Sterile or Cry
Which electrolyte is primarily found in the intracellular fluid (ICF)?
A. Sodium
B. Chloride
C. Potassium
D. Bicarbonate
ICF = K
ECF = Na
A patient in hypertensive emergency is receiving IV sodium nitroprusside. How frequently should the nurse assess BP during initial administration?
A) Every 15 minutes
B) Every 5 minutes
C) Every 2-3 minutes
D) Continuously via arterial line only
Answer: C) Every 2-3 minutes
Rationale: Antihypertensive drugs given IV have a rapid (within seconds to minutes) onset of action. Assess the patient's BP and HR every 2 to 3 minutes during their initial administration using an arterial line or automated noninvasive BP machine.
sherpath ai
A patient presents with scabies. The provider prescribes Elimite.
What is the correct patient instruction?
A. Apply to affected area only for 30 minutes
B. Apply to entire body from neck down for 8–14 hours
C. Apply twice daily for 7 days
D. Apply only to visible burrows
B. Apply to entire body from neck down for 8–14 hours
Scabies treatment:
Elimite
Apply to all skin from neck down
Leave on 8–14 hours
Shower with soap and water
What are key side effects of each drug listed?
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
Rifampin : Hepatoxicity, Thrombocytopenia, Red bodily fluids (not in ppt)
Isoniazid: Hepatotoxicity, Peripheral Neuropathy
Pyrazinamide: Teratogenic & can cause gout exacerbations (not in ppt)
Ethambutol: Optic Neuritis
A patient presents with chest pain at rest lasting 20 minutes. Troponin is normal. ECG shows no ST elevation.
Which is it? - provide rationale for the correct and incorrect answers
A. Stable angina
B. Unstable angina
C. NSTEMI
D. STEMI
B = Unstable angina.
Chest pain at rest
Troponin normal
No ST elevation
Stable angina - relieved w/ rest &/or nitroglycerin
NSTEMI - troponin levels elevated, ST depression and/or T wave inversion
STEMI - troponin elevated, ST elevation
A patient with hypernatremia (Na 152) is dehydrated. The provider wants to rehydrate the patient slowly and shift water into cells.
Which IV fluid is most appropriate?
A. 0.9% normal saline
B. Lactated Ringers
C. 0.45% normal saline
D. D5NS
C. 0.45% normal saline
A nurse is administering IV sodium nitroprusside for hypertensive emergency. The patient's initial MAP is 140 mmHg. What is the target MAP for the first hour of treatment?
A) 90-95 mmHg
B) 105-112 mmHg
C) 120-125 mmHg
D) 70-80 mmHg
Answer: B) 105-112 mmHg
Rationale: The initial goal is to decrease MAP by no more than 20% to 25% or to decrease MAP to 110-115 mmHg. Lowering BP too quickly or too much may decrease cerebral, coronary, or renal perfusion and could cause stroke, MI, or renal failure. Calculate: 140 × 0.20 = 28; 140 - 28 = 112 mmHg (20% reduction).
A patient with asthma is experiencing severe wheezing and is using accessory muscles to breathe. After several nebulizer treatments, the wheezing suddenly disappears but the patient becomes very quiet and fatigued.
What is the nurse’s priority interpretation?
A. The bronchodilator has worked
B. The patient is improving
C. Airflow is severely reduced
D. The patient is becoming anxious
C Airflow is severely reduced
Air movement has become so poor that you no longer hear wheezing. This is called a “silent chest” and signals impending respiratory failure.
A patient develops ventricular tachycardia (VT) with a pulse and is clinically stable. Which medication is appropriate for treatment?
A) Atropine
B) Adenosine
C) Amiodarone
D) Epinephrine
For monomorphic VT in a clinically stable patient with preserved left ventricular function, IV procainamide, lidocaine, or amiodarone are appropriate options. If drug therapy is ineffective, cardioversion is used. VT without a pulse is treated as VF with CPR and rapid defibrillation.
sherpath ai
A patient receiving 0.9% NS develops swelling at the IV site. The area is cool, pale, and taut. The patient reports tightness but minimal pain.
What is occurring?
A. Phlebitis
B. Infection
C. Infiltration
D. Thrombophlebitis
Correct.
Cool
Pale
Swollen
Taut
= Infiltration
Which formula correctly calculates cardiac output?
A) CO = HR × SV
B) CO = MAP × SVR
C) CO = SV ÷ HR
D) CO = CI × BSA
Answer: A) CO = HR × SV
Rationale: Cardiac output is the volume of blood in liters pumped by the heart in 1 minute, calculated by multiplying heart rate and stroke volume. CO and the forces opposing blood flow determine blood pressure.
The following are clinical manifestations of which disease?
• Chronic cough
• Hemoptysis
• Night sweats
• Weight loss
• Low-grade fever
Active Tuberculosis
Which treatment is the definitive therapy of choice for atrial flutter?
A) Beta-blockers
B) Electrical cardioversion
C) Radiofrequency catheter ablation
D) Calcium channel blockers
Radiofrequency catheter ablation in an EPS laboratory is the treatment of choice for atrial flutter. Low-voltage, high-frequency electrical energy ablates the ectopic foci through a catheter in the right atrium, restoring normal sinus rhythm. The primary goal is to slow ventricular response by increasing AV block.
sherpath ai
While changing central line tubing, the patient suddenly becomes short of breath and complains of chest pain. The nurse suspects an air embolism.
What is the nurse’s immediate action?
A. Place patient in left lateral Trendelenburg position
B. Administer oxygen only
C. Flush the line
D. Elevate the head of the bed
A. Place patient in left lateral Trendelenburg position
Air embolism → left lateral Trendelenburg position.
Your notes specifically list:
• Clamp catheter
• Tape all connections
• Position flat during dressing/tubing change
• Left lateral Trendelenburg for air embolism
A patient's ECG shows wide, distorted QRS complexes lasting 0.14 seconds occurring irregularly. No P waves are visible before these beats. What dysrhythmia is this?
A) Atrial fibrillation
B) Premature ventricular contractions (PVCs)
C) Ventricular tachycardia
D) Bundle branch block
Answer: B) Premature ventricular contractions (PVCs)
Rationale: PVC characteristics include: wide and distorted QRS lasting >0.12 seconds, P wave rarely visible (usually lost in the QRS complex), irregular rhythm due to premature beats, and T wave generally large and opposite in direction to the QRS complex.
What is the most important nursing intervention to prevent COPD exacerbations?
A) Annual chest x-rays
B) Smoking cessation counseling
C) Daily spirometry monitoring
D) Restricting physical activity
Answer: B) Smoking cessation counseling
Rationale: Smoking cessation is vital and the only way to slow disease progression. After stopping smoking, the rapid decline in lung function slows to almost non-smoking levels. Additional prevention includes avoiding sick contacts, hand hygiene, taking medications as prescribed, regular exercise, and receiving influenza, COVID-19, and pneumococcal vaccinations.
A patient presents with crushing chest pain. ECG shows ST elevation in leads II, III, and aVF. Troponin is elevated.
What is the priority intervention?
A. Administer morphine and observe
B. Schedule outpatient stress test
C. Prepare for immediate PCI
D. Repeat troponin in 6 hours
C
What is the door to balloon time for STEMI?
How long does it take Troponin levels to increase post-MI ?
A patient has a nonfunctional GI tract due to bowel obstruction. Oral and enteral feeding are not possible.
What is the primary reason TPN is indicated?
A. To improve appetite
B. To rest the pancreas
C. To provide nutrition when the GI tract cannot be used
D. To correct dehydration only
C
TPN is indicated when:
• The GI tract is nonfunctional
• Poor GI absorption
• Oral/enteral feeding not viable
It bypasses the GI tract entirely.
A nurse observes a run of 5 consecutive wide QRS complexes on a patient's cardiac monitor. All QRS complexes are the same shape and size. What type of ventricular tachycardia is this?
A) Polymorphic VT
B) Monomorphic VT
C) Torsades de pointes
D) Ventricular fibrillation
Answer: B) Monomorphic VT
Rationale: A run of 3 or more PVCs defines ventricular tachycardia (VT). Monomorphic VT has QRS complexes that are the same in shape, size, and direction. Polymorphic VT occurs when the QRS complexes gradually change back and forth from one shape, size, and direction to another over a series of beats.
State step by step the flow of blood through the heart and body
(starting with the Superior/Inferior Vena Cava)
list all chambers and valves
Superior/Inferior Vena Cava --> Right Atrium --> Tricuspid Valve --> Right Ventricle --> Pulmonic Valve --> Pulmonary Artery --> Lungs --> Pulmonary Vein --> Left Atrium --> Mitral Valve --> Left Ventricle --> Aortic Valve --> Aorta --> Body --> Systemic circulation back to vena cava
A patient develops monomorphic VT with a pulse and stable blood pressure. Which medication is appropriate for initial treatment?
A) Atropine
B) Amiodarone
C) Adenosine
D) Calcium chloride
Answer: B) Amiodarone
Rationale: If the VT is monomorphic and the patient is clinically stable (pulse is present) with preserved left ventricular function, options include IV procainamide, lidocaine, or amiodarone. Cardioversion is used if drug therapy is ineffective.