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1. In order to compute the infusion rate for Dopamine you must know which of the following: *
a) weight of the patient in Kg b) desired drug effect c) amount of D5W diluent and drug concentration br /> d) all of the above
2. Which of the following drugs is used to reverse the effects of heparin? *
a) Neo-synephrine br /> b) Mannitol 10% c) Protamine sulfate d) Vitamin K
3. The usual dosage range of intravenous aminophylline is: *
a) 5 - 10 mg./h b) 10 - 60 mg/h c) 250 - 500 mg/h d) 0.5 - 2. Gm/h
4. Which of the following pressures are within normal limits? *
a) Pulmonary artery: 30/10 mm Hg br /> b) Pulmonary artery: 40/20 Hg c) Pulmonary capillary wedge pressure: 20 mm Hg d) Pulmonary capillary wedge pressure: 2 mm Hg
5. Which of the following compensatory mechanisms is usually the first response to an acute loss of circulating blood volume: *
a) C N S ischemic response b) Baroreceptor reflex c) Renin-agiotensin system activation d) Capillary fluid shifts
6. The nurse administering IV Pronestyl should monitor the patient for: *
a) Hypotension b) Seizures c) Bradycardia d) All of the above
7. Your patient has just been intubated and you hear no breath sounds on the left; what should be done? *
a) Remove the tube and reinsert it b) Pull the tube back slightly c) Observe the patient carefully for increasing hypoxia d) Draw blood gases and reposition the tupe if hypercapnia is present
8. A patient who is mechanically ventilated has this ABG: ph 7.30, pC02 52, p02 88, HC03 22. Which of the following medical therapies would be most appropriate initially to correct this problem? *
a) Decrease the FI02 b) Add 5 cm. PEEP c) Increase the tidal volume and/or respiratory frequency d) Begin weaning the patient from the ventilator
9. What is the appropriate therapy for a trauma victim who has undergone an emergency repair of a significant vessel tear and now has the following hemnodynamic measurements: BP 84/60, HR 118, RA 3, PCWP 4, C.I. 2.1, SVR 1890: *
a) Dopamine infusion at 2 - 10 mcg/kg/min b) Tridil infusion at 20 - 50 mcg/min c) Preload reduction d) Volume replacement
10. Placing a patient on 10 cm PEEP will have the following effect on the PCWP: *
a) No change b) Decrease in previous readings by 10 mmHg c) Increase in previous readings by 1 - 5 mmHG d) Insufficient data available
11. Which of the following could be present with massive pulmonary embolization: *
a) Acute cor pulmonale and shock b) Pleuritic chest pain c) Tachypnea; tachycardia d) All of the above
12. Progressive subcutaneous emphysema in the pneumonectomy patient usually means: *
a) The patient will have to return to surgery b) A leak in the pleural anastomosis c) A leak in the bronchial stump d) Both a and c
13. Which of the following clinical findings would be expected with a left tension pneumothorax and mediastinal shift: *
a) Tracheal deviation to the left b) Hypertension c) New S4 heart sound d) Shift of PMI (point of maximal impulse) to the right
14. The low pressure alarm goes off on your patients ventilator: the first thing you should do is: *
a) Suction the patient b) Check for a disconnect in the system c) Turn off the alarm and allow the vent to recycle d) Turn up the tidal volume
15. Which of the following drug(s) may be used to manage extreme hyperkalemia for patients in acute renal failure: *
a) Sodium bicarbonate and calcium chloride b) Glucose and insulin infusion c) Kayexalate and sorbitol d) b and c
16. The glomerular filtration rate is chiefly determined by: *
a) Creatinine b) Serum sodium c) Level of ADH d) BP
17. The nursing management of patients receiving peritoneal dialysis includes: *
a) Warming the solution to 100 degrees F prior to instillation b) Draining the dialysate by gravity c) Maintaining the rate of dialysis exchange at 3 L per hour d) Both a and b
18. Which of the following diuretics will generally cause the least potassium loss: *
a) Spironolactone b) Dyrenium c) Lasix d) Diazoxide
19. Which of the following statements regarding the edema of renal failure are TRUE: *
a) It is directly related to the degree of water retention b) It usually presents in nondependent areas c) It is related to hypoalbuminemia d) All of the above
20. The diagnosis of preenal oliguria is consistent with which of the following lab data: *
a) Serum creatinine of 4 mg b) Glycosuria but no proteinuria c) Urine sodium of 8mEq/L d) Specific gravity of 1.010
21. The treatment for hypoglycemia may include any of the following EXCEPT: *
a) I V Glucose b) Glucagon c. Food d) Insulin
22. Which of the following are present in Hyperglycemic Hyperosmolar Nonketotic Coma: *
a) Hypoglycemia; hyperkalemia and hypernatremia b) Normal blood sugar; coma and hypovolemia c) Hyperglycemia; hyponatremia and polyuria d) Thirst; polyuria; stupor; hypovolemia and hyperglycemia
23. All of the following would be valid treatment modalities for diabetic ketoacidosis EXCEPT: *
a) 1 amp of bicarbonate stat if the pH is below 7.1 or the plasma bicarbonate is less than 8 mEq/L b) 1 Liter of 1/2 N.S. rapidly during the first hour c) Switch to 5% D/Saline when the serum glocuse reaches 300 mg % d) IV NPH insulin 50 - 100 units stat and repeated doses according to the serum glucose
24. Hypomagnesemia is a risk for patients in critical care with: *
a) Alkalosis b) Congestive heart failure c) Prolonged hyperalimentation therapy d) Decreased aldosterone secretion
25. Immediate postoperative complications of thyroidectomy may include: *
a) Hypercalcemia b) Laryngospasm due to recurrent laryngeal nerve damage c) Myxedema d) Conns syndrome
26. Preload will be decreased by which group of drugs: *
a) Nitrates b) Sympathomimetics c) Bronchodilators d) Volume expanders
27. Which of the following disorders would likely present with the development of unequal pupils: *
a) Compression of oculomotor nerve fibers due to tentorial herniation b) disruption ofsympathetic pathways secondary to spinal cord injury c) Bells Palsy d) Hydrocephalus
28. The preferred method of administering insulin to patients in acute diabetic ketoacidosis is by: *
a) Hourly IV boluses per serum glucose levels b) Q4 hourly SQ per urine clinitest and acetest c) Continuous infusion per serum glucose levels d) IM or SQ hourly per serum glucose levels
29. Your patients intracranial pressure measured by an intraventricular catheter is 26 mmHG and his BP is 94/64 mmHG. His CPP (cerebral perfusion pressure) is: *
a) 20 mmHg br /> b) 48 mmHg c) 120 mmHG d) Insufficient information available
30. Which of the following drugs will cause pupillary dilation: *
a) Phenergan b) Atropine c) Opiates d) Glutethimide
31. In patients with a spinal cord injury at the C-6 level, hypo-ventilation is a potential problem because the patient is breathing: *
a) At a rapid rate b) Using the diaphragm only c) Using accessory muscles only d) At a slow rate
32. The correct interpretation of the following CSF (cerebrospinal fluid) values: Glucose 66, protein 125 mg/dl, 4 WBC/ul mg/100 values would be: *
a) CSF within normal limits b) Protein level elevated c) Significant infection is present d) Patient has hypoglycemia
33. Prostigmin is what type of drug: *
a) Sympathomimetic b) Cholinergic c) Anticholinesterase d) Both b and c
34. The most common first manifestation of disseminated intravascular coagulation is: *
a) Mild oozing of blood at venipuncture sites b) Significant bleeding from all body orifices c) Decreasing hematocrit d) Pumonary embolization
35. Which of the following laboratory tests aids in the differential diagnosis of DIC: *
a) Fibrin Split Products b) RPR c) CBC
36. Which of the following drugs is contraindicated in patients with bleeding disorders: *
a) Aqueous penicillin b) Lasix c) Acetaminophen d) Aspirin
37. Your patients coagulation screen shows the following vales: PT - 40, PTT > 150, platelets 38,000, Fibinogen 70 indicating *
a) Coagulation values within normal range b) Thrombocytopenia purpura c) Disseminated Intravascular Coagulation (DIC) d) Hemophilia B
38. The usual order for carrying out physical assessment of the abdomen is: *
a) Inspection; palpation; ausculation; percussion b) Inspection; percussion; palpation; auscultation c) Inspection; auscultation; percussion; palpation d) Inspection; auscultation; palpation; percussion
39. Bowel sounds that are loud, high-pitched and tinkling associated with pain, cramping and visible peristalsis are often due to: *
a) Borborygmi b) Intestinal obstruction c) Peritonitis d) Hyperperistalsis
40. Syndrome of Inappropriate ADH will present with: *
a) Serum osmolarity > 320 b) Urine output > 10 L/day c) Hyponatremia d) Hypotension
41. The administration of vasopressin may be indicated in patients who have: *
a) Diabetes insipidus b) Coronary artery disease c) Gout d) Diabetes mellitus
42. Which of the following lab measurements is of least concern for patients with acute pancreatitis: *
a) Serum amylase>br /> b) Serum calcium c) Serum glucose d) CPK-MB
43. Asphyxia may be imminent when a patient with a Sengstaken-Blakemore tube suddenly cannot ventilate. Which of the following statements about this emergency are TRUE: *
a. The most likely cause is a leaking or ruptured gastric balloon b. Airway compromise results when the esophageal balloon is pulled upward c. The nurse should cut the tube and remove it when this occurs d. All of the above
44. The most frequent precursor to the development of multi organ dysfunction syndrome (MODS - formerly MSOF) is: *
a. Sepsis b. Severe head injury c. Multiple orthopedic injuries d. Massive blood replacement
45. Enteral feeding of a critically ill patient is considered safer than total parenteral nutrition because the former does not enhance the likelihood of: *
a. Tracheoesophageal fistula b. Over hydration c. Sepsis d. Hyperglycemia
