Shocky
What kind of shock occurs secondary to acute blood loss?
A. Septic
B. Cardiogenic
C. Neurogenic
D. Hypovolemic
D. Hypovolemic
The infant you are caring for is diagnosed with central DI. The anticipated treatment for this condition is:
A. Thyroid stimulating hormone
B. Aldosterone
C. Sliding scale insulin
D. DDAVP
D. DDAVP
Which of the following is NOT typically seen with cardiac tamponade?
A. Muffled heart sounds
B. Bradycardia
C. Hypotension
D. Jugular venous distention
B. Bradycardia
1 year old patient admitted with respiratory distress. He is increasingly restless and has petechia on his trunk, arms, and legs. His abdomen is slightly distended and he has increased respiratory effort. He is now obtunded an you note pink-tinged urine in his diaper and oozing from the IV insertion site. You suspect:
A. DIC
B. Pulmonary emboli
C. Fat embolism
D. Meningitis
A. DIC
You are caring for a patient s/p cardiac catheterization. Complications you expect include:
A. Bleeding at the arterial puncture site
B. Cerebrovascular accident
C. Cardiac tamponade
D. Renal failure
A. Bleeding at the arterial puncture site
Which of the following statements about shock is most accurate?
A. Patients with early septic shock may have warm peripheral skin and bounding pulses
B. PRBC administration is the initial treatment of choice in most cases of hypovolemic shock
C. Patients with isolated cardiogenic shock usually have decreased CVP
D. Distributive shock is genearlly caused by vasoconstriction
A. Patients with early septic shock may have warm peripheral skin and bounding pulses
If diabetic ketoacidosis is suspected, what should be the first test performed?
A. Hemoglobin A1c
B. Urine glucose & ketones
C. Fingerstick glucose
D. Blood electrolytes
C. Fingerstick glucose
Which clinical feature is NOT likely to occur with a tension pneumothorax?
A. Hypertension
B. Unilateral decrease in breath sounds
C. Tachycardia
D. Tracheal shift
A. Hypertension
Acute post-hemorrhagic anemia develops after:
A. Bone marrow is damaged.
B. The spleen is damaged.
C. Iron levels decrease by more than 15%.
D. A rapid loss of erythrocytes
D. A rapid loss of erythrocytes
The critical care nurse is most likely to expect therapeutic hypothermia in the treatment plan for which of the following?
A. Septic shock
B. DIC
C. Coma secondary to drug overdose
D. TBI with elevated ICP
D. TBI with elevated ICP
Which is least likely to be found in early stages in a patient with hypovolemic shock?
A. Bradycardia
B. Cold Skin
C. Delayed cap refill
D. Confusion
A. Bradycardia
Which is NOT seen in SIADH?
A. Increased urinary sodium
B. Decreased urinary potassium
C. Hypernatremia
D. Increased urine osmolarity
C. Hypernatremia
What is the best step in a patient with spleen trauma without hemodynamic instability?
A. Bedrest
B. CT guided drainage
C. Angiogram with embolization
D. Surgery
A. Bedrest
Your patient's mother carries the sickle cell trait. Which of the following about sickle cell anemia is true?
A. Sickle cell anemia always results in death by age 40
B. Sickle cell anemia causes a loss of protein intrinsic factor
C. High blood viscosity and low oxygen tension may cause a sickle cell crisis
D. Sickle cell disease is limited to the African American and Caucasian population
C. High blood viscosity and low oxygen tension may cause a sickle cell crisis
7 yo presents with 1 day history of fever, cough, SOB, and poor intake. She is fatigued with Respiratory Distress. ABG shows pH 7.21, PCO2 63, PO2 74, HCO3 23. The patient is in:
A. Respiratory acidosis with metabolic compensation
B. Acute respiratory acidosis without metabolic compensation
C. Mixed respiratory and metabolic acidosis
D. Acute metabolic acidosis without respiratory compensation
B. Acute respiratory acidosis without metabolic compensation
Fluid refractory shock should trigger the initiation of which of the following?
A. Norepinephrine
B. Atropine
C. Milrinone
D. IV Fluids
A. Norepinephrine
Which is true regarding diabetes in children?
A. Hyperosmolar nonketotic coma is common
B. Mortality from DKA is usually due to cerebral edema.
C. Mental status changes in DKA correlate with the degree of acidosis or hyperglycemia
D. Teens are generally compliant with their insulin treatment
B. Mortality from DKA is usually due to cerebral edema.
A patient undergoes surgery for a fractured ulna & radius. The surgeon is worried about compartment syndrome and is to be called at the first sign of this syndrome. The nurse will call with what symptom?
A. Loss of pulses
B. Pain
C. Parasthesia
D Swelling
B. Pain
In a patient with heparin induced thrombocytopenia associated with bleeding, which of the following is the most appropriate treatment?
A. FFP
B. Vitamin K
C. Platelets
D. Cryoprecipitate
C. Platelets
A 16 yo girl is admitted after an intentional ingestion of amitriptyline (tricyclic antidepressant). She is disoriented with tachycardia, and dilated pupils. EKG shows sinus tachycardia with a prolonged QRS interval. The nurse anticipates administration of:
A. IV sodium bicarbonate
B. Emergent hemodialysis
C. IV benzodiazepines
D. Continued monitoring until symptoms resolve.
A. IV sodium bicarbonate
A patient with neurogenic shock after acute spinal cord injury is most likely to exhibit:
A. Hypotension and tachycardia
B. Hypertension and tachycardia
C. Hypotension and bradycardia
D. Hypertension and bradycardia
C. Hypotension and bradycardia
A 4 week old presents with vomiting, diarrhea, and poor feeding since birth. The child has respiratory distress and is lethargic. The parents report they saw similar symptoms with another infant who died at 6 weeks of age. Which finding would the nurse suspect is indicative of an inborn error of metabolism?
A. Microcephaly
B. Micrognathia
C. Abnormal urine odor
D. Abnormal urine output volume
C. Abnormal urine odor
A 2 yo is admitted after accidental submersion injury. Eight hours after injury, the chest x-ray reveals diffuse bilateral patchy infiltrates, and the ventilator settings reveal impaired pulmonary compliance with a high O2 requirement. The most likely explanation is:
A. ARDS
B. Congestive heart failure with pulmonary edema
C. Bacterial pneumonia
D. Dislodged ETT
A. ARDS
Which of the following is NOT true of massive blood transfusions?
A. Dilutional thrombocytopenia can occur
B. Hypocalcemia can occur
C. Coagulation abnormalities can occur
D. Hypokalemia can occur
D. Hypokalemia can occur
12 yo patient with bacterial meningitis develops symptoms consistent with impending brain herniation. After stabilization of airway, breathing, and circulation, which of the following would be performed?
A. Fluid restriction to maintain BP lower than normal
B. Placement of patient in Trendelenberg position
C. Mild hyperventilation with goal PCO2 around 35 mmHg
D. IV ketamine administration
C. Mild hyperventilation with goal PCO2 around 35 mmHg