Your patient comes into the emergency room and is diagnosed by the ER doctor with
abdominal compartment syndrome. Which of the following types of shock would you
watch for with this condition?
You walk into your intubated patient's room with an IV fentanyl drip at 25mcg/hour who
presents with the following:
You walk into your intubated patient's room with an IV fentanyl drip at 25mcg/hour who
presents with the following:
You have just been given report on your patient in the ICU. You immediately go into
your patients room to assess for pain. Which of the following would be indicative that
the patient is in pain? Select all that apply.
You are caring for an intubated patient in the intensive care unit. The patient is awake
but groggy from the sedation. To assess for pain, which of the following techniques
performed by the nurse would be inappropriate for this situation?
You are caring for a patient who is experiencing delirium due to a lack of sleep. Which
of the following nursing interventions would be *inappropriate* in treating this patients'
condition?
You are caring for a patient in the ICU that is exhibiting signs of delirium. Which of the
following interventions made by you, the nurse, would be inappropriate to help treat the
delirium?
You are caring for a patient in the ICU that is exhibiting signs of delirium. Which of the
following interventions made by you, the nurse, would be inappropriate to help treat the
delirium?
You are caring for a patient following a motor vehicle accident in the Intensive Care Unit
at your hospital. Which of the following would *not* be a primary concern for you in the
critical care setting?
You are caring for a patient and you are concerned they may have a decreased cardiac
output. Which of the following are signs of low cardiac output? Select all that apply.
You are caring for a client who has sinus bradycardia. Which of the following is *not* a
cause of sinus bradycardia?
You are caring for a client in hypovolemic shock. Which of the follow manifestations
would you expect to see in this type of shock?
You are caring for a client in hypovolemic shock. Which of the follow manifestations
would you expect to see in this type of shock?
You are caring for a client in cardiogenic shock. Which of the follow manifestations
would you expect to see in this type of shock?
You are a nurse preceptor teaching several nursing students about the concept of
delirium in the ICU. Which of the following statements made the student is a true
statement about delirium?
With what percentage of blood loss does the body activate the SNS response? -
ANSWER- 15-30%
With what percentage of blood loss can the body recover on it's own? - ANSWER-
<15%
With relative, there is no massive blood or fluid loss, but fluids from inside the vessels
switch to the outside, called third spacing, such as with *burns.*
-Wide QRS complex
,Why do patients need intra-arterial pressure monitoring? - ANSWER- 1. To monitor
arterial blood pressure
While caring for a client who has sustained an MI, the nurse notes eight PVCs in one
minute on the cardiac monitor. The client is receiving an IV infusion of D5W and oxygen
at 2 L/minute. The nurse's first course of action should be to:
Which patient is most at risk for developing delirium?
Which of the following would a patient most likely exhibit that has delirium? Select all
that apply.
Which of the following would *not* be considered a cause of communication difficulties
with the critical care patient, according to the lecture?
Which of the following would *not* be considered a cause of anxiety with the patient in
an intensive care unit, according to the lecture?
Which of the following should the nurse do first?
Which of the following should the nurse do first?
Which of the following patients would *not* need sedation?
Which of the following medications would cause an increased heart rate? Select all that
apply.
Which of the following is NOT a likely sign of pain in a nonverbal patient?
Which of the following effects of calcium channel blockers causes a reduction in blood
pressure?
Which of the following ECG findings alerts the nurse that the client needs an
antiarrhythmic?
Which of the following are potential causes of sinus tachycardia? Select all that apply.
Which of the following are potential causes of AV blocks? Select all that apply.
Which of the following are causes of atrial fibrillation, atrial flutter, and SVT? Select all
that apply.
Where would you label SVR on a heart diagram? - ANSWER- On the branches of the
aorta (Arrows going in opposite direction/toward the heart)
Where would you label PVR on a heart diagram? - ANSWER- On the pulmonary
arteries (Arrows going in opposite direction/toward the heart)
Where would you label contractility on a heart diagram? - ANSWER- On the branches
of the pulmonary arteries (Arrows would face away from the heart)
Where should you place the transducer? - ANSWER- The phlebostatic axis (right
atrium) at the 4th intercostal space and mid-axillary line
Where is preload? (Could be a hot spot question) - ANSWER- You would click on the
superior vena cava and/or the left atrium (Got from picture in PPT)
When titrating an analgesic to manage pain, what is the priority goal?
When inserting PAC, should the balloon be inflated or deflated? - ANSWER- Deflated
When administering dopamine (Intropin), it is most important for the nurse to know that:
When administering an antiarrhythmic agent, which of the following assessment
parameters is the most important for the nurse to evaluate?
What would you need to measure stroke volume? - ANSWER- 1. Arterial line
What would you need to measure ejection fraction? - ANSWER- Echocardiogram
What would cause cardiac output and cardiac index to be high? - ANSWER- 1.
Sympathetic nervous system activation (And anything that would cause SNS activation,
such as pain)
,What would cause a low PAOP/PAWP or LAP? - ANSWER- 1. Low right atrial pressure
(if the pressure is too low in the right atrium that can mean that there is not enough
blood there, which would mean that a low amount of blood is getting to the pulmonary
arteries, where the PAOP/PAWP is measured)
What would cause a low cardiac output/cardiac index? - ANSWER- 1. Parasympathetic
nervous system activation
What would cause a high systemic vascular resistance? - ANSWER- 1. Peripheral
vasoconstriction
What would cause a high PAOP/PAWP or LAP? - ANSWER- 1. Left ventricular
inefficiency (If the left ventricle isn't pumping well, that blood is going to back up into the
left atrium, causing a higher pressure in the left atrium)
What two substances make up tissue plasminogen activator? - ANSWER- Streptokinse
and retaplase
What two rhythms do you do defibrillation? - ANSWER- Vtach w/o a pulse
What three rhythms would you consider doing pacing? - ANSWER- Symptomatic
bradycardia
What three antidysrhythmic drugs are used for heart rates that are too fast? - ANSWER-
Amiodarone
What should we watch for when administering albumin to a patient? - ANSWER- Fluid
overload
What should we monitor with a patient on 3% NaCl? - ANSWER- Monitor for
hypernatremia
What should we closely monitor with septic shock? - ANSWER- Blood pressure and
CVP (To make sure blood is getting back to the heart, this is measured with CVP)
What scale do we use to assess a patients' sedation status in the ICU? - ANSWER-
RASS (Richmond Agitation Sedation Scale)
What position do you put your patient in with PAC discontinuation? - ANSWER-
Trendelenburg
What position do we put a patient in when inserting a PAC? - ANSWER- Trendelenburg
What patients need hemodynamic monitoring? - ANSWER- 1. Unable patients with
burns, who had heart surgery, are severely dehydrated, were in a trauma, or
hemorrhaged
What labs should you monitor with a patient who is on Propofol? - ANSWER-
Triglyceride (>150 high) and cholesterol (>200 high)
What is t-PA used for? - ANSWER- STEMIs
What is the purpose of sedation? - ANSWER- To decrease level of consciousness,
establishing a state of calm
What is the primary nursing intervention indicated for a symptomatic client with a PAWP
of 3 mm Hg (low)?
What is the only direct measurement of contractility? - ANSWER- Ejection fraction
What is the most common cause of cardiogenic shock?
What is the first line treatment for a STEMI? - ANSWER- PCI (Percutaneous Coronary
Intervention)
What is the difference between absolute and relative hypovolemic shock? - ANSWER-
With absolute, there is actual blood or fluid loss such as with *hemorrhage, diarrhea,
vomiting, dehydration, etc.*
, What is the benzodiazepine of choice in the ICU?
What is the assessment gold standard for pain? - ANSWER- Verbal report
What is PCI? (Percutaneous Coronary Intervention) - ANSWER- This is the first line
treatment for a STEMI. The patient is brought to the catheterization lab where a
cardiologist can assess the blockage and possibly place a stent to open the artery
again.
What is needed to measure CO? - ANSWER- An invasive line (ex. IV, arterial line,
central line, etc.)
What is ACS caused by? (Acute Coronary Syndrome) - ANSWER- Thrombus formation
in the coronary artery
What health conditions and medications can cause peripheral vasoconstriction? -
ANSWER- 1. Early hypovolemic shock (Compensation stage)
What four rhythms do you do synchronized cardioversion? - ANSWER- SVT
What does preload indicate? - ANSWER- Intravascular value and/or ventricular pump
ability
What can we give to patients to improve O2 carrying capacity? - ANSWER- Blood
products
What can cause left ventricular inefficiency/failure? - ANSWER- 1. Left-sided heart
failure
What can cause a low systemic vascular resistance? - ANSWER- 1. Systemic
vasodilation (Distributive shocks!)
What can an ICU monitor measure? - ANSWER- Arterial blood pressure (Make sure to
check accuracy my obtaining an non-invasive blood pressure with a BP cuff)
What can a Vigileo monitor measure? - ANSWER- CO, CI, SVR, SV
What can a PAC measure, in addition to CO, CI, SVR, and SV? - ANSWER- RAP, PAP,
PAOP/PAWP
What are two other causes? - ANSWER- Acute myocardial infarction
What are the three common sites of intra-arterial pressure monitoring? - ANSWER- 1.
Radial artery
What are the nursing considerations? - ANSWER- Midazolam (Versed)
What are the 5 P's of neuromuscular compromise? - ANSWER- 1. Pain
What are some clinical manifestations of neurogenic shock? - ANSWER- 1.
Hypotension and bradycardia
What are some clinical manifestations of hypovolemic shock? - ANSWER- 1. Anxiety
What are some clinical manifestations of cariogenic shock? - ANSWER- 1. Tachypnea
with crackles
What are some clinical manifestations of anaphylactic shock? - ANSWER- 1.
Hypotension
What are our goals when treating cardiogenic shock? - ANSWER- Restore blood flow to
the myocardium
We use hemodynamic monitoring to assess fluid balance, heart function, and the effects
of fluids and drugs on cardiac output.
Watch for: dysrhythmias, give through central line, watch for peripheral vasoconstriction
(pulses, paresthesia) - ANSWER- Dopamine
Watch for: dysrhythmias - ANSWER- Norepinephrine
abdominal compartment syndrome. Which of the following types of shock would you
watch for with this condition?
You walk into your intubated patient's room with an IV fentanyl drip at 25mcg/hour who
presents with the following:
You walk into your intubated patient's room with an IV fentanyl drip at 25mcg/hour who
presents with the following:
You have just been given report on your patient in the ICU. You immediately go into
your patients room to assess for pain. Which of the following would be indicative that
the patient is in pain? Select all that apply.
You are caring for an intubated patient in the intensive care unit. The patient is awake
but groggy from the sedation. To assess for pain, which of the following techniques
performed by the nurse would be inappropriate for this situation?
You are caring for a patient who is experiencing delirium due to a lack of sleep. Which
of the following nursing interventions would be *inappropriate* in treating this patients'
condition?
You are caring for a patient in the ICU that is exhibiting signs of delirium. Which of the
following interventions made by you, the nurse, would be inappropriate to help treat the
delirium?
You are caring for a patient in the ICU that is exhibiting signs of delirium. Which of the
following interventions made by you, the nurse, would be inappropriate to help treat the
delirium?
You are caring for a patient following a motor vehicle accident in the Intensive Care Unit
at your hospital. Which of the following would *not* be a primary concern for you in the
critical care setting?
You are caring for a patient and you are concerned they may have a decreased cardiac
output. Which of the following are signs of low cardiac output? Select all that apply.
You are caring for a client who has sinus bradycardia. Which of the following is *not* a
cause of sinus bradycardia?
You are caring for a client in hypovolemic shock. Which of the follow manifestations
would you expect to see in this type of shock?
You are caring for a client in hypovolemic shock. Which of the follow manifestations
would you expect to see in this type of shock?
You are caring for a client in cardiogenic shock. Which of the follow manifestations
would you expect to see in this type of shock?
You are a nurse preceptor teaching several nursing students about the concept of
delirium in the ICU. Which of the following statements made the student is a true
statement about delirium?
With what percentage of blood loss does the body activate the SNS response? -
ANSWER- 15-30%
With what percentage of blood loss can the body recover on it's own? - ANSWER-
<15%
With relative, there is no massive blood or fluid loss, but fluids from inside the vessels
switch to the outside, called third spacing, such as with *burns.*
-Wide QRS complex
,Why do patients need intra-arterial pressure monitoring? - ANSWER- 1. To monitor
arterial blood pressure
While caring for a client who has sustained an MI, the nurse notes eight PVCs in one
minute on the cardiac monitor. The client is receiving an IV infusion of D5W and oxygen
at 2 L/minute. The nurse's first course of action should be to:
Which patient is most at risk for developing delirium?
Which of the following would a patient most likely exhibit that has delirium? Select all
that apply.
Which of the following would *not* be considered a cause of communication difficulties
with the critical care patient, according to the lecture?
Which of the following would *not* be considered a cause of anxiety with the patient in
an intensive care unit, according to the lecture?
Which of the following should the nurse do first?
Which of the following should the nurse do first?
Which of the following patients would *not* need sedation?
Which of the following medications would cause an increased heart rate? Select all that
apply.
Which of the following is NOT a likely sign of pain in a nonverbal patient?
Which of the following effects of calcium channel blockers causes a reduction in blood
pressure?
Which of the following ECG findings alerts the nurse that the client needs an
antiarrhythmic?
Which of the following are potential causes of sinus tachycardia? Select all that apply.
Which of the following are potential causes of AV blocks? Select all that apply.
Which of the following are causes of atrial fibrillation, atrial flutter, and SVT? Select all
that apply.
Where would you label SVR on a heart diagram? - ANSWER- On the branches of the
aorta (Arrows going in opposite direction/toward the heart)
Where would you label PVR on a heart diagram? - ANSWER- On the pulmonary
arteries (Arrows going in opposite direction/toward the heart)
Where would you label contractility on a heart diagram? - ANSWER- On the branches
of the pulmonary arteries (Arrows would face away from the heart)
Where should you place the transducer? - ANSWER- The phlebostatic axis (right
atrium) at the 4th intercostal space and mid-axillary line
Where is preload? (Could be a hot spot question) - ANSWER- You would click on the
superior vena cava and/or the left atrium (Got from picture in PPT)
When titrating an analgesic to manage pain, what is the priority goal?
When inserting PAC, should the balloon be inflated or deflated? - ANSWER- Deflated
When administering dopamine (Intropin), it is most important for the nurse to know that:
When administering an antiarrhythmic agent, which of the following assessment
parameters is the most important for the nurse to evaluate?
What would you need to measure stroke volume? - ANSWER- 1. Arterial line
What would you need to measure ejection fraction? - ANSWER- Echocardiogram
What would cause cardiac output and cardiac index to be high? - ANSWER- 1.
Sympathetic nervous system activation (And anything that would cause SNS activation,
such as pain)
,What would cause a low PAOP/PAWP or LAP? - ANSWER- 1. Low right atrial pressure
(if the pressure is too low in the right atrium that can mean that there is not enough
blood there, which would mean that a low amount of blood is getting to the pulmonary
arteries, where the PAOP/PAWP is measured)
What would cause a low cardiac output/cardiac index? - ANSWER- 1. Parasympathetic
nervous system activation
What would cause a high systemic vascular resistance? - ANSWER- 1. Peripheral
vasoconstriction
What would cause a high PAOP/PAWP or LAP? - ANSWER- 1. Left ventricular
inefficiency (If the left ventricle isn't pumping well, that blood is going to back up into the
left atrium, causing a higher pressure in the left atrium)
What two substances make up tissue plasminogen activator? - ANSWER- Streptokinse
and retaplase
What two rhythms do you do defibrillation? - ANSWER- Vtach w/o a pulse
What three rhythms would you consider doing pacing? - ANSWER- Symptomatic
bradycardia
What three antidysrhythmic drugs are used for heart rates that are too fast? - ANSWER-
Amiodarone
What should we watch for when administering albumin to a patient? - ANSWER- Fluid
overload
What should we monitor with a patient on 3% NaCl? - ANSWER- Monitor for
hypernatremia
What should we closely monitor with septic shock? - ANSWER- Blood pressure and
CVP (To make sure blood is getting back to the heart, this is measured with CVP)
What scale do we use to assess a patients' sedation status in the ICU? - ANSWER-
RASS (Richmond Agitation Sedation Scale)
What position do you put your patient in with PAC discontinuation? - ANSWER-
Trendelenburg
What position do we put a patient in when inserting a PAC? - ANSWER- Trendelenburg
What patients need hemodynamic monitoring? - ANSWER- 1. Unable patients with
burns, who had heart surgery, are severely dehydrated, were in a trauma, or
hemorrhaged
What labs should you monitor with a patient who is on Propofol? - ANSWER-
Triglyceride (>150 high) and cholesterol (>200 high)
What is t-PA used for? - ANSWER- STEMIs
What is the purpose of sedation? - ANSWER- To decrease level of consciousness,
establishing a state of calm
What is the primary nursing intervention indicated for a symptomatic client with a PAWP
of 3 mm Hg (low)?
What is the only direct measurement of contractility? - ANSWER- Ejection fraction
What is the most common cause of cardiogenic shock?
What is the first line treatment for a STEMI? - ANSWER- PCI (Percutaneous Coronary
Intervention)
What is the difference between absolute and relative hypovolemic shock? - ANSWER-
With absolute, there is actual blood or fluid loss such as with *hemorrhage, diarrhea,
vomiting, dehydration, etc.*
, What is the benzodiazepine of choice in the ICU?
What is the assessment gold standard for pain? - ANSWER- Verbal report
What is PCI? (Percutaneous Coronary Intervention) - ANSWER- This is the first line
treatment for a STEMI. The patient is brought to the catheterization lab where a
cardiologist can assess the blockage and possibly place a stent to open the artery
again.
What is needed to measure CO? - ANSWER- An invasive line (ex. IV, arterial line,
central line, etc.)
What is ACS caused by? (Acute Coronary Syndrome) - ANSWER- Thrombus formation
in the coronary artery
What health conditions and medications can cause peripheral vasoconstriction? -
ANSWER- 1. Early hypovolemic shock (Compensation stage)
What four rhythms do you do synchronized cardioversion? - ANSWER- SVT
What does preload indicate? - ANSWER- Intravascular value and/or ventricular pump
ability
What can we give to patients to improve O2 carrying capacity? - ANSWER- Blood
products
What can cause left ventricular inefficiency/failure? - ANSWER- 1. Left-sided heart
failure
What can cause a low systemic vascular resistance? - ANSWER- 1. Systemic
vasodilation (Distributive shocks!)
What can an ICU monitor measure? - ANSWER- Arterial blood pressure (Make sure to
check accuracy my obtaining an non-invasive blood pressure with a BP cuff)
What can a Vigileo monitor measure? - ANSWER- CO, CI, SVR, SV
What can a PAC measure, in addition to CO, CI, SVR, and SV? - ANSWER- RAP, PAP,
PAOP/PAWP
What are two other causes? - ANSWER- Acute myocardial infarction
What are the three common sites of intra-arterial pressure monitoring? - ANSWER- 1.
Radial artery
What are the nursing considerations? - ANSWER- Midazolam (Versed)
What are the 5 P's of neuromuscular compromise? - ANSWER- 1. Pain
What are some clinical manifestations of neurogenic shock? - ANSWER- 1.
Hypotension and bradycardia
What are some clinical manifestations of hypovolemic shock? - ANSWER- 1. Anxiety
What are some clinical manifestations of cariogenic shock? - ANSWER- 1. Tachypnea
with crackles
What are some clinical manifestations of anaphylactic shock? - ANSWER- 1.
Hypotension
What are our goals when treating cardiogenic shock? - ANSWER- Restore blood flow to
the myocardium
We use hemodynamic monitoring to assess fluid balance, heart function, and the effects
of fluids and drugs on cardiac output.
Watch for: dysrhythmias, give through central line, watch for peripheral vasoconstriction
(pulses, paresthesia) - ANSWER- Dopamine
Watch for: dysrhythmias - ANSWER- Norepinephrine
