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Critical Care Nursing Exam 2025/2026: Trauma, Ventilation, and Emergency Management, Exams of Nursing

City University of New York (CUNY) - Hostos Community CollegeNursing

A series of multiple-choice questions and answers related to critical care nursing, focusing on the management of trauma patients, ventilator care, neurological assessments, and various medical conditions such as diabetic ketoacidosis and renal failure. It covers essential nursing interventions, diagnostic assessments, and pharmacological considerations relevant to critical care settings. The questions address key aspects of patient care, including recognizing early signs of complications, prioritizing nursing actions, and understanding the rationale behind different treatment modalities. This material is useful for nursing students and professionals seeking to enhance their knowledge and skills in critical care.

Typology: Exams

2024/2025

Available from 05/28/2025

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BKAT 9R EXAM NEWEST 2025/2026
WITH QUESTIONS AND CORRECT
ANSWERS
Your trauma patient, who is 4 days post fracture of the right femur, suddenly develops shortness of
breath. The most likely cause is:
1. Fat embolus
2. Pneumonia
3. Pleural effusion
4. Pulmonary edema - answer-Fat embolism
To help prevent ventilator acquired pneumonia (VAP), the most important nursing action would be to:
1. keeping FIO2 at 60%
2. changing the ventilator tubing qshift
3. careful hand-washing and use of gloves when suctioning
4. treat low peak-inspiratory pressures - answer-Careful hand-washing and use of gloves when
suctioning
The most important nursing activity for a patient admitted with the diagnosis of cervical spinal cord
injury is:
1. keeping the patient flat
2. immobilizing the head
3. noting change in feeling extremities
4. doing hourly neuro checks - answer-Immobilizing the head
In a patient with cervical spine injury, the most important observations the nurse makes concerns which
of the following physiological parameters?
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Partial preview of the text

Download Critical Care Nursing Exam 2025/2026: Trauma, Ventilation, and Emergency Management and more Exams Nursing in PDF only on Docsity!

BKAT 9R EXAM NEWEST 202 5/

WITH QUESTIONS AND CORRECT

ANSWERS

Your trauma patient, who is 4 days post fracture of the right femur, suddenly develops shortness of breath. The most likely cause is:

  1. Fat embolus
  2. Pneumonia
  3. Pleural effusion
  4. Pulmonary edema - answer-Fat embolism To help prevent ventilator acquired pneumonia (VAP), the most important nursing action would be to:
  5. keeping FIO2 at 60%
  6. changing the ventilator tubing qshift
  7. careful hand-washing and use of gloves when suctioning
  8. treat low peak-inspiratory pressures - answer-Careful hand-washing and use of gloves when suctioning The most important nursing activity for a patient admitted with the diagnosis of cervical spinal cord injury is:
  9. keeping the patient flat
  10. immobilizing the head
  11. noting change in feeling extremities
  12. doing hourly neuro checks - answer-Immobilizing the head In a patient with cervical spine injury, the most important observations the nurse makes concerns which of the following physiological parameters?
  1. heart rate
  2. respirations
  3. urinary output
  4. pupillary response to light - answer-respirations The earliest sign of increased intracranial pressure generally involves changes in:
  5. response to pain
  6. level of consciousness
  7. equality of pupillary reactions
  8. respiratory rate - answer-level of consciousness
  9. Deepening intracranial pressure is characterized by:
  10. tachycardia
  11. pinpoint pupils
  12. widened pulse pressure
  13. increasing respirations - answer-Widened pulse pressure The drug of choice used to reduce increased intracranial pressure is:
  14. the calcium channel blocker
  15. phenobarbital
  16. Mannitol
  17. Furosemide (Lasix) - answer-Mannitol A positive Babinski response in an adult:
  18. Indicates depressed reflexes
  19. Is an expected finding
  20. Is plantar flexion (curling under) of the toes
  21. Indicates an abnormal finding - answer-Indicates an abnormal finding
  1. Potassium replacements
  2. IV fluid administration - answer-Dextrose 50% IV infusion Patients with diabetes mellitus who are acutely ill generally require a:
  3. higher dose of insulin
  4. restricted caloric intake
  5. decrease in fluid intake
  6. lower dose of insulin - answer-Higher dose of insulin The psychophysiologic stress response from acute illness and being in an ICU can result in decreased:
  7. Heart rate
  8. Alertness
  9. Systolic blood pressure
  10. Urine output - answer-Urine output Which of the following types of insulin when given sub-q will have a peak action within 2 to 4 hours?
  11. Hummulin Lente
  12. NPH
  13. Lantus (glargine)
  14. Regular - answer-Regular An unconscious trauma patient who was just admitted to the ICU is a diabetic who received his usual dose of sub-q NPH insulin at 7 AM. In how many hours after administration might you expect an insulin reaction to occur?
  15. 1 - 2
  16. 3 - 4
  17. 8 - 14
  18. 18 - 24 - answer- 8 - 14

A dangerous effect of rapidly re-warming a hypothermic patient is:

  1. bradycardia
  2. vasodilation and hypotension
  3. seizure activity
  4. sudden rise in blood pressure - answer-vasodilation and hypotension Mrs.Smith, who is post-operative craniotomy patient has a fasting blood sugar of 100mg, complains of extreme thirst, and has a urine greater than 1,000 ml's over two hours. You should suspect:
  5. Increasing intracranial pressure
  6. Overproduction of ADH
  7. Acute adrenal insufficiency
  8. Diabetes insipidus - answer-Diabetes Insipidus Mrs. Reece, a 64 yo woman with acute renal failure and oliguria, was admitted with congestive heart failure. Which of the following tests is abnormal?
  9. BUN of 18 mg/dl
  10. Urine specific gravity of 1.
  11. Creatinine of 1.0 mg/dl
  12. Potassium of 5.8 mEq/L - answer-Potassium 5.8 mEq/L A patient is admitted with a probable diagnosis of acute renal failure. The normal ml's of urine output for this 150 pound person per hour is:
  13. 75
  14. 100
  15. 30
  16. 10 - answer- 30 Practices to decrease catheter associated urinary tract infections does not include which response below?
  17. Having a protocol for limiting urinary catheter use
  1. wide QRS, tall peaked T wave - answer-Wide QRS, tall peaked T wave When feeding a patient using continuous tube feedings, the most important intervention in preventing aspiration is to:
  2. Keep the head of the bed elevated
  3. Aspirate stomach contents Q4-6h for residual
  4. check the position of the tube feeding each shift
  5. turn the patient frequently - answer-keep the head of the bed elevated Low intermittent suction of gastric contents is not generally used in which response below?
  6. to decompress abdominal distention
  7. to prevent aspiration
  8. when bowel sounds are absent
  9. to control bleeding - answer-To control bleeding The safe placement of a nasogastric tube in an unconscious patient can be best assessed by:
  10. instilling 30ml of normal saline through the tube
  11. aspirating gastric content
  12. checking the pH of the gastric aspirate
  13. obtaining radiographic confirmation - answer-obtaining radiographic confirmation While caring for a day-two post-operative exploratory laparotomy patient, you notice "coffeground" material coming from her nasogastric tube. You should:
  14. know this is a normal finding
  15. irrigate the tube right aware
  16. have the drainage tested for blood
  17. listen for overactive bowel sounds - answer-have the drainage tested for blood Your patient, who is receiving a blood transfusion, has a sudden increase in body temperature. Your first response is to:
  1. take the blood pressure
  2. check the blood type of the patient
  3. quickly observe for a rash
  4. stop the transfusion - answer-stop the transfusion In a symptomatic sinus bradycardia, which of the following could be used to increase the heart rate
  5. Propanolol
  6. Digoxin
  7. Atropine
  8. Verapamil - answer-Atropine Which of the following drugs will crystallize when given IV with D5S?
  9. Avelox
  10. fosphenytoin
  11. Dilantin (phenytoin)
  12. phenobarbital - answer-Dilantin Precautions in using IV nitroprusside is not included in which response below?
  13. protection of the solution from light
  14. continuous monitoring for a sudden decrease in blood pressure
  15. use of a fresh mixture at appropriate intervals
  16. alertness to the development of an acute hypertensive episode - answer-Alertness to the development of an acute hypertensive episode The dosage of which drug must be tapered off slowly to prevent acute adrenal insufficiency
  17. Nitroprusside
  18. Cortisone
  19. Phenytoin
  20. Pitressin - answer-Cortisone

The classical ECG change with muscle injury in acute myocardial infarction is:

  1. presence of a Q wave
  2. ST segment elevation
  3. myocardial electrical irritability
  4. a peaked T wave - answer-ST segment elevation Elevated cardiac iso-enzyme generally does not occur in which response below?
  5. Closed chest injury
  6. pericarditis
  7. congestive heart failure
  8. cardiac surgery - answer-Congestive heart failure The major therapeutic goal in the treatment of cardiogenic shock is to:
  9. Increase the afterload
  10. Improve renal perfusion
  11. Increase cardiac output
  12. Decrease fluid volume - answer-Increase cardiac output You receive orders to starte Nipride and Dobutamine in your patient with end-stage cardiomyopathy. How will this treatment regimen affect cardiac output?
  13. Increase preload and reduces afterload
  14. Reduces preload and increases afterload
  15. Reduces preload and afterload and improves contractility
  16. Reduces preload and improves contractility - answer-Reduces preload and afterload and improves contractility In dealing with a depressed patient during the first days post AMI the most appropriate nursing action would be:
  17. Encourage to patient to ventilate his/her concerns
  18. Provide for privacy so the patient can rest
  1. Limit visits only to family members
  2. Provide a quiet environment for the patient - answer-Encourage the patient to ventilate his/her concerns Mr. Seamore is receiving thrombolytics (TPA) 3 hours after an AMI. Which of the following would most likely require discontinuing the infusion?
  3. PVCs
  4. Bleeding gums
  5. Oozing at the insertion site
  6. Change in mental status - answer-Change in mental status The following monitor would indicate that the pulmonary artery (Swan Ganz) catheter is in which position?
  7. Superior vena cava
  8. Right ventricle
  9. Pulmonary artery
  10. Pulmonary artery occlusion (wedge) - answer-Pulmonary artery occlusion (wedge) A systolic murmur that is auscultated at the 2nd intercostal space, right sternal border is called:
  11. aortic insufficiency
  12. aortic stenosis
  13. pulmonary insufficiency
  14. pulmonic stenosis - answer-aortic stenosis Which of the following wave patterns indicates proper functioning of an arterial line? - answer-High to low After an arterial catheter is removed, direct pressure should generally be applied to the artery:
  15. For 2 full minutes
  16. For 8 - 10 minutes
  1. 21 - 26 - answer- 6 - 12 An elevated PAOP may indicate:
  2. Hypovolemia
  3. Peripheral vasodilation
  4. systemic hypotension
  5. left ventricular failure - answer-left ventricular failure Mr. Adams, a 68 yo patient, complains of feeling "a little funny in his chest." His ECG shows atrial fibrillation/flutter. Which of the following medications could be used to treat his cardiac rhythm?
  6. Digoxin
  7. Nifedipine
  8. Diltiazem
  9. Adenosine - answer-Diltiazem A QRS complex wider than 0.12 seconds most likely indicates:
  10. Normal sinus node conduction
  11. Bundle branch block
  12. Second degree heart block
  13. myocardial infarction - answer-bundle branch block The following rhythm represents: - answer-First degree HB Special care should be exercised when administering IV dopamine because:
  14. Infiltration leads to tissue necrosis
  15. High doses may lead to a profound bradycardia
  16. Precipitation can occur when used in a dextrose IV solution
  1. even low doses decrease renal perfusion - answer-Infiltration leads to tissue necrosis The following strip is: - answer-Aflutter A strong ventricular stimulus is potentially dangerous when it lands on the:
  2. U wave
  3. P wave
  4. T wave
  5. QRS complex - answer-T wave The rhythm strip below shows: - answer-VTach An indication for use of an external cardiac pacemaker includes:
  6. paroxysmal atria tachycardia
  7. Ventricular fibrillation
  8. Wenckebach (Mobitz Block Type 1)
  9. Symptomatic complete heart block - answer-Symptomatic complete heart block In the following rhythm strip the transvenous pacemaker shows:
  10. Failure to sense
  11. Demand pacing
  12. Failure to fire
  13. Failure to capture - answer-Failure to sense The initial drug treatment for sustained ventricular tachycardia when a pulse is present is:
  14. Isuprel 1.0 mg in 250 ml D5W drip
  15. Epinephrine 1.0 mg IV push
  16. Atropine 0.5 mg IV push
  17. Amiodarone 150 mg IV over 10 mn - answer-Amiodarone 150 mg IV over 10 min

Signs of cardiac tamponade do not include which response below?

  1. distended neck veins
  2. pulsus paradoxus
  3. decreased systolic pressure
  4. bradycardia - answer-bradycardia In the patient with ventricular fibrillation, the correct energy setting for the first defibrillation when using a biphasic defibrillator is how many joules?
  5. 240
  6. 360
  7. 150
  8. 80 - answer- 150 A patient becomes apneic and pulseless. The monitor shows asystole. The drug that would most likely be used initially is:
  9. verapamil
  10. atropine
  11. epinephrine
  12. amiodarone - answer-Epinephrine The antidote for heparin is:
  13. Protamine sulfate
  14. Narcan
  15. Glucagone hydrochloride
  16. vitamin K - answer-Protamine sulfate The most important step in preventing central venous catheter related sepsis is:
  17. Use of a transparent membrane dressing
  18. Scrubbing access ports with alcohol
  1. using antibiotic ointment under the dressing
  2. thorough hand washing - answer-Thorough hand washing An excessive amount of chest tube drainage in the first few hours following thoracic surgery is how many ml's per hour?
  3. 150
  4. 75
  5. 50
  6. 30 - answer- 150 A routine check of your patient's blood gas values show a pH of 7.40, pO2 of 98 mm Hg, pCO2 of 38 mm Hg, and HCO3 of 25 mEq. These results reflect:
  7. metabolic acidosis
  8. metabolic alkalosis
  9. normal values
  10. respiratory compensation - answer-normal values Before suctioning a patient, you adjust the vacuum pressure so that it is:
  11. 150 mm Hg of vacuum pressure
  12. as high as needed to effectively remove secretions
  13. 120 mm Hg of vacuum pressure
  14. no higher than the diastolic blood pressure - answer- 120 mm Hg of pressure Your post-operative patient has a left anterior chest tube. When you auscultate the lung fields bilaterally, you hear diminished breath sounds in the right posterior base. This would most likely be due to:
  15. pleuritis
  16. consolidation
  17. the chest tube
  18. atelectasis - answer-atelectasis
  1. a pulmonary bleed
  2. development of a pneumothorax
  3. cervical spinal-cord injury - answer-Development of a pneumothorax A moderately burned trauma patient is admitted to your unit. The most important treatment related to the burns during the first 24 hours after injury is:
  4. fluid replacement
  5. accurate administration of antibiotics
  6. pain relief measures
  7. early wound cultures - answer-fluid replacement