QUESTIONS WITH CORRECT AND DETAILED ANSWERS
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NUR 445 FINAL
What medication is used to decrease ICP? - - ANS - -Mannitol
-osmotic diuretic
-reduces ICP by inducing diuresis (creates an osmotic gradient across the blood-
brain barrier [BBB] and increased serum osmolality -> pulls fluid out of brain cells
and shifts it into the intravascular compartment)
What medication would you plan on administering to a patient who is experiencing
bradycardia or heart block? - - ANS - -Atropine
-administer over 1 minute
-therapeutic effect desired = increased HR
-rapid administration may be used during cardiac resuscitation (follow with 20 mL
saline flush)
A patient suffering from a hypertensive crisis enters the ED. What medication is used
to treat this emergent situation? - - ANS - -Nitroprusside
-arteriole vasodilator
-rapidly lowers BP
-decreases preload and afterload
,What is clonidine used for? - - ANS - -lowering of BP
Nitroprusside is the preferred agent if BP needs to be lowered quickly
What medication prevents the absorption of ammonia from the GI tract in order to
treat hepatic encephalopathy? - - ANS - -Lactulose
-expect more frequent bowel movements
-should see clearing of confusion, apathy, and irritation and improved mental status
(24-48 hours after oral administration)
Under what condition would you administer tPA? - - ANS - -patient that is suffering
from an ischemic stroke
What is mutual support? - - ANS - -assisting others
providing feedback
advocacy behaviors when patient safety is threatened
What is the difference between formal and informal feedback? - - ANS - -Formal
should be retrospective and scheduled in advance
Informal occurs in real time and includes huddles/debriefs
,Explain the phenomenon of alarm fatigue - - ANS - -Frequency of alarms becomes
overwhelming, resulting in delayed response to alarms and deliberate alarm
deactivation which may impact patient safety
What is the purpose of palliative care? - - ANS - -nursing and medical treatments are
combined with control of pain and symptoms
What is the CUS method of advocacy? - - ANS - -I am concerned
I am uncomfortable
This is a safety issue
What does DESC stand for? - - ANS - -Describe the situation
Express what you think and feel
Suggest a solution
Consequences if no changes
What is the normal rate of the SA node, AV node, and ventricular rate? - - ANS - -SA =
60-100
AV = 40-60
Ventricular = 20-40
What is the normal length of a P wave, QRS complex, and QT interval? - - ANS - -P =
0.12-0.20 sec
QRS = ≤ 0.12 sec
QT = 0.32-0.40 sec
, What nursing care should be provided to a patient with PACs? - - ANS - -Nothing
unless symptomatic
beta blocker, CCB
What are the causes of asystole? - - ANS - -Hs & Ts
Hypovolemia, hypoxemia, hypo/hyperkalemia
Tension pneumo, tamponade, thrombosis
What are treatments for asystole? - - ANS - -Epi and CPR/ACLS
-Unable to shock because no electrical activity
How do we treat Vtach? - - ANS - -defibrillation and/or amiodarone
How do we treat Torsades de pointes? - - ANS - -Magnesium sulfate and amiodarone
What would we do in the event of pulseless Vtach? - - ANS - -SCREAM
Shock
CPR
Rhythm check
Epi