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The emergency drug therapy of choice for polymorphic ventricular tachycardia is: A) Atropine B) Amiodarone C) Adenosine D) Magnesium ANSWERV V D) Magnesium (Correct) You are caring for a patient post cardiac arrest who is receiving Targeted Temperature Management (TTM). Which of the following clinical findings should you be concerned about? A) Heart rate of 30 bpm with a wide QRS and prolonged QT interval B) Increasing diuresis C) Increasing insulin requirements D) Core body temperature of 34 C ANSWERV V A) Heart rate of 30 bpm with a wide QRS and prolonged QT interval (Correct) The nurse is caring for a patient admitted for medical management of a dissecting abdominal aortic aneurysm (AAA). The patient describes sudden onset severe abdominal and back pain. Patient data: HR 120, BP 138/78 (98), RR 26, 94% SpO2 on RA. Which of the following interventions is a priority of care for the registered nurse? A) Administer PRN IV narcotic analgesia B) Provide oxygen via nasal cannula C) Administer PRN IV Beta-Blocker D) Complete assessment of peripheral movement and sensation ANSWERV V A) Administer PRN IV narcotic analgesia (Correct) Pharmaceutical management of hypertrophic cardiomyopathy should include: A) Metoprolol (Lopressor) B) Furosemide (Lasix) C) Digoxin (Lanoxin) D) Nitroprusside (Nipride) ANS WERV ¥ A) Metoprolol (Lopressor) (Correct) The nurse is caring for a patient admitted for medical management of a dissecting abdominal aortic aneurysm (AAA). The patient describes sudden onset severe abdominal and back pain. Patient data: HR 120, BP 138/78 (98), RR 26, 94% SpO2 on RA. Which of the following interventions is a priority of care for the registered nurse? A) Provide oxygen via nasal cannula B) Administer PRN IV narcotic analgesia C) Administer PRN IV Beta-Blocker | D) Complete assessment of peripheral movement and sensation ANS WERV Vv B) Administer PRN IV narcotic analgesia (Correct) Which set of hemodynamic parameters is associated with right sided heart failure? A) Increased CO/CI, increased CVP, increased PAOP, increased SVR B) Increased CO/CI, decreased CVP, increased PAOP, decreased SVR B) Decrease the sensitivity by raising the mV C) Increase the milliamps (mA) D) Decreased the milliamps (mA) ANSWERV V A) Increase the sensitivity by lowering the mV (Correct) A patient is post-op day 3 for a cardiac transplant. During the night the patient develops symptomatic bradycardia. Your best action to treat the bradycardia should include: A) Administer Atropine 1 mg IV and apply 100% 02 B) Connect epicardial pacing wires to a generator and pace the patient C) Give Atropine and start and Isuprel infusion D) Start a Dopamine infusion ANSWERV V B) Connect epicardial pacing wires toa generator and pace the patient (Correct) A 55-year-old female presents to the ED anxious and SOB. Her 12 lead ECG reveals a STEMI. Which of the following findings suggests an absolute contraindication for thrombolytic therapy? A) Dull chest pain, ST elevation in V4, V5, V6, new left bundle branch block | B) History of cholecystectomy 2 weeks ago, ST elevation in V3, V4, V5 | C) Sudden onset severe chest and back pain, uncontrolled BP 195/115, ST elevation LI, III, aVF, and a new diastolic murmur over the left sternal border D) Left arm pain, BP 180/100 casily controlled on antihypertensive meds, ST elevation in V1, V2 V3 ANSWER¥V ¥ C) Sudden onset severe chest and back pain, uncontrolled BP 195/115, ST clevation I, HI, aVF, and a new diastolic murmur over the left sternal border (Correct) A 68-year-old patient presents to your unit 9 days after a 3 vessel CABG complaining of chest pain. A 12-lead ECG reveals non-specific ST elevation in leads V1 4€" V6. Cardiac enzymes are not elevated. He states the pain is better when he sits up and leans forward. This scenario is most consistent with: A) Acute inferior wall MI B) Post-operative cardiac tamponade C) Pleural effusions D) Pericarditis ANS WERV ¥V D) Pericarditis (Correct) Signs of cardiac tamponade include: A) Increased CVP, narrow pulse pressure, hypertension B) Wide mediastinum on chest x-ray, narrow pulse pressure, hypotension C) Widening pulse pressure, hypotension, elevated CVP D) A fall in SBP > 10 mm Hg during inspiration, decreased CVP, hypotension ANSWERV ¥ B) Wide mediastinum on chest x-ray, narrow pulse pressure, hypotension (Correct) A patient is admitted complaining of chest pain and nausea. The ECG monitor reveals second-degree AV heart block, Type Il. These findings are probably a result of occlusion of which one of the following coronary artcrics? A) LAD B) Circumflex C) Posterior descending D) RCA ANSWERV V A) LAD (Correct) A 56 year old patient presents with substernal chest pain radiating to her left arm. A 12 lead LKG reveals ST segment elevation in leads II, III and AVI’. You would expect reciprocal changes in which leads? A) V4-V6 B)I, AVL C) AVR, AVL, V1 D) V3. V4 ANSWERVV B)I, AVL (Correct) A patient with an inferior wall and right ventricular infarction develops tachycardia and hypotension. What would be the best initial treatment for his hypotension? A) Nitroglycerin infusion B) Dopamine infusion C) Dobutamine infusion D) Isotonie fluid boluses ANSWERV Vv D) Isotonic fluid boluses (Correct) You are caring for a patient with a resolving AMI with right sided heart failure that now requires preload reduction. This can be accomplished using medications that cause: A) Arterial dilation B) Venous dilation C) Arterial constriction D) Venous constriction ANS WERYV ¥ B) Venous dilation (Correct) Common clinical manifestations of cardiogenic shock include: A) Decreased systemic vasculature resistance B) Decreased pulmonary artery occlusive pressure (PAOP) C) Expiratory wheezes D) Cool, pale, moist skin ANSWERV ¥V D) Cool, pale, moist skin (Correct) Side effects of Neosynephrine (phenylephrine) include which of the following: A) Reflexive bradycardia B) Seizures C) Nephrotoxicity D) Respiratory depression ANSWERV V A) Reflexive bradycardia (Correct) A patient with bacterial endocarditis should be closely observed for which of the following clinical changes? A) Pulmonary edema B) Neurologic impairment C) Oliguria D) Rising liver enzymes ANSWERV ¥ B) Neurologic impairment (Correct) A major goal for a patient who is 48 hours s/p valve replacement surgery is to: A) Administer antibiotics B) Stabilize hemodynamics C) Prevent thrombus formation You are assessing a patient 24 hours after an anterior septal wall myocardial infarction. Findings include a new, harsh holosystolic murmur and a thrill, BP 88/56 (66), HR 108, RR 35 and O2 sat 86% on 2 L NC. You should anticipate which of the following diagnostics to investigate the new murmur, hypotension, rapid breathing and desaturation? A) Lab work and re-administration of fibrinolyties B) Transesophageal echo and cardiac catheterization C) Intubation and mechanical ventilation D) Echocardiogram and cardiac surgery ANS WERV ¥ D) Echocardiogram and cardiac surgery (Correct) An $4 heart sound is expected in which of the following? A) Pericarditis B) Left ventricular failure C) Ventricular hypertrophy D) Bundle branch block ANSWERV ¥ C) Ventricular hypertrophy (Correct) Which of the following labs must be closely monitored when administering Lisinopril to a patient with systolic heart failure? A) Sodium B) Phosphate C) Magnesium D) Potassium ANSWERV ¥V D) Potassium (Correct) Which anatomical structure in the kidneys is responsible for the secretion of renin? A) Adrenal medulla B) Adrenal Cortex C) Bowman's capsule D) Juxtaglomerular cells ANSWERV ¥ D) Juxtaglomerular cells (Correct) Long term medical management for heart failure includes which of the following? A) Beta blockers, ACE inhibitors and Spironolactone B) ACE inhibitors, Angiotensin receptor blocker and vasopressors C) Angiotensin receptor blockers, beta blockers and calcium channel blockers D) Beta blockers, ACE inhibitors and calcium channel blockers ANS WER¥V V A) Beta blockers, ACE inhibitors and Spironolactone (Correct) You are caring for a patient with a resolving AMI with right sided heart failure that now requires preload reduction. This can be accomplished using medications that cause: A) Arterial dilation B) Venous dilation C) Arterial constriction D) Venous constriction ANSWERV ¥ B) Venous dilation (Correct) Which of the following medications would you anticipate to administer in a patient with mental status changes due to worsening hepatic encephalopathy? A) Elevated urine osmolality, decreased serum osmolality, decreased serum sodium B) Decreased urine osmolality, elevated serum osmolality, elevated serum sodium C) Elevated urine osmolality, elevated serum osmolality, decreased serum sodium D) Decreased urine osmolality, decreased serum osmolality, elevated serum sodium ANSWERVV A) Elevated urine osmolality, decreased serum osmolality, decreased serum sodium (Correct) The immune mediated response to stress or injury is: A) Ilistamine B) Vasoconstriction C) Movement of RBCs D) Retention of fluids ANSWERV ¥ A) Histamine (Correct) A 52-year-old man has had a renal transplant. Two weeks after surgery he complains of having the "flu." Rejection of transplanted organs occurs due to the function of which of the following? A) Cellular immunity B) Humoral immunity C) Delayed hypersensitivity reaction D) Complement cascade ANSWERV V A) Cellular immunity (Correct) Bone marrow transplant failure with leukemia can present with which of the following? A) Bleeding and increased risk of infection B) Increased risk of infection and hypercoagulation C) Anemia and hypercoagulation D) Decreased risk of infection and bleeding ANSWERV V A) Blecding and increased risk of infection (Correct) A patient in Disseminated Intravascular Coagulopathy (DIC) would show the following lab results? A) Elevated PT and PTT B) Normal D-Dimer C) Elevated Fibrinogen Degradation Products (FDP) D) Elevated AST, ALT ANSWERV ¥ C) Elevated Fibrinogen Degradation Products (FDP) (Correct) Hemolytic anemia will result in which of the following? A) Jaundice B) Loss of proprioception C) Acidosis D) Petechiae ANSWERV V A) Jaundice (Correct) A patient says she has "anemia." The patient's CBC shaws microcytic, hypochromic RBCs. What type of anemia does this patient most likely have? A) Anemia of chronic disease Sodium can be replaced quickly A) True B) False ANSWERV V B) False (Correct) Which of the following class of medications should be avoided in cocaine induced MI? A) Calcium channel blockers B) ACE Inhibitors C) Aldosterone antagonists D) Beta blockers ANS WERV Vv D) Beta blockers (Correct) A patient has been admitted for a third suicide attempt. Which of the following is not a priority for assessment? A) Co-conspirators B) Injury C) Intent D) Lethality ANSWERV V A) Co-conspirators (Correct) A patient experiencing a fourth episode of heart failure states, "I cannot take it anymore. I wish I could end all of this." A priority when caring for this patient's response to stress is to: A) place the patient in a hospital gown or pajamas B) explore the intent of the comment with the patient C) manage the patient in a restrictive environment for the first 48 hours D) allow the patient to have only short periods alone once in a safe environment ANSWERV ¥ B) explore the intent of the comment with the patient (Correet) Which is the most effective strategy to limit the incidence of delirium? A) Early mobility B) Restrict visitors C) Sedate D) Elevate HOB ANSWERV V A) Early mobility (Correct) An 81-year-old woman has been in the critical care unit for 6 days. She has become increasingly confused over the last 24 hours. Which of the following would be an appropriate intervention? A) Arrange for uninterrupted periods of sleep B) Arrange for a psychiatric consult C) Request a sedative D) Request transfer out of the unit ANSWERV V A) Arrange for uninterrupted periods of sleep (Correct) Which of the following best explains why ethical issues in health care are more complex today than in the past? A) More lawyers B) Declining religious values C) Scientific advancement B) perform a literature search to identify current trends in dressing protocols C) recommend an evaluation of the present dressing protocol D) apply an antibiotic ointment to wounds when changing the dressing ANSWERV V B) perform a literature search to identify current trends in dressing protocols (Correct) A fellow nurse co-worker is having difficulty with a patients family and she consults a more experienced nurse. The best approach / response from the experienced nurse would be to: A) Offer to speak to the family B) Offer to change the nursing assignment C) Suggest utilizing active listening techniques D) Suggest she ignore the family and just care for the patient ANSWER¥V V C) Suggest utilizing active listening techniques (Correct) Several nurses on the unit are concerned with the accuracy of a new noninvasive device measuring stroke volume. The best way to initially address their concerns is to: A) Research new devices to replace the existing equipment B) Discuss concerns with the attending physician during rounds C) Request an in-service from the device company D) Take the issue to the unit nursing research council to investigate ANSWERV ¥ C) Request an in-service from the device company (Correct) Which of the following statements is an example of the patient characteristics that demonstrate resiliency? A) A return to the level of functioning using compensatory / coping mechanisms B) Susceptibility to actual or potential stressors C) Ability to maintain homeostasis D) The expectation of a certain course or events of the illness ANSWERV ¥ A) A return to the level of functioning using compensatory / coping mechanisms (Correct) A patient in a hyperosmolar hyperglycemic state (HHS) is being admitted with dehydration and a serum glucose level of 836 mg/dl. Which of the following additional laboratory findings should the nurse anticipate? A) decreased BUN, decreased creatinine and elevated serum osmolality B) elevated BUN, decreased creatinine and decreased serum osmolality C) decreased BUN, elevated creatinine and decreased serum osmolality D) elevated BUN, elevated creatinine and elevated serum osmolality ANSWERV V D) elevated BUN, elevated creatinine and elevated serum osmolality (Correct) Which of the following sets of hemodynamic data is associated with neurogenic shock? (CVP /CL/SVR/ SBP) A)3/2.5/ 650/88 B)4/7.5/ 1500/ 100 C) 18/1.7/ 1500/88 D) 18/2.0/ 750/11 ANSWERY V A) 3/2.5/ 650 / 88 (Correct) The nurse is caring for a patient in the ICU admitted with a subdural hematoma. The patient has an ICP monitor in place. What change in the ICP waveform morphology should the nurse expect to sce with an increase in ICPs in the setting of decreased compliance? 
