Emergency Medicine Quiz
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Questions and Answers

What is the primary laboratory test used to monitor the effectiveness of heparin therapy in a patient with a pulmonary embolism?

  • Vitamin K levels
  • Bleeding times
  • Activated partial thromboplastin time (aPTT) (correct)
  • Prothrombin time/international normalized ratio (PT/INR)

    • In the Parkland formula for fluid resuscitation, the total fluid requirement is divided into two phases. What percentage of the total fluid is administered during the first 8 hours?

  • 25%
  • 75%
  • 100%
  • 50% (correct)

    • How is the total body surface area (TBSA) burned calculated using the Rule of Nines for a patient with burns to the anterior chest, perineum, and entire right leg?

  • 37% + 1% + 18%
  • 18% + 1% + 18% (correct)
  • 18% + 1% + 25%
  • 18% + 2% + 18%

    • For a 75-kg patient with a TBSA burned of 37%, what would be the total fluid requirement calculated using the Parkland formula?

    <p>11,100 mL</p> Signup and view all the answers

    What is the fluid requirement for the first 8 hours for a patient requiring a total of 11,100 mL of fluid based on the Parkland formula?

    <p>5,550 mL</p> Signup and view all the answers

    Which of the following is NOT a typical initial management step in treating a patient with a pulmonary embolism?

    <p>Calling a local hyperbaric chamber</p> Signup and view all the answers

    What does the Parkland formula specifically calculate for burn victims?

    <p>Fluid resuscitation requirements</p> Signup and view all the answers

    In assessing the effectiveness of heparin therapy, which test is least relevant?

    <p>Hematocrit level</p> Signup and view all the answers

    What is the pathophysiologic consequence of disseminated intravascular coagulation (DIC)?

    <p>Excessive thrombosis and fibrinolysis</p> Signup and view all the answers

    Which laboratory result should the nurse prioritize in reporting for a patient receiving chemotherapy?

    <p>White blood cells (WBC) 1700/uL</p> Signup and view all the answers

    In cardiogenic shock, the symptoms are primarily due to which issue?

    <p>Inability of the heart to pump blood forward</p> Signup and view all the answers

    Which action regarding blood transfusion can the nurse delegate to assistive personnel (AP)?

    <p>Verify the patient identification (ID) according to hospital policy</p> Signup and view all the answers

    For a patient admitted with gastrointestinal hemorrhage due to esophagogastric varices, which medication should the nurse expect to be prescribed?

    <p>Vasopressin</p> Signup and view all the answers

    What pathophysiologic mechanism causes esophagogastric varices?

    <p>Portal hypertension resulting in diversion of blood to low-pressure areas</p> Signup and view all the answers

    Which finding would indicate the need for blood administration in a patient with esophageal bleeding?

    <p>Hemoglobin less than 7 g/dL</p> Signup and view all the answers

    What type of injury is indicated for a patient brought to the emergency department after a house fire?

    <p>Inhalation injury from smoke</p> Signup and view all the answers

    What is a common cause for the high-pressure limit alarm on a ventilator?

    <p>A kink in the ventilator tubing</p> Signup and view all the answers

    Which method is best for quickly confirming endotracheal tube placement after intubation?

    <p>End-tidal CO₂ monitor</p> Signup and view all the answers

    What is the correct term for the response showing internal rotation, adduction, and flexion of the arms in a brain-injured patient?

    <p>Decorticate posturing</p> Signup and view all the answers

    Which vital sign indicates a need for urgent communication after evacuation of an epidural hematoma?

    <p>Temperature of 101.6°F</p> Signup and view all the answers

    What are two common medications prescribed at discharge for a patient who has undergone coronary artery stenting?

    <p>Aspirin and clopidogrel</p> Signup and view all the answers

    What potential harm can excessive pressure in a ventilator circuit cause?

    <p>Barotrauma</p> Signup and view all the answers

    What alarm condition is likely if a patient is disconnected from the ventilator?

    <p>Low pressure</p> Signup and view all the answers

    How does a leak in the ET tube cuff primarily affect the ventilator alarms?

    <p>It causes low tidal volume alarms</p> Signup and view all the answers

    What is hematemesis indicative of in a patient?

    <p>Recent bleeding from the upper gastrointestinal tract</p> Signup and view all the answers

    What condition can lead to gastrointestinal hemorrhage in patients with severe head injury?

    <p>Stress-related mucosal disease (SRMD)</p> Signup and view all the answers

    Which of the following is true regarding melena?

    <p>It indicates digested blood from the upper gastrointestinal tract.</p> Signup and view all the answers

    What role does lactulose play in a patient with acute liver failure?

    <p>It reduces the absorption of ammonia in the gut.</p> Signup and view all the answers

    Which of the following best describes stable angina?

    <p>Responds predictably well to nitrates.</p> Signup and view all the answers

    In acute liver failure with elevated ammonia levels, what is the main risk of high ammonia?

    <p>Development of hepatic encephalopathy.</p> Signup and view all the answers

    What is an accurate description of the assist-control mode of ventilation?

    <p>It provides gas at a preset volume and rate with patient effort.</p> Signup and view all the answers

    Which option correctly identifies a symptom of gastrointestinal hemorrhage?

    <p>Black, tarry stools (melena).</p> Signup and view all the answers

    Which admission order should the nurse question for a patient with ecchymoses around the eyes and clear nasal drainage?

    <p>Insert nasogastric tube to low suction.</p> Signup and view all the answers

    What best describes shock based on the understanding of its physiologic implications?

    <p>Shock is an acute, widespread process of inadequate tissue perfusion.</p> Signup and view all the answers

    Which of these signs might indicate transplant rejection in a recent heart transplant patient?

    <p>Shortness of breath</p> Signup and view all the answers

    Which intervention is NOT expected in the collaborative management of a patient with acute liver failure?

    <p>Insulin drip for hyperglycemia and hyperkalemia</p> Signup and view all the answers

    Which intervention is important when managing a client with end-stage liver disease and hypervolemia?

    <p>Monitoring daily weights</p> Signup and view all the answers

    Which laboratory finding is commonly associated with tumor lysis syndrome (TLS)?

    <p>Elevated creatine</p> Signup and view all the answers

    Which intervention is essential to reduce complications when suctioning an artificial airway?

    <p>Use a smaller suction catheter if possible</p> Signup and view all the answers

    What condition commonly leads to hypotension and warrants prompt intervention?

    <p>Hypovolemia due to significant fluid loss</p> Signup and view all the answers

    What physiological change occurs due to the sympathetic nervous system's impact on blood vessels in the skin?

    <p>Impaired temperature regulation</p> Signup and view all the answers

    Which disorder is suspected in a patient exhibiting low-grade fever, joint pain, and a history of similar symptoms in the northeast?

    <p>Idiopathic thrombocytopenic purpura</p> Signup and view all the answers

    What should the nurse's immediate response be when finding a client with cirrhosis on the floor after fainting?

    <p>Have the client assessed by the primary provider due to the risk of internal bleeding.</p> Signup and view all the answers

    In which stage of hepatic encephalopathy might lethargy and slurred speech be observed?

    <p>Stage 2</p> Signup and view all the answers

    What is the priority nursing care for a patient recovering from liver transplantation?

    <p>Implementation of infection-control measures</p> Signup and view all the answers

    What should the nurse do in response to subtle changes in cognition and behavior in a client with cirrhosis?

    <p>Report this finding to the primary provider due to the possibility of hepatic encephalopathy.</p> Signup and view all the answers

    Which symptom would most likely indicate that a patient is experiencing impaired thermoregulation?

    <p>Experiencing hypothermia in a warm room</p> Signup and view all the answers

    What condition could the agitation and pain in the admitted patient indicate?

    <p>Acute viral infection</p> Signup and view all the answers

    Study Notes

    Questions and Answers

    • Question 1: A patient with a head injury opens his eyes to verbal stimulation, curses when stimulated, and does not respond to a verbal command to move but attempts to push away a painful stimulus. How would the nurse record the patient's Glasgow Coma Scale score?

      • Correct answer: 9

    • Question 2: A patient is admitted after she develops disseminated intravascular coagulation (DIC) after a vaginal delivery. Which laboratory value would the nurse expect to note to support this diagnosis?

      • Correct answer: Decreased fibrinogen degradation products

    • Question 3: Which action would the nurse implement when caring for a patient who has an acute exacerbation of polycythemia vera?

      • Correct answer: Place the patient on bed rest.

    • Question 4: A patient with submassive pulmonary embolism has been prescribed warfarin in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse's response is based on which rationale?

      • Correct answer: The combination of heparin and an oral anticoagulant results in fewer adverse effects than heparin used alone.

    • Question 10: Using the "rule of nines," calculate the percent of injury in an adult who was injured as follows: the patient sustained partial and full-thickness burns to half of his left arm, his entire left leg, and his perineum.

      • Correct answer: 23.5%

    • Question 13: A patient has been admitted with anaphylactic shock due to an unknown allergen. The nurse understands that the decrease in the patient's cardiac output is the result of which mechanism?

      • Correct answer: Peripheral vasodilation

    • Question 14: A client is being discharged on anticoagulant therapy for a low-risk stable pulmonary embolism. Which anticoagulant enhances the activity of antithrombin III and does require activated partial thromboplastin time (aPTT) or activated clotting time (ACT) monitoring?

      • Correct answer: Heparin

    • Question 15: A patient with coronary artery disease (CAD) is admitted with chest pain. The patient is suddenly awakened with severe chest pain. Three nitroglycerin sublingual tablets are administered 5 minutes apart without relief. A 12-lead electrocardiograph (ECG) reveals nonspecific ST segment elevation. The nurse suspects the patient may have which disorder?

      • Correct answer: Unstable angina

    • Question 16: Which statement best describes the effects of positive-pressure ventilation on cardiac output?

      • Correct answer: Positive-pressure ventilation increases intrathoracic pressure, which decreases venous return and cardiac output.

    • Question 17: What is the primary mechanism in the development of tumor lysis syndrome?

      • Correct answer: Destruction of malignant cells through radiation or chemotherapy

    • Question 18: The patient is admitted with an acute inferior myocardial infarction (MI). A 12-lead electrocardiogram (ECG) is done to validate the area of infarction. Which finding on the ECG is most conclusive for infarction?

      • Correct answer: Pathologic Q waves

    • Question 19: Which action will the emergency department nurse anticipate for a patient diagnosed with a concussion who did not lose consciousness?

      • Correct answer: Provide discharge instructions about monitoring neurological status.

    • Question 20: Admission vital signs for a patient who has a brain injury are blood pressure of 128/68 mm Hg, pulse of 110 beats/min, and of respirations 26 breaths/min. Which set of vital signs, if taken 1 hour later, will be of most concern to the nurse?

      • Correct answer: Blood pressure 134/72 mm Hg, pulse 90 beats/min, respirations 32 breaths/min

    • Question 21: A patient has been newly diagnosed with stable angina. He tells the nurse he knows a lot about his diagnosis already because his father had the same diagnosis 15 years ago. The nurse asks him to state what he already knows about angina. Which response indicates the need for additional education?

      • Correct answer: He can no longer get a strong back massage.

    • Question 22: A patient with known penicillin allergies developed anaphylactic shock after ampicillin was given in error. Which medication would the nurse administer?

      • Correct answer: Epinephrine

    • Question 23: A patient with possible disseminated intravascular coagulation arrives in the emergency department with a blood pressure of 82/40, temperature 102° (38.9°C), and severe back pain. Which prescribed action will the nurse implement first?

      • Correct answer: Administer morphine sulfate 4 mg IV.

    • Question 24: The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by assistive personnel (AP), if observed by the nurse, would require an intervention?

      • Correct answer: The AP stands by the patient's bed for 30 minutes talking with the patient.

    • Question 25: During the change-of-shift report, the nurse learns about the following four patients. Which patient would the nurse assess first?

      • Correct answer: A patient with cirrhosis and ascites who has a temperature of 102°F (38.8°C).

    • Question 26: Patient who is being treated with chemotherapy and radiation for stage IV lung cancer tells the nurse about intense new-onset back pain. Which action would the nurse take first?

      • Correct answer: Assess for sensation and strength in the legs.

    • Question 27: Which action would the nurse include in the plan of care for a patient who has thalassemia major?

      • Correct answer: Administer blood component therapy as needed.

    • Question 10: Using the "rule of nines," calculate the percent of injury in an adult who was injured as follows: the patient sustained partial and full-thickness burns to half of his left arm, his entire left leg, and his perineum.

      • Correct answer: 23.5%

    • Question 30: The nurse is caring for a patient after a liver transplant. Which finding would be of most concern to the nurse?

      • Correct answer: Elevated prothrombin time and INR.

    • Question 31: A patient Admitted with a severe head injury. The nurse knows that critically patients are at risk for gastrointestinal hemorrhage due to stress related mucosal disease. The nurse would monitor the patient for which signs and symptoms?

      • Correct answer: Hematemesis and melena

    • Question 32: Which statement regarding the difference between stable and unstable angina is accurate?

      • Correct answer: Stable angina responds predictably well to nitrates.

    • Question 33: The nurse is caring for a patient with acute liver failure. The patient has elevated ammonia levels. Which medication would the nurse expect the provider to order for this patient?

      • Correct answer: Lactulose

    • Question 34: Which statement describes the assist-control mode of ventilation?

      • Correct answer: It delivers gas at preset volume, at a set rate, and in response to the patient's inspiratory efforts.

    • Question 36: A patient has been admitted with neurologic disorder. With which disorder should the nurse be the most vigilant for the development of neurogenic shock?

      • Correct answer: Spinal cord injury

    • Question 37: A patient is admitted with a brain and spinal cord injury secondary to a motor vehicle crash. The nurse is monitoring the patient for signs of neurogenic shock. Clinical findings in neurogenic shock are related to which pathophysiologic process?

      • Correct answer: Loss of sympathetic nervous system innervation

    • Question 38: A patient is admitted with symptoms of a low-grade fever, joint pain, tachycardia, hepatomegaly, photophobia, and an inability to follow commands. The patient is becoming more agitated and complaining of pain. The parent says the patient has had similar symptoms when they were living in the northeast states. The nurse suspects that the patient has which disorder?

      • Correct answer: Sickle cell anemia

    • Question 39: A nurse has entered the room of a client with long term cirrhosis and found the client on the floor. The client reports feeling faint and falling when transferring to the commode. The client's vital signs are within reference ranges and the nurse observes no apparent injuries. What is the nurse's most appropriate action?

      • Correct answer: Have the client assessed by the primary provider due to the risk of internal bleeding.

    • Question 40: A patient was admitted with acute liver failure. The patient is lethargic, slurred speech, has marked asterixis. What is the earliest stage of hepatic encephalopathy that finding may be seen?

      • Correct answer: Stage 2

    • Question 41: A nurse on a solid organ transplant unit is planning for the care of a client who will soon be admitted based on immediate recovery following liver transplantation. What aspect of nursing care is the nurse's priority?

      • Correct answer: Implementation of infection-control measures

    • Question 42: A nurse is caring for a client with cirrhosis secondary to heavy alcohol use. The nurse's most recent assessment reveals subtle changes in the client's cognition and behavior. What is the nurse's most appropriate response?

      • Correct answer: Report this finding to the primary provider due to the possibility of hepatic encephalopathy.

    • Question 43: A patient's ICP is 34 mm Hg, and his cerebral perfusion pressure is 65 mm Hg. Given that the provider has left appropriate orders, which action should the nurse take next? - Correct answer: No action is required.

    • Question 44: A nurse is caring for a patient in shock with elevated lactate levels. Which order should the nurse question in the management of this patient?

      • Correct answer: Administer sodium bicarbonate to keep arterial pH greater than 7.5.

    • Question 45: The nurse is caring for a patient with acute liver failure. The provider asks the nurse to assess the patient for asterixis. How should the nurse assess this symptom?

      • Correct answer: Have the patient extend the arms and dorsiflex the wrists.

    • Question 46: A client survived a massive myocardial infarction (MI) and is advised to have an ICD implanted. What dysrhythmia is most frequently associated with sudden cardiac death after an MI?

      • Correct answer: Ventricular tachycardia

    • Question 47: A patient is admitted after being burned while lighting the barbecue. The injuries appear moist and red with some blister formation and the patient states they are very painful. What kind of burn would the nurse document in the patient's record?

      • Correct answer: Partial-thickness, second-degree burn

    • Question 48: A patient is admitted after she develops disseminated intravascular coagulation (DIC) after a vaginal delivery. The nurse knows that DIC is known to occur in patients with retained placental fragments. What is the pathophysiologic consequence of DIC?

      • Correct answer: Excessive thrombosis and fibrinolysis.

    • Question 49: The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Thich laboratory result is most important to report to the health care provider

      • Correct Answer: White blood cells (WBC) 1700/uL

    • Question 50: A nurse is caring for a patient in cardiogenic shock. The nurse recognizes that the patient's signs and symptoms are the result of what problem?

      • Correct Answer: Inability of the heart to pump blood forward

    • Question 51: The nurse is planning to administer a transfusion of packed red blood cells (PRBCs) to a patient. Which action can the nurse delegate to assistive personnel (AP)?

      • Correct Answer: Verify the patient identification (ID) according to hospital policy.

    • Question 52: A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. What medication would the nurse expect the provider to order for this patient?

      • Correct Answer: Vasopressin

    • Question 53: A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. The nurse knows that varices are caused by which pathophysiologic mechanism?

      • Correct Answer: Portal hypertension resulting in diversion of blood from a high-pressure area to a low-pressure area.

    • Question 54: A patient with a history of alcoholism is admitted with esophageal bleeding. Which finding would be an indication for the administration of blood in this patient?

      • Correct answer: Hemoglobin less than 7 g/dL

    • Question 55: A patient is brought to the emergency department after a house fire. The patient sustained an inhalation injury. The nurse is aware that this injury predisposes the patient to the development of what complication?

      • Correct answer: Adult respiratory distress syndrome (ARDS)

    • Question 56: A patient has been admitted with tumor lysis syndrome (TLS). Which intervention would be incorporated into the plan of care to prevent the metabolic imbalances associated with this disorder? Correct Answer:Restrict all oral fluids.

    • Question 57: What ventilator mode has the preset positive pressure used to augment the patient's inspiratory effort and can be used as a weaning mode?

      • Correct Answer: Pressure support ventilation (PSV)

    • Question 58: A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). Which information would the nurse include in the patient's teaching plan? Correct Answer:Protective isolation is required for several weeks after the stem cell transplant.

    • Question 59: A patient who has been anticoagulated with warfarin has been admitted for gastrointestinal bleeding .The history and physical examination indicated that the patient has been taking too much warfarin. The nurse will anticipate that the patient will receive which antidote?

      • Correct answer: Vitamin K

    • Question 60: Which action would the nurse in the emergency department take first for a patient with cirrhosis who arrives vomiting blood?

      • Correct answer: Check blood pressure and heart rate.

    • Question 61: When assessing an intubated patient, the nurse notes normal breath sounds on the right side of the chest and absent breath sounds on the left side of the chest. What problem should the nurse suspect?

      • Correct answer: Left pneumothorax

    • Question 62: A patient has been admitted with hypovolemic shock due to traumatic blood loss. Which nursing measure can best facilitate the administration of large volumes of fluid?

      • Correct Answer: Inserting a large-diameter peripheral intravenous catheter

    • Question 63: A client who has undergone liver transplantation is ready to be discharged home. Which outcome of health education should the nurse prioritize?

      • Correct Answer: The client will exercise three times a week

    • Question 64: A patient was admitted to the critical care unit with acute respiratory failure. The patient has been on a ventilator for 3 days and is being considered for weaning. Which criteria would indicate that the patient is not tolerating weaning and therefore postpone weaning?

      • Correct answer: An increase in respiratory rate from 22 to 38 breaths/min

    • Question 65: A patient with acute lung failure has been on a ventilator for 3 days and is being considered for weaning. The ventilator high-pressure limit alarm keeps alarming. What would cause this problem?

      • Correct answer: A kink in the ventilator tubing

    • Question 66: A patient with chronic obstructive pulmonary disease (COPD) requires intubation. After the provider intubates the patient, the nurse auscultates for breath sounds. Breath sounds are questionable in this patient. Which action would best quickly assist in determining correct endotracheal tube placement in this patient?

      • Correct Answer: Stat chest radiographic examination

    • Question 67: When a brain-injured patient responds to nail bed pressure with internal rotation, adduction, and flexion of the arms, how would the nurse report the response?

      • Correct answer: Decorticate posturing

    • Question 68: After evacuation of an epidural hematoma, a patient's intracranial pressure (ICP) is being monitored with an intraventricular catheter. Which information obtained by the nurse requires urgent communication with the health care provider?

      • Correct Answer: Intracranial pressure of 15 mm Hg

    • Question 69: What two medications are commonly prescribed at discharge for a patient who had a coronary artery stent placed?

      • Correct Answer: Aspirin and clopidogrel

    • Question 70: A patient has had a kidney transplant. The nurse knows that monitoring of which parameter would have the highest priority?

      • Correct Answer: Electrolytes

    • Question 71: A group of nurses have attended an in-service on the prevention of occupationally acquired diseases that affect health care providers. What action has the greatest potential to reduce a nurse's risk of acquiring hepatitis C in the workplace?

      • Correct Answer: Disposing of sharps appropriately and not recapping needles.

    • Question 72: Which pathophysiologic event contributes to renal failure associated with tumor lysis syndrome?

      • Correct Answer: Crystallization of uric acid in the renal tubules

    • Question 73: The patient is 72 hours postoperative for a coronary artery bypass graft (CABG). The patient s vital signs include temperature 103°F, heart rate 112, respiratory rate 22, blood pressure 134/78 mm Hg, and 02 saturation 94% on 3L nasal cannula. The nurse suspects that the patient has developed what problem?

      • Correct Answer: Infection

    • Question 74: When caring for a patient who has cirrhosis, which nursing action could the registered nurse (RN) delegate to assistive personnel (AP)?

      • Correct answer: Providing oral hygiene after a meal

    • Question 75: Answer is B. Neutropenia

    • Question 76: After change-of-shift report on the oncology unit, which patient would the nurse assess first?

      • Correct answer: Patient who is neutropenic and has a temperature of 100.5°F (38.1°C).

    • Question 77: Which statement by a patient who is being discharged from the emergency department (ED) after a concussion indicates a need for intervention by the nurse? Correct Answer: "I am going to drive home and go right to bed."

    • Question 78: Less than 24 hours ago a patient sustained full -thickness burns to his face, chest and bilateral upper arms, in a house fire. He also sustained an inhalation injury. The patient was intubated and ventilated and is now showing signs of increasing agitation and rising peak airway pressures. The nurse suspects the patient's change in condition is due to which problem?

      • Correct answer: A leak in the patient's endotracheal (ET) tube cuff

    • Question 79: A patient admitted with a diffuse axonal injury has a systemic blood pressure (BP) of 106/52 mm Hg and an intracranial pressure (ICP) of 14 mm Hg. Which action would the nurse take first?

      • Correct answer: Report the BP and ICP to the health care provider.

    • Question 80: What is the rationale for administering a fibrinolytic agent to a patient experiencing acute ST-elevation myocardial infarction (STEMI)?

      • Correct Answer: Restoration of blood flow via lysis of the thrombus.

    • Question 81: The nurse has administered prescribed IV mannitol to an unconscious patient. Which parameter would the nurse monitor to determine the medication's effectiveness?

      • Correct Answer: Intracranial pressure

    • Question 82: A nurse is caring for a patient in septic shock due to urinary sepsis. Which pathophysiologic mechanism results in septic shock?

      • Correct Answer: Bacterial toxins lead to vasodilation

    • Question 83: A patient with a history of chronic alcoholism was admitted with acute decompensated cirrhosis. What intervention would the nurse include in the patient's plan of care?

      • Correct Answer: Monitor the patient for hypovolemic shock from plasma volume depletion.

    • Question 84: What is the preferred initial treatment of an acute myocardial infarction?

      • Correct Answer: Percutaneous coronary intervention (PCI)

    • Question 85: A nurse is providing care to a patient on fibrinolytic therapy. Which statements from the patient warrants further assessment and intervention by the nurse?

      • Correct Answer: "My back is killing me!"

    • Question 86: Which nursing intervention is a priority for a patient with gastrointestinal hemorrhage from esophageal varices?

      • Correct Answer: Ensuring the patient has a patent airway

    • Question 87: A 26-yr-old patient who was admitted with viral hepatitis has severe anorexia and fatigue, and is homeless. Which goal has the highest priority in the plan of care?

      • Correct Answer: Maintain adequate nutrition.

    • Question 88: After the emergency department nurse has received a status report on the following patients with head injuries, which patient would the nurse assess first?

      • Correct Answer: A 50-yr-old patient whose right pupil is 10 mm, unresponsive to light.

    • Question 89: The nurse is admitting a patient with a basal skull fracture. The nurse notes ecchymoses around both eyes and clear drainage from the patient's nose. Which admission order would the nurse question?

      • Correct Answer: Insert nasogastric tube to low suction

    • Question 90: A nurse is discussing the concept of ALL the different types of shock with a new graduate nurse. Which statement indicates the new graduate nurse understood the information?

      • Correct Answer: "Shock is an acute, widespread process of inadequate tissue perfusion."

    • Question 91: The nurse is caring for a patient who has had a recent heart transplant. Which signs and symptoms would alert the nurse that the patient is rejecting the transplant? (Select all that apply.)

      • Correct answer: Shortness of breath; Sudden onset of edema; Decreased weight

    • Question 92: A patient has been admitted with acute liver failure. Which interventions would the nurse expect as part of the interprofessional collaborative management plan? (Select all that apply.)

      • Correct Answers: Benzodiazepines for agitation; Pulse oximetry and serial arterial blood gas measurements; Monitoring electrolyte blood levels; Assessing for signs of neurologic deficits

    • Question 93: A client with end-stage liver disease has developed hypervolemia. What nursing interventions would be most appropriate when addressing the client s fluid volume excess? Select all that apply.

      • Correct Answers: Administering diuretics; Implementing fluid restrictions; Monitoring daily weights

    • Question 94: A patient has been admitted with tumor lysis syndrome (TLS). Which laboratory findings would the nurse expect to note to support this diagnosis? (Select all that apply.)

      • Correct Answers: Increased calcium; Elevated blood urea nitrogen (BUN); Elevated creatine

    • Question 95: Which interventions minimize the complications associated with suctioning an artificial airway? (Select all that apply.)

      • Correct Answers: Hyperoxygenate the patient prior to the start of the procedure; Hyperoxygenate the patient after each pass of the suction catheter; Limit the duration of each suction pass to 20 seconds

    • Question 96: A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis B. What preventative measures should the educator promote? Select all that apply.

      • Correct Answers: Immunization; Use of standard precautions

    • Question 97: The nurse is caring for a patient on a mechanical ventilator that is set on 91. assist-control mode. Which statements accurately describe this function? (Select all that apply.)

      • Correct Answers: The ventilator delivers a set tidal volume; The ventilator delivers a set number of breaths even if the patient's rate falls; The ventilator helps prevent respiratory alkalosis

    • Question 98: Which disorders or conditions are potential causes of acute liver failure/cirrhosis? (Select all that apply.)

      • Correct Answers: Alcoholism; Hepatitis A, B, C, D, E; Chronic biliary obstruction and cholangitis

    • Question 99: A patient is being admitted with septic shock. The nurse appreciates that the key to treatment is finding the cause of the infection. Which cultures would the nurse obtain before initiating antibiotic therapy? (Select all that apply.)

      • Correct Answers: Blood cultures; Wound cultures; Urine cultures; Sputum cultures

    • Question 100: The nurse at the clinic is interviewing a 54-yr-old woman who is 5 feet, 3 inches tall and weighs 125 lb (57 kg). The patient has not seen a health care provider for 20 years. Which preventative measures should the nurse plan to include in the patient's teaching about cancer screening and decrease cancer risk?

      • Correct Answers: Pap testing; Tobacco use; Sunscreen use; Mammography; Colorectal screening

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