Question 1

After gastric bypass surgery,the patient is getting vitamin B12 injections.The patient asks about the purpose of this vitamin.The nurse explains that

Accepted Answer

A)  vitamin B12 is needed for the formation of red blood cells. 
B)  vitamin B12 is needed to prevent a type of anemia. 
C)  vitamin B12 is essential for surgical wound healing. 
D)  vitamin B12 is always deficient in obese people. 
A)  vitamin B12 is needed for the formation of red blood cells. 
B)  vitamin B12 is needed to prevent a type of anemia. 
C)  vitamin B12 is essential for surgical wound healing. 
D)  vitamin B12 is always deficient in obese people. A

Question 2

The nurse is to assist the provider in performing bedside endoscopy on a patient.To prevent respiratory complications,the nurse places the patient

Accepted Answer

A)  supine in Trendelenburg position. 
B)  in a left lateral reverse Trendelenburg position. 
C)  flat with the feet elevated. 
D)  in a semi-Fowler's position. 
A)  supine in Trendelenburg position. 
B)  in a left lateral reverse Trendelenburg position. 
C)  flat with the feet elevated. 
D)  in a semi-Fowler's position. B

Question 3

The patient has a hemoglobin of 8.5 g/dL and hematocrit of 27%.The nurse administers 2 units of packed red blood cells to the patient and repeats the lab work a few hours later.The new hemoglobin and hematocrit would be expected to be

Accepted Answer

A)  hemoglobin 7.5 g/dL and hematocrit 25%. 
B)  hemoglobin 9.5 g/dL and hematocrit 29%. 
C)  hemoglobin 10.5 g/dL and hematocrit 32%. 
D)  hemoglobin 12.5 g/dL and hematocrit 36%. 
A)  hemoglobin 7.5 g/dL and hematocrit 25%. 
B)  hemoglobin 9.5 g/dL and hematocrit 29%. 
C)  hemoglobin 10.5 g/dL and hematocrit 32%. 
D)  hemoglobin 12.5 g/dL and hematocrit 36%. C

Question 4

Infection by Helicobacter pylori bacteria is a major cause of

Accepted Answer

A)  duodenal ulcers. 
B)  Cushing's ulcers. 
C)  Curling's ulcers. 
D)  stress ulcers. 
A)  duodenal ulcers. 
B)  Cushing's ulcers. 
C)  Curling's ulcers. 
D)  stress ulcers.

Question 5

The nurse is assessing the patient and notices that the oral cavity is only slightly moist and contains a scant amount of thick saliva even though the patient's fluid intake has been sufficient.The nurses realizes that the condition of the patient's mouth is probably caused by

Accepted Answer

A)  thoughts of food. 
B)  sympathetic nerve stimulation. 
C)  overstimulation of the sublingual glands. 
D)  parasympathetic nerve stimulation. 
A)  thoughts of food. 
B)  sympathetic nerve stimulation. 
C)  overstimulation of the sublingual glands. 
D)  parasympathetic nerve stimulation.

Question 6

The nurse is caring for a critically ill patient with respiratory failure who is being treated with mechanical ventilation.As part of the patient's care to prevent stress ulcers,the nurse would provide: (Select all that apply.)

Accepted Answer

A)  vagal stimulation. 
B)  proton pump inhibitors. 
C)  anticholinergic drugs. 
D)  antacids. 
E)  cholinergic drugs. 
A)  vagal stimulation. 
B)  proton pump inhibitors. 
C)  anticholinergic drugs. 
D)  antacids. 
E)  cholinergic drugs.

Question 7

The nurse is caring for a patient who has had a portacaval shunt placed surgically.The nurse is aware that this procedure

Accepted Answer

A)  improves survival in patients with varices. 
B)  decreases the risk of encephalopathy. 
C)  decreases the incidence of ascites. 
D)  decreases rebleeding. 
A)  improves survival in patients with varices. 
B)  decreases the risk of encephalopathy. 
C)  decreases the incidence of ascites. 
D)  decreases rebleeding.

Question 8

The nurse is assessing a patient admitted with pancreatitis.In doing so,the nurse

Accepted Answer

A)  palpates the pancreas for size and shape. 
B)  emphasizes to the patient that pancreatic inflammation does not spread. 
C)  assesses symptoms that could indicate involvement of the stomach. 
D)  explains to the patient that back pain is not a sign of pancreatitis. 
A)  palpates the pancreas for size and shape. 
B)  emphasizes to the patient that pancreatic inflammation does not spread. 
C)  assesses symptoms that could indicate involvement of the stomach. 
D)  explains to the patient that back pain is not a sign of pancreatitis.

Question 9

The nurse is caring for a patient who is receiving several cardiac medications designed to stimulate the sympathetic nervous system,vitamin B12,and an H2 blocker.The nurse should do which of the following?

Accepted Answer

A)  Assess for signs of peptic ulcer. 
B)  Be watchful for increased saliva production. 
C)  Evaluate for a decrease in potassium level. 
D)  Give the patient medications to prevent anemia. 
A)  Assess for signs of peptic ulcer. 
B)  Be watchful for increased saliva production. 
C)  Evaluate for a decrease in potassium level. 
D)  Give the patient medications to prevent anemia.

Question 10

The nurse is caring for a patient with liver disease.When assessing the patient's laboratory values,the nurse should

Accepted Answer

A)  disregard the level of conjugated bilirubin. 
B)  assess the total bilirubin 
C)  call the provider immediately if the direct bilirubin is elevated. 
D)  be aware that unconjugated bilirubin is harmless. 
A)  disregard the level of conjugated bilirubin. 
B)  assess the total bilirubin 
C)  call the provider immediately if the direct bilirubin is elevated. 
D)  be aware that unconjugated bilirubin is harmless.

Question 11

The nurse is caring for a critically ill patient with end-stage liver disease.The nurse knows that the patient is at risk for hyperdynamic circulation and varices.Which of the following assessments would indicate a hyperdynamic status?

Accepted Answer

A)  Jugular venous distension 
B)  Normal sinus rhythm on the cardiac monitor 
C)  Blood pressure of 180/90 mm Hg 
D)  Stools that are guaiac positive 
A)  Jugular venous distension 
B)  Normal sinus rhythm on the cardiac monitor 
C)  Blood pressure of 180/90 mm Hg 
D)  Stools that are guaiac positive

Question 12

The nurse is caring for a patient who is passing bright red blood rectally.The nurse should expect to insert a nasogastric tube to

Accepted Answer

A)  rule out massive upper GI bleeding. 
B)  detect the presence of melena in the stomach. 
C)  visually determine the presence of occult bleeding. 
D)  obtain samples for guaiac to confirm current bleeding. 
A)  rule out massive upper GI bleeding. 
B)  detect the presence of melena in the stomach. 
C)  visually determine the presence of occult bleeding. 
D)  obtain samples for guaiac to confirm current bleeding.

Question 13

The patient is admitted with generalized fatigue and low hemoglobin and hematocrit levels.The patient denies vomiting and states that the last bowel movement earlier that day was normal in color and consistency.However,because GI blood loss can be a cause of anemia,the nurse should expect to

Accepted Answer

A)  obtain a stool sample for guaiac testing. 
B)  chart that the patient reports the presence of melena in his stool. 
C)  inspect the patient's next stool for the presence of coffee-ground contents. 
D)  obtain guaiac positive stools only if bleeding is current. 
A)  obtain a stool sample for guaiac testing. 
B)  chart that the patient reports the presence of melena in his stool. 
C)  inspect the patient's next stool for the presence of coffee-ground contents. 
D)  obtain guaiac positive stools only if bleeding is current.

Question 14

The nurse is caring for a patient with acute pancreatitis.To provide adequate pain control,the nurse

Accepted Answer

A)  should suggest that the patient receive epidural analgesia. 
B)  provides oral pain medication on an "as needed" (PRN) basis. 
C)  removes any nasogastric tubes. 
D)  administers pain medication on a routine schedule. 
A)  should suggest that the patient receive epidural analgesia. 
B)  provides oral pain medication on an "as needed" (PRN) basis. 
C)  removes any nasogastric tubes. 
D)  administers pain medication on a routine schedule.

Question 15

The patient is admitted with acute pancreatitis and is later diagnosed as having a pseudocyst.The nurse realizes that

Accepted Answer

A)  surgery for pseudocysts must be done immediately. 
B)  a cholecystectomy is usually done when pseudocysts are found. 
C)  pseudocysts may resolve spontaneously, so surgery may be delayed. 
D)  pseudocysts require pancreatic resection, removing the entire pancreas. 
A)  surgery for pseudocysts must be done immediately. 
B)  a cholecystectomy is usually done when pseudocysts are found. 
C)  pseudocysts may resolve spontaneously, so surgery may be delayed. 
D)  pseudocysts require pancreatic resection, removing the entire pancreas.

Question 16

The patient is being treated for an H.pylori infection with proton pump inhibitor,metronidazole,and tetracycline but is not responding.The nurse expects that

Accepted Answer

A)  bismuth will be added to the current triple therapy. 
B)  a 6-day course of levofloxacin may be used. 
C)  a second-line therapy is not usually effective. 
D)  the proton pump inhibitor will be changed to a higher dose. 
A)  bismuth will be added to the current triple therapy. 
B)  a 6-day course of levofloxacin may be used. 
C)  a second-line therapy is not usually effective. 
D)  the proton pump inhibitor will be changed to a higher dose.

Question 17

The nurse is caring for a patient who has a Sengstaken-Blakemore tube in place.In caring for this patient,the nurse must

Accepted Answer

A)  maintain as little traction as possible. 
B)  apply external traction using a side rail of the bed. 
C)  deflate the gastric balloon before the esophageal balloon. 
D)  deflate the esophageal balloon before the gastric balloon. 
A)  maintain as little traction as possible. 
B)  apply external traction using a side rail of the bed. 
C)  deflate the gastric balloon before the esophageal balloon. 
D)  deflate the esophageal balloon before the gastric balloon.

Question 18

The patient is diagnosed with hepatitis.In caring for this patient,the nurse should

Accepted Answer

A)  administer anti-inflammatory medications. 
B)  provide rest, nutrition, and antiemetics if needed. 
C)  provide antianxiety medications freely to decrease agitation. 
D)  instruct the patient to take over-the-counter anti-inflammatory medications at home. 
A)  administer anti-inflammatory medications. 
B)  provide rest, nutrition, and antiemetics if needed. 
C)  provide antianxiety medications freely to decrease agitation. 
D)  instruct the patient to take over-the-counter anti-inflammatory medications at home.

Question 19

The nurse is caring for a patient who is being treated for peptic ulcer disease.Suddenly,the patient yells that the pain has become extreme.The nurse notes that the patient's abdomen is rigid.The nurse should

Accepted Answer

A)  call the provider immediately. 
B)  give the patient pain medication. 
C)  remove the NG tube. 
D)  give the patient an antacid. 
A)  call the provider immediately. 
B)  give the patient pain medication. 
C)  remove the NG tube. 
D)  give the patient an antacid.

Question 20

The liver plays a major role in homeostasis by

Accepted Answer

A)  synthesizing factor I but not factor II. 
B)  synthesizing clotting factors without the need for vitamin K. 
C)  removing active clotting factors from the circulation. 
D)  synthesizing factor II but not factor I. 
A)  synthesizing factor I but not factor II. 
B)  synthesizing clotting factors without the need for vitamin K. 
C)  removing active clotting factors from the circulation. 
D)  synthesizing factor II but not factor I.

Exam 18: Gastrointestinal Alterations

After gastric bypass surgery,the patient is getting vitamin B12 injections.The patient asks about the purpose of this vitamin.The nurse explains that

The nurse is to assist the provider in performing bedside endoscopy on a patient.To prevent respiratory complications,the nurse places the patient

The patient has a hemoglobin of 8.5 g/dL and hematocrit of 27%.The nurse administers 2 units of packed red blood cells to the patient and repeats the lab work a few hours later.The new hemoglobin and hematocrit would be expected to be

Infection by Helicobacter pylori bacteria is a major cause of

The nurse is assessing the patient and notices that the oral cavity is only slightly moist and contains a scant amount of thick saliva even though the patient's fluid intake has been sufficient.The nurses realizes that the condition of the patient's mouth is probably caused by

The nurse is caring for a critically ill patient with respiratory failure who is being treated with mechanical ventilation.As part of the patient's care to prevent stress ulcers,the nurse would provide: (Select all that apply.)

The nurse is caring for a patient who has had a portacaval shunt placed surgically.The nurse is aware that this procedure

The nurse is assessing a patient admitted with pancreatitis.In doing so,the nurse

The nurse is caring for a patient who is receiving several cardiac medications designed to stimulate the sympathetic nervous system,vitamin B12,and an H2 blocker.The nurse should do which of the following?

The nurse is caring for a patient with liver disease.When assessing the patient's laboratory values,the nurse should

The nurse is caring for a critically ill patient with end-stage liver disease.The nurse knows that the patient is at risk for hyperdynamic circulation and varices.Which of the following assessments would indicate a hyperdynamic status?

The nurse is caring for a patient who is passing bright red blood rectally.The nurse should expect to insert a nasogastric tube to

The patient is admitted with generalized fatigue and low hemoglobin and hematocrit levels.The patient denies vomiting and states that the last bowel movement earlier that day was normal in color and consistency.However,because GI blood loss can be a cause of anemia,the nurse should expect to

The nurse is caring for a patient with acute pancreatitis.To provide adequate pain control,the nurse

The patient is admitted with acute pancreatitis and is later diagnosed as having a pseudocyst.The nurse realizes that

The patient is being treated for an H.pylori infection with proton pump inhibitor,metronidazole,and tetracycline but is not responding.The nurse expects that

The nurse is caring for a patient who has a Sengstaken-Blakemore tube in place.In caring for this patient,the nurse must

The patient is diagnosed with hepatitis.In caring for this patient,the nurse should

The nurse is caring for a patient who is being treated for peptic ulcer disease.Suddenly,the patient yells that the pain has become extreme.The nurse notes that the patient's abdomen is rigid.The nurse should

The liver plays a major role in homeostasis by

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-of-Life Care and Palliative Care in Critical Care Settings

Comfort and Sedation

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Organ Donation

Shock,Sepsis,and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Respiratory Failure

Acute Kidney Injury

Hematological and Immune Disorders

Endocrine Alterations

Trauma and Surgical Management

Burns

Filters

After gastric bypass surgery,the patient is getting vitamin B₁₂ injections.The patient asks about the purpose of this vitamin.The nurse explains that

The nurse is caring for a patient who is receiving several cardiac medications designed to stimulate the sympathetic nervous system,vitamin B₁₂,and an H₂ blocker.The nurse should do which of the following?