Quiz Questions

Question 1

A patient is admitted to the unit after ORIF of RT femur fracture. The patient becomes agitated and sypenic. His apical heart rate increases to 120 bpm and he has severe petechiae across his upper chest. You call the doctor because you suspect:
a. fat emboli
b. pulmonary emboli
c. myocardial infarction
d. compartment syndrome

Answer 1

A. fat emboli

Question 2

A few minutes after changing your patient’s TPN tubing, he complains of chest pain and SOB. His pulse is weak and thready. Which intervention takes top priority?
a. turning the patient on his left side with his head lower than his body
b. calling a code and initiating CPR
c. stopping the TPN and keeping the line open with NS
D. notify the doctor because the patient is having an allergic reaction

Answer 2

a. turning the patient on his left side with his head lower than his body

Question 3

You are caring for a patient who underwent an abdominal aortic aneurysm repair. Because of his unstable postop course, he reuquires prolonged bedrest, which increases his risk for pulmonary embolism. What is the key sign or symptom of pulmonary embolism?
a. apprehension
b. cough
c. dyspnea
d. chest pain

Answer 3

c. dyspnea

Question 4

A patient admitted with dyspnea, pleuritic chest pain, and hemoptysis is extremely anxious. Which condition do you suspect?
a. hemothorax
b. pneumothorax
c. pulmonary emboli
d. ARDS

Answer 4

c. pulmonary emboli

Question 5

Your postop pt suddenly develops respiratory distress. You suspect pulmonary embolus. Which diagnostic test is most likely used to confirm the diagnosis?
a. VQ scan
b. pulmonary angiography
C. ABG analysis
D. US

Answer 5

a. VQ scan

Question 6

A 29 YO patient who has been on bedrest for 4 weeks (due to premature labor) has developed a pulmonary embolism. Which of the following assessments indicates pulmonary embolism?
a. crackles, edema, third heart sound
b. crushing substernal chest pain radiating to the LT arm
c. pleuritic chest pain, dyspnea, hypoxemia
d. thick sputum, clubbed fingers, and cough

Answer 6

c. pleuritic chest pain, dyspnea, hypoxemia

Question 7

Your patient has adult ARDS. Which statement about ARDS is correct?
a. severe bronchospasms leads to impaired gas exchange
b. decreased pulmonary capillary blood flow causes shunting
c. fluid from the LT heart backs up into the pulmonary system
d. increased alveolar-capillary permeability leads to fluid leakage

Answer 7

d. increased alveolar-capillary permeability leads to fluid leakage

Question 8

blood passing through the pulmonary vasculature and bypassing alveoli without exchanging gas is known as:
a. blockage
b. diffusion
c. shunting
d. perfusion

Answer 8

c. shunting

Question 9

You suspect that a patient has developed adult ARDS. which of the following findings most suggests ARDS?
a. elevated carboxyhemoglobin
b. decreased PaO2
c. elevated PaCO2
d. decreased HCO3

Answer 9

b. decreased PaO2

Question 10

A 28 YO patient who sustained a head injury in a motorcycle crash develops ARDS. Which of the following interventions is most appropriate?
a. chest percussion and postural drainage
b. intermittent positive-pressure breathing
c. chest to tube insertion and connection to high negative suction
d. mechanical ventilation with PEEP

Answer 10

d. mechanical ventilation with PEEP

Question 11

a patient is diagnosed with ARDS. The primary goal when treating a patient with ARDS is:
a. identify and treat underlying condition
b. maintain nutritional requirements
c. maintain adequate tissue oxygenation
d. prevent secondary infection

Answer 11

a. identify and treat underlying condition

Question 12

55 YOM with hx CHF following CABG. On home PO 40mg Lasix. He is currently in the stepdown unit for SOB, bilateral crackles, UOP less than 10mL/hr. He is being admitted for close monitoring, telemetry, and to r/o CHF. BP 108/60; P 113; Temp 37.3; swelling ankles. What type of shock is he in?

Answer 12

cardiogenic shock

Question 13

A patient presents with nonexertional chest pain 8/10, intermittent, sharp, non-radiating. The patient experienced non-exertional stinging transient chest pain 3 days prior, but it went away. Denied SOB, cough.
Hx HDL, HTN, CVA (10 years ago)
Troponin: 0.23, CK 178, ST elevation noted on EKG.
What does the patient most likely have, and what do we expect to be done for the patient?

Answer 13

STEMI -> PCI

Question 14

What is MONA

Answer 14

• morphine
• oxygen
• nitroglycerin
• aspirin

Question 15

How long should eptifibatide (Integrilin) be continued after PCI?

Answer 15

18-24 hours
(eptifibatide is an anticoagulant)

Question 16

Which methods can be utilized to assess for circulation? Select all that apply
a. visually assess skin color
b. palpate pulses
c. visually inspect pulses
d. check capillary refill by pressing on nail beds and releasing
e. check pulse oximetry
f. check for blood return from the PIV

Answer 16

a. visually assess skin color
b. palpate pulses
d. check capillary refill by pressing on nail beds and releasing

Question 17

The nurse is caring for the client with increased intracranial pressure. The nurse would note which of the following trends in vital signs if the ICP is rising?
a. increasing T, increasing HR, increasing RR, decreasing BP
b. increasing T, decreasing HR, decreasing RR, increasing BP
c. decreasing T, decreasing HR, increasing RR, decreasing BP
d. decreasing T, increasing HR, decreasing RR, increasing BP

Answer 17

b. increasing T, decreasing HR, decreasing RR, increasing BP

Question 18

The nurse is assessing the motor function of an unconscious patient. The nurse would plan to use which of the following to test the client’s peripheral response to pain?
a. sternal rub
b. pressure on orbital rim
c. squeezing the sternocleidomastoid muscle
d. nail bed pressure

Answer 18

d. nail bed pressure

Question 19

A lumbar puncture is performed for suspected bacterial meningitis. CSF is obtained and the nurse determines that which of the following results would verify the diagnosis?
a. cloudy CSF, decreased protein, decreased glucose?
b. cloudy CSF, increased protein, decreased glucose
c. clear CSF, elevated protein, decreased glucose
d. clear CSF, decreased pressure, elevated protein

Answer 19

b. cloudy CSF, increased protein, decreased glucose

Question 20

Which is the most appropriate action for the nurse to take before administering digoxin?
a. monitor potassium level
b. assess blood pressure
c. evaluate UO
d. avoid giving with thiazide diuretic

Answer 20

a. monitor K levels

Question 21

Which of the following EKG findings alerts the nurse that the client needs an antiarrhythmic?
a. NSR
b. sinus bradycardia
c. sinus tachycardia
d. frequent ventricular ectopies

Answer 21

d. frequent ventricular ectopies

examples of antiarrhythmics: atropine, amiodarone, beta blockers

Question 22

James is taking beta-blockers, all of the following should be included in his assessment except:
a. pulmonary function tests
b. baseline EKG
c. glucose level
d. blood pressure

Answer 22

a. pulmonary function tests = only needed if pt has known pulmonary condition

• beta blockers can cause hyperglycemia and negate hypoglycemic drug effects

Question 23

Which valve in the heart prevents blood refluxing from the LT ventricle to LT atrium?
a. pulmonic valve
b. aortic valve
c. tricuspid valve
d. mitral valve
e. patent ductus arteriosus valve

Answer 23

d. mitral valve

Question 24

Which of the following are considered cardiac enzymes and checked during MI? Select all that apply
a. troponin
b. LDH
c. lactate
d. CKMB
e. B- hydroxybutyrate

Answer 24

a. troponin
d. CKMB

Question 25

What is the most sensitive indicator for cardiac tissue damage?
a. CK
b. troponin
c. LDH
d. ketones

Answer 25

b. troponin

Question 26

Where would you find the PMI during auscultation of the heart?
a. 2nd intercostal space, mid-clavicular line, RT sternum
b. 5th intercostal space, mid-clavicular line, RT sternum
c. 5th intercostal space, mid-clavicular line, LT sternum
d. 3 inches below Erb’s point

Answer 26

c. 5th intercostal space, mid-clavicular line, LT sternum