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Level 4 Exam 1 Quiz 3

Total questions: 25

Worksheet time: 50mins

Name
Class
Date
1.

A patient develops stable ventricular tachycardia (VT) with a pulse. What is the PRIORITY nursing intervention?

a)

Prepare for immediate defibrillation

b)

Administer epinephrine IV push

c)

Prepare for elective cardioversion

d)

Begin high-quality CPR

2.

A patient with complete heart block has a heart rate of 32 bpm and is dizzy. What is the PRIORITY nursing action?

a)

Obtain a 12-lead ECG

b)

Assess blood pressure and level of consciousness

c)

Administer prescribed antihypertensive medication

d)

Prepare discharge instructions

3.

Which finding indicates the patient with complete heart block is experiencing decreased cardiac output?

a)

Oxygen saturation 97%

b)

Urine output 20 mL/hr

c)

Capillary refill < 2 seconds

d)

Warm, flushed skin

4.

The nurse administered broad-spectrum antibiotics to a patient with septic shock 30 minutes after sepsis recognition. Which evaluation finding indicates EFFECTIVE intervention?

a)

Blood pressure increased from 88/50 to 92/54 mm Hg

b)

Serum lactate decreased from 4.2 to 2.8 mmol/L

c)

Temperature decreased from 103°F to 99°F

d)

White blood cell count increased from 4,000 to 8,000/mm³

5.

Which assessment finding is expected during the oliguric phase of acute kidney injury?

a)

Increased urine output

b)

Fluid volume deficit

c)

Hyperkalemia

d)

Hypotension

6.

A client with ARDS on mechanical ventilation is started on propofol. Which finding is the PRIORITY to report to the provider?

a)

Triglycerides 110 mg/dL

b)

BP 84/46 mm Hg

c)

Richmond Agitation-Sedation Scale (RASS) −2

d)

Urine output 45 mL/hr

7.

A nurse is caring for a client with ARDS. Which assessment finding is MOST characteristic of this condition?

a)

Sudden onset of productive cough

b)

Decreased pulmonary capillary wedge pressure

c)

Refractory hypoxemia despite oxygen therapy

d)

Bradycardia with hypotension

8.

Which ECG finding is characteristic of atrial fibrillation?

a)

Regular rhythm with sawtooth waves

b)

Irregular rhythm with no distinct P waves

c)

Prolonged PR interval

d)

Wide QRS complexes

9.

Which clinical finding is MOST characteristic of cystic fibrosis?

a)

Pink, frothy sputum

b)

Thick, tenacious mucus

c)

Dry, nonproductive cough

d)

Sudden onset hemoptysis

10.

Which assessment finding is MOST concerning in a patient with complete heart block?

a)

Mild fatigue

b)

Bounding peripheral pulses

c)

Hypotension and altered mental status

d)

Palpitations

11.

A nurse is caring for a client with acute left-sided heart failure. Which assessment finding requires IMMEDIATE intervention?

a)

Peripheral edema

b)

Crackles in both lung bases

c)

Fatigue with activity

d)

Nocturia

12.

Which manifestation is MOST consistent with acute right-sided heart failure?

a)

Frothy pink sputum

b)

Orthopnea

c)

Jugular venous distention

d)

Pulmonary crackles

13.

Which medication order should the nurse QUESTION for a patient with AKI and hyperkalemia?

a)

Regular insulin IV

b)

Sodium polystyrene sulfonate

c)

Spironolactone

d)

Calcium gluconate IV

14.

Which ECG change should the nurse anticipate in a client with CHF who develops hypokalemia?

a)

Peaked T waves

b)

ST elevation

c)

Flattened T waves

d)

Widened QRS complex

15.

What is the nurse’s FIRST priority intervention for a patient in hypovolemic shock?

a)

Administer vasopressors

b)

Obtain blood cultures

c)

Initiate rapid IV fluid resuscitation

d)

Administer diuretics

16.

Which IV fluid is MOST appropriate for initial management of hypovolemic shock?

a)

D5W

b)

0.45% NS

c)

0.9% normal saline or lactated Ringer’s

d)

Albumin first

17.

A patient with hypovolemic shock from GI bleeding receives fluids but remains hypotensive. What does the nurse anticipate NEXT?

a)

Antibiotics

b)

Blood transfusion

c)

Diuretics

d)

Beta-blockers

18.

The nurse is evaluating the effectiveness of sodium polystyrene sulfonate. Which finding indicates therapeutic effect?

a)

Decreased serum creatinine

b)

Increased urine output

c)

Decreased serum potassium

d)

Increased blood pressure

19.

The nurse is preparing to administer vancomycin to a patient with sepsis. Which action is the PRIORITY?

a)

Infuse the medication rapidly

b)

Check peak serum levels

c)

Monitor renal function

d)

Administer with dextrose solution

20.

Which outcome BEST indicates that medication therapy for SIRS is effective?

a)

Decreased WBC count and stable vital signs

b)

Increased appetite

c)

Decreased pain score

d)

Improved sleep patterns

21.

Which intervention indicates effective treatment of septic shock?

a)

Blood pressure remains 80/50

b)

Fever persists at 102°F

c)

Heart rate >120 bpm

d)

Urine output ≥ 30 mL/hr and MAP ≥ 65 mmHg

22.

Which assessment finding indicates progression of SIRS toward sepsis?

a)

Heart rate 104/min

b)

Temperature 38.3°C (101°F)

c)

Positive blood cultures

d)

Respiratory rate 24/min

23.

Which laboratory value is most concerning in a patient with SIRS?

a)

Potassium 4.1 mEq/L

b)

Platelets 85,000/mm³

c)

Hemoglobin 13 g/dL

d)

Sodium 136 mEq/L

24.

Which medication is expected to be administered after the first shock if ventricular fibrillation persists?

a)

Adenosine

b)

Amiodarone

c)

Diltiazem

d)

Digoxin

25.

A patient with VT is conscious, has a pulse, BP 110/70, and reports dizziness. What is the PRIORITY nursing action?

a)

Begin CPR

b)

Defibrillate immediately

c)

Administer IV antiarrhythmic medication

d)

Prepare for asystole

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