Critical Care Simulation Lab
Textbook Exam Questions
Course Introduction
Critical Care Simulation Lab is a hands-on course designed to immerse students in realistic, high-acuity clinical scenarios using advanced simulation technology. The course emphasizes the development of critical thinking, teamwork, and technical skills necessary for managing complex, life-threatening conditions commonly encountered in critical care settings. Students actively participate in simulated emergencies, such as cardiac arrest, respiratory failure, and sepsis, while receiving real-time feedback from instructors and peers. Through repeated practice and debriefing, this course fosters clinical competence, situational awareness, and effective communication, preparing participants to perform confidently and safely in high-pressure critical care environments.
Recommended Textbook
Critical Care Nursing Diagnosis and Management 8th Edition by Linda D. Urden
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41 Chapters
1210 Verified Questions
1210 Flashcards
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Chapter 1: Critical Care Nursing Practice
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) What type of therapy is an option to conventional treatment?
A) Alternative
B) Holistic
C) Complementary
D) Individualized
Answer: A
Q2) What type of practitioner is instrumental in ensuring care that is evidence based and that safety programs are in place?
A) Clinical nurse specialist
B) Advanced practice nurse
C) Registered nurses
D) Nurse practitioners
Answer: A
Q3) What is a health condition primarily resolved by nursing interventions or therapies called?
A) Nursing diagnosis
B) Nursing interventions
C) Nursing outcomes
D) Nursing process
Answer: A
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Chapter 2: Ethical Issues
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Sample Questions
Q1) The principle of respect for persons incorporates what additional concepts?
A) Confidentiality and privacy
B) Truth and reflection
C) Autonomy and justice
D) Beneficence and nonmaleficence
Answer: A
Q2) Which of the following is/are criteria for defining an ethical dilemma?
A) An awareness of different options
B) An issue in which only one viable option exists
C) The choice of one option compromises the option not chosen
D) An issue that has different options
Answer: A,C,D
Q3) What is the first step of the ethical decision-making process?
A) Consulting with an authority
B) Identifying the health problem
C) Delineating the ethical problem from other types of problems
D) Identifying the patient as the primary decision maker
Answer: B
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4
Chapter 3: Legal Issues
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Sample Questions
Q1) What element of malpractice is based on the existence of a nurse-patient relationship?
A) Duty
B) Breach
C) Damages
D) Harm caused by the breach
Answer: A
Q2) On the way to surgery,a patient expresses doubt about proceeding with the planned procedure.The patient states that the doctor did not explain it very well and she would like to talk to her again before starting the procedure.The nurse knows the surgery schedule is very tight,reassures the patient that everything will be all right,and administers the preoperative sedation.This scenario describes what possible type of negligence?
A) Assessment failure
B) Planning failure
C) Implementation failure
D) Evaluation failure
Answer: D
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Chapter 4: Genetic Issues
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Sample Questions
Q1) A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known which of the following?
A) Chromatids
B) Karyotype
C) Genomics
D) Histones
Q2) What is a genetic variant that exists in greater than 1% of the population termed?
A) Genetic mutation
B) Genetic polymorphism
C) Genetic deletion
D) Tandem repeat
Q3) What is the study of all the genetic material within the cell and its impact on biologic and physical characteristics called?
A) Chromatids
B) Karyotype
C) Genomics
D) Histones
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Chapter 5: Patient and Family Education
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Sample Questions
Q1) When writing goals and outcomes,what should be incorporated in the outcome statement?
A) An action oriented intervention list
B) An observable verb
C) The objectives for the nurse
D) The length of the education session
Q2) Which statement best describes the efficacy of group discussion as a patient teaching strategy for educating both a patient newly diagnosed with diabetes and a patient who has had the disease for years?
A) It is an efficient use of the nurse's time.
B) It is an efficient use of the patient's time.
C) It is an effective strategy as both patients have identical goals.
D) It is not an appropriate teaching strategy.
Q3) Which questions can a nurse use to obtain assessment information to determine the immediate need for education?
A) "How can we help you today?"
B) "Can you tell me why you take each medication?"
C) "Are you in pain?"
D) "Are these people your main support system?"
E) "How well do you understand the directions?"
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Chapter 6: Psychosocial and Spiritual Alterations and Management
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Sample Questions
Q1) Which therapeutic technique may be used to enhance coping in the critical care environment?
A) Encourage the patient to let the staff have total control of the patient's care
B) Encourage the patient to deny the presence of the illness
C) Inform the patient that everything will be all right
D) Foster trust in the interprofessional health care team
Q2) An adult patient sustains third- and fourth-degree burns to more than 70% of her body related to a house fire.The patient begins a pattern of behavior similar to that of a young child,in which she repeatedly whines and throws "temper tantrums" in an attempt to keep her nurse at the bedside.What coping mechanism is the patient exhibiting?
A) Regression
B) Identity disturbance
C) Denial
D) Trust
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8
Chapter 7: Nutrition Alterations and Management
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Sample Questions
Q1) A patient with heart failure is placed on a sodium and fluid restriction.What is the purpose of this order?
A) To enhance the metabolize of medications
B) To normalize the patient's weight
C) To reduce cardiac workload
D) To decrease serum lipids
Q2) A tracheostomy patient is experiencing regurgitation of tube feeding formula.What should be the nurse's first priority?
A) Checking to make sure the tracheostomy cuff is inflated during tube feedings
B) Placing the patient in the right lateral decubitus position to promote gastric emptying
C) Discussing the use of metoclopramide to facilitate gastric motility with the practitioner
D) Placing the patient in prone position to improve draining from mouth
Q3) What is one effect of malnutrition on respiratory system function?
A) Decreased surfactant production
B) Increased vital capacity
C) Decreased carbon dioxide production
D) Increased respiratory rate
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Chapter 8: Pain and Pain Management
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Sample Questions
Q1) The nurse is caring for a patient with liver dysfunction.What is the maximum dose of acetaminophen the patient should receive in 24 hours?
A) 1 grams
B) 2 grams
C) 4 grams
D) 500 milligrams
Q2) Why use a specific pain intensity scale in the critical care unit?
A) It eliminates the subjective component from the assessment.
B) It focuses on the objective component of the assessment.
C) It provides consistency of assessment and management.
D) It provides a way to interpret physiologic indicators.
Q3) The patient has received ketamine for its analgesic effects.The patient suddenly states,"I feel like I am floating and can see everything you are doing.I am not in control." What is this response called?
A) Hallucination state
B) Guided imagery
C) Dissociative state
D) Adverse event
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Chapter 9: Sedation,Agitation,and Delirium Management
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Sample Questions
Q1) A patient is admitted unit with acute respiratory distress syndrome (ARDS).The patient has been intubated and is mechanically ventilated.The patient is becoming increasingly agitated,and the high-pressure alarm on the ventilator has been frequently triggered.What action should be the nurse take first?
A) Administer midazolam 5 mg by intravenous push immediately.
B) Assess the patient to see if a physiologic reason exists for his agitation.
C) Obtain an arterial blood gas level to ensure the patient is not hypoxemic.
D) Apply soft wrist restraints to keep him from pulling out the endotracheal tube.
Q2) Which intervention is an effective nursing strategy to decrease the incidence of delirium?
A) Restriction of visitors
B) Early nutritional support
C) Clustering of nursing care activities
D) Bedrest
Q3) What are the risk factors for delirium?
A) Hypertension, alcohol abuse, and benzodiazepine administration
B) Coma, hypoxemia, and trauma
C) Dementia, hypertension, and pneumonia
D) Coma, alcohol abuse, hyperglycemia
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Chapter 10: End-Of-Life Care
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Sample Questions
Q1) Haloperidol are traditionally been used to managed which symptom?
A) Anxiety
B) Dyspnea
C) Delirium
D) Pain
Q2) A patient tells the nurse to call his family and tell them they need to come so they can say their goodbyes.The patient is sure he will not be here tomorrow because his grandparent is waiting for him.What is the patient exhibiting?
A) Anxiety
B) Delirium
C) Metabolic derangement
D) Near-death awareness
Q3) Hospice care is an option that should be considered,especially in end-stage illness.Hospice care can help families with which issue(s)?
A) Organ and tissue donations
B) Symptom management and family support
C) Procurement of advance directives and living wills
D) Legal and voluntary euthanasia
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Chapter 11: Cardiovascular Anatomy and Physiology
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Sample Questions
Q1) Depolarization of one myocardial cell will likely result in what physiologic response?
A) Completion of the action potential in that cell before a new cell can accept an impulse
B) Quick depolarization and spread to all of the heart
C) Depolarization of only cells superior to the initial depolarization
D) Quick depolarization of only cells inferior to the initial depolarization
Q2) What is the normal resting membrane potential of a myocardial cell?
A) 10 to 20 mV
B) 30 to 40 mV
C) -20 to -30 mV
D) -80 to -90 mV
Q3) An echocardiogram reveals an ejection fraction of 55%.On the basis of this information,how would the patient's cardiac function be described?
A) Adequate
B) Mildly decreased
C) Moderately decreased
D) Severely decreased
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13
Chapter 12: Cardiovascular Clinical Assessment
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Sample Questions
Q1) During a history examination,a patient tells the nurse,"The cardiologist says I have a leaking valve." The nurse documents that the patient has a history of what condition?
A) Acute mitral regurgitation
B) Aortic insufficiency
C) Chronic mitral regurgitation
D) Pericarditis
Q2) A patient is admitted with left-sided heart failure related to mitral stenosis.Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur.Which statement about an S3 is accurate?
A) It is normal for a person this age.
B) It is synonymous with a ventricular gallop.
C) It is only heard during systole.
D) It is best heard best with the diaphragm of the stethoscope.
Q3) The abdominojugular reflux test determines the presence of which disorder?
A) Right ventricular failure
B) Cirrhosis
C) Liver failure
D) Coronary artery disease
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Chapter 13: Cardiovascular Diagnostic Procedures
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74 Verified Questions
74 Flashcards
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Sample Questions
Q1) What is the formula for calculating mean arterial pressure (MAP)?
A) Averaging three of the patient's blood pressure readings over a 6-hour period
B) Dividing the systolic pressure by the diastolic pressure
C) Adding the systolic pressure and two diastolic pressures and then dividing by 3
D) Dividing the diastolic pressure by the pulse pressure
Q2) Patient education for a patient with a Holter monitor should include which instruction?
A) Keep a diary of activities, symptoms, and any medications that are taken.
B) Do not drink coffee while the recorder is on.
C) Do not take a bath but a shower is alright.
D) Carry the monitor in a purse or backpack.
Q3) Which statement made by a patient would indicate the need for further education before an electrophysiology procedure?
A) "I need to take all my heart medications the morning of the procedure."
B) "The doctor is going to make my heart beat wrong on purpose."
C) "I will be awake but relaxed during the procedure."
D) "I will be x-rayed during the procedure."
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Page 15
Chapter 14: Cardiovascular Disorders
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Sample Questions
Q1) Which intervention is an essential aspect of the patient teaching plan for the patient with chronic heart failure?
A) Instructing the patient to call the practitioner prior to dental surgery
B) Stressing the importance of compliance with diuretic therapy
C) Instructing the patient to take nitroglycerin if chest pain occurs
D) Teaching the patient how to take an apical pulse
Q2) A patient with coronary artery disease (CAD)is admitted with chest pain.The patient is suddenly awakened with severe chest pain.Three nitroglycerin sublingual tablets are administered 5 minutes apart without relief.A 12-lead electrocardiograph (ECG)reveals nonspecific ST segment elevation.The nurse suspects the patient may have which disorder?
A) Silent ischemia
B) Stable angina
C) Unstable angina
D) Prinzmetal angina
Q3) Which description best describes the pain associated with aortic dissection?
A) Substernal pressure
B) Tearing in the chest, abdomen, or back
C) Numbness and tingling in the left arm
D) Stabbing in the epigastric area
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Chapter 15: Cardiovascular Therapeutic Management
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Sample Questions
Q1) Which finding is a reliable indicator of reperfusion after fibrinolytic therapy?
A) Dysrhythmias
B) Q waves
C) Elevated ST segments
D) Immediate rapid decrease in cardiac biomarkers
Q2) Noninvasive emergency pacing is best achieved via the use of which type of temporary pacing?
A) Transvenous (endocardial)
B) Epicardial
C) Transthoracic
D) Transcutaneous
Q3) When analyzing the electocardiogram (ECG)strip of the patient with a pacemaker,the nurse notices there is a spike before each QRS complex.What is this phenomenon indicative of?
A) 60-cycle electrical interference; check equipment
B) Pacing artifact; the pacemaker is sensing and capturing
C) Electrical artifact; the pacemaker is not sensing
D) Patient movement; check electrodes
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17
Chapter 16: Pulmonary Anatomy and Physiology
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Sample Questions
Q1) Which factor will increase diffusion of gases across the alveolar capillary membrane?
A) A decrease in the surface area of the membrane
B) An increase in the thickness of the membrane
C) An increase in the driving pressure of the gas
D) A decrease in the solubility coefficient of the gas
Q2) The lymphatic system plays which of the following important roles?
A) Ridding lung tissue of excess CO
B) Connecting the thebesian veins to the coronary circulation
C) Removing fluid from the lungs
D) Producing immune responses
E) Removing cell debris from the lungs
Q3) Muscles of exhalation include which of the following?
A) Abdominal
B) Diaphragm
C) External intercostals
D) Internal intercostals
E) Scalene
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18
Chapter 17: Pulmonary Clinical Assessment
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Sample Questions
Q1) When auscultating a patient's lungs,the nurse notes breath sounds that sound like popping in the small airways.What should the nurse document in the patient's record?
A) Sonorous wheezes
B) Crackles
C) Sibilant wheezes
D) Pleural friction rub
Q2) How does the patient history assist the nurse in developing the management plan?
A) Provides direction for the rest of the assessment
B) Exposes key clinical manifestations
C) Aids in developing the plan of care
D) The degree of the patient's distress determines the extent of the interview
E) Determines length of stay in the hospital setting
Q3) The nurse is performing a pulmonary assessment on a patient with a pleural effusion.Which finding is unexpected?
A) Increased diaphragmatic excursion
B) Decreased tactile fremitus
C) Dull percussion tones
D) Pleural friction rub
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Chapter 18: Pulmonary Diagnostic Procedures
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Sample Questions
Q1) The patient's arterial blood gas (ABG)values on room air are PaO ,40 mm Hg; pH,7.10; PaCO ,44 mm Hg; andHCO ¯,16 mEq/L.What is the interpretation of the patient's ABG?
A) Uncompensated respiratory acidosis
B) Uncompensated metabolic acidosis
C) Compensated metabolic acidosis
D) Compensated respiratory acidosis
Q2) A patient's pulse oximeter alarm goes off.The monitor reads 82%.What is the first action the nurse should perform?
A) Prepare to intubate.
B) Assess the patient's condition.
C) Turn off the alarm and reapply the oximeter sensor.
D) Increase O level to 4L/NC.
Q3) Which arterial blood gas (ABG)values represent uncompensated metabolic acidosis?
A) pH, 7.29; PaCO , 57 mm Hg;HCO ¯ , 22 mEq/L
B) pH, 7.36; PaCO , 33 mm Hg;HCO ¯, 18 mEq/L
C) pH, 7.22; PaCO , 42 mm Hg;HCO ¯, 18 mEq/L
D) pH, 7.52; PaCO , 38 mm Hg;HCO ¯ , 29 mEq/L
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Chapter 19: Pulmonary Disorders
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Sample Questions
Q1) A patient was admitted after a left pneumonectomy.The patient is receiving 40% oxygen via a simple facemask.The morning chest radiography study reveals right lower lobe pneumonia.After eating breakfast,the patient suddenly vomits and aspirates.What action should the nurse take next?
A) Lavage the airway with normal saline.
B) Place the patient supine in a semi-Fowler position.
C) Manually ventilate the patient.
D) Suction the airway.
Q2) Which cause of hypoxemia is the result of blood passing through unventilated portions of the lungs?
A) Alveolar hypoventilation
B) Dead space ventilation
C) Intrapulmonary shunting
D) Physiologic shunting
Q3) Patients with left-sided pneumonia may benefit from placing them in which position?
A) Reverse Trendelenburg
B) Supine
C) On the left side
D) On the right side
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Chapter 20: Pulmonary Therapeutic Management
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Sample Questions
Q1) Which medication can cause bronchospasms and should be administered with a bronchodilator?
A) Beta-2 agonist
B) Mucloytics
C) Anticholinergic agents
D) Xanthines
Q2) What is an indication for a pneumonectomy?
A) Peripheral granulomas
B) Bronchiectasis
C) Unilateral tuberculosis
D) Single lung abscess
Q3) Which oxygen delivery device is considered a low-flow system?
A) Nasal cannula
B) Simple face mask
C) Reservoir cannula
D) Air-entrainment nebulizer
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Chapter 21: Neurologic Anatomy and Physiology
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Sample Questions
Q1) A lack of which two substances can cause disruption in neuronal function and irreversible damage?
A) Oxygen and glucose
B) Protein and insulin
C) Oxygen and protein
D) Protein and glucose
Q2) A patient is admitted after a stroke.The patient has an altered level of consciousness and garbled speech.A computed tomography scan is performed to determine the cause of the stroke,and a lumbar puncture is performed for analysis of cerebrospinal fluid (CSF).Because the patient's speech is garbled,the nurse documents the occurrence of which type of aphasia?
A) Fluent
B) Receptive
C) Expressive
D) Global
Q3) Cranial nerves IX,X,XI,and XII are located in which section of the brainstem?
A) Midbrain
B) Pons
C) Medulla oblongata
D) Reticular formation
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Chapter 22: Neurologic Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) The nurse knows that change in pupil size is a significant neurologic finding particularly in the patient with a head injury.How much of a size difference between the two pupils is still considered normal?
A) 1 mm
B) 1.5 mm
C) 2 mm
D) 2.5 mm
Q2) The practitioner has ordered a carotid Doppler study for a patient.The patient asks the nurse what the test is for.How should the nurse respond?
A) The test evaluates blood flow in the anterior, middle, or posterior cerebral arteries.
B) The test estimates blood flow velocity thought the carotid arteries.
C) The test assesses arteriovenous circulation in the intracranial space.
D) The test gauges global cerebral blood flow.
Q3) Cerebral infarction is a serious complication of which procedure?
A) Extracranial Doppler
B) Evoked potential testing
C) Myelography
D) Cerebral angiography
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Chapter 23: Neurologic Disorders and Therapeutic Management
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Sample Questions
Q1) A patient is admitted with an acute head injury after a motor vehicle accident.The patient is intubated and ventilated,and a ventriculostomy is placed.In addition to monitoring of intracranial pressure,what treatment can be provided with the ventriculostomy?
A) Instillation of mannitol
B) Drainage of subdural hematoma
C) Brain tissue sampling
D) Cerebrospinal fluid drainage
Q2) What are the most common medications used in high-dose barbiturate therapy?
A) Phenytoin and fosphenytoin
B) Mannitol and nimodipine
C) Lidocaine and phenobarbital
D) Pentobarbital and thiopental
Q3) After neurosurgery,the patient is at risk of developing what problem?
A) Aspiration
B) Diabetes mellitus
C) Seizures
D) Corneal abrasions
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Chapter 24: Kidney Anatomy and Physiology
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Sample Questions
Q1) The mobilization of calcium from bone stores is accomplished through the influence of which hormone?
A) Antidiuretic hormone (ADH)
B) Parathyroid hormone (PTH)
C) Thyroid-stimulating hormone (TSH)
D) Erythropoietin
Q2) What is the primary function of aldosterone?
A) Excretion of potassium through the renal tubules
B) Control of sodium and water
C) Regulation of bicarbonate
D) Reabsorption of sodium and potassium
Q3) The initial filtering of the blood occurs in which structure?
A) The distal tubule
B) The proximal tubule
C) The glomerulus
D) The collecting tubule
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Chapter 25: Kidney Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) A patient was admitted with acute heart failure a few days ago.Today the patient's urine has a specific gravity of 1.040.What could be the potential cause for this value?
A) Volume overload
B) Volume deficit
C) Acidosis
D) Urine ketones
Q2) A patient has been admitted in acute heart failure.Which parameter would indicate to the nurse that the patient is fluid overloaded?
A) Central venous pressure of 4 mm Hg
B) Pulmonary artery occlusion pressure (PAOP) of 18 mm Hg
C) Cardiac index of 2.5 L/min/m²
D) Mean arterial pressure of 40 mm Hg
Q3) The patient complains of a metallic taste and loss of appetite.The nurse is concerned that the patient has developed what problem?
A) Glycosuria
B) Proteinuria
C) Myoglobin
D) Uremia
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Chapter 26: Kidney Disorders and Therapeutic Management
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Sample Questions
Q1) What is the most common site for short-term vascular access for immediate hemodialysis?
A) Subclavian artery
B) Subclavian vein
C) Femoral artery
D) Radial vein
Q2) One therapeutic measure for treating hyperkalemia is the administration of dextrose and regular insulin.Which statement regarding how this treatment works is accurate?
A) Glucose and insulin force potassium out of the cells, lowering it on a cellular level.
B) Glucose and insulin promote higher excretion of potassium in the urine.
C) Glucose and insulin bind with potassium, lowering available amounts.
D) Glucose and insulin force potassium into the cells, lowering it on a serum level.
Q3) Which medication is classified as a loop diuretic?
A) Acetazolamide
B) Furosemide
C) Mannitol
D) Metolazone
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Page 28
Chapter 27: Gastrointestinal Anatomy and Physiology
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Sample Questions
Q1) Where in the gastrointestinal tract are Bacteroides,Lactobacillus,and Clostridium organisms commonly found?
A) Stomach
B) Small intestine
C) Large intestine
D) Liver
Q2) What is the pH of gastric juices prior to being mixed with food?
A) 1.0
B) 3.0
C) 5.0
D) 7.0
Q3) What is the main function of bile?
A) Emulsify fat globules
B) Serve as a reservoir for bilirubin
C) Maintain triglyceride levels in the blood
D) Aid in detoxification of drugs in the liver
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Chapter 28: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) The nurse is caring for a patient with an upper gastrointestinal bleed.What procedure would the nurse expect the practitioner to order to confirm this diagnosis?
A) Endoscopic retrograde cholangiopancreatography (ERCP)
B) Colonoscopy
C) Endoscopy
D) Angiography
Q2) A patient was admitted with pancreatitis.In which order would the nurse perform an assessment of the gastrointestinal system?
A) Inspection, palpation, percussion, auscultation
B) Palpation, percussion, inspection, auscultation
C) Inspection, auscultation, percussion, palpation
D) Palpation, inspection, auscultation, percussion
Q3) The practitioner has ordered a magnetic resonance imaging (MRI)of the liver.What would the nurse do to prepare the patient for the examination?
A) Explain the patient must lie still during the procedure.
B) Explain the patient may experience deep pressure sensation.
C) Inform the patient that he or she will have to drink contrast.
D) Inform the patient that the procedure will be performed at the bedside.
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Chapter 29: Gastrointestinal Disorders and Therapeutic Management
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Q1) A patient with a history of chronic alcoholism was admitted with acute pancreatitis.The nurse is developing a patient education plan.Which topic would the nurse include in the plan?
A) Diabetes management
B) Alcohol cessation
C) Occult blood testing
D) Anticoagulation management
Q2) A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices.What medication would the nurse expect the practitioner to order for this patient?
A) Histamine2 (H2) antagonists
B) Vasopressin
C) Heparin
D) Antacids
Q3) Which nursing intervention is a priority for a patient with gastrointestinal hemorrhage?
A) Positioning the patient in a high-Fowler position
B) Ensuring the patient has a patent airway
C) Irrigating the nasogastric tube with iced saline
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D) Maintaining venous access so that fluids and blood can be administered
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Chapter 30: Endocrine Anatomy and Physiology
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Q1) A patient is receiving insulin due to the development of steroid-induced hyperglycemia.In addition to lowering blood glucose levels,what other physiologic effect may occur when insulin is administered?
A) Breakdown of proteins
B) Hypercalcemia
C) Hypokalemia
D) Cellular dehydration
Q2) A patient is admitted with multiple trauma.Which hormone would the nurse expect to be increased in response to physiologic stress?
A) Mineralocorticoid
B) Corticosteroid
C) Glucocorticoid
D) Cortisol
Q3) A patient with thyrotoxicosis has been admitted.What effect of increased T and T levels might the nurse expect to see in this patient?
A) Increased oxygen consumption
B) Decreased basal metabolic rate
C) Decreased cardiac output
D) Increased calcium levels
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Chapter 31: Endocrine Clinical Assessment and Diagnostic
Procedures
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Q1) A patient is reporting a headache,fatigue,abdominal pain,and blurred vision.The nurse knows that these signs may indicate the patient has what problem?
A) Hypothyroidism
B) Pituitary tumor
C) Cushing syndrome
D) Hyperglycemia
Q2) A nurse is teaching a patient with diabetes mellitus.The patient asks the nurse what is an acceptable HbA c level for him.What should the nurse tell the patient?
A) An acceptable level is less than 5.4%.
B) An acceptable level is less than 6.5%.
C) An acceptable level is determined by your practitioner.
D) It is dependent on your age.
Q3) A patient has been admitted who is suspected of having thyrotoxicosis.Which symptom would support this diagnosis?
A) Lethargy despite adequate sleep
B) Bradycardia not related to medications
C) Constipation despite laxatives
D) Weight loss despite increased appetite
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Chapter 32: Endocrine Disorders and Therapeutic Management
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Q1) A patient has been admitted with diabetic ketoacidosis (DKA).The nurse knows that the top priority in the initial treatment of DKA is which intervention?
A) Lowering the blood sugar as quickly as possible
B) Administering intravenous fluids
C) Administering sodium bicarbonate
D) Determining the precipitating cause
Q2) An older patient presents with a serum glucose level of 900 mg/dL,hematocrit of 55%,and no serum ketones.Immediate attention must be given to which intervention?
A) Evaluating clotting factors
B) Fluid administration
C) Insulin administration
D) Sodium replacement
Q3) A patient has been admitted with diabetic ketoacidosis,and treatment has been initiated.Which findings would lead the nurse to suspect the patient is dehydrated?
A) Poor skin turgor and flat neck veins
B) Dyspnea and crackles
C) Presence of Chvostek and Trousseau signs
D) Extra heart sounds and 3+ edema
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Chapter 33: Trauma
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Q1) A trauma patient's condition has deteriorated.The nurse notes changes in patient's condition,including trachea shift,absence of breath sounds on the left side,and hypotension.The nurse suspects that the patient has developed what complication?
A) Cardiac tamponade
B) Hemothorax
C) Open pneumothorax
D) Ruptured diaphragm
Q2) Older trauma patients have a higher mortality than younger trauma patients.The nurse understands that this fact is probably related to what physiologic change?
A) Deterioration of cerebral and motor skills
B) Poor vision and hearing
C) Diminished pain perception
D) Limited physiologic reserve
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Chapter 34: Shock,sepsis,and Multiple-Organ Dysfunction Syndrome
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Q1) A patient has been admitted with septic shock due to urinary sepsis.The practitioner inserts a pulmonary artery (PA)catheter.Which hemodynamic value would the nurse expect to note to support this diagnosis?
A) Cardiac output (CO) of 8 L/min
B) Right atrial pressure (RAP) of 17 mm Hg
C) Pulmonary artery occlusion pressure (PAOP) of 23 mm Hg
D) Systemic vascular resistance (SVR) of 1100 dyne/s/cm-5
Q2) The nurse is caring for a patient with multiple-organ dysfunction syndrome (MODS).The nurse understands that earlier nutritional support is critical for the patient to prevent profound weight loss.Why does this occur in patient MODS?
A) Patient experiences hypometabolism.
B) Patient experiences hypermetabolism.
C) Patient experiences anorexia.
D) Patient has gut dysfunction.
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Chapter 35: Burns
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Q1) A patient is admitted after being burned in a car fire.The wound surface is red with patchy white areas that blanch with pressure but no blister formation.What kind of burn would the nurse document in the patient's record?
A) Superficial partial-thickness burn
B) Moderate partial-thickness burn
C) Deep dermal partial-thickness burn
D) Full-thickness burn
Q2) The nursing management plan for a patient with full-thickness burns includes which intervention?
A) Daily replacement of autografts
B) Daily wound care with premedication
C) Weekly wound care until all eschar is debrided
D) Surgical skin grafting within 8 hours of admission
Q3) Which topical antimicrobial agent is commonly used as a broad-spectrum and fights against gram-positive and -negative bacteria?
A) Pure silver
B) Bacitracin
C) Mafenide acetate cream
D) Silver sulfadiazine
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Chapter 36: Organ Donation and Transplantation
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Q1) After a pancreatic transplant with bladder exocrine drainage,the nurse would anticipate which order?
A) Continuous bladder irrigation
B) Intermittent insulin injections
C) Removal of the nasogastric tube as soon as the patient is alert
D) Daily hematocrit and hemoglobin levels
Q2) Which federal laws regulate the medical and surgical therapy involved with organ transplantation?
A) Omnibus Budget Reconciliation Act
B) Uniform Anatomical Gift Act
C) Hospital Conditions of Participation-Organ Donations
D) Medical Examiner Laws
E) Uniform Determination of Death Act
Q3) A patient who has received a transplant is being taught about azathioprine.Which statement made by the patient would indicate the teaching was effective?
A) "I will notify my health care provider if my gums start to bleed."
B) "I will make sure to increase the amount of fiber in my diet."
C) "I realize I may have an increase in hair growth."
D) "I know the flulike symptoms will go away as I get used to the drug."
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Chapter 37: Hematologic and Oncologic Emergencies
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Q1) A patient has been admitted with tumor lysis syndrome (TLS).Which laboratory findings would the nurse expect to note to support this diagnosis?
A) Increased calcium
B) Decreased potassium
C) Dysrhythmias
D) Elevated blood urea nitrogen (BUN)
E) Elevated creatine
Q2) How is the intrinsic coagulation pathway activated?
A) Local blood vessels constrict at the injury site.
B) Damaged subendothelium comes into contact with circulating blood.
C) Tissue factor is released by injured vascular cells.
D) Serotonin and histamine are released.
Q3) The nurse is caring for a patient with type 2 heparin-induced thrombocytopenia (HIT).The nurse knows that pulmonary embolism is a serious complication of HIT.Which findings would alert the nurse to the presence of this complication?
A) Blanching of fingers and toes and loss of peripheral pulses
B) Chest pain, pallor, and confusion
C) Headache, impaired speech, and loss of motor function
D) Dyspnea, pleuritic pain, and rales
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Chapter 38: The Obstetric Patient
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Q1) A patient has been admitted with preeclampsia.The nurse understands that this disorder is characterized by what widespread physiologic changes?
A) Increase in circulating plasma volume
B) Vasospasms in the arterial system
C) Disseminated intravascular coagulation
D) High systemic vascular resistance
Q2) A patient is admitted who is pregnant and has a congenital cardiac disorder.The patient is experiencing complications that include dysrhythmias,heart failure,and thromboembolism.The nurse recognizes that these are symptoms of which condition?
A) Atrial septal defect
B) Ventricular septal defect
C) Patent ductus arteriosus
D) Mitral stenosis
Q3) What intrinsic factor can influence fetal development?
A) Fungal infections
B) Chromosomal abnormalities
C) Radiation exposure
D) Medication exposure
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Chapter 39: The Pediatric Patient
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Q1) What is the difference between the upper airway of an infant and that of an adult?
A) The infant's epiglottis is located lower than an adult's.
B) The infant's tongue is larger than the adult's, and it fills the oral cavity.
C) The infant's larynx is more tubular shaped with its narrowest portion at the epiglottis.
D) The infant's airway is more rigid than an adult's.
Q2) A 3-month-old infant presents with vomiting and diarrhea.The infant appears to be drowsy; his pulse rate is 180 beats/min; and he has had a dry diaper for the past 3 hours.The nurse suspects the patient has developed which condition?
A) Mild dehydration
B) Moderate dehydration
C) Desiccation
D) Severe dehydration
Q3) What is the initial treatment for hypoxia,acidosis,or hypothermia?
A) Vasopressin
B) Bronchodilators
C) Oxygenation and ventilation
D) Hydration
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Chapter 40: The Older Adult Patient
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Q1) Which age-related changes contribute to a higher risk for myocardial ischemia in an older patient?
A) Increased diastolic filling pressures
B) Decreased intracellular free calcium
C) Thinning of the left ventricular wall
D) Increased myocardial collagen content
E) Increased myocardial oxygen consumption
Q2) Which nonsteroidal antiinflammatory drug (NSAID)has the side effect of renal failure,hypertension (HTN),heart failure,and gastrointestinal (GI)bleed in the elderly population?
A) Indomethacin
B) Ketorolac
C) Aspirin greater than 325 mg
D) Naproxen
Q3) An older patient is admitted to the hospital with a hip fracture.Which nursing intervention would be a priority?
A) Encourage frequent deep breathing.
B) Administer stool softeners.
C) Perform neurologic checks.
D) Frequently offer liquids to drink.
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Chapter 41: The Perianesthesia Patient
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Q1) When a patient develops postoperative hypertension,what potential cause would the nurse investigate?
A) Opioid administration
B) Fluid overload
C) Bladder distention
D) Dysrhythmias
Q2) When a patient emerges in a very restless state,what is the first problem the nurse must suspect?
A) Anxiety
B) Hypoxia
C) Pain
D) Gastric distention
Q3) The nurse is caring for a postoperative patient who is complaining of being cold and shivering.The patient's temperature is normal.The nurse understands that shivering can occur in the normothermic patient for what reason?
A) Dehydration
B) Delayed response to being hypothermic during surgery
C) Effects of anesthetic agents
D) Anxiety
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