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Worksheets

Finals

Total questions: 121

Worksheet time: 2hrs 31mins

Name
Class
Date
1.

Which of these descriptions by the patient is most typical pf the pain associated with acute MI?

a)

I have has severe chest pain that is worse when i take a deep breath

b)

I had severe chest pain that got better after i sat down and took my NTG

c)

I have had steady pressure in my chest for over half an hour

d)

I have a sharp chest pain that is better after I eat

 

2.

(Match) Levothyroxine

a)

T4 hormone replacement

b)

Synthetic aldosterone

c)

anti-dysrhythmic

d)

Proton pump inhibitor

e)

Calcium Channel Blocker

3.

(Match) Florinef

a)

Laxative

b)

Proton pump inhibitor

c)

Synthetic aldosterone

d)

anti-dysrhythmic

e)

T4 hormone replacement

4.

(Match) Amiodarone

a)

Synthetic aldosterone

b)

anti-dysrhythmic

c)

Proton pump inhibitor

d)

Calcium Channel Blocker

e)

Laxative

5.

(Match) Pantoprazole

a)

Laxative

b)

T4 hormone replacement

c)

Calcium Channel Blocker

d)

Proton pump inhibitor

e)

Synthetic aldosterone

6.

(Match) Nimodipine

a)

Calcium Channel Blocker

b)

Synthetic aldosterone

c)

anti-dysrhythmic

d)

T4 hormone replacement

e)

Laxative

7.

(Match) Lactulose

a)

anti-dysrhythmic

b)

Laxative

c)

Calcium Channel Blocker

d)

Synthetic aldosterone

e)

T4 hormone replacement

8.

Match: Correct PRESSURE with correct region (2-10mmhg)

a)

Pulmonary artery pressure

b)

MAP

c)

Right atrial pressure (CVP)

d)

Pulmonary Capillary wedge pressure

 

9.

Match: Correct PRESSURE with correct region (8-12mmhg)

a)

Right atrial pressure (CVP)

b)

MAP

c)

Pulmonary artery pressure

d)

Pulmonary Capillary wedge pressure

 

10.

Match: Correct PRESSURE with correct region (80-100mmhg)

a)

Right atrial pressure (CVP)

b)

MAP

c)

Pulmonary artery pressure

d)

Pulmonary Capillary wedge pressure

 

11.

Match: Correct PRESSURE with correct region (20-30/5-15mmhg)

a)

Right atrial pressure (CVP)

b)

MAP

c)

Pulmonary artery pressure

d)

Pulmonary Capillary wedge pressure

 

12.

Matching Treatment of type of shock:

Afterload reduction

a)

Cardiogenic shock

b)

Hemorrhagic shock

c)

Anaphylactic shock

d)

Septic shock

13.

Matching Treatment of type of shock:

Transfusion

a)

Cardiogenic shock

b)

Hemorrhagic shock

c)

Anaphylactic shock

d)

Septic shock

14.

Matching Treatment of type of shock:

Epinephrine

a)

Cardiogenic shock

b)

Hemorrhagic shock

c)

Anaphylactic shock

d)

Septic shock

15.

Matching Treatment of type of shock:

Anti-infectives

a)

Cardiogenic shock

b)

Hemorrhagic shock

c)

Anaphylactic shock

d)

Septic shock

16.

Match following ABGs with appropriate acid-base imbalance:

pH: 7.50 CO2: 26 O2: 98 bicarb: 24

a)

Metabolic acidosis

b)

Respiratory alkalosis

c)

Respiratory acidosis

d)

Metabolic alkalosis

e)

Mixed Respiratory and metabolic

17.

Match following ABGs with appropriate acid-base imbalance:

pH: 7.21 CO2: 60 O2: 76 bicarb: 26

a)

Metabolic acidosis

b)

Respiratory alkalosis

c)

Respiratory acidosis

d)

Metabolic alkalosis

e)

Mixed Respiratory and metabolic

18.

Match following ABGs with appropriate acid-base imbalance:

pH: 7.20 CO2: 36 O2: 80 bicarb: 10

a)

Metabolic acidosis

b)

Respiratory alkalosis

c)

Respiratory acidosis

d)

Metabolic alkalosis

e)

Mixed Respiratory and metabolic

19.

Match following ABGs with appropriate acid-base imbalance:

pH: 7.52 CO2: 40 O2: 88 bicarb: 38

a)

Metabolic acidosis

b)

Respiratory alkalosis

c)

Respiratory acidosis

d)

Metabolic alkalosis

e)

Mixed Respiratory and metabolic

20.

Match following ABGs with appropriate acid-base imbalance:

pH: 7.54 CO2: 22 O2: 92 bicarb: 32

a)

Metabolic acidosis

b)

Compensated respiratory alkalosis

c)

Respiratory acidosis

d)

Metabolic alkalosis

e)

Mixed Respiratory and metabolic

21.

Match following ABGs with appropriate acid-base imbalance:

pH: 7.43 CO2: 33 O2: 86 bicarb: 19

a)

Metabolic acidosis

b)

Compensated respiratory alkalosis

c)

Respiratory acidosis

d)

Metabolic alkalosis

e)

Mixed Respiratory and metabolic

22.

Match the Dysrhythmia with correct definition:

Ventricular tachycardia

a)

Irregular rhythm with no 

b)

Abnormal and rapid heart rate

c)

Regular P waves and regular

d)

Heart rate of 50 BPM

23.

Match the Dysrhythmia with correct definition:

3rd degree heart block

a)

Irregular rhythm with no 

b)

Abnormal and rapid heart rate

c)

Regular P waves and regular

d)

Heart rate of 50 BPM

24.

Match the Dysrhythmia with correct definition:

Junctional rhythm

a)

Irregular rhythm with no 

b)

Abnormal and rapid heart rate

c)

Regular P waves and regular

d)

Heart rate of 50 BPM

25.

Match the Dysrhythmia with correct definition:

Atrial fibrillation

a)

Irregular rhythm with no 

b)

Abnormal and rapid heart rate

c)

Regular P waves and regular

d)

Heart rate of 50 BPM

26.

Match the abnormal lab value with disease it effects:

Low calcium

a)

myocardial infarction

b)

diabetes mellitus

c)

acute pancreatitis

d)

cirrhosis

e)

end stage renal disease

27.

Match the abnormal lab value with disease it effects:

Elevated troponin

a)

myocardial infarction

b)

diabetes mellitus

c)

acute pancreatitis

d)

cirrhosis

e)

end stage renal disease

28.

Match the abnormal lab value with disease it effects:

Elevated transaminase

a)

myocardial infarction

b)

diabetes mellitus

c)

acute pancreatitis

d)

cirrhosis

e)

end stage renal disease

29.

Match the appropriate Nursing Dx problem to the disease process associated: Impaired gas exchange

a)

Cardiogenic shock

b)

ARDS

c)

Acute subdural hematoma

d)

Acute Kidney Injury

e)

3rd degree burn

30.

Match the abnormal lab value with disease it effects:

Hyperglycemia

a)

myocardial infarction

b)

diabetes mellitus

c)

acute pancreatitis

d)

cirrhosis

e)

end stage renal disease

31.

Match the abnormal lab value with disease it effects:

Low hemoglobin

a)

myocardial infarction

b)

diabetes mellitus

c)

acute pancreatitis

d)

cirrhosis

e)

end stage renal disease

32.

Match the abnormal lab value with disease it effects:

Elevated ACTH

a)

pituitary tumor

b)

diabetes mellitus

c)

Pulmonary embolism

 

d)

Addison disease

e)

end stage renal disease

33.

Match the abnormal lab value with disease it effects:

Low cortisol

a)

pituitary tumor

b)

diabetes mellitus

c)

Pulmonary embolism

 

d)

Addison disease

e)

end stage renal disease

34.

Match the abnormal lab value with disease it effects:

Elevated D-Dimer

a)

pituitary tumor

b)

diabetes mellitus

c)

Pulmonary embolism

 

d)

Addison disease

e)

end stage renal disease

35.

Match the appropriate Nursing Dx problem to the disease process associated: Decreased tissue perfusion

a)

Cardiogenic shock

b)

ARDS

c)

Acute subdural hematoma

d)

Acute Kidney Injury

e)

3rd degree burn

36.

Match the appropriate Nursing Dx problem to the disease process associated: Altered mental status

a)

Cardiogenic shock

b)

ARDS

c)

Acute subdural hematoma

d)

Acute Kidney Injury

e)

3rd degree burn

37.

Match the appropriate Nursing Dx problem to the disease process associated: Excessive fluid volume

a)

Cardiogenic shock

b)

ARDS

c)

Acute subdural hematoma

d)

Acute Kidney Injury

e)

3rd degree burn

38.

Match the appropriate Nursing Dx problem to the disease process associated: Impaired skin integrity

a)

Cardiogenic shock

b)

something shock

c)

Acute subdural hematoma

d)

Acute Kidney Injury

e)

3rd degree burn

39.

Match the appropriate Nursing Dx problem to the disease process associated:

Fluid volume deficit

a)

Cardiogenic shock

b)

something shock

c)

Acute subdural hematoma

d)

Acute Kidney Injury

e)

3rd degree burn

40.

Match classifications of head injuries with characteristics of each:

Subarachnoid hemorrhage

a)

Traumatic sheering injury

b)

Signs include meningeal irritation

c)

Accumulation of blood

d)

Clinical signs include CSF

41.

Match classifications of head injuries with characteristics of each:

Basilar skull fracture

a)

Traumatic sheering injury

b)

Signs include meningeal irritation

c)

Accumulation of blood

d)

Clinical signs include CSF

42.

Match classifications of head injuries with characteristics of each:

Diffuse axonal injury

a)

Traumatic sheering injury

b)

Signs include meningeal irritation

c)

Accumulation of blood

d)

Clinical signs include CSF

43.

Match classifications of head injuries with characteristics of each:

Acute subdural hematoma

a)

Traumatic sheering injury

b)

Signs include meningeal irritation

c)

Accumulation of blood

d)

Clinical signs include CSF

44.

You are caring for a patient on a nitroglycerine drip. The physician orders the infusion to be titrated for pain management. You decide to start the infusion at 50mcg/min. Pharmacy mixes a drip of 50 mg in 250ml D5w. What will you set the pump at?

a)

50ml/hr

b)

40ml/hr

c)

15ml/hr

d)

5ml/hr

45.

An acute MI will have which of the following effects on heart function?

a)

Decreased cardiac contractility

b)

Increased cardiac output

c)

Increased ejection fraction

d)

Decreased myocardial irritability

46.

Post resuscitation from cardiac arrest, the physican orders hypothermia treatment to be initiated. The nurse knows that the purpose for this therapy is to:

a)

Prevent the need for coronary bypass surgery

b)

Decrease the incidence of ventricular dysrhythmias

c)

Increase coronary artery perfusion

d)

Maintain perfusion to the cerebral tissues

47.

You have received a patient post PCI to your unit. After 2 hours, he starts to complain of severe mid-back pain, his heart rate is elevated and blood pressure is starting to drop. You would notify the primary care provider suspecting which of the following complications?

a)

Acute kidney injury

b)

Atrial fibrillation

c)

internal bleeding

d)

Infection

48.

An ICD/Pacemaker will have which of the following capabilities?

a)

Synchronized cardioversion

b)

Apnea alert

c)

Defibrillation

d)

Continuous non-pulsatile flow

49.

Your patient has just returned post-insertion of a permanent pacemaker. When you examine the telemetry strip, you note the following rhythm strip. Which of the following interpretations would be correct to report to the physician?

a)

The rate is set too fast

b)

There is failure to sense

c)

There is failure to capture

d)

Overdrive pacing is occurring

50.

Your patient's Cardiac index has been calculated at 3.5 L/min/cm2. Which treatment modality would the nurse expect based on this finding?

a)

Increase afterload with a vasopressor

b)

None-this is normal value

c)

Increase contractility with an inotrope

d)

Decrease preload with a diuretic

51.

What is the rationale for monitoring mixed venous oxygen saturation (SVO2) in the management of the critically ill patient?

a)

It will assess the diffusion at gases at the alveolar capillary membrane

b)

It estimates myocardial workload during heart failure and acute pulmonary edema

c)

It can detect an imbalance of oxygen supply and metabolic tissue demand.

d)

It indicates oxygen saturation pressures at the capillary level.

52.

When considering the complications of nursing diagnosis of "risk for dysrhythmias" for acute MI patient, you should consider calling the primary care provider if

a)

the heart rate dropped from 116 to 72 best per minute

b)

the patient reports SOB with moderate exertion

c)

You note the chest x-ray reports basilar ateletactis 

d)

Lab calls you with potassium level of 3.1

 

53.

Your patient has been admitted with an acute MI, you are seeing the following hemodynamic value the monitor: PAP32/21 PCWP 19: CO 3.1 CI: 1.5 These values indicate which of the following

a)

cor pulmonaire 

b)

Left-ventricular failure

c)

Hypovolemia

d)

Pulmonary embolism

54.

Which of the following are sued to confirm a diagnosis of acute MI?

a)

history, 12 lead EKG, Cardiac enzymes

b)

Chest pain characteristic an SOB

c)

Cardiac enzymes, cardiac output electrolytes

d)

Hemodynamic measurements with Swan Ganz Catheter

55.

Common medications used in the treatment of the patient with heart failure includes:

a)

Diuretics, beta blockers, inotropes

b)

Adrenergic agonists, sedatives, and antidysrhythmic

c)

Anticholinergics, ACE inhibitors, and calcium channel blockers

d)

Beta blockers, sedatives-vasopressors

56.

You have been assigned a 58 year old male patient who has admitted to the CCU from the ED where he presented with chest discomfort and SOB. Upon review of his tabs you note the following: -0.22 Myoglobin - 126: CK-MB - 5.1: BNP - 52. You know that this indicates that he:

a)

Has findings significant for heart failure

b)

Needs a CT scan of his chest to confirm the diagnosis

c)

Will need to be monitored specifically in Lead II

d)

Has had an acute MI

 

57.

Appropriate care for a patient with a balloon pump catheter inserted is:

a)

Closely monitor urinary output

b)

Perform active range of motion exercises to the affected extremity

c)

Withhold all anticoagulant medications

d)

Keep the head of the bed elevated to 45 degrees

 

58.

Your patient is admitted with a diagnosis of dissecting Type A aneurysm. Which is the first type of medication would you expect to administer?

a)

 Inotrope

b)

Analgesic

c)

Vasoconstrictor

d)

Beta Blocker

59.

You would suspect DIC If you were to see which of the following lab results for your patient

a)

Elevated fibrinogen

b)

Elevated fibrin split products

c)

Increased RBCs

d)

Increased platelets

60.

Primary rationale for placement of a Foley catheter in a patient in shock is that:

a)

The patient may not be able to use a bedpan

b)

Urine output is a valuable index of vital organ perfusion 

c)

It will reduce the workload of the heart

d)

It provides a means of monitoring specific gravity (monitor renal perfusion)

61.

The off-going nurse reports that the Levophed drip is ruining at 7.5 ml/hr. The pharmacy has mixed 8 mg in 250 ml of D5W. Your patient weights 110kg. What is the close that he is receiving?

a)

7.5 mcg/hr

b)

4 mg/min

c)

1.28 mcg/kg/min

d)

0.55mcg/min

62.

Your patient is presenting to the ED following a motor vehicle accident. You assess the following: Neuro: Slightly anxious, GCS 15Skin: Pale and cool to touchCardiac: BP 112/72 HR 108, 2+ pulses radically, cap refill at 2 secResp: Rate 22, deep and regular, sats 96%Urine Output: 30ml/hrWhat stage of shock would you consider him in?

a)

Refractory

b)

Compensatory

c)

Progressive

d)

Symptomatic

63.

An outcome goal in the early treatment of sepsis is designed to:

a)

Achieve oxygen saturation >96%

b)

Maintain a pulse rate > 90

c)

Elevate lactate levels to 6

d)

Attain a CVP of 8 - 12

64.

You would suspect decreased tissue perfusion in your patient if they presented with:

a)

Flushed skin with capillary refill +2 second

b)

A systolic blood pressure 90mmhg and widened pulse pressure

c)

Confusion oliguria and increased lactate levels

d)

Diaphoresis and ejection fraction of 60s

65.

Neurogenic shock is best identified by which of the following sets of hemodynamic parameters:

a)

BP 90/40 P-132 C.O. 7.2 PCWP 8

b)

BP 86/52 P-66 C.O. 3.4 PCWP 4

c)

BP 80/66 P-110 C.O. 2.2 PCWP 26

d)

BP 96/68 P-132 C.O. 7.2 PCWP 2

66.

A 90 year old female is admitted to the ICU from home with a diagnosis of sepis. She has PEG tube and a foley cath. She also has a stage III ulcer on her sacral area. Vital signs on admission are: T-101.6F, p-115, BP-88/56. She is restless and confused. What are the priorities for this patient?

a)

Administer fluids, provide inotropic support and afterload reduction

b)

Obtain cultures, administer fluids and start antibodies within specific time frame

c)

Administer antibiotics, administer sedation obtain a chest xray

d)

Determine the probable source of infection, administer vassopressors and antipyretics

67.

Which of the following findings would be consistent with a patient in the hyperdynamic (early or warm) stage of septic shock?

a)

Pale, cool clammy skin, C.I 2.5 liters/ min

b)

Warm, cool clammy skin, C.O 9 liters/min

c)

Peripheral cyanosis, flushed core, C.I. 1.5 Liters/min/mm

d)

Decreased level consciousness C.O. 1 liter/min

68.

Patient’s with recurrent pulmonary emboli are potential candidates for which of the following therapies?

a)

Video assisted thorascopic surgery

b)

Vena Cava filter

c)

Implantable cardiovascular-defibrillator

d)

Intra aortic balloon pump

69.

Your patient's PEEP was increased from 5cmh20. You know to watch which possible adverse reaction

a)

Arise in the Pao2

b)

A drop in the blood pressure

c)

Increased use of accessory muscles

d)

Decrease in central venous pressure

70.

Your patient was admitted with ARDS secondary to acute bacterial pneumonia. What is the PRIMARY goal in the management of his care?

a)

Reduce carbon dioxide retention

b)

Maintain hemodynamic status with vasopressors

c)

Treat the causative condition

d)

Ensure recovery of all lung tissue

71.

When providing care for your patient on a ventilator, you would recognize that it is appropriate as a preventative measure for VAP to:

a)

Hold all tube feedings to prevent aspiration

b)

Endotracheal suctioning to decrease trauma

c)

Request low tidal volume delivery to privet pneumothorax

d)

Provide frequent oral care to prevent microbial growth

72.

Which of the following suggests pulmonary edema of non-cardiogenic origin (ARDs)

a)

BNP returns at

b)

FWOP AT 22mmhg

c)

There is an enlarged left atrium on chest x-ray

d)

PaO2 / FiO2 ratio is 165 mmHg

73.

Your post-op thoracotomy patient has nursing diagnosis of "ineffective airway clearance RT ineffective cough secondary to pain." Which of following is an appropriate treatment option to address this problem?

a)

Decrease the amount of suction on the chest tube

b)

Only position the patient on the inoperative side

c)

Provide analgesia and encourage the use of incentive spirometer

d)

Clamp the chest tube intermittently to relieve pressure

 

74.

Albuterol

a)

Prevents the leukotriene- Mediated effects of inflammation

b)

Breaks up sputum and mucus might be clogging up the airways

c)

Inhibits the sympathetic nervous system

d)

Directly releases bronchial smooth muscles (relaxation of bronchial muscles)

75.

A patient with a severe diffuse axonal injury will typically presents with:

a)

Significant findings on CT scan

b)

A deeply depressed level of consciousness

c)

Occult bleeding under the meninges

d)

Confusion and repetitive questioning

76.

Primary cerebral injury

a)

Is an adverse effect of reperfusion to tissues

b)

Occurs at the time of impact

c)

Results from prolonged hypoxia and ischemia

d)

Has no relevance to the ultimate outcome for the patient

77.

When assessing your patient as a potential organ donor, you know that a definitive indication that your patient may be brain dead would be

a)

A negative babinski reflex

b)

The cardiac monitor is only showing a placed rhythm

c)

The EEG shows continuous seizure activity

d)

Clinical evaluation shows absence of cranial nerve response

78.

Ms. M has been admitted with subarachnoid hemorrhage. While reviewing her history you would expect to see which of the following prior symptoms?

a)

Extended loss of consciousness

b)

Bilateral constricted ....

c)

Diffuse one sided weaknesses

d)

Abstract onset of severe headache

79.

Given an ICP of 22 mmhg and a blood pressure of 124/64 the calculated cerebral pressure (CPP) would be:

a)

83 mmhg

b)

72mmhg

c)

 66mmhg

d)

62mmhg

80.

When assessing your patient with a subarachnoid hemorrhage the nurse knows that the MOST COMMON cause is from? 

a)

A blunt head trauma

b)

Chronic Hypertension

c)

A cerebral aneurysm leak

d)

Cerebral artery disease

81.

The body is able to compensate for increased intracerebral swelling by

a)

Expanding the capacity of the cranium

b)

Increasing vascular capacity by vasodilation

c)

Increasing cerebral spinal fluid production

d)

Shunting cerebral spinal fluid to the spinal canal

82.

To help prevent re-bleeding in your patient with cerebral aneurysm you would:

a)

Provide stimulus free Environment

b)

Use D5W to prevent cerebral swelling

c)

Restrict fluids to TKO rate

d)

Keep the head of the bed flat

83.

The nurse will recognize meningeal irritation in the patient who presents with

a)

Altered level of consciousness

b)

Nuchal rigidity

c)

Hemiparesis

d)

Hydrocephalus

84.

The EARLIEST symptom indicting that the intracranial pressure is increasing is

a)

Ipsilateral small dilation ?

b)

An alteration in LOC

c)

Loss of cranial nerve reflexes?

d)

Widening pulse pressure

85.

Levothyroxine is indicated for patient with:

a)

Graves disease

b)

Inflammatory thyroiditis

c)

Chronic lymphocytic thyroiditis

d)

Thyroid adenoma

86.

When reviewing the lab work for your patient, you would suspect PRIMARY hypothyroidism if the results showed a low T3 level along with

a)

elevated TSH

b)

Decreased Thyroglobulin 

c)

Elevated T4 levels

d)

Decreased Serum Iodine

87.

Heat intolerance along with increased metabolic rate suggests:

a)

Chronic lymphocytic thyroiditis

b)

Myxedema Coma

c)

Hyperthyroidism

d)

Hashimotos disease

88.

What risk does a patient on long term cortisol replacement face if steroids are bruptlly withdrawn?

a)

Rebound hyperglycemia

b)

Development of Cushing's syndrome

c)

Acute adrenal crisis

d)

Increased sodium and fluid retention

89.

The nurse would suspect a pheochromocytoma for the patient with intermittent

a)

Menstral irregularities

b)

Severe hypertension

c)

Profound lethargy

d)

Hyponatermia

90.

Immediate therapeutic goals in the management of acute adrenal crisis include:

a)

Control of hypertensive crisis with beta-blockers therapy

b)

Insulin drip and antihypertensive management

c)

Fluid replacement and administration of a cortisol preparation

d)

Vasopressin administration and volume replacement

91.

Your patient came in with DKA and a blood sugar of 8.76, inital gases showed ph 7.1, PaCO2 of 24, O2 of 88 and Bicarb of 11. Electrolytes were as follows. Na 145, K 4.3, CI 110, CO2 13. Following initial care, your labs and blood gases are re-drawn. Which of the following labs would you consider calling the primary provider for?

a)

Bicarb of 10

b)

PaCO2 of 28

c)

Potassium of 3.5

d)

Glucose of 560

92.

A diagnosis of HHN5 would be suspected of the nurse recognized which clinical findings?

a)

Urine ketones are present

b)

High serum osmolality

c)

Kussmaul respirations

d)

Severe metabolic acidosis

93.

The basic mechanism responsible for portal hypertension is due to

a)

Toxic effects of animals

b)

Increased resistance to blood flow through diseased liver

c)

Hepatic artery occlusion

d)

Sympathetic vascular stimulation secondary to cirrhosis

94.

Fulminant liver failure would be suspected if your patient presented with

a)

Sudden weight loss

b)

Normal serum ammonia levels

c)

Long standing liver disease

d)

Rapid onset hepatic encephalopathy

95.

In order to replace clotting factors the nurse would request which blood product

a)

Albumin

b)

Packed red blood cells

c)

Fresh frozen plasma

d)

Metastrach

96.

The purpose of a porto-canal shunt is to

a)

Decrease the effects of elevated ammonia levels on the brain tissue

b)

Increase the breakdown of ammonia in the intestinal tract

c)

Decrease the blood flow through the vascular system in the liver

d)

Allow for absorption of acidic fluid into the gut

97.

Hepato-renal syndrome is

a)

a results of sepsis and increased complement activation

b)

Kidney injury as a result of liver disease

c)

Primary renal failure which causes hepatic failure

d)

An early sign of acute liver disease

98.

Which of the following lab findings is related to the presence of ascites

a)

Potassium of 3.4

b)

Blood sugar of 126

c)

Hgb HCL of 14.3

d)

Serum albumin of 1.3

99.

You know your patient understands the LeVeen Shunt when he says

a)

"A catheter is inserted into my abdomen which will drain the fluid into the bloods stream"

b)

"A stent will be placed through my liver to improve the flow of blood"

c)

"The doctor will be putting off fluid from my abdomen with needle"

100.

Your patient is receiving lactulose. As part of the follow up for this patient you would be monitoring

a)

Serum levels of ammonia

b)

Conjugated bilirubin levels

c)

Abdominal girth

d)

Hepatic portal hypertension

101.

You would be most likely to recommend for a liver transplant procedure patient who has

a)

Diagnosis of Hep C

b)

Multi-system organ disease

c)

Metastatic liver cancer

d)

Just entered an alcohol rehab program

102.

Your patient has sustained abdominal trauma and the waiting for surgery. Which of the following would indicate possible abdominal compartment syndrome

a)

Sudden decrease in urinary output

b)

Significant decrease in serum liver enzymes

c)

Increase in systolic blood pressure

d)

Increase in gastric secretions through NG tube

103.

Treatment with pancreatic rest includes

a)

Clear liquid diets

b)

Total parenteral nutrition

c)

Strict bed rest

d)

IV administration of sodium bicarbonate

104.

Your patient with pancreatitis would be expected to have

a)

Hypocalcemia

b)

Hyperglycemia

c)

Decreased lipids and enzymes

d)

Hyperalbuminemia

105.

You know that following symptoms is a significant finding for hepatic encephalopathy

a)

Hypoalbuminemia

b)

Asterixis

c)

Caput medusae

d)

Hemophilia

106.

Your patient was admitted with complications of acute liver failure. He weighs 85 kg and his creatinine on admission 2 days ago was 1.2. Today his labs show a creatinine of 1.9 and his urine output has been 20 ml/hr for the first 4 hours. You know that he's now exhibiting signs of being in

a)

End stage kidney disease

b)

The "risk" category for RIFLE criteria

c)

Stage 5 of the AKIN criteria

d)

Need dialysis

107.

When reviewing the analysis of your patient's urine test, you would consider damage to the glomerular membrane if the urine with positive for?

a)

Bicarbonate ion

b)

Protein

c)

Creatinine

d)

Sodium

108.

You anticipate which patient with chronic renal failure as a candidate for dialysis?

a)

eGFR drops to <90 ml/min

b)

Injury phase of the RIFLE category

c)

ESRD with hyperkalemia

d)

Acute onset of an UTI

109.

Postrenal cause of AKI is usually associated with

a)

Hypo perfusion

b)

Fluid overload

c)

High urine outputs

d)

Obstructive uropathy

110.

A patient with decreased kidney function and oliguria would manifest with

a)

Flat neck veins when in supine position

b)

Increased glomerular filtration rate

c)

Generalized edema and electrolyte imbalance

d)

Elevated hemoglobin and hematocrit levels

111.

Which of the following is considered effective in preventing contrast induced nephropathy (CIN)?

a)

Prophylactic foley catheter insertion

b)

Increasing hydration with administration of IV fluids

c)

Holding antihypertensive medication for 24 hours

d)

Giving a diuretic just before the procedure

112.

Acute transplant rejection

a)

Is reversible with medication

b)

Only occurs in the first few hours post transplant procedure

c)

Will only happen once in the lifetime of the tissue recipient

d)

Leads to long term permanent tissue damage

113.

Suspicion of tissue rejection for your post-op kidney transplant patient would be identified by?

a)

Hyperglycemia

b)

Flat neck veins

c)

Oliguria

d)

Hypokalemia

114.

You should have a high index of suspicion of rhabdomyolysis if your patient is presented with:

a)

"Tea-colored" urine

b)

Pulmonary edema

c)

CVA tenderness

d)

Elevated serum bicarbonate levels

115.

When assessing a patient with electrical burns, the nurse knows that it is important to be aware of

a)

CBC with Diff

b)

Cardiac enzymes

c)

Carboxyhemoglobin

d)

Serum bicarbonate levels

116.

Clinical manifestations of third degree burns include

a)

Burn depth to superficial dermal layer

b)

Extreme pain

c)

Leathery consistency to the skin

d)

Blistering of the skin

117.

Which type of skin graft is the only permanent skin graft?

a)

Hydrocolloid

b)

 Synthetic

c)

Allograft

d)

Autograft

118.

A 7- year old 35 kg patient was burned with scalding water leaving her with 25% second degree burns and 10 % first degree burns. According to Consesus formula how much IV fluid should you give over the first 11 hours?

a)

2,450 ml

b)

1, 225 ml

c)

725 ml

d)

1, 750 ml

119.

During the initial assessment of your burn patient, you understand that the importance of calculating an accurate BSA involvement is done in order to determine

a)

They type of wound care management

b)

The depth of the burn injury

c)

Adequate fluid resuscitation

d)

IF they will require ICU admission

120.

The main treatment goal during the second phase of burn injury care would be to provide

a)

Psychological support for emotional stress

b)

On-going evaluation of wound healing

c)

Aggressive electrolyte replacement therapy

d)

Fluids for hemodynamic stability

121.

A patient in a car fire was burned over 35% with thermal burns over the upper torso and arms 12 hours ago. In this phase of the burn injury the nurse would expect to find:

a)

Hypokalemia due to tissue destruction

b)

Severe burn wound sepsis

c)

Significant EKG dysrhythmias

d)

Shifts of fluids from the intravascular to interstitial spaces

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