PROPHECY GENERAL ICU QUESTIONS AND
ANSWERS SURE A+
✔✔20. Your patient requires intermittent mannitol. They have a serum osmolality above
320 mOsm/L. What would you do next? - ✔✔
✔✔Hold the mannitol to reduce the risk of renal failure and alert the provider. - ✔✔
✔✔21. Your patient had a large right hemisphere stroke. You are assessing their gaze
and vision. What assessment finding would you expect? - ✔✔
✔✔Left deviated gaze. - ✔✔
✔✔22. A patient at an outside hospital with an acute ischemic stroke received tissue
plasminogen activator (tPA). The patient transfers to your facility. You are told during
bedside report that the patient has a large vessel occlusion with a last known well 3
hours prior. What treatment would you anticipate? - ✔✔
✔✔Endovascular Thrombectomy. - ✔✔
✔✔23. Your patient with a severe TBI is on a ventilator. They suddenly need STAT
mannitol or 23.4% sodium chloride administration for signs of brain herniation. Which
signs indicate brain herniation? BP of 220/116 mmHg, HR of 46, and no longer opening
their eyes. - ✔✔
✔✔24. After a prolonged ICU stay your patient who is intubated begins to develop acute
respiratory distress syndrome (ARDS). After increasing positive end-expiratory pressure
(PEEP) the provider orders a continuous cisatracurium besilate (Nimbex) drip for
ventilator synchrony and compliance. In addition to adequate sedation and pain control.
What intervention would you implement prior to starting you Nimbex drip? - ✔✔
, ✔✔Perform a central line placement. - ✔✔
✔✔25. The neurosurgeon asks you to prep your patient for a bedside neurosurgical
procedure. You expect your patient to be supine with a surgical towel covering most of
their face. You also expect mild to moderate sedation administered. What interventions
would you perform prior to the procedure? - ✔✔
✔✔Apply a nasal cannula with end-tidal carbon dioxide monitoring. - ✔✔
✔✔26. What clinical condition do pseudotumor cerebri symptoms often mimic? - ✔✔
✔✔Large brain tumor. - ✔✔
✔✔27. You are planning to accompany your patient to MRI so you can monitor them
during the imaging test. They have an external ventricular drain (EVD) and their
intracranial pressures (ICP) are currently within normal parameters. What would you do
prior to transporting the patient to the test? - ✔✔
✔✔Close/Clamp the EVD. - ✔✔
✔✔28. Your patient is returning from an endovascular procedure. They have a TR band
over their right radial artery puncture site. What intervention would you perform to best
monitor adequate perfusion? - ✔✔
✔✔Compare skin color and temperature on the left and right hand every 15 minutes. -
✔✔
✔✔29. Your patient experienced a large right hemisphere stroke. What neurological
deficits would you anticipate? - ✔✔
✔✔Hemispheric neglect and impulsive behavior style. - ✔✔
✔✔30. Your patient is being worked up for possible Guillain-Barre syndrome with acute
onset of weakness. What type of presenting weakness would you expect the patient to
manifest with this clinical condition? - ✔✔
✔✔Bilateral ascending paralysis. - ✔✔
✔✔31. What type of medications could make oral contraception less effective? Anti
Seizure medications. - ✔✔
✔✔32. Your patient has a BP of 176/96 mmHg 2 hours after an ischemic stroke and
after tPA administration. What intervention, in any, would you anticipate? - ✔✔
ANSWERS SURE A+
✔✔20. Your patient requires intermittent mannitol. They have a serum osmolality above
320 mOsm/L. What would you do next? - ✔✔
✔✔Hold the mannitol to reduce the risk of renal failure and alert the provider. - ✔✔
✔✔21. Your patient had a large right hemisphere stroke. You are assessing their gaze
and vision. What assessment finding would you expect? - ✔✔
✔✔Left deviated gaze. - ✔✔
✔✔22. A patient at an outside hospital with an acute ischemic stroke received tissue
plasminogen activator (tPA). The patient transfers to your facility. You are told during
bedside report that the patient has a large vessel occlusion with a last known well 3
hours prior. What treatment would you anticipate? - ✔✔
✔✔Endovascular Thrombectomy. - ✔✔
✔✔23. Your patient with a severe TBI is on a ventilator. They suddenly need STAT
mannitol or 23.4% sodium chloride administration for signs of brain herniation. Which
signs indicate brain herniation? BP of 220/116 mmHg, HR of 46, and no longer opening
their eyes. - ✔✔
✔✔24. After a prolonged ICU stay your patient who is intubated begins to develop acute
respiratory distress syndrome (ARDS). After increasing positive end-expiratory pressure
(PEEP) the provider orders a continuous cisatracurium besilate (Nimbex) drip for
ventilator synchrony and compliance. In addition to adequate sedation and pain control.
What intervention would you implement prior to starting you Nimbex drip? - ✔✔
, ✔✔Perform a central line placement. - ✔✔
✔✔25. The neurosurgeon asks you to prep your patient for a bedside neurosurgical
procedure. You expect your patient to be supine with a surgical towel covering most of
their face. You also expect mild to moderate sedation administered. What interventions
would you perform prior to the procedure? - ✔✔
✔✔Apply a nasal cannula with end-tidal carbon dioxide monitoring. - ✔✔
✔✔26. What clinical condition do pseudotumor cerebri symptoms often mimic? - ✔✔
✔✔Large brain tumor. - ✔✔
✔✔27. You are planning to accompany your patient to MRI so you can monitor them
during the imaging test. They have an external ventricular drain (EVD) and their
intracranial pressures (ICP) are currently within normal parameters. What would you do
prior to transporting the patient to the test? - ✔✔
✔✔Close/Clamp the EVD. - ✔✔
✔✔28. Your patient is returning from an endovascular procedure. They have a TR band
over their right radial artery puncture site. What intervention would you perform to best
monitor adequate perfusion? - ✔✔
✔✔Compare skin color and temperature on the left and right hand every 15 minutes. -
✔✔
✔✔29. Your patient experienced a large right hemisphere stroke. What neurological
deficits would you anticipate? - ✔✔
✔✔Hemispheric neglect and impulsive behavior style. - ✔✔
✔✔30. Your patient is being worked up for possible Guillain-Barre syndrome with acute
onset of weakness. What type of presenting weakness would you expect the patient to
manifest with this clinical condition? - ✔✔
✔✔Bilateral ascending paralysis. - ✔✔
✔✔31. What type of medications could make oral contraception less effective? Anti
Seizure medications. - ✔✔
✔✔32. Your patient has a BP of 176/96 mmHg 2 hours after an ischemic stroke and
after tPA administration. What intervention, in any, would you anticipate? - ✔✔
