Question 1

A 49 year old male patient has experienced a myocardial infarction with an approximate 55% damage to his ventricle. What interventions would most likely NOT be performed for this patient to avoid the complication of cardiogenic shock?

Accepted Answer

A) Intraaortic balloon pump 
B) Angioplasty 
C) Bypass surgery 
D) Chest tube insertion

Question 2

The nurse has called the doctor about a patient suspected to be experiencing a hypertensive crisis. What medications would the nurse anticipate the doctor ordering?

Accepted Answer

A) Intravenous Nitroprusside 
B) Intravenous Metroprolol 
C) Sublingual Nitroglycerin 
D) Intravenous Furosemide

Question 3

Besides increasing the risk for increased intrathoracic pressure, what other adverse effect could occur when a Constant Positive Airway Pressure (CPAP) is left at higher than 10cm H20?

Accepted Answer

A) Pneumonia 
B) Respiratory failure 
C) Pneumothorax 
D) Internal bleeding

Question 4

Dopamine is a drug commonly used with patients who are going through cardiogenic shock. What is the primary effect of Dopamine?

Accepted Answer

A) Promotes arterial resistance and reduces systolic blood pressure. 
B) Decreases venous resistance and helps decrease angina pain. 
C) Increases renal perfusion and increases the pumping action of the heart. 
D) Promotes arterial vasodilation and reduces the preload and afterload, increasing the pumping action of the heart.

Question 5

A patient with a history of previous myocardial infarction is being monitored on the cardiac care unit when he suddenly goes into ventricular fibrillation. Electrical external defibrillation is attempted by the attending physician however it is unsuccessful. What is the drug of choice for ventricular fibrillation after failed electrical external defibrillation?

Accepted Answer

A) lidocaine 
B) amiodarone 
C) epinephrine 
D) atropine

Question 6

A patient being is being admitted to the floor after 4 days of nausea, vomiting and diarrhea with a diagnosis of Hypernatremia. What signs and symptoms would you expect to see?

Accepted Answer

A) Confusion, dry and sticky mucous membranes and lethargy 
B) Increase in Intra Cranial Fluid (ICF), restlessness and muscle cramps 
C) Headache, muscle pain and lethargy 
D) Numbness and tingling in extremities, dry and sticky mucous membranes, irritability

Question 7

The nurse is taking care of a patient with Ketoacidosis. She is concerned that the patient is developing further acidosis. The latest ABG's reflect a pH of 7.0. What treatment of acidosis is most likely to correct this imbalance?

Accepted Answer

A) Fluids and insulin. 
B) Oxygenation and insulin. 
C) Fluids and potassium replacement. 
D) Fluids and arterial blood gases every 6 hours.

Question 8

A patient is admitted in the ER for severe back pain without relief. The patient tells the nurse that he has been taking 4 tabs of Acetaminophen every three hours for back pain with no relief. What lab values would you look at to assess for damage caused by acetaminophen overdose?

Accepted Answer

A) Hemoglobin and hematocrit 
B) BUN and Creatinine 
C) Troponin and CK MB 
D) PT and Serum Bilirubin

Question 9

What is the most common cause for Cardiogenic shock?

Accepted Answer

A) Stroke 
B) Hypertensive crisis 
C) Myocardial infarction 
D) Acute pulmonary edema

Question 10

What are some signs and symptoms of an impending Aneurysm rupture?

Accepted Answer

A) Profuse sweating, headache, lethargy, nausea and vomiting. 
B) Shortness of breath at rest, rapid heart rate, low grade fever, hypotension 
C) High blood pressure, onset of chest pain and shortness of breath 
D) Headache, nausea, back and leg stiffness that lasts several days

Question 11

When preparing to remove an endotracheal tube, the nurse should NOT do which of the following:

Accepted Answer

A) Get the help of another nurse to hold the tube while you untape the tube. 
B) Deflate the cuff before moving the endotracheal tube. 
C) Extubate the endotracheal tube if no air leak is detected around the deflated cuff. 
D) Suction during extubation of the endotracheal tube to remove secretions retained at the end of the tube.

Question 12

What is the best way a nurse can prevent the development of pressure ulcers in a patient who is in a drug induced coma?

Accepted Answer

A) Closely monitor the patient's intracranial pressure (ICP), electrocardiogram and vital signs. 
B) Make sure that all visitors wash their hands before entering the room and making contact with the patient. 
C) Turn and reposition the patient every two hours. 
D) Assess the heels for signs of redness and foot drop.

Question 13

What is the most common cause of Hypovolemic shock?

Accepted Answer

A) Loss of fluids by the gastrointestinal tract 
B) Hemorrhage 
C) Plasma losses 
D) Renal losses

Question 14

A 35 year old woman comes to your office. She states that recently she has been having a lot of problems. Some of her symptoms include periodic episodes of feeling like she is very afraid. You decide that there is likely a psychiatric component to her symptoms and decide to treat her medically with a combination of the most appropriate medications. A panic attack does NOT involve the sudden appearance of which of the following symptoms:

Accepted Answer

A) Chest pain or discomfort 
B) Sweating 
C) Otalgia 
D) Palpitations or accelerated heart rate

Question 15

What are the most likely antibiotics used to treat Helicobacter pylori infection?

Accepted Answer

A) Metronidazole 
B) Vancomycin 
C) Doxycline 
D) Levaquin

Question 16

An experienced intensive care unit nurse is teaching a class of new nurses. What would she emphasize as nursing interventions to prevent ventilator associated pneumonia?

Accepted Answer

A) Prophylactic treatment of antibiotics. 
B) Vital signs every 30 minutes. 
C) Repositioning every two hours. 
D) Elevate the head of the bed 30 to 45 degrees.

Question 17

A 50-year-old patient who is 72 hours post-operative repair of a ruptured abdominal aortic aneurysm suddenly becomes dyspneic and his respiratory rate increases from 24 to 40/min. An arterial blood gas sample obtained while the patient is receiving oxygen via a nasal cannula at 6L/min reveals pH of 7.50, pCO2 of 31 and pO2 of 48. A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of the lungs reveals basilar rales that were not previously present. On the basis of this information, the nurse should suspect that the patient has developed

Accepted Answer

A) a pulmonary embolus. 
B) bacterial pneumonia. 
C) chronic obstructive pulmonary disease. 
D) acute respiratory distress syndrome.

Question 18

You are working in a busy emergency room when an 84 year old male comes rushing in with crushing pain over his sternum. What is the first treatment for angina?

Accepted Answer

A) morphine 
B) nitrogylcerine 
C) defibrillation 
D) obtain a stat EKG

Question 19

You are attending to an 87 year old female, when a physician assistant states that your patients cardiac output is decreasing. Why is cardiac output important?

Accepted Answer

A) for monitoring EKG rhythms 
B) for monitoring electrolytes 
C) for monitoring central venous pressure 
D) for determining blood pressure

Question 20

All of the following diagnostic tests are part of the diagnostic workup of Amyotrophic Lateral Sclerosis (ALS), except

Accepted Answer

A) EMG 
B) Lumbar puncture 
C) CBC 
D) Computed tomography (CT) scans

Exam 1: Adult