Professional Practice in Critical Care Settings Practice Exam
Course Introduction
This course provides an in-depth exploration of professional practice within critical care environments, with a focus on the development of advanced clinical skills, ethical decision-making, and effective interdisciplinary collaboration. Students will examine evidence-based interventions, patient safety protocols, and crisis resource management strategies essential for high-acuity care. Through case studies, simulations, and reflective practice, learners will build competencies in communication, leadership, and managing the complex needs of critically ill patients and their families, preparing them for effective roles within multidisciplinary critical care teams.
Recommended Textbook
Priorities in Critical Care Nursing 7th Edition by Linda D. Urden
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42 Chapters
1239 Verified Questions
1239 Flashcards
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Chapter 1: Critical Care Nursing Practice
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Sample Questions
Q1) According to Kupperschmidt,to become a skilled communicator,one must
A) become candid.
B) become reflective.
C) set goals and develop action plans.
D) survey the team.
E) become aware of self-deception.
Answer: A,B,E
Q2) The term diversity encompasses the following:
A) ethnic sensitivity.
B) openness to different lifestyles.
C) values.
D) beliefs.
E) opinions.
Answer: A,B,C,D,E
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Page 3
Chapter 2: Ethical Issues
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Sample Questions
Q1) Failures and inadequacies in the health care facility's operation and organization are often misinterpreted as ethical issues.These issues are known as
A) systems problems.
B) social problems.
C) ethical issues.
D) governmental problems.
Answer: A
Q2) Institutional ethics committees (IECs)review ethical cases that are problematic for the practitioner.Major functions of IECs include
A) consultation with purely binding recommendations.
B) support and education to health care providers.
C) conflict resolution for moral dilemmas.
D) recommendations that are binding in all cases.
Answer: B
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Chapter 3: Legal Issues
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Sample Questions
Q1) Which of the following actions demonstrate the act of battery?
A) Performing CPR on a patient with a DNR order
B) Threatening to punch someone
C) Sexual misconduct
D) Drawing blood without the patient's consent
E) Threatening to restrain a patient for not using his or her call light for mobility assistance
Answer: A,C,D
Q2) During transport to the operating room for mitral valve replacement,a patient with a signed consent form says that she does not want to go through with the surgery and asks to be returned to her room.The best response from the nurse is:
A) "The operating room is prepared; let's not keep the surgeon waiting."
B) "You have the right to cancel surgery, but it could be weeks before you are rescheduled."
C) "You sound frightened; tell me what you are thinking."
D) "Your preoperative medications will have you feeling more relaxed in a minute; it will be OK."
Answer: C
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Chapter 4: Genetics and Genomics in Critical Care
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Sample Questions
Q1) Monozygotic twins separated at birth are used to compare the effects of genetics versus environment and health because
A) they share an identical genome.
B) monozygotic twins have different sex chromosomes.
C) it is easier to do because siblings are separated at the time of adoption.
D) genetics, environment, and health issues are stable in a study group.
Q2) The study of all the genetic material within the cell and its impact on biological and physical characteristics is known as:
A) chromatids.
B) karyotype.
C) genomics.
D) histones.
Q3) An example of direct-to-consumer genomic testing is:
A) genetic testing through amniocentesis.
B) paternity testing from buccal swabs of the child and father.
C) biopsy of a lump for cancer.
D) drug testing using hair follicles.
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Chapter 5: Patient and Family Education
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Sample Questions
Q1) _____ often occur(s)during the initial ICU visit by the family.
A) Sensory deprivation
B) Discharge teaching
C) Repeated questioning
D) Stress and anxiety
Q2) Learning domains are identified as:
A) knowledge, ability, and willingness to learn.
B) psychologic, skills, and knowledge.
C) knowledge, skills, and attitude.
D) skills, attitude, and psychologic.
Q3) Identify which of the following questions a nurse could use to obtain assessment information.
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) Interventions to help family members who are extremely upset include
A) encouraging the family to visit as much as possible.
B) conveying what the patient is experiencing to the family.
C) supporting the family members away from the bedside.
D) assuring the family that the staff will take care of the technical aspects of the patient's care.
Q2) A patient is admitted into the ICU with the diagnosis of gunshot wound to the head,suicide attempt.While the patient is in the ICU the nurse's interventions should include
A) limiting interaction with the patient due to antisocial behaviors exhibited by the suicidal attempt.
B) ignoring the patient's need to talk about the incident.
C) validating the patient's worth and self-esteem.
D) discontinuing any psychotropic medications.
Q3) Because of the nature of the environment,_____ is a serious concern in the critical care environment.
A) family involvement
B) use of complementary therapies
C) sleep deprivation
D) calm environment
Page 8
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Chapter 7: Sleep Alterations and Management
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Sample Questions
Q1) _____ is used during polysomnography to determine when the patient enters REM sleep.
A) Electrooculography
B) Electromyography
C) Electroencephalography
D) Polysomnography
Q2) A patient with mild obstructive sleep apnea (OSA)can expect treatment to consist of
A) medical management with protriptyline.
B) weight loss, elimination of alcohol before bedtime, and side sleeping.
C) immediate use of continuous positive airway pressure (CPAP).
D) surgical intervention with uvulopalatopharyngoplasty (UPPP).
Q3) Sleep deprivation can result from which of the following?
A) CPAP machine use
B) Mechanical ventilation
C) Use of nonbenzodiazepine short-acting hypnotics
D) Use of analgesic medications to control pain
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Chapter 8: Nutrition Alterations and Management
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Sample Questions
Q1) A primary nutritional intervention for hypertension is
A) decreasing carbohydrates.
B) limiting salt.
C) increasing protein.
D) increasing fluids.
Q2) A patient is admitted to the critical care unit with severe malnutrition as a result of hepatic failure.A triple-lumen central venous catheter is placed in the right subclavian vein,and TPN is started.For which of the following complications should the patient be evaluated immediately after insertion of the catheter?
A) Pneumothorax
B) Hypoglycemia
C) Central venous thrombosis
D) Pulmonary aspiration
Q3) The loss of exocrine function of pancreatitis results in A) anorexia.
B) obesity.
C) malabsorption.
D) hyperglycemia.
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Chapter 9: Pain and Pain Management
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Sample Questions
Q1) Which of the following assessment findings might indicate respiratory depression after opioid administration?
A) Flushed, diaphoretic skin
B) Shallow respirations with a rate of 24 breaths/min
C) Tense, rigid posture
D) Snoring
Q2) The patient is admitted to the CCU with hemodynamic instability and an allergy to morphine.The nurse anticipates that the physician will order which medication for severe pain?
A) Hydromorphone
B) Codeine
C) Fentanyl
D) Methadone
Q3) The subjective characteristic implies that pain is
A) an uncomfortable experience present only in the patient with an intact nervous system.
B) an unpleasant experience accompanied by crying and tachycardia.
C) activation of the sympathetic nervous system from an injury.
D) whatever the patient experiencing it says it is, occurring when that patient says it does.
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Chapter 10: Sedation,Agitation,Delirium: Assessment and Management
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Sample Questions
Q1) To achieve ventilator synchrony in a mechanically ventilated patient with acute respiratory distress syndrome (ARDS),which level of sedation might be most effective?
A) Light
B) Moderate
C) Conscious
D) Deep
Q2) A patient was admitted into the critical care unit 3 days ago.She has just been weaned from mechanical ventilation.She suddenly becomes confused,seeing nonexistent animals in her room and pulling at her gown.You suspect this patient is A) experiencing delirium or "ICU psychosis."
B) experiencing confusion caused by increased hypoxia.
C) hypocalcemic.
D) acting out to receive the attention she was getting while intubated.
Q3) Risk factors for delirium include
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 11: End-Of-Life Issues
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Sample Questions
Q1) A patient was admitted to the critical care unit several weeks ago with an acute myocardial infarction and subsequently underwent coronary artery bypass grafting surgery.Since a cardiac arrest 5 days ago,the patient has been unresponsive.An electroencephalogram shows no meaningful brain activity.The decision is made to remove the patient from the ventilator.Which of the following statements is most accurate?
A) The cardiac monitor should be left on so everyone will know when the patient has died.
B) Opioids, sedatives, and neuromuscular blocking agents should be discontinued just before removing the ventilator.
C) The family and health care team should decide the best method for removing the ventilator: terminal wean versus immediate extubation.
D) If terminal weaning is selected, the family should be sent to the waiting room until the ventilator has actually been removed.
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Chapter 12: Cardiovascular Anatomy and Physiology
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Sample Questions
Q1) A patient is admitted to the critical care unit with a diagnosis of acute myocardial infarction.The monitor pattern reveals bradycardia.The patient weight is 70 kg and height is 5 feet,5 inches tall.Based on the above information; occlusion of which coronary artery most likely resulted in bradycardia from sinoatrial node ischemia?
A) Right
B) Left anterior descending
C) Circumflex
D) Dominant
Q2) The contribution of atrial kick to ventricular filling is approximately
A) 10%.
B) 20%.
C) 5%.
D) 45%.
Q3) In a myocardial cell,the normal resting membrane potential is
A) 10 to 20 mV.
B) 30 to 40 mV.
C) -20 to -30 mV.
D) -80 to -90 mV.
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14
Chapter 13: Cardiovascular Clinical Assessment
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Sample Questions
Q1) A heart murmur is described as blowing,grating,or harsh.This description would fall under which criteria?
A) Intensity
B) Quality
C) Timing
D) Pitch
Q2) A sudden increase in left atrial pressure,acute pulmonary edema,and low cardiac output,caused by the ventricle contracting during systole,are all characteristics of A) acute mitral regurgitation.
B) aortic insufficiency.
C) chronic mitral regurgitation.
D) pericardial friction rub.
Q3) The abdominojugular reflux test determines the presence of A) right ventricular failure.
B) hypoxemia.
C) liver failure.
D) pitting edema.
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Chapter 14: Cardiovascular Diagnostic Procedures
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Sample Questions
Q1) What is the initial intervention in a patient with sinus tachycardia with the following vital signs: HR,136 beats/min; BP,102/60 mm Hg; RR,24 breaths/min; T,99.2° F; SpO<sub>2</sub>,94% on oxygen 2 L/min by nasal cannula?
A) Stat adenosine to decrease heart rate
B) Identification and correction of the cause of the increased heart rate
C) Sublingual nitroglycerine 0.4 mg
D) Lidocaine 75 mg IV push
Q2) Which of the following statements 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."
Q3) Which of the following cardiac enzymes is a highly specific biomarker for myocardial damage?
A) CK-MB
B) Troponin I
C) Troponin T
D) LDH
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Page 16
Chapter 15: Cardiovascular Disorders
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Sample Questions
Q1) The patient is on day 3 of hospitalization in the ICU.The 45-year-old patient was admitted with a diagnosis of acute MI.The patient complains of fatigue,not sleeping the past two nights,and change in appetite.The nurse is aware that these are symptoms of A) angina.
B) anxiety.
C) depression.
D) endocarditis.
Q2) Which of the following values,when elevated,places the patient at lowest risk for CAD?
A) Very-low-density lipoproteins (VLDLs)
B) Triglycerides
C) Low-density lipoproteins (LDLs)
D) High-density lipoproteins (HDLs)
Q3) Dyspnea with wheezing,a nonproductive cough,and pulmonary crackles that progress to the gurgling sounds of pulmonary edema is described as A) dyspnea.
B) orthopnea.
C) paroxysmal nocturnal dyspnea.
D) cardiac asthma.
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Chapter 16: Cardiovascular Therapeutic Management
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Sample Questions
Q1) A patient is diagnosed with third-degree heart failure.The nurse reviews the patient's medication list because the following classifications of drugs should be avoided with patients with heart failure.
A) NSAIDs
B) Antidysrhythmics
C) ACE inhibitors
D) Calcium channel blockers
E) Beta-blockers
Q2) A nurse is providing care to a patient on fibrinolytic therapy.Which of the following statements from the patient warrants further assessment and intervention by the critical care nurse?
A) "My back is killing me!"
B) "There is blood on my toothbrush!"
C) "Look at the bruises on my arms!"
D) "My arm is bleeding where my IV is!"
Q3) Adenosine (Adenocard)is an antidysrhythmic agent given primarily to
A) convert supraventricular tachycardias.
B) act as a second-line drug for premature ventricular contractions (PVCs).
C) treat AV blocks.
D) coarsen ventricular fibrillation so that defibrillation is effective.
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Chapter 17: Pulmonary Anatomy and Physiology
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Sample Questions
Q1) Lack of surfactant can cause which of the following conditions?
A) Pulmonary embolus
B) Pulmonary hypertension
C) Pulmonary atelectasis
D) Pulmonary edema
Q2) Trauma to which vertebrae will cause ventilation dysfunction?
A) C3-C5
B) C5-T?
C) T? -T6
D) T7-T10
Q3) The conducting airways
A) participate in gas exchange.
B) cool the incoming airway.
C) remove moisture from incoming air.
D) prevent the entry of foreign material.
Q4) The lobes are divided into 18 segments.How many are on the right lung?
A) 3
B) 8
C) 10
D) 15
Page 19
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Chapter 18: Pulmonary Clinical Assessment
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Q1) Which of the following is an example of a disorder with increased tactile fremitus?
A) Emphysema
B) Pleural effusion
C) Pneumothorax
D) Pneumonia
Q2) Why would the nurse perform an inspection of the oral cavity during a complete pulmonary assessment?
A) To provide evidence of hypoxia
B) To provide evidence of dyspnea
C) To provide evidence of dehydration
D) To provide evidence of nutritional status
Q3) The use of observation for assessment is known as A) inspection.
B) palpation.
C) percussion.
D) auscultation.
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Page 20
Chapter 19: Pulmonary Diagnostic Procedures
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Q1) On admission,a patient presents as follows: pH,7.38; respiratory rate,24 breaths/min,regular,pursed-lip breathing; PaO<sub>2</sub>,66 mm Hg; heart rate,112 beats/min,sinus tachycardia; PaCO<sub>2</sub>,52 mm Hg; blood pressure,110/68 mm Hg; HCO<sub>3</sub>-,24 mEq/L; and SpO<sub>2</sub>,90% on O<sub>2</sub> 2 L/min nasal cannula.These gases show
A) uncompensated metabolic alkalosis.
B) uncompensated respiratory acidosis.
C) compensated metabolic acidosis.
D) compensated respiratory alkalosis.
Q2) Which of the following patients would be considered hypoxemic?
A) A 70-year-old man with a PaO<sub>2</sub> of 72
B) A 50-year-old woman with a PaO<sub>2</sub> of 65
C) An 84-year-old man with a PaO<sub>2</sub> of 96
D) A 68-year-old woman with a PaO<sub>2</sub> of 80
Q3) A static lung compliance of 40 mL/cm H<sub>2</sub>O is indicative of which of the following disorders?
A) Pneumonia
B) Bronchospasm
C) Pulmonary emboli
D) Upper airway obstruction
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Chapter 20: Pulmonary Disorders
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Q1) A patient with acute respiratory failure may require a bronchodilator if which of the following occurs?
A) Excessive secretions
B) Bronchospasms
C) Thick secretions
D) Fighting the ventilator
Q2) Which of the following conditions develops when air enters the pleural space from the lung on inhalation and cannot exit on exhalation?
A) Tension pneumothorax
B) Sucking chest wound
C) Open pneumothorax
D) Pulmonary interstitial empyema
Q3) The most common presenting signs and symptoms associated with PEs are
A) tachycardia and tachypnea.
B) hemoptysis and evidence of deep vein thromboses.
C) apprehension and dyspnea.
D) right ventricular failure and fever
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Chapter 21: Pulmonary Therapeutic Management
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Q1) Which of the following statements are true regarding rotational therapy?
A) Continuous lateral rotation therapy (CLRT) can be effective for improving oxygenation if used for at least 18 hours/day.
B) Kinetic therapy can decrease the incidence of ventilator-acquired pneumonia in neurologic and postoperative patients.
C) Use of rotational therapy eliminates the need for other pressure ulcer prevention strategies.
D) CLRT helps avoid hemodynamic instability secondary to the continuous, gentle turning of the patient.
E) CLRT has minimal pulmonary benefits for critically ill patients.
Q2) Which route for ETT placement is used in an emergency?
A) Orotracheal
B) Nasotracheal
C) Nasopharyngeal
D) Trachea
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Chapter 22: Neurologic Anatomy and Physiology
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Q1) A patient has coherent speech but the words are illogical.Which part of the brain has been affected?
A) The cerebellum
B) The Broca area
C) The Wernicke area
D) The hypothalamus
Q2) Which statement best describes the role of neuroglial cells?
A) They are fewer in number than neurons.
B) They provide support to the neuron in nutrients and structural formation.
C) They protect the CNS from nonmetabolic primary neoplasms.
D) They produce a steady supply of neurotransmitters.
Q3) The primary functions of which lobe are hearing,speech,behavior,and memory?
A) Frontal lobe
B) Temporal lobe
C) Occipital lobe
D) Parietal lobe
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Chapter 23: Neurologic Clinical Assessment and Diagnostic Procedures
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Q1) While starting an intravenous line on the right hand of an unconscious patient,the patient reaches over with his left hand and tries to remove the noxious stimuli.This response is called
A) decorticate posturing.
B) decerebrate posturing.
C) withdrawal.
D) localization.
Q2) Testing of extraocular eye movements assesses
A) pupillary response to light.
B) function of the three cranial nerves of the eye.
C) the ability of the eyes to accommodate to a closer moving object.
D) the oculocephalic reflex.
Q3) Which of the following patients may need sedation before having an MRI scan?
A) Claustrophobic patient
B) Comatose patient
C) Elderly patient
D) Patient with a spinal cord injury
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Page 25
Chapter 24: Neurologic Disorders and Therapeutic Management
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Q1) One of the earliest and most important signs of increased ICP is A) Cushing triad.
B) decerebrate posturing (abnormal extension).
C) a decrease in the level of consciousness.
D) an increase in pupillary size.
Q2) After neurosurgery,the patient is at the greatest risk of developing A) injury from falls.
B) infection.
C) seizures.
D) corneal abrasions.
Q3) A patient who has experienced a right-sided stroke with hemiagnosia may experience
A) reading the right side of the newspaper only.
B) denying ownership of the right side of the body.
C) being hyperresponsive when approached on the right side.
D) attempting to comb the hair with a toothbrush.
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Chapter 25: Kidney Anatomy and Physiology
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Q1) For micturition to occur,stimulation from what receptor(s)will cause the parasympathetic messages to contract the detrusor muscle of the bladder?
A) Bladder wall and ureters
B) Bladder wall and urethra
C) Ureters and urethra
D) Urethra
Q2) To prevent acid-base disturbances,the ratio between carbonic acid and bicarbonate should be
A) 10 mEq of carbonic acid to 20 mEq of bicarbonate.
B) 20 mEq of carbonic acid to 10 mEq of bicarbonate.
C) 1 mEq of carbonic acid to 20 mEq of bicarbonate.
D) 20 mEq of carbonic acid to 1 mEq of bicarbonate.
Q3) Complications of kidney function in older adults will occur with the presence of A) proteinuria.
B) vasopressin.
C) BUN.
D) creatine.
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Page 27
Chapter 26: Kidney Clinical Assessment and Diagnostic Procedures
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Q1) A patient is admitted to the critical care unit in congestive heart failure secondary to renal insufficiency.The patient reports that over the past few weeks,his urine output has decreased,and he has developed peripheral edema and ascites.A diagnosis of renal failure is made.Which of the following diagnostic tests would give the best information about the internal kidney structures,such as the parenchyma,calyces,pelvis,ureters,and bladder?
A) Kidney-ureter-bladder (KUB)
B) Intravenous pyelography (IVP)
C) Renal ultrasonography (ECHO)
D) Renal angiography
Q2) Which of the following may be present in the patient with significant fluid volume overload?
A) S3 or S4 may develop.
B) Distention of the hand veins will disappear if the hand is elevated.
C) When testing the quality of skin turgor, the skin will not return to the normal position for several seconds.
D) Tachycardia with hypotension may be present.
E) Dependent edema may be present.
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Chapter 27: Kidney Disorders and Therapeutic Management
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Q1) What is the dose for low-dose dopamine?
A) 1 to 2 mcg/kg/min
B) 1 to 2 mg/kg/min
C) 2 to 3 mcg/kg/min
D) 2 to 3 mg/kg/min
Q2) To prevent catheter-associated UTI (CAUTI),the nurse should
A) insert urinary catheters using aseptic techniques.
B) change the urinary catheter daily.
C) review the need for the urinary catheter daily and remove promptly.
D) flush the urinary catheter q8 hours to maintain patency.
E) avoid unnecessary use of indwelling urinary catheters.
Q3) An alert and oriented patient presents with a pulmonary artery wedge pressure of 4 mm Hg and a cardiac index of 0.8.The BUN is 44 mg/dL,creatinine is 3.2 mg/dL,and BP is 88/36 mm Hg.Urine output is 15 mL/hr.Lungs are clear to auscultation with no peripheral edema noted.Which of the following treatments would the physician most likely order?
A) Lasix 40 mg intravenous push
B) 0.9% normal saline at 125 mL/hr
C) Dopamine 15 ?g/kg/min
D) Transfuse 1 U of packed red blood cells
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Chapter 28: Gastrointestinal Anatomy and Physiology
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Q1) The liver receives nutrient-rich blood from the gut,pancreas,spleen,and stomach from the
A) hepatic artery.
B) hepatic vein.
C) portal vein.
D) intralobular veins.
Q2) Bacteroides,Lactobacillus,and Clostridium organisms are commonly found in the: A) stomach.
B) small intestine.
C) large intestine.
D) liver.
Q3) Which component of gastric juice is necessary for the breakdown of proteins?
A) HCl
B) Pepsin
C) Intrinsic factor
D) Potassium
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Chapter 29: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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Q1) A health care provider has ordered an MRI (magnetic resonance imaging)of the liver.The nurse's first action is to
A) prepare the patient psychologically and physically for the procedure.
B) monitor the patient's response to the procedure.
C) assess the patient after the procedure.
D) inform the patient's family of the results.
Q2) The best diagnostic test for the determination of upper gastrointestinal bleeding is A) endoscopic retrograde cholangiopancreatography (ERCP).
B) colonoscopy.
C) endoscopy.
D) angiography.
Q3) When assessing the abdomen,how long must the nurse listen to the abdomen to be able to accurately chart that bowel sounds are absent?
A) 30 seconds in each quadrant
B) 1 minute
C) 3 minutes
D) 5 minutes
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Page 31
Chapter 30: Gastrointestinal Disorders and Therapeutic Management
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Q1) Roux-en-Y gastric bypass is
A) a restrictive type of bariatric surgery.
B) a malabsorptive type of bariatric surgery.
C) a combination of restrictive and malabsorption types of bariatric surgery.
D) standard operation for pancreatic cancer.
Q2) To administer sucralfate through a gastric tube it should be
A) crushed and mixed with 10 mL of water.
B) dissolved in 10 mL of water to form a slurry.
C) mixed in 15 mL of water to form a solution.
D) administered as a whole pill with a 35-mL water flush.
Q3) A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.Based on the diagnosis,the patient
A) is at risk for hypovolemic shock from plasma volume depletion.
B) requires observation for hypoglycemia and hypercalcemia.
C) should be started on enteral feedings after the nasogastric tube is placed.
D) is placed on a fluid restriction to avoid the fluid sequestration.
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Chapter 31: Endocrine Anatomy and Physiology
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Q1) Glucagon release is stimulated by which of the following?
A) Increases in circulating insulin
B) Decreases in blood amino acids
C) Stimulation of the parasympathetic nervous system
D) Exercise
Q2) Which of the following best describes the effects of somatostatin?
A) It stimulates the release of antidiuretic hormone and oxytocin.
B) It suppresses the release of pancreatic polypeptide.
C) It inhibits the release of insulin and glucagon.
D) It inhibits the release of thyroid-stimulating hormone and thyroid hormone.
Q3) Which organ secretes catecholamine epinephrine and norepinephrine?
A) Adrenal cortex
B) Adrenal medulla
C) Anterior pituitary
D) Posterior pituitary
Q4) The effect of increased T? and T? on the body is
A) increased oxygen consumption and use.
B) lowering of the basal metabolic rate.
C) decreased cardiac output.
D) increased parasympathetic response.
Page 33
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Chapter 32: Endocrine Clinical Assessment and Diagnostic
Procedures
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Q1) The nurse knows that the best test to differentiate between central and nephrogenic DI is
A) the water deprivation test.
B) serum osmolality.
C) computed tomography scan.
D) the ADH test.
Q2) The nurse knows that a serum osmolality of 378 mOsm/kg indicates a patient who is
A) overhydrated.
B) normal.
C) dehydrated.
D) hypokalemic.
Q3) When evaluating the patient for a pituitary tumor,attention on the computed tomography scan should be focused on the
A) frontal lobe.
B) sella turcica.
C) temporal lobe.
D) anterior fossa.
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Page 34
Chapter 33: Endocrine Disorders and Therapeutic Management
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Q1) The patient's temperature is 93° F rectally.The most appropriate intervention with this patient would be to
A) give aggressive therapy that includes warm peritoneal lavage.
B) allow the patient to maintain this body temperature to decrease oxygen demands.
C) use warming blankets to slowly warm the patient.
D) wait until the patient shivers to start warming.
Q2) Which of the following nursing interventions should be initiated on all patients with SIADH?
A) Placing the patient on an air mattress
B) Forcing fluids
C) Initiating seizure precautions
D) Applying soft restraints
Q3) During the first 24 hours when the nurse administers hypertonic saline in a patient with SIADH,the serum sodium should be raised no more than
A) 5 mEq/day.
B) 12 mEq/day.
C) 20 mEq/day.
D) 25 mEq/day.
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Chapter 34: Trauma
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Q1) Clinical manifestations of abdominal compartment syndrome include which of the following?
A) Decreased cardiac output
B) Decreased peripheral vascular resistance
C) Decreased urine output
D) Hypoxia
E) Bradycardia
F) Hypotension
Q2) The nursing care plan of a patient with a diffuse axonal injury (DAI)would involve which of the following considerations?
A) Neurologic assessments should be performed only once a shift.
B) The patient will need a computed tomography scan for definitive diagnosis of the injury.
C) Blood pressure and temperature elevations are common.
D) The patient is at risk for volume overload because of syndrome of inappropriate antidiuretic hormone.
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36
Chapter 35: Shock,sepsis,and Multiple Organ Dysfunction Syndrome
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Q1) When SIRS is the result of infection,it is called A) inflammation.
B) anaphylaxis.
C) sepsis.
D) pneumonia.
Q2) The difference between primary and secondary multiple organ dysfunction syndrome (MODS)is that primary MODS is the result of A) widespread systemic inflammation that results in dysfunction of organs not involved in the initial insult.
B) direct organ injury.
C) disorganization of the immune system response.
D) widespread disruption of the coagulation system.
Q3) Immunoglobulin E (IgE)-mediated anaphylactic shock occurs as a result of A) direct activation of mast cells.
B) laryngeal edema.
C) an antigen entering on a repeat exposure, triggering a secondary immune response.
D) the systemic inflammatory response.
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Page 37
Chapter 36: Burns
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Q1) Which of the following is most important when determining whether or not to refer a patient to a burn center?
A) The size and depth of burn injury and the burning agent
B) The age and present medical history of the patient
C) The depth of the burn injury and the presence of soot in the sputum
D) The medical history of the patient and the size and depth of the burn injury
Q2) A red and white wound surface with blanching but no blister formation describes what depth of burn injury?
A) Superficial partial-thickness burn
B) Moderate partial-thickness burn
C) Deep dermal partial-thickness burn
D) Full-thickness burn
Q3) Which zone is the site of the most severe damage?
A) Zone of coagulation
B) Peripheral zone
C) Zone of stasis
D) Zone of hyperemia
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Chapter 37: Organ Donation and Transplantation
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Q1) After a urinary diversion pancreatic transplant,the nurse must 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) Because a patient who has received a lung transplant is at risk for ventilation/perfusion (V/Q)mismatch,it would be a priority for the nurse to monitor
A) blood gases.
B) cardiac output.
C) lung sounds.
D) blood pressure.
Q3) Rejection that occurs within hours after the transplantation and results in immediate graft failure is known as
A) acute rejection.
B) intermediate rejection.
C) chronic rejection.
D) hyperacute rejection.
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Chapter 38: Hematologic Disorders and Oncologic Emergencies
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Q1) A patient is admitted into the critical care unit with symptoms of a low-grade fever,joint pain,tachycardia,hepatomegaly,photophobia,and an inability to follow commands.The patient is becoming more agitated and complaining of pain.The nurse suspects that the patient has A) ITP.
B) heparin-induced thrombocytopenia.
C) sickle cell anemia.
D) DIC.
Q2) Medication used to increase the level of fetal hemoglobin in the RBCs and reduce the concentration of sickle hemoglobin is known as A) transfusion therapy.
B) hydroxyurea.
C) Kayexalate.
D) oxygen.
Q3) The most common cause of disseminated intravascular coagulation (DIC)is
A) sepsis caused by gram-positive organisms.
B) sepsis caused by gram-negative organisms.
C) sickle cell anemia.
D) burns.
Page 40
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Chapter 39: The Obstetric Patient
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Q1) Pre-eclampsia is characterized by widespread physiologic changes,including
A) increase in circulating plasma volume.
B) vasospasms in the arterial system.
C) disseminated intravascular coagulation.
D) high systemic vascular resistance
Q2) Unique causes of septic shock in pregnant patients include
A) postpartum pyelonephritis.
B) ectopic pregnancy.
C) chorioamnionitis.
D) septic abortion.
E) postpartum hemorrhage.
Q3) The greatest risk for developing pulmonary embolism (PE)occurs
A) at the beginning of labor.
B) during the transition period of labor.
C) when the mother is pushing during a vaginal delivery.
D) in the immediate postpartum period.
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Chapter 40: The Pediatric Patient
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Q1) A 4-year-old child is admitted to the critical care unit with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.Nursing management for this patient would include
A) measuring and documenting head circumference.
B) allowing the patient's siblings to visit.
C) isolating the patient during initial antibiotic treatment and for 24 hours thereafter.
D) administering anticonvulsant medications every 6 hours.
Q2) The patient is a 1-month-old infant with stable supraventricular tachycardia (SVT)at a rate of 250 beats/min.She weighs 6 kg.How much adenosine should be given?
A) 0.05 mg rapid IV push
B) 0.1 mg rapid IV push
C) 0.6 mg rapid IV push
D) 0.5 mg rapid IV push
Q3) What is the daily fluid requirement for a 60-kg child?
A) 2600 mL/m² per day
B) 1500 mL/m² per day
C) 2400 mL/m² per day
D) 3000 mL/m² per day
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Chapter 41: The Older Adult Patient
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Q1) An older patient is admitted to the hospital with a hip fracture.Which of the following nursing interventions would be a priority?
A) Facilitate frequent deep breathing.
B) Administer stool softeners.
C) Perform neurologic checks.
D) Frequently offer liquids to drink.
Q2) Which medications are considered an alternative to angiotensin-converting enzyme (ACE)inhibitors in older adult hypertension patients with diabetes mellitus and heart failure (HF)?
A) Angiotensin-receptor blockers
B) Beta-blockers
C) Calcium antagonists
D) Direct renin inhibitors
Q3) Which of the following nonsteroidal anti-inflammatory drugs (NSAIDs)has the side effect of renal failure,HTN,heart failure,and GI bleed in the elderly population?
A) Indomethacin
B) Ketorolac
C) Aspirin greater than 325 mg
D) Naproxen
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Page 43
Chapter 42: The Perianesthesia Patient
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Q1) The stir-up regimen consists of
A) deep breathing exercises, suctioning, warming, and nausea management.
B) incentive spirometry, abdominal breathing, warming, drinking, and pain management.
C) incentive spirometry, coughing, suctioning, warming, mobilization, and eating.
D) deep breathing exercises, coughing, positioning, mobilization, and pain management.
Q2) In the postanesthesia care unit,patients should be stimulated to take three to four deep breaths every
A) 1 to 2 minutes.
B) 3 to 5 minutes.
C) 5 to 10 minutes.
D) 30 to 60 minutes.
Q3) Nursing management of a postoperative patient who is experiencing prolonged vomiting includes
A) withholding all pain medication until the nausea has subsided.
B) removing the nasogastric tube.
C) inserting an oral airway.
D) increasing intravenous fluids.
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