AACN Certification and Core Review for High Acuity and Critical Care by Elsevier Health Sciences

Author:Elsevier Health Sciences [Alspach, JoAnn Grif]
Language: eng
Format: epub
ISBN: 978-1-4377-2558-2
Publisher: Elsevier Health Sciences
Published: 2008-03-14T16:00:00+00:00

3

Core Review Test 3

3-1. Which of the following assessment findings would the nurse anticipate in patients with both right- and left-sided heart failure?

A. S3 and S4 heart sounds

B. Orthopnea

C. Basilar crackles

D. Elevated PA pressures

3-2. A patient is admitted to the ICU after attempted drug overdose. He develops generalized muscle rigidity followed by a rhythmic muscle jerking. The nurse observes this activity for 1 minute and pages the physician managing the patient’s care. The activity continues for 10 minutes despite administration of lorazepam 4 mg IV. The next course of action the nurse should anticipate is

A. STAT EEG to confirm that the patient is having a seizure and to localize foci

B. STAT serum and urine labs including myoglobin

C. Infusion of lorazepam with phenytoin 15 mg/kg IV

D. Infusion of pentobarbital 20 mg/kg IV

3-3. A patient is admitted after exhibiting several neuropsychiatric symptoms including motor coordination difficulties, delayed reaction times, headache, and impaired cognitive skills. During the nurse’s conversations with the family to secure a patient history, the patient’s spouse mentioned that they are in the process of renovating a home that has been in the family for over 50 years. This information suggests that the most likely etiology for this patient’s symptoms is

A. Cyanide poisoning

B. Carbon monoxide exposure

C. Exposure to pesticides

D. Lead poisoning

3-4. Occlusion of the left anterior descending coronary artery is associated with which of the following complications?

A. Papillary muscle dysfunction

B. Left ventricular aneurysm

C. Bradycardia

D. Pulmonary edema

3-5. A patient from the Mediterranean is admitted for unstable angina. The patient reports substernal chest pain 7/10, radiating down his left arm. Vital signs are 136/78 mm Hg, HR 106 beats/min, RR 24/min, temp 98.6° F (37° C). Which of the following medications should be administered with caution to this patient?

A. Aspirin

B. Metoprolol (Lopressor®)

C. Nitroglycerin

D. Morphine

3-6. Two hours after open surgical repair of an abdominal aortic aneurysm, a patient is hemodynamically stable and mechanically ventilated. Nursing care of the patient at this time should focus on

A. Preventing peripheral vascular damage with a bed cradle and toe padding

B. Ensuring return of bowel function by instituting a bowel protocol

C. Frequent suctioning to prevent pneumonia

D. Pain control

3-7. A patient with acute exacerbation of COPD is minimally responsive, tachypneic, and tachycardic. Arterial blood gas results include pH 7.20, PaO2 55 mm Hg, and PaCO2 68 mm Hg. The nurse anticipates that the next intervention will be

A. Instituting BiPAP

B. Endotracheal intubation

C. Application of low flow oxygen by nasal cannula

D. Administration of 50 mg sodium bicarbonate to correct acidosis

3-8. A 35-year-old Asian man is admitted with jaundice, elevated liver enzyme levels, malaise, and lack of appetite. His total bilirubin is 34 mg/dL; aspartate aminotransferase (AST) 874 U/L; alanine aminotransferase (ALT) 789 IU/L; prothrombin time (PT) 23 sec; international ratio (INR) 3.2. His HAV IgM is negative; HAV IgG is positive; HCV Ab is negative; HBVsAg is positive; HBVsAb is negative. The probable cause of these findings is

A. Hepatitis A

B. Hepatitis B

C. Hepatitis C

D. Hepatitis D

3-9. Which of the following findings indicates that end organ dysfunction has occurred in a patient undergoing treatment for hypertensive crisis?

A.

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