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Chest Trauma/ER
O2/Vents/ARDS
Acid-Base Imbalances
Nutrition/Blood Transfusion
Misc.
100
Which order should the following patients be seen in the ER? (most severe to least severe) 1. pt. suffering from penetrating chest wound 2. pt. with major burns to the neck and face area 3. pt. complaining of a sore throat 4. pt. with severe headache A. 2,4,3,1 B. 4,3,1,2 C. 1,2,4,3 D. 2,1,4,3
What is D. 2,1,4,3
100
Which NSG dx would be the priority for a client with ARDS? A. Impaired gas exchange B. Risk for infection C. Imbalanced nutrition: Less than body requirements D. Impaired skin integrity
What is A. Impaired gas exchange
100
Client is in danger of resp. arrest following administration of an opioid analgesic. An ABG value is obtained. The nurse should expect the PaCO2 to be...? A. 15 mm Hg B. 30 mm Hg C. 40 mm Hg D. 80 mm Hg
What is D. 80 mm Hg
100
Which route is preferred in ventilator patients? A. enteral B. liquid diet C. TPN D. all of the above
What is C. TPN
100
What is the priority nursing intervention for ICU families? A. encourage family participation in care B. use medical jargon whenever possible C. keep them updated on the patient D. assign a different nurse everyday
What is C. keep them updated on the patient
200
What are 3 reasons for blood transfusions?
What is Restore blood volume, Increase O2 carrying capacity of blood, Assist will coagulation
200
A client with emphysema should receive only 1 to 3L/minute of oxygen, if needed, or he may lose his hypoxic drive. Which statement is correct about hypoxic drive? A. client doesn't notice need to breathe B. client breathes only when his O2 levels climb above a certain pt C. client breathes only when O2 dip below certain pt D. client breathes only when CO2 level dip below certain pt
What is C. client breathes only when O2 dip below certain pt.
200
A client's ABG results are as follows: pH 7.16; PaCO2 80mmHg; PaO2 46 mm Hg; HCO3 24 mEq/L; SaO2 81%. These result represent which condition? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
What is C. Respiratory acidosis
200
The metabolic rate increases __ in major trauma? A. 50% B. 20% C. 60% D. 89%
What is C. 60%
200
A nurse is suctioning fluids from a female client through an ET tube. During the procedure, the nurse notes that the heart rate is decreasing. Which of the following is the appropriate nursing intervention? A. Continue to suction B. Notify the physician immediately C. Stop the procedure and reoxygenate the client D. Ensure that the suction is limited to 15 sec
What is C. stop the procedure and reoxygenate the client
300
A chest tube is inserted and attached to a drainage system. Bubbling appears in water seal chamber. Which factor is the most likely cause of bubbling? A. Air leak B. Adequate suction C. Inadequate suction D. Kinked chest tube
What is A. air leak
300
Which statement best describes the ventilation-perfusion mismatch that occurs with a PE? A. the area of the lung ventilated isn't being perfused B. the area of the lung perfused isn't being ventilated C. the area of the lung ventilated is also being perfused D. the amt of ventilation occurring doesn't equal perfusion
What is A. the area of the lung being ventilated isn't being perfused
300
Client w/ massive PE will have an ABG analysis performed to determine the extent of hypoxia. Which acid-base disorder may be present? A. Respiratory acidosis B. Metabolic alkalosis C. Metabolic acidosis D. Respiratory alkalosis
What is D. respiratory alkalosis
300
Who is at risk for nutritional problems? Select all that apply A. Cancer B. Fractured femur C. Excessive inflammation D. Hemorrhage E. Hyperthyroidism
What is A,C,D,E
300
BiPAP is delivered through a special oxygen mask that performs which function? A. provides 100% O2 at both inspiration and expiration B. provides pressurized O2 so the client can breathe easier C. provides pressurized O2 at the end of expiration to open collapsed alveoli D. provides both CPAP and PEEP to provide optimal oxygenation and ventilation
What is D. provides both CPAP and PEEP to provide optimal oxygenation and ventilation
400
Which pt. should the charge nurse assign to the LPN? A. Pt. w/ pneumonia, has pulse ox reading of 91% B. Pt. w/ hemothorax, has Hb of 9g/dL & Hct of 20% C. Pt. w/ chest tubes, has JVD and BP of 96/60 D. Pt. who is 2 hrs post-bronchoscopy procedure
What is D. pt. who is 2 hrs post-bronschoscopy procedure
400
The arterial blood gas measurement that best reflects the adequacy of alveolar ventilation is the: A. PaO2 B. PaCO2 C. pH D. SaO2
What is B. PaCO2
400
What has decreased PO2, increased dyspnea, "white lung", and also referred to as ALI? (vent pts)
What is ARDS
400
What type of drug will sometimes be given between units of blood and post-transfusion?
What is Diuretics
400
The appropriate way to suction a pt. on a ventilator includes...select all that apply A. Instill normal saline solution into the ET tube B. Suction PRN C. Suction for the longest duration possible D. Hyperoxygenate the pt before and after E. Limit to lowest level of pressure needed
What is B,D,E
500
Pt. w/ R-sided chest tube due to pneumothorax. Which interventions should be implemented? Select all that apply A. Place the pt in low Fowler's B. Assess chest tube drainage system frequently C. Maintain strict bedrest D. Secure a loop of drainage tubing to prevent dislodgement E. Observe site for SQ emphysema
What is B,D,E
500
What are care essentials for ventilator pts? A. HOB elevated, suction daily, assess pain B. perform oral care,eye care, hypo-oxygenate w/ suction C. ensure nutritional needs, manage airway, communication D. all of the above
What is C. ensure nutritional needs, manage airway, communication
500
What respiratory condition S/S include: chest pain, dyspnea, decreased PCO2 and PO2, and increased pH?
What is Pulmonary Embolus
500
NPO pt. receiving TPN via subclavian line. Which precautions should be implemented? Select all that apply A. Place solution on IV pump at prescribed rate B. Monitor blood glucose every 6 hrs C. Weigh pt. weekly, first thing in morning D. Change IV tubing every 3 days E. Monitor I&O every shift
What is A,B,E
500
Nurse anticipates the use of which drugs for emergent induction, intubation and sedation of a patient with (ARDS) that requires ventilation? (Select all that apply) A. Fentanyl (Duragesic, Sublimaze) B. Propofol (Diprivan) C. Midazolam (Versed) D. Nitrous oxide
What is A,B,C