial infarction due to a blockage in the left coronary artery. You know that which of the following is true about this type of blockage?

A patient is complaining of chest pain. You obtain a 12-lead EKG and see ST elevation in leads II, III, AVF. What area of the heart does this represent?

Which of the following EKG changes are abnormal findings that may indicate ischemia or injury to the cardiac muscle found on a 12-lead EKG? SELECT-ALL-THAT-APPLY:*

A patient is being discharged home after receiving treatment for a myocardial infarction. The patient will be taking Coreg. What statement by the patient demonstrates they understood your education material about this drug?*

A patient is 36 hours status post a myocardial infarction. The patient is starting to complain of chest pain when they lay flat or cough. You note on auscultation of the heart a grating, harsh sound. What complication is this patient mostly likely suffering from?*

A patient is admitted with chest pain to the ER. The patient has been in the ER for 5 hours and is being admitted to your unit for overnight observation. From the options below, what is the most IMPORTANT information to know about this patient at this time?

A patient taking Lovenox is having a severe reaction. What is the antidote for this medication?

A patient is complaining of a nagging cough that is continuous. Which medication below can cause this side effect?

A client with myocardial infarction is developing cardiogenic shock. Because of the risk of myocardial ischemia, what condition should the nurse carefully assess the client for?

A client with myocardial infarction suddenly becomes tachycardia, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. Which finding would the nurse anticipate when auscultating the client’s breath sounds?

A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia?

Which of the following patients are MOST at risk for developing pneumonia? Select all that apply:

You’re caring for a patient with pneumonia. The patient has just started treatment for pneumonia and is still experiencing hypoxemia. You know that respiratory acidosis is very common in patients with pneumonia. Which arterial blood gas reading below represent respiratory acidosis that is NOT compensated?

Which of the following are typical signs and symptoms of pneumonia? Select all that apply:

A 72-year-old male patient who is diagnosed with bilateral lower lobe pneumonia is admitted to your unit. The patient has a history of systolic heart failure and arthritis. On assessment, you note the patient has a respiratory rate of 21, oxygen saturation 93% on 2 L nasal cannula, is alert & oriented, and has a productive cough with green/yellowish sputum. Which of the following nursing interventions will you provide to this patient based on your assessment findings and the patient’s diagnosis? Select all that apply:

You’re providing discharge teaching to a patient who was admitted for pneumonia. You are discussing measures that patient can take to prevent pneumonia. Which of the following statements by the patient indicates they did NOT understand your education material?

Select all the medications used to treat pneumonia that are narrow-spectrum?

You are about to hang a bag of intravenous Vancomycin for a patient who has severe pneumonia. Which statement by the patient causes you to hold the bag of Vancomycin and notify the doctor immediately?

You’re providing care to a patient who is being treated for aspiration pneumonia. The patient is on a 100% non-rebreather mask. Which finding bwlow is a HALLMARK sign and symptom that the patient is developing acute respiratory distress syndrome (ARDS).

During the exudative phase of acute respiratory distress syndrome (ARDS), the patient’s lung cells that produce surfactant have become damaged. As the nurse you know this will lead to?

You’re providing care to a patient who was just transferred to your unit for the treatment of ARDS. The patient is in the exudative phase. The patient is ordered arterial blood gases. The results are back. Which results are expected during this early phase of acute respiratory distress syndrome that correlates with this diagnosis?

A patient is on mechanical ventilation with PEEP (positive end-expiratory pressure). Which finding below indicates the patient is developing a complication related to their therapy and requires immediate treatment?

You are caring for a patient with acute respiratory distress syndrome. As the nurse you know that prone positioning can be beneficial for some patients with this condition. With findings below indicate this type of positioning was beneficial for your patient with ARDS?

You’re precepting a nursing student who is assisting you care for a patient on mechanical ventilation with PEEP for treatment of ARDS. The student asks you why the PEEP setting is at 10 mmHg. Your response is:

A patient has been intubated and placed on a volume-cycled mechanical ventilator. The nurse carefully assesses the patient for findings associated with a risk associated with this type of ventilator. What is that risk?

A patient’s ventilator settings were changed as follows: tidal volume increased from 450 mL to 500 mL and rate increased from 14 breaths to 16 breaths per minute. What ABG change would the nurse anticipate?