Cardiovascular
Mrs. Jones has an exacerbation of her heart failure, with signs and symptoms of JVD, Peripheral edema, and abdominal pain. These signs are specific to:
acute left ventricular failure
chronic right ventricular failure
acute right ventricular failure
chronic dehydration
chronic right ventricular failure
Each of the following is a clinical feature of ARDS except:
bilateral chest infiltrates on an x-ray
PAOP>18 cm H2O
refractory hypoxemia
tachypnea
PAOP >18 cm H2O
A patient who has sustained traumatic injuries has required a transfusion of 7 units of PRBCs. Which of the following is TRUE related to the care of this patient?
pressors will most likely be required
the patient will need to be monitored for hypercalcemia
blood products and crystalloids should be warmed
platelets will need to be given if the platelet count drops
blood products and crystalloids should be warmed
patient presents with a left cerebral hemishpheric ischemic stroke. This patient would most likely have which of the following?
left babinski reflex
eye deviation to the right
left homonymous hemianopsia
right pronator drift
right pronator drift
A patient has suddenly become verbally aggressive and loud. Which of the following is the best strategy for the nurse to use at this time?
speak loudly to the patient
restrain the patient
stand directly in front of the patient
provide direct care with a colleague
provide direct care with a colleague
What pulse change might a nurse expect in the presence of cardiac tamponade?
pulsus alternans
pulsus paradoxus
pulsis magnus
pulsus bisferiens
pulsus paradoxus
While monitoring a patient post-thoracotomy, the nurse suspects that there is hypoventilation. Which characteristic best defines hypoventilation?
PaCO2 >45 mmHg
respiratory rate < 12
pH < 7.35
PaO2 <60 mmHg
PaCO2 >45 mmHg
Which of the following regarding targeted temperature management (TTM) is CORRECT?
TTM should be provided to all patients status post V-fib
Potassium infusions will most likely be required during rewarming
Shivering is expected and generally self-limiting
Insulin infusions are often required during the maintenance phase
Insulin infusions are often required during the maintenance phase
Patient has a serum K+ of 8.8 mEq/L and has a slowing of the heart rate with widening of the QRS. Which of the following would be an appropriate treatment for this patient?
kayexalate enema
calcium gluconate, glucose, and insulin intravenously
lactulose by mouth
hemodialysis
calcium gluconate, glucose, and insulin intravenously
Patient with septic shock is thought to be developing DIC. Which of the following lab results would be most indicative of DIC?
prolonged PT, PTT, and bleeding time
decreased platelet count
positive ELISA
elevated fibrin split products and D-dimer
elevated fibrin split products and D-dimer
Day 3 post acute MI, 67 yo M complains of chest pain and develops a fever. Pain is worse with inspiration and is relieved when he leans forward. There are nonspecific ST changes in the precordial leads. The nurse anticipates treatment for:
thoracic aneurysm
Dressler's syndrome
reinfarction
pleuritis
Dressler's syndrome
A trauma patient with multiple long bone fractures develops agitation, tachypnea, tachycardia, and mild hypoxemia. Lungs are clear and a petechial rash is noted on her upper body. Which of the following is suspected?
acute respiratory distress syndrome
fat embolism
deep vein thrombosis
delirium
fat embolism
Patient with upper GI bleed received midazolam during endoscopy. He required high doses to maintain sedation and screened positive for OSA. Which is TRUE regarding his plan of care?
respiratory depression will generally precede sedation
pulse oximetry will detect early hypoventilation
waveform capnography monitoring is indicated for this patient post-procedure
the max dose of flumazenil for midazolam reversal is 0.2 mg IV
waveform capnography monitoring is indicated for this patient post-procedure
Increased ICP may be caused by many disorders. Which of the following would most likely prevent a further increase in intracranial pressure or a decrease in the cerebral perfusion pressure?
maintaining PaCO2 between 22 mmHg and 35 mmHg
maintaining neck flexion
preventing/treating agitation/pain
keeping the head of the bed flat
preventing/treating agitation/pain
Which of the following findings would be expected for a patient with HHS?
a pH of 7.15
a urine specific gravity of 1.030
a K+ level of 6.1 mEq/L
a serum osmolality of 270 mOsm/kg
a urine specific gravity of 1.030
Patient post left internal carotid stent placement is AOx4, weak right hand grip, right facial droop, stable vitals, dry procedure site. RN should contact the physician because the patient is likely experiencing:
a right cerebral hemorrhage
hyperperfusion syndrome
acute cerebrovascular insufficiency
hypovolemia
acute cerebrovascular insufficiency
Which of the following may be an effect of mechanical ventilation and PEEP (positive end-expiratory pressure)?
atelectasis
oxygen toxicity
ARDS
reduced cardiac output
reduced cardiac output
73 y.o. female admitted with SOB, fatigue, bibasilar crackles, venous congestion and cardiomegaly on chest x-ray, gained 20 pounds in 2 weeks. Which of the following hemodynamic alterations does she have and what treatment is indicated?
increased afterload, decreased contractility, decreased preload; nesiritide to increase contractility
decreased afterload, decreased contractility, increased preload; furosemide to increase afterload
decreased afterload, increased contractility, increased preload; amiodarone to decrease preload
increased afterload, decreased contractility, increased preload; dobutamine to increase contractility
increased afterload, decreased contractility, increased preload; dobutamine to increase contractility
Patient with esophageal varices is admitted with hypovolemic shock secondary to upper GI bleeding. The following interventions related to the care of this patient are appropriate EXCEPT:
preparing the patient for emergency surgery
ensuring scissors are at the bedside if the patient has an esophageal balloon in place
administering lactulose if the patient has a history of cirrhosis
closely monitoring the patient's respiratory status and neurological status
preparing the patient for emergency surgery
The unit upgraded the patient beds, and they have many new features. all nurses received education on the new beds. On the first day of work with the new beds a nurse realizes he has forgotten most of the education. the nurse should:
complain to colleagues that the education took place too far in advance
make a point to review the new bed at some point during the shift
request the educator or another colleague review essential operations
look up the bed vendor on the Internet as soon as possible
request the educator or another colleague review essential operations
Patient admitted with ST elevation in V2, V3, and V4. Four days later patient suddenly developed a holosystolic murmur at the lower left sternal border, chest pain, and hypotension. What complication should the nurse expect?
papillary muscle rupture
ventricular septal defect
acute mitral valve stenosis
acute reinfarction
ventricular septal defect
Patient has mild tachypnea, productive cough, broncial breath sounds in the right mid and lower lobes, dullness to percussion on the right lower chest, and an SpO2 of 92% on 0.40 FiO2. Which intervention would be appropriate?
contact the physician to order a bronchodilator
use noninvasive ventilation
avoid turning the patient to the right side
maintain the patient in a supine position
avoid turning the patient to the right side
Which of the following will most likely result in an SvO2 of 82%?
hypovolemic shock
anaphylactic shock
septic shock
cardiogenic shock
septic shock
A patient with AKI has the following ABG: pH 7.32, PaCO2 35, and HCO3 18. This acid-base abnormality is the result of the kidneys' inability to:
excrete the acid by-products of metabolism
excrete carbon dioxide
excrete bicarbonate ions
excrete calcium ions
excrete the acid by-products of metabolism
A diabetic patient with hypoglycemia is most likely to present with a coma if the patient is also receiving which of the following?
glipizide (Glucotrol)
phenytoin (Dilantin)
hydrochlorothiazide
metoprolol (Lopressor)
metoprolol (Lopressor)