Question 1

A patient with unstable angina has an Intra-aortic balloon pump (IABP) inserted. The patient's hemodynamics are: HR = 148 (sinus tachycardia); MAP = 40 mm Hg; PCWP = 25 mm Hg; CI = 1.4 L/min/m2. Which of the following should be included in this patient's plan of care?

Accepted Answer

A) checking timing of the IABP, decreasing balloon to 1:2 frequency 
B) stat echocardiogram, furosemide (Lasix), checking timing of the IABP 
C) dobutamine (Dobutrex), isoproterenol (Isuprel), 12-lead EKG 
D) adenosine, stat Hgb and HCT, dobutamine (Dobutrex)

Question 2

A patient has been admitted for chronic renal failure. The patient has a history of noncompliance with medication and care. He begins to complain of a severe, throbbing headache in the back of his head and vomits 300 cc of emesis. He states that his vision has become blurry and he is becoming short of breath. What might be the cause of the sudden onset of symptoms?

Accepted Answer

A) Myocardial infarction 
B) Acute respiratory distress syndrome 
C) Cardiogenic Shock 
D) Hypertensive crisis

Question 3

When administering the non-opioid analgesics Acetaminophen, why is the total daily intake monitored and limited to not more than 4 grams/day?

Accepted Answer

A) More than 4 grams a day may cause injury to the kidneys. 
B) No damage will occur unless the patient has sensitivity to acetaminophen. 
C) More than 4 grams a day will cause injury to the liver. 
D) More than 4 grams /day only adversely affects the geriatric population.

Question 4

A nurse is coming on shift and receives report about a patient who is in septic shock. What signs and symptoms would the nurse expect to see?

Accepted Answer

A) Heart rate of 60 beats/minute, temperature of 100.2 
B) Respiratory rate of 28/minute, heart rate of 70 beats per minute 
C) Temperature of 101.2 F, heart rate of 120 
D) Respiratory rate of 18/minute, heart rate of 96

Question 5

The nurse is helping the patient in end stage renal disease build a diet plan. The dietician has been called but will not be able to see the patient for 2 more days. What electrolytes are the most important to limit in a renal diet?

Accepted Answer

A) Calcium and phosphorus 
B) Vitamin C and calcium 
C) Sodium, potassium and phosphorus 
D) Potassium, calcium, and protein

Question 6

You are working in the emergency room when a 45 year old male comes in with signs and symptoms of acute renal failure. What is the most accurate measure of renal function?

Accepted Answer

A) glomerular filtration rate 
B) urea 
C) creatinine 
D) urine output

Question 7

Who is most at risk for developing a pulmonary embolism?

Accepted Answer

A) A 37 year old woman 6 weeks after an appendectomy 
B) A patient with atrial fibrillation and one day post operative a total knee replacement 
C) A 27 marathon runner who has been in the hospital for two days for an exacerbation of asthma 
D) A 80 year old patient who is been admitted for chest pain, rule out myocardial infarction

Question 8

A patient is suspected of developing an Upper Gastrointestinal bleed two days after a total hip replacement. What are the most appropriate nursing actions?

Accepted Answer

A) Make the patient NPO (nothing by mouth) and insert a Nasogastric tube to intermittent suction. 
B) Make the patient NPO (nothing by mouth) and saline lock the intravenous device (IV). 
C) Check the vital signs and check the labs to evaluate the Hemoglobin and Hematocrit. 
D) Give the patient ice chips only and evaluate the patient for signs and symptoms of bleeding.

Question 9

Antacids are a common medication used to neutralize stomach acid and decrease the effects of a gastrointestinal bleed. When is the optimal time to administer antacids?

Accepted Answer

A) 30 minutes before meals 
B) After meals and before bedtime 
C) Every 6 hours three times a day 
D) Any time throughout the day

Question 10

What characteristics would the nurse most likely assess in a patient with reduced Renal Reserve (early stages of renal disease)?

Accepted Answer

A) Elevated BUN (blood, urea, nitrogen) lab value. 
B) Mild anemia and hypertension 
C) Terminal uremia 
D) Nocturia

Question 11

Knowing that the patient is beginning to display signs of Tetany, the nurse checks the chemistry panel and notes the serum calcium level has dropped to 5.2. What medication would the nurse anticipate being ordered to correct the Hypocalcemia?

Accepted Answer

A) Intravenous potassium replacement 
B) Intravenous calcium gluconate 
C) Calcium tablets three times a day 
D) Vitamin D injection and calcium 500 mg twice a day

Question 12

The nurse notices that the positive end-expiratory pressure (PEEP) on the patient with respiratory failure is at 11 cm H20 to maintain the patient's oxygenation. The patient's blood pressure is at 84/46. What would be the optimal choice to increase the preload of the heart?

Accepted Answer

A) Stop the PEEP (positive end-expiratory pressure) and wait for the patient's blood pressure to go up. 
B) Obtain orders for a fluid bolus. 
C) Hold the blood pressure medications. 
D) Increase the stimulation of the patient's environment.

Question 13

A nurse is caring for a 37-year-old patient with a ventricular drain. The nurse continues to assess for complications of rapid cerebrospinal fluid drainage. The signs and symptoms of complications of excessive CSF drainage include:

Accepted Answer

A) Headache, tachycardia, diaphoresis, and nausea 
B) Shortness of breath, rapid heart rate, and hypotension 
C) Severe headache, shallow and irregular respirations, and decrease in level of consciousness 
D) Vomiting, amnesia, irritability, and dizziness

Question 14

A 29 year old female has been admitted with severe abdominal pain of unknown origin. What kind of pain would Pancreatitis most likely be the cause of?

Accepted Answer

A) Pain relieved by laying down 
B) Pain that worsens when laying down 
C) Pain that radiates to the chest 
D) Pain that is most acute in the left upper quadrant of the abdomen

Question 15

What precautions should be followed when administering Phenytoin?

Accepted Answer

A) Phenytoin should always be mixed with a dextrose solution when given in an intravenous form. 
B) Phenytoin should be given as a pill only. 
C) Most people don't react well to Phenytoin so Fosphenytoin is given as an alternate. 
D) Phenytoin should not be mixed with a dextrose solution.

Question 16

The nurse is assessing the patient who will be receiving dialysis later in the day. What assessment can the nurse do to evaluate the patency of the patient's graft site where dialysis will be accessed?

Accepted Answer

A) Look at the x-ray that was done earlier in the morning 
B) Listen for the presence of a bruit and thrill over the graft site 
C) Monitor the platelet and Prothrombin time on the morning lab draw 
D) Ask the patient if there has been any swelling around the graft site

Question 17

Panic disorders may be associated with abnormal activation in which part of the human brain?

Accepted Answer

A) Amygdala 
B) Broca's region 
C) Cerebellum 
D) Corpus callosum

Question 18

A 62 year old woman is admitted to the Intensive Care Unit. She has a history of a kidney transplant 11 years ago and has had no problems with her kidney function. She has been taking Furosemide 20 mg by mouth twice a day since the kidney transplant. In the last two days she has voided less than 200 mL a day. What abnormal lab values would the nurse most likely see?

Accepted Answer

A) Elevated Amylase and lipase 
B) Elevated potassium and decreased sodium 
C) Increased Creatinine and low potassium 
D) Increased Creatinine and increased calcium

Question 19

What is the most common and first clinical symptom of Appendicitis?

Accepted Answer

A) Anorexia 
B) Nausea and vomiting 
C) Indigestion 
D) Abdominal pain

Question 20

After the nurse quickly assesses her patient is having a hemolytic reaction to the blood they are receiving, what is the first action that the nurse should take?

Accepted Answer

A) Call the doctor. 
B) Stop the blood. 
C) Take vital signs and administer epinephrine. 
D) Administer a bolus of normal saline and call the doctor.

Exam 1: Adult

A patient with unstable angina has an Intra-aortic balloon pump (IABP) inserted. The patient's hemodynamics are: HR = 148 (sinus tachycardia) ; MAP = 40 mm Hg; PCWP = 25 mm Hg; CI = 1.4 L/min/m2. Which of the following should be included in this patient's plan of care?