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A patient with an inferior wall MI and right ventricular infarction develops tachycardia and hypotension. what would be the best initial treatment for hypotension? a. nitro gtt b. dopamine gtt c. dobutamine d. fluid boluses ANSWERV JV D which of the following complications would the rn assess for after an arteriogram’? a. impaired renal function b. acid base imbalance c. clevated liver enzymes. d. iner MAP ANSWERVV A a pl experiencing ST segment clevations in leads V1-V4 likely has an occlusion mm which coronary artery? a. left anterior descending b. right coronary artery ¢, circumflex artery d. posterior descending artery ANSWERV V a which type of heart block would you monitor for if your pt has an anterior wall MI? a. Ist degree b. 2nd degree type 1 (Wenckebach) c. 2nd degree type 2 d. sinus brady ANSWERV ¥ C a 58 year old experienced an anterior wall MI 2 days ago. she is c/o chest pain and dizziness. upon auscultation you note a new, loud systolic murmur. what do you think the issue is? a. acute tricuspid regurg b. acute aortic stenosis c. left ventricular outflow obstruction d. acute papillary muscle dysfunction ANSWERV V d clinical signs of cardiogenic shock secondary to acute left ventricular failure include: a. hypotension, s4 heart sound, pericardial friction rub b. s3 heart sound, hypotension, systolic murmur ¢. diastolic murmur, s4 heart sound, hypertension d. crackles, s3 heart sound, hypotension ANSWERVV d a pt admitted with HF develops hypotension, tachycardia, decreasing LOC, cool clammy skin, decr UOP, and tachypnea. which of the following would be included in the pts plan of care? a. positive inotropes, diuretics. and vasodilators ensuring BP and perfusion are adequate b. ace inhibs, adenosine, beta blockers c. beta blockers, diurctics, CCBs d. negative inotropes, digoxin, anti dysrhythmics ANSWERV V a the primary effect and rationale for using dobutamine in cardiogenic shock is to: a. deer myocardial ischemia b. improve uo states the pain is better when he sits up and leans forward. the scenario is most consistent with: a. acute inferior wall MI b. post op cardiac tamponade c. pleural effusions d. pericarditis ANSWERV V d which of the following is a complication of infective endocarditis’? a. myocarditis b. heart failure c. emboli d. pericarditis ANSWERV V c a pt has pneumonia and sepsis. he was treated with 4 days of abx and iv fluids. he is increasingly SOB and is now 100% fio2 via NRB mask. An ABG shows ph 7.20 paco2 60 pao2 102 HCOs 28 and his chest xray reveals bilat pulmonary infiltrates the pt is likely developing: a. worsening pneumonia b. ARDS c. pulmonary embolus d. atelectasis ANSWERV V B the purpose of utilizing PEEP in ARDS is to: a. prevent collapse of distal airways b. promote secretion mobilization c. deer interstitial edema d. improve the ph ANSWERV V A when increasing the level of PEEP, you should monitor for what side effect? a. hypotension b. hypercapnia c¢. worsening acidosis d. increased lactate level ANSWERV ¥ A you are caring for a pt who developing ARDS after bacterial pneumonia. the CXR shows diffuse patchy infiltrates with worsening hypoxemia. vent settings: TV 540, RR 24, FIO2 100%, PEEP 10 ABG: ph 7.22, paco2 56, pao2 42, hco3 28 which intervention would be the highest priority? a. decr the set ventilation rate b. iner TV c. decr inspiratory hold time d. iner the PEEP ANSWERV ¥ D a pt presents with SOB and chest pain after being discharged after a left hip replacement and also has pain in her right calf and leg. HR 110, RR 32, T 37.2, BP 112/68 you administer albuterol nebs to a pt with an asthma exacerbation. their initial ABG was pl 7.45, paco2 28, pao2 142, heo3 22 an ominous sign of impending respiratory failure includes; a. respiratory alkalosis b. hypercapnia c. hypocapnia d. metabolic acidosis ANS WERV V B whats the gas? ph 7.36, paco2 48, hco3 24 ANSWERV ¥ compensated respiratory acidosis whats the gas? ph 7.26, paco2 35, hco3 16 ANSWERV ¥ uncompensated metabolic acidosis whats the gas? ph 7.30 paco2 58 hco3 30 ANSWERY ¥ partially compensated respiratory acidosis ina pt with a middle cerebral artery stroke, which of the following symptoms do you expect? a. Icfi lateral visual ficld loss in both eyes b. right sided hemiparesis c. bilateral nystagmus d. speech deficits ANSWERVV d ina pt with anterior cerebral artery stroke, which of the following symptoms do you expect? a. mouth and eye drooping b. leg weakness and decr sensation c. visual field loss d. bilateral nystagmus ANSWERV V b in a pt with posterior cerebral artery stroke, which of the following symptoms do you expect? a. visual field loss b. arm wkness/decr sensation c. speech difficulties d. dysphagia ANSWERVV a which of the following pts is at highest risk for developing embolic stroke? a. patent foramen ovale b. SVT c. second degree AV block type 1 d. Wolff parkinson white syndrome ANS WERV ¥ a (stagnant blood flow, clot formed, stroke) a pt is admitted with an acute ischemic stroke. after a head ct scan and assessment, there is high suspicion for embolic stroke. TPA is ordered. the pts BP is 220/160. your initial priority is a. prep for stat admin of the tpa b. prep for stat cerebral angiogram c. admin mannitol IV to deer cerebral edema d. lowering the pts bp to less than 185/110 ANSWERVV d elevated p2 waves in an icp waveform are a sign of: a. incr intracranial compliance b. systemin htn c. iner ICP d. brain death ANSWERV V C management of a pt post SAH with incr ICP includes; a. hypotonic saline, osmotic diuretics, and loop diuretics b. bb's, hypertonic saline, CCB c. optimal positioning, osmotic diuretics, and hypertonic saline d. CCBs, hypotonic saline, anticonvulsants ANSWERV Vv ¢ which of the following would be expected in a pt expericncing herniation and cushings triad? a. narrow pulse pressure, bradycardia, hypotension b. narrow pulse pressure, tachycardia, hypotension c. wide pulse pressure, bradycardia, incr systolic pressure d. wide pulse pressure, tachycardia, incr systolic pressure ANSWERV V ¢ sign of a small bowel infarction include a. diarrhea and increased bilirubin b. abd pain and leukocytosis c. tympanic sounds over the abd d. hyperactive bowel sounds and jaundice ANSWERV V b early signs of a proximal small bowel obstruction include: a. diarrhea b. fever ¢. increased appetite d. vomiting ANSWERVV d which of the following lab findings would be expected in a pt with acute pancreatitis? a. hypercalcemia and hypokalemia b. hypocalcemia and hyperglycemia c. hyperkalemia and hypocalcemia d. hyperglycemia and hypercalcemia ANSWERV ¥ b damage to beta cells (produce insulin) so you may sce hyperglycemia. as pancreas auto digests itself and pancreatic fat is mobilized, caleemia goes with it which of the following lab values would you expect to see in a pt with acute pancreatitis a. elevated amylase, lipase, albumin b. elevated albumin, decr amylase and lipase c. decr albumin, elevated amylase and lipase d. decr albumin, amylase, and lipase ANSWERV V c pt with ESLD admitted with confusion, elevated ammonia, hypoalbuminemia, and ascites. BP 82/46. what is the best immediate intervention to improve BP? a. give Liter fluid bolus b. put the pt on their side c. start dopamine d. passive leg raise ANSWERV V b 
