Pass CCRN test bank
Which of the following would be the earliest auscultatory finding in left ventricular failure (LVF)?
A. Crackles
B. S3
C. Murmur of mitral regurgitation
D. Pericardial friction rub - ✔✔✔B. S3
LVF would be the most subtle because early changes are usually subtle changes. Choose "S3."
A patient with a triple-lumen subclavian catheter has been receiving total parenteral nutrition,
maintenance fluids, and antibiotics by the catheter. He has been slightly confused. Suddenly he grasps
the catheter and pulls it out. He then complains of shortness of breath, and his pulse oximetry indicates
an SpO2 of 84%. How should this patient be positioned?
A. Head down, left side
B. Head down, right side
C. Head of bed elevated, left side
D. Head of bed elevated, right side - ✔✔✔A. Head down, left side
Envision a big air bubble in the patient's heart. Think: what position would decrease the movement of
the air embolism out of the right side of the heart. Chose "Head down, left side."
Oxygen delivery (DO2) is the product of which of the following?
A.
,PaO2, hemoglobin, mean arterial pressure
B.
SaO2, hemoglobin, cardiac output
C.
SvO2, cardiac index, SaO2
D.
PaO2, mean arterial pressure, SvO2 - ✔✔✔B. SaO2, hemoglobin, cardiac output
Oxygen is delivered from the arterial end, so choose an option that has SaO2
Which of the following is the most significant complication of status asthmaticus?
A.
Pulmonary embolism
B.
Acute respiratory failure
C.
Hypertension
D.
Anaphylaxis - ✔✔✔B. Acute respiratory failure
A 22-year-old man is admitted to the critical care unit after a motor vehicle collision. The emergency
department nurse reports that he was unconscious at the scene of the accident, but he is now alert and
oriented. Skull films show a linear fracture of the right temporal bone. He is at significant risk for:
,A.
scalp hematoma.
B.
subdural hematoma.
C.
epidural hematoma.
D.
intracerebral hematoma. - ✔✔✔C. epidural hematoma.
Linear fractures of the temporal bone frequently disrupt the middle meningeal artery and cause epidural
hematoma. Patients with an epidural hematoma classically present with a short period of
unconsciousness followed by a lucid interval and then rapid deterioration. An epidural hematoma is
usually caused by arterial bleeding.
A patient is admitted to the ICU after sustaining a concussion and blunt abdominal trauma to the right
upper quadrant in a domestic dispute. The patient's vital signs are BP 145/86 mm Hg, pulse 86
beats/min, respiration 15 breaths/min, and temperature 98.8° F. The nurse is monitoring the patient's
bowel sounds, abdominal tenderness, and abdominal girth frequently. Which of the following laboratory
parameters is especially important for the nurse to closely monitor for bleeding in this patient?
A.
Platelet count
B.
Protime
C.
Hematocrit
D.
Mean corpuscular volume - ✔✔✔C. Hematocrit
, Common injuries resulting from blunt abdominal trauma can include injury to the liver, spleen,
mesenteric vessels, pancreas, or kidneys. In a nonoperative approach to blunt abdominal trauma,
observation and monitoring include serial hematocrits to evaluate for intra-abdominal bleeding. The
platelet count does not fluctuate unless there is a disease process (e.g. cirrhosis, leukemia) or significant
blood loss. Protime is a monitor of coagulation status and can be prolonged without active bleeding.
Mean corpuscular volume measures the average volume or size of a single RBC and is used in classifying
anemias.
Which of the following is associated with chest pain, confusion, and petechiae?
A.
Dissecting aneurysm
B.
Fat embolism
C.
Pneumothorax
D.
Myocardial infarction - ✔✔✔B. Fat embolism
Chest pain, confusion, and petechiae are suggestive of a fat embolism, especially within the first 48 to 72
hours after a long-bone fracture.
The clincher is the petechiae. None of the other choices would cause petechiae.
Which type of shock is most likely to be iatrogenic?
A.
Which of the following would be the earliest auscultatory finding in left ventricular failure (LVF)?
A. Crackles
B. S3
C. Murmur of mitral regurgitation
D. Pericardial friction rub - ✔✔✔B. S3
LVF would be the most subtle because early changes are usually subtle changes. Choose "S3."
A patient with a triple-lumen subclavian catheter has been receiving total parenteral nutrition,
maintenance fluids, and antibiotics by the catheter. He has been slightly confused. Suddenly he grasps
the catheter and pulls it out. He then complains of shortness of breath, and his pulse oximetry indicates
an SpO2 of 84%. How should this patient be positioned?
A. Head down, left side
B. Head down, right side
C. Head of bed elevated, left side
D. Head of bed elevated, right side - ✔✔✔A. Head down, left side
Envision a big air bubble in the patient's heart. Think: what position would decrease the movement of
the air embolism out of the right side of the heart. Chose "Head down, left side."
Oxygen delivery (DO2) is the product of which of the following?
A.
,PaO2, hemoglobin, mean arterial pressure
B.
SaO2, hemoglobin, cardiac output
C.
SvO2, cardiac index, SaO2
D.
PaO2, mean arterial pressure, SvO2 - ✔✔✔B. SaO2, hemoglobin, cardiac output
Oxygen is delivered from the arterial end, so choose an option that has SaO2
Which of the following is the most significant complication of status asthmaticus?
A.
Pulmonary embolism
B.
Acute respiratory failure
C.
Hypertension
D.
Anaphylaxis - ✔✔✔B. Acute respiratory failure
A 22-year-old man is admitted to the critical care unit after a motor vehicle collision. The emergency
department nurse reports that he was unconscious at the scene of the accident, but he is now alert and
oriented. Skull films show a linear fracture of the right temporal bone. He is at significant risk for:
,A.
scalp hematoma.
B.
subdural hematoma.
C.
epidural hematoma.
D.
intracerebral hematoma. - ✔✔✔C. epidural hematoma.
Linear fractures of the temporal bone frequently disrupt the middle meningeal artery and cause epidural
hematoma. Patients with an epidural hematoma classically present with a short period of
unconsciousness followed by a lucid interval and then rapid deterioration. An epidural hematoma is
usually caused by arterial bleeding.
A patient is admitted to the ICU after sustaining a concussion and blunt abdominal trauma to the right
upper quadrant in a domestic dispute. The patient's vital signs are BP 145/86 mm Hg, pulse 86
beats/min, respiration 15 breaths/min, and temperature 98.8° F. The nurse is monitoring the patient's
bowel sounds, abdominal tenderness, and abdominal girth frequently. Which of the following laboratory
parameters is especially important for the nurse to closely monitor for bleeding in this patient?
A.
Platelet count
B.
Protime
C.
Hematocrit
D.
Mean corpuscular volume - ✔✔✔C. Hematocrit
, Common injuries resulting from blunt abdominal trauma can include injury to the liver, spleen,
mesenteric vessels, pancreas, or kidneys. In a nonoperative approach to blunt abdominal trauma,
observation and monitoring include serial hematocrits to evaluate for intra-abdominal bleeding. The
platelet count does not fluctuate unless there is a disease process (e.g. cirrhosis, leukemia) or significant
blood loss. Protime is a monitor of coagulation status and can be prolonged without active bleeding.
Mean corpuscular volume measures the average volume or size of a single RBC and is used in classifying
anemias.
Which of the following is associated with chest pain, confusion, and petechiae?
A.
Dissecting aneurysm
B.
Fat embolism
C.
Pneumothorax
D.
Myocardial infarction - ✔✔✔B. Fat embolism
Chest pain, confusion, and petechiae are suggestive of a fat embolism, especially within the first 48 to 72
hours after a long-bone fracture.
The clincher is the petechiae. None of the other choices would cause petechiae.
Which type of shock is most likely to be iatrogenic?
A.
