Question 1

What is the first step in treating a patient with Acute Respiratory Distress Syndrome?

Accepted Answer

A) Maintain fluid and electrolyte balance 
B) Maintain oxygenation 
C) Provide adequate nutrition 
D) Prevent respiratory and metabolic complications

Question 2

A forty four year old patient was admitted for a rule out myocardial infarction after 2 hours of severe chest pain. However, labs have just returned and her serum T3, T4 levels are elevated, the EKG shows Supraventricular Tachycardia at a rate of 140 and her breathing is rapid and shallow. The doctor suspects that she has developed a thyroid storm. What medication would be contraindicated?

Accepted Answer

A) Corticosteroids 
B) Propylthiouracil 
C) Aspirin 
D) Intravenous beta blockers

Question 3

A patient is brought to the emergency department after a bee sting. The family reports a history of severe allergic reaction, and the patient appears to have some oral swelling. Which of the following is the most urgent nursing action?

Accepted Answer

A) Consult a physician. 
B) Maintain a patent airway. 
C) Administer epinephrine subcutaneously. 
D) Administer diphenhydramine (Benadryl) orally.

Question 4

An 18 year old female Type I diabetic patient is in the emergency room after suffering an episode of Diabetic Ketoacidosis. Which of the following is true regarding regular insulin administered subcutaneously?

Accepted Answer

A) peak in 6 hours 
B) peak in 30 minutes 
C) peak in 2 hours 
D) peak in 2-4 hours

Question 5

A new nurse is on the floor and has been verbally belittled and rudely treated by a small group of senior nurses. What is the most effective way to deal with this horizontal violence?

Accepted Answer

A) Call the hospital's anonymous hotline and report what is going on between the staff. 
B) Ignore the hostile staff and advise the new nurse to push through it until the staff gets to know her better. 
C) Work with the floor manger to promote awareness and education of horizontal violence through staff development activities and continuing education. 
D) Recognize the harm caused by the behavior and confront the hostile nurses directly.

Question 6

An intensive care nurse answers a rapid response call for a 54 year old female patient on the pre-surgery floor who is scheduled to have a left partial knee replacement later today. When the nurse arrives, she notes the ashen color of the woman's face and profuse sweating. The monitor shows a blood pressure of 170/90, a heart rate of 122 and an oxygen saturation of 92% on 1 liter of oxygen. The admitting nurse states that the woman had been complaining of nausea. What is the most likely cause of the patient's condition?

Accepted Answer

A) Pulmonary embolism 
B) Myocardial infarction 
C) Cardiac tamponade 
D) Anxiety attack

Question 7

What is the drug of choice for treatment of anaphylactic and anaphylactoid shock?

Accepted Answer

A) Epinephrine 
B) Albuterol 
C) Diphenhydramine 
D) Narcan

Question 8

You are beginning treatment on a patient with HIV. Besides drugs that are specifically targeted at HIV, what other group of medications would the patient be started on to avoid common complications of HIV?

Accepted Answer

A) Empiric antibiotics 
B) Anti fungal medications 
C) Non steroidal anti-inflammatory medications 
D) Pain medication

Question 9

A patient has been admitted to the intensive care unit with a diagnosis of "rule out" Guillain-Barre syndrome. The nurse is completing the admission data base and asking about the patient's history. What diagnosis might precipitate a diagnosis of Guillian-Barre syndrome?

Accepted Answer

A) Myocardial infarction within the last 6 months 
B) Headache, nausea and nuchal rigidity 
C) Mild fevers, upper respiratory infection or a minor virus 
D) Slurred speech and weakness in one or both sides of the body

Question 10

The nurse has just inserted a Nasogastric tube on a patient who is experiencing a severe gastrointestinal bleed and has been continuously vomiting for 24 hours. She has Hemoglobin of 6.4. What nursing intervention would be most likely to prevent aspiration?

Accepted Answer

A) Continue with intravenous fluids. 
B) Monitor the electrolyte levels. 
C) Administer a proton pump inhibitor via the intravenous route. 
D) Keep the head of the bed elevated.

Question 11

Extravasation has occurred in the 20 gauge IV site in the left arm of the patient who just received a dose of Vancomycin. What is the best way to treat the site to minimize pain to the patient?

Accepted Answer

A) Immediately disconnect the tubing as close to the hub of the catheter as possible and attempt to aspirate the remaining drug from the IV line using a syringe. 
B) Apply ice packs or warm packs directly to the site, approximately 20 minutes at a time. 
C) Document the date and time of the infusion, the condition of the patient and the time the doctor was notified. 
D) Remember that some signs of symptoms such as erythema and ulceration may be delayed for up to 48 hours and continue to assess the arm.

Question 12

What would not be a nursing intervention for the patient with tonic-clonic seizures?

Accepted Answer

A) Restraining a patient during a seizure. 
B) Clear the area of hard objects. 
C) Turn the patient's head or turn him on his side. 
D) Assist the patient to a lying position and loosen any tight clothing.

Question 13

A 50 year old female is in the emergency department with a diagnosis of Thyroid Crisis. What are the main signs and symptoms of thyroid crisis?

Accepted Answer

A) low urine output, hypertension 
B) low urine output , hypotension 
C) tacycardia, delirium and elevated blood glucose 
D) tachycardia, elevated temperature

Question 14

A 36-year-old obese male is one day post-gastroplasty. He has a sudden onset of restlessness, dyspnea, and chest pain. His heart rate is 122/min., and auscultation of heart sound reveals an increased intensity of a pulmonary S2. The nurse should expect which of the following to confirm the patient's diagnosis?

Accepted Answer

A) chest x-ray and arterial blood gases 
B) pulmonary radioisotope scan 
C) blood enzyme studies 
D) pulmonary artery pressures

Question 15

A patient has second and third degree burn injuries to his anterior chest and abdomen, anterior left arm, anterior right arm and left anterior leg. Using the Rule of Nines, what percentage of the body surface area (BSA) is affected?

Accepted Answer

A) 36% 
B) 50% 
C) 27% 
D) 31%

Question 16

A patient two day status post a three way coronary artery bypass graft procedure has a blood glucose level of 44 and is diaphoretic and shaking in bed. He states he doesn't feel well. What would be the most appropriate intervention for this patient?

Accepted Answer

A) Administer Intravenous Dextrose 50 bolus. 
B) Give 3 glucose tablets followed by 4 ounces of orange juice. 
C) Change the bag of normal saline to dextrose 5% at 200 mL/ hour. 
D) Monitor the patient for seizures or change in mental status.

Question 17

The nurse is taking care of a 48 year old woman who has suffered a closed head injury secondary to a motor vehicle accident. She has started to experience tonic-clonic seizures. Which nursing intervention is most appropriate for this patient?

Accepted Answer

A) Pad the bedside rails. 
B) Ensure that someone is with the patient at all times. 
C) Have the equipment for oxygen and suction at the bedside. 
D) Place a padded tongue blade on the bedside table.

Question 18

What is the best explanation for why low flow oxygen devices are tried first with patients who have chronic lung disease and retain PaCO2?

Accepted Answer

A) High levels of oxygen can cause them to lose their drive to breathe. 
B) It is dangerous for their oxygen saturation levels to rise above 97%. 
C) High levels of oxygen cause more problems and complications. 
D) People with chronic lung disease don't need as much oxygen.

Question 19

A patient at a mental health clinic is taking Haldol (haloperidol) for treatment of schizophrenia. She calls the clinic to report abnormal movements of her face and tongue. The nurse concludes that the patient is experiencing which of the following symptoms:

Accepted Answer

A) Co-morbid depression. 
B) Psychotic hallucinations. 
C) Negative symptoms of schizophrenia. 
D) Tardive dyskinesia.

Question 20

A patient is showing the signs and symptoms of septicemia. What test would confirm the suspected diagnosis?

Accepted Answer

A) Chest X-ray 
B) Urine specimen 
C) Vital Sign changes 
D) Changes in level of consciousness

Exam 1: Adult