Question 1

Which of the following drugs is best described as decreasing the heart rate and blood pressure, therefore decreasing the oxygen demand to the heart?

Accepted Answer

A) Beta Blockers 
B) Angiotensin Converting Enzyme (AC
E)  inhibitors 
C) Diuretics 
D) AT-2 Receptor Blockers (ARBs)

Question 2

The nurse is called in to see a 47 year old patient who underwent abdominal surgery to remove abdominal tumors. He anxiously tells her that he feels oozing around his incision. When the nurse assesses the site, she notes part of the bowels protruding through a dehiscence in the wound. The first thing the nurse would need to do:

Accepted Answer

A) Use sterile technique to cover the wound with warm sterile saline soaks. 
B) Call the doctor and prepare the patient for surgery. 
C) Administer pain medication and antibiotics. 
D) Administer intravenous fluids to replace fluid lost from the wound.

Question 3

What would be identified on the arterial blood gas results as a reflection of acute respiratory distress syndrome?

Accepted Answer

A) Low PaO2 levels 
B) High PaO2 levels 
C) Decreased PaCO2 
D) Increased HcO3

Question 4

The nurse is assessing the newly placed chest tube in a patient and notices the constant bubbling in the water seal chamber. An appropriate action to take would be:

Accepted Answer

A) Assess the chest drainage unit and tubing for an air leak. 
B) Do nothing and continue with the assessment; this is a normal finding. 
C) Clamp the chest tube and call the doctor immediately. 
D) Place the patient in a semi Fowler's position.

Question 5

The nurse is determining which room to put the incoming OR admission- a 42 year old woman who underwent an appendectomy for a ruptured appendix. Which would be the most appropriate roommate for the incoming patient?

Accepted Answer

A) A seventy-two year old woman recovering from a total hip revision surgery. 
B) A sixty seven year old female with acute exacerbation of COPD and acute renal failure. 
C) A thirty two year old woman recovering from an infected cesarean section delivery, an overflow patient from the post partum unit. 
D) A forty five year old woman with LOC and ETOH withdrawal.

Question 6

The husband of a 59 year old woman about to begin Thrombolytic Therapy for a myocardial infarction. What is the best way to explain Thrombolytic Therapy to him?

Accepted Answer

A) "Thrombolytic therapy dissolves clots that occlude coronary arteries and increase blood flow." 
B) "Thrombolytic therapy works to prevent any more thrombus from forming and increase the blood flow in the arteries." 
C) "Thrombolytic therapy works to open the arteries and restore blood flow in the vessels." 
D) "Thrombolytic therapy is estimated to increase the survival rate of people with acute myocardial infarction to 95%."

Question 7

A patient with a new diagnosis of schizophrenia has been taking haloperidol for a week. The nurse would suspect an adverse reaction of Tardive Dyskinesia if the patient had the following symptoms:

Accepted Answer

A) Loss of affect and insomnia and disinterest in food 
B) Abnormal facial movements and tongue protrusion 
C) An increase of auditory and visual hallucinations 
D) Muscle or joint pain

Question 8

The nurse is preparing to wean a patient from mechanical ventilation. What option is NOT a method of weaning the patient from mechanical ventilation?

Accepted Answer

A) Pressure support ventilation 
B) Controlled mandatory ventilation 
C) Using a T-piece, perform spontaneous breathing trials 
D) Intermittent mandatory ventilation

Question 9

All of these signs and symptoms are early stages of Hypovolemic shock except for:

Accepted Answer

A) Tachycardia 
B) Hypotension 
C) Tachypnea 
D) Decreased urinary output

Question 10

A 33 year old female has been admitted with severe abdominal pain that has lasted greater than 3 days. She has had severe diarrhea and rectal bleeding for 48 hours. She is scheduled for an Endoscopy in one hour. What disease does this patient most likely have?

Accepted Answer

A) Small bowel obstruction 
B) Portal hypertension 
C) Ulcerative colitis 
D) Gastroesophageal reflux disease

Question 11

A nurse is calling the doctor to obtain an order for medication to help maintain the tissue perfusion for a patient with acute respiratory distress syndrome who is continuing to be Hypotensive. Which medication would she anticipate being ordered?

Accepted Answer

A) Dopamine 
B) Phenylephrine 
C) Nitroglycerin 
D) Sodium nitroprusside

Question 12

What is the drug of choice for treating pain in the patient with acute Pancreatitis?

Accepted Answer

A) Morphine 
B) Meperidine 
C) Hydromorphone 
D) Fentanyl citrate

Question 13

What does an elevated level of B-type Natriuretic Peptide indicate?

Accepted Answer

A) Pneumonia 
B) Sepsis 
C) Heart failure 
D) Hypertension

Question 14

You have received report and are making your first rounds. You observe that your 87 year old female patient, in the hospital for exacerbation of congestive heart failure, has mistakenly received an infusion of 750 cc of normal saline. What will you look for in the next few hours?

Accepted Answer

A) Agitation and decreased level of consciousness 
B) Signs and symptoms of fluid overload 
C) The sodium level on the next lab draw 
D) Difficulty urinating

Question 15

The nurse is evaluating the 12 lead electrocardiograph of a patient who had a myocardial infarction approximately 2 hours ago. The doctor stated the MI was still "evolving." What abnormalities would the nurse expect to see to reflect the ischemic event?

Accepted Answer

A) ST segment elevation 
B) A widening of the QRS interval 
C) ST segment depression 
D) The emergence of Q waves

Question 16

A code has been called on a 50 year male on the medicine ward due to no pulse. Advanced Cardiac Life Support protocol is begun and the first rhythm strip demonstrates ventricular tachycardia. What is the first choice of treatment for a patient with unstable ventricular tachycardia?

Accepted Answer

A) unsynchronized cardioversion 
B) synchronized cardioversion 
C) administer epinephrine 
D) administer lidocaine and epinephrine

Question 17

What is a possible side effect of Thrombolytic Therapy that should be reported to the doctor immediately?

Accepted Answer

A) Superficial bleeding from the IV site 
B) Changes in mental status 
C) Hematuria 
D) Arrhythmias

Question 18

The nurse is taking care of a patient who is has been admitted with a diagnosis of "brain dead post traumatic injury." The nurse would expect all of the following clinical manifestations except:

Accepted Answer

A) Absent papillary responses 
B) Slight eye movement during the caloric test. 
C) No corneal reflex present. 
D) Fixed eyes during the doll's eyes test.

Question 19

A nurse is taking care of a patient who has Hemoglobin of 4.2. The nurse hung the second unit of packed red blood cells five minutes ago and the patient is suddenly flushed, breathing rapidly. The monitor shows a heart rate of 150. What is the first thing the nurse should do?

Accepted Answer

A) Apply oxygen via a non-rebreather mask to the patient. 
B) Administer antihistamines or beta 2 agonists. 
C) Call the rapid response team. 
D) Discontinue the blood.

Question 20

Which gland is responsible for the release of Calcitonin?

Accepted Answer

A) Thyroid 
B) Parathyroid 
C) Adrenal 
D) Pituitary

Exam 1: Adult