Pericardial friction run would show what on an 12 lead EKG? - CORRECT-
ANSWERSST elevation in II, III, aVF, and V2-V5
The doc asks the nurse to determine the capture threshold. Which of the
following should the nurse do? - CORRECT-ANSWERSSlowly decrease the mA
output until the capture is lost.
A pt with ARDS needs to receive how many ml/kg of tidal volume? -
CORRECT-ANSWERS4-5ml/kg tidal volume in order to prevent volutrauma.
A lower respiratory rate will help provide this. Short expiratory time, PEEP,
and larger tidal volumes will all promote air trapping or auto peep. Thus
increasing intrathoracic pressure and reducing cardiac output.
Which of the following is an appropriate strategy when providing mechanical
ventilation for the patient with status asthmaticus? - CORRECT-ANSWERSUse
lower respiratory rates
A patient is admitted with serum calcium of 15.1 mEq/L. Which of the
following interventions should the nurse anticipate? - CORRECT-
ANSWERSRule out hypokalemia, then administer diuretics.
Which of the following patients is likely to experience a heart block? -
CORRECT-ANSWERSMitral Valve repair
The patient with chronic alcohol abuse is admitted with a serum phosphorus
of 1.8 mEq/L. The nurse will need to observe the patient closely for: -
CORRECT-ANSWERSHypoventilation
,Low phosphorous causes what? - CORRECT-ANSWERSconstipation, not
diarrhea
Which of following nursing behaviors is usually most helpful to patients and
families regarding end-of-life decisions? - CORRECT-ANSWERSacting as an
arbitrator between family members.
Pt receiving PCA, morphine 1 mg per hour IV infusion, and 2 mg q 15 minutes
as PRN doses. Pt is having episodes of sleep apnea and is arousable only by
touch. Priority interventions include: - CORRECT-ANSWERSSTOP the
continuous infusion and give naloxone slow IV until patient awakens.
Which patient according to ranson's criteria has poorest prognosis when it
comes to acute pancreatitis? - CORRECT-ANSWERSWBC 32,000; Glucose
220; LDH 400
A shunt requires more than oxygen to correct hypoxemia, for example: -
CORRECT-ANSWERSPEEP
Will a V/Q mismatch respond to oxygen administration? - CORRECT-
ANSWERSTrue
What should the patient watch out for when it comes to Myasthenia gravis: -
CORRECT-ANSWERSMuscle weakness
Which of the following is the earliest indication that the patient may be
aspirating oral feedings? - CORRECT-ANSWERSTachypnea and tachycardia
The patient was admitted status post motor vehicle crash. The patients
sustained an intracranial bleed, is hypotensive, and is tachycardic. The
patient's clinical status is most likely due to which of the following? -
CORRECT-ANSWERSShock from multiple trauma
Neurogenic shock and brain herniation result in bradycardia? - CORRECT-
ANSWERSTrue
Pt states he is "sick of it all." Which is the best intervention: - CORRECT-
ANSWERSConsult with Doc regarding a psych consult.
Traumatic injury, patient's arterial blood gas shows Respiratory alkalosis -
what interventions is best at this time? - CORRECT-ANSWERSIncrease
FIO2/assess for pain.
Acute anterior wall myocardial infarction and suddenly develops a loud
holosystolic murmur, loudest at the left sternal border, 5th intercostal space,
tachypnea, and bibasilar crackles. Which of the following would provide most
, definitive diagnosis of this problem? - CORRECT-ANSWERSIncreased oxygen
saturation in the pulmonary artery and the right ventricle.
Patient agitated with a RASS score of +3 and behavioral pain scale of 10
(range 3-13). Spo2 AND BREATH sounds are unchanged. BP and heart rate
are somewhat higher. Interventions? - CORRECT-ANSWERSGive morphine
2mg IV
Increasing prop won't do anything for the pain.
A 56 yr-old male is admitted to the ICU with a blood pressure of 225/135 and
complains of a headache and nausea. He reports he ran out of blood
pressure meds three days ago, but also appears to be confused to the date
and situation. What is the most appropriate treatment approach? - CORRECT-
ANSWERSRapidly lower the diastolic pressure to 100 with IV antihypertensive
meds, then continue to gradually reduce the diastolic pressure to 85 with
oral antihypertensive meds.
The maximum initial decrease should be no more than 25% reduction from
initial presenting value. Reducing the blood pressure too quickly can lead to
cerebral edema or renal failure.
A patient has sepsis, receives Lactated ringers 500ml IV bolus. Which finding
indicate that this intervention is having it's intended effect? - CORRECT-
ANSWERSScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid resuscitation at 30
ml/kg to maintain a CVP of 8-12 or 12-15 if mechanically ventilated, MAP
greater than 65, ScvO2 greater than 70%, and urine output greater than 0.5
kg/hr
72 male patient in ICU for 6 days on the ventilator for treatment of a COPD
exacerbation. He has been receiving VTE prophylaxis and subcutaneous
Heparin since admission. Today his platelet count decreased significantly to
43,000 and was found to have new DVT on his right upper extremity. What
do you suspect is the most likely cause of these findings? - CORRECT-
ANSWERSHIT
The hallmark sign of HIT is a significant decrease in platelet count over a 24
hours period (>50%) within 5-10 days of administering Heparin. The other
hallmark sign is a new development of DVT despite being on VTE
prophylaxis.
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