NSER 7210 Final Exam Questions and Answers
Which of the following statements about norepinephrine is false?
a) It is a catecholamine with potent alpha adrenergic effects
b) It Is very helpful in distributive forms of shock because of it's potent vasoconstrictive
characteristics
c) It does not significantly increase heart rate as compared to epinephrine
d) It is a good choice for patients with low cardiac outputs states secondary to hypovolemia
- -D) It is a good choice for patients with low cardiac outputs states secondary to
hypovolemia
-When resuscitating a severely hypovolemic patient, when should blood products be
considered?
A) after 4-6 litres of crystalloids have been infused and the patient remains unstable
B) after 2-3 litres of crystalloids have been infused and the patient remains unstable
C) only when obvious deadly bleeding is observed
D) only when the serum blood test results reveal a severely low hemoglobin - -B) after 2-3
liters of crystalloids have been infused and the patient remains unstable
-True or false: all ectopic pregnancies must be managed surgically? - -false
-Which blood component contains coagulation factors?
a) PRBC
b) platelets
c) plasma
d) RH positive blood - -c) plasma
-A geriatric patient presents to your ED with a sudden onset of confusion. What is the most
common cause of acute confusion in the elderly?
a)
Adverse effects from medications (i.e. drug-drug interaction or toxic levels of drug)
b)
Untreated anemia
c)
Nutritional deficiency
d)
It is a normal result from the aging process - -A) adverse effects from medications
-Which of the following statements about crystalloids is false?
a)
They most closely mimic the body's extracellular fluid
b)
They draw fluid from the interstitial and intracellular space into the intravascular space
c)
Examples of crystalloids include normal saline and ringers lactate
,d)
They expand circulating volume so it is important to monitor for fluid excess or overload -
-B) they draw fluid from the interstitial and intracellular space into the intravascular space
-Which of the following statements about medications used in RSI are true?
1. An induction agent should be given prior to a neuromuscular blocking agent
2. A non-depolarizing NMBA might be preferred over a depolarizing NMBA in a patient
with a crush injury, renal disease, or hyperkalemia
3. A dose of Atropine should be considered in infants < 12 months of age to prevent reflex
bradycardia
4. Propofol is a good induction agent choice in the hemodynamically unstable patient due
to it's hemoprotective characteristics
a)
1 and 2
b)
2 and 3
c)
1, 2, and 3
d)
1, 3, and 4 - -C) 1, 2, 3
1. An induction agent should be given prior to a neuromuscular blocking agent
2. A non-depolarizing NMBA might be preferred over a depolarizing NMBA in a patient
with a crush injury, renal disease, or hyperkalemia
3. A dose of Atropine should be considered in infants < 12 months of age to prevent reflex
bradycardia
-Which of the following would be appropriate actions to take when a patient discloses they
are experiencing intimate partner violence?
1. Validate that the disclosure and ask open ended questions about the abuse they are
experiencing2. Determine if they feel safe leaving the ED, and if not, link them to a domestic
violence agency to seek alternative housing3. Offer the opportunity for assistance in
contacting law enforcement should they want to report the IPV4. Provide instructions on
how to keep them (and their children) safe should they need to leave the home quickly if
violence escalates5. Provide a referral to local or national IPV/domestic violence hot lines.
a)
1, 2, and 5
b)
1, 3, and 4
c)
2, 3, and 5
d)
1, 2, 3, and 4
e)
1, 2, 3, 4 and 5 - -E) 1, 2, 3, 4, 5
, -Which of the following is not a potential cause of hypovolemic shock?
a)
Ruptured ectopic pregnancy
b)
Prolonged vomiting and diarrhea
c)
A large surface burn
d)
A pulmonary embolism - -D) pulmonary embolism
-The most significant potential problem for a patient with a tubal rupture from an ectopic
pregnancy is:
A)
serious abdominal pain
B)
hypovolemic shock
C)
fetal death
D)
surgical scarring - -B) hypovolemic shock
-A septic patient's MAP is still only 58 after receiving 2 fluid boluses. The physician does
not want to give further crystalloid boluses. What is the next best treatment option?
A)
Trendelenburg position to "fool the baroreceptors" and increase the MAP.
B)
giving colloids such as blood or Pentaspan.
C)
MAST pants, if available in the hospital.
D)
initiating vasopressors to "squeeze the pipes." - -D) initiating vasopressors to squeeze the
pipes
-The concentration of epinephrine given SQ or IM in anaphylaxis is:
A) 1:1,000
B) 1:10,000 - -A) 1: 1000
-Multiorgan dysfunction in sepsis can be prevented by:
A)
maintaining adequate oxygenation and perfusion to cells.
B)
getting the patient to ICU in 4 hours.
C)
keeping the patient on bedrest for 12 hours.
D)
, monitoring serum glucose every 2 hours. - -A) maintaining adequate oxygenation and
perfusion to cells
-Abrupt alcohol cessation can result in:
A)
euphoria and exaggerated feeling of well-being.
B)
reduced self-control and sedation.
C)
irritability, tremors, and potential seizures.
D)
hypotension and falls. - -C) irritability, tremors, and potential seizures
-Rodney, a 55-year-old male presents to the ED with a wound on his arm requiring
suturing. After being in the waiting room for a few hours he is moved to the rapid
assessment zone (where you are working) for treatment. You notice he appears shaky and
diaphoretic. His radial pulse is rapid but strong, his skin feels hot, and his blood pressure is
170/92. He is complaining of nausea. You ask about his alcohol use and he admits to being
a heavy drinker (12-16 beer per day) and his last drink was 5 hours ago. What
signs/symptoms does Rodney have that are indicative of early alcohol withdrawal
syndrome?
1. Diaphoresis2. Tremors3. Nausea4. Tachycardia5. Hyperthermia
a)
1, 2, and 3
b)
2, 3, and 4
c)
2, 3, 4, and 5
d)
1, 3, and 5
e)
1, 2, 3, 4, and 5 - -E) 1, 2, 3, 4, 5
-Kate is eating a meal in a restaurant. She is allergic to shellfish and suddenly feels tingling
in her mouth and increasing tightness in her throat. When she arrives at the hospital she
states she feels short of breath, has tongue swelling, and has difficulty swallowing. A co-
worker can see that Kate is distressed and offers help. You are starting an IV at the point of
"C" in your assessment. What can your co-worker do that will be priority care for this
patient?
A)
gather and prepare the anticipated medications the doctor will order STAT
B)
check blood glucose level
C)
apply an allergy band to Kate
D)
Which of the following statements about norepinephrine is false?
a) It is a catecholamine with potent alpha adrenergic effects
b) It Is very helpful in distributive forms of shock because of it's potent vasoconstrictive
characteristics
c) It does not significantly increase heart rate as compared to epinephrine
d) It is a good choice for patients with low cardiac outputs states secondary to hypovolemia
- -D) It is a good choice for patients with low cardiac outputs states secondary to
hypovolemia
-When resuscitating a severely hypovolemic patient, when should blood products be
considered?
A) after 4-6 litres of crystalloids have been infused and the patient remains unstable
B) after 2-3 litres of crystalloids have been infused and the patient remains unstable
C) only when obvious deadly bleeding is observed
D) only when the serum blood test results reveal a severely low hemoglobin - -B) after 2-3
liters of crystalloids have been infused and the patient remains unstable
-True or false: all ectopic pregnancies must be managed surgically? - -false
-Which blood component contains coagulation factors?
a) PRBC
b) platelets
c) plasma
d) RH positive blood - -c) plasma
-A geriatric patient presents to your ED with a sudden onset of confusion. What is the most
common cause of acute confusion in the elderly?
a)
Adverse effects from medications (i.e. drug-drug interaction or toxic levels of drug)
b)
Untreated anemia
c)
Nutritional deficiency
d)
It is a normal result from the aging process - -A) adverse effects from medications
-Which of the following statements about crystalloids is false?
a)
They most closely mimic the body's extracellular fluid
b)
They draw fluid from the interstitial and intracellular space into the intravascular space
c)
Examples of crystalloids include normal saline and ringers lactate
,d)
They expand circulating volume so it is important to monitor for fluid excess or overload -
-B) they draw fluid from the interstitial and intracellular space into the intravascular space
-Which of the following statements about medications used in RSI are true?
1. An induction agent should be given prior to a neuromuscular blocking agent
2. A non-depolarizing NMBA might be preferred over a depolarizing NMBA in a patient
with a crush injury, renal disease, or hyperkalemia
3. A dose of Atropine should be considered in infants < 12 months of age to prevent reflex
bradycardia
4. Propofol is a good induction agent choice in the hemodynamically unstable patient due
to it's hemoprotective characteristics
a)
1 and 2
b)
2 and 3
c)
1, 2, and 3
d)
1, 3, and 4 - -C) 1, 2, 3
1. An induction agent should be given prior to a neuromuscular blocking agent
2. A non-depolarizing NMBA might be preferred over a depolarizing NMBA in a patient
with a crush injury, renal disease, or hyperkalemia
3. A dose of Atropine should be considered in infants < 12 months of age to prevent reflex
bradycardia
-Which of the following would be appropriate actions to take when a patient discloses they
are experiencing intimate partner violence?
1. Validate that the disclosure and ask open ended questions about the abuse they are
experiencing2. Determine if they feel safe leaving the ED, and if not, link them to a domestic
violence agency to seek alternative housing3. Offer the opportunity for assistance in
contacting law enforcement should they want to report the IPV4. Provide instructions on
how to keep them (and their children) safe should they need to leave the home quickly if
violence escalates5. Provide a referral to local or national IPV/domestic violence hot lines.
a)
1, 2, and 5
b)
1, 3, and 4
c)
2, 3, and 5
d)
1, 2, 3, and 4
e)
1, 2, 3, 4 and 5 - -E) 1, 2, 3, 4, 5
, -Which of the following is not a potential cause of hypovolemic shock?
a)
Ruptured ectopic pregnancy
b)
Prolonged vomiting and diarrhea
c)
A large surface burn
d)
A pulmonary embolism - -D) pulmonary embolism
-The most significant potential problem for a patient with a tubal rupture from an ectopic
pregnancy is:
A)
serious abdominal pain
B)
hypovolemic shock
C)
fetal death
D)
surgical scarring - -B) hypovolemic shock
-A septic patient's MAP is still only 58 after receiving 2 fluid boluses. The physician does
not want to give further crystalloid boluses. What is the next best treatment option?
A)
Trendelenburg position to "fool the baroreceptors" and increase the MAP.
B)
giving colloids such as blood or Pentaspan.
C)
MAST pants, if available in the hospital.
D)
initiating vasopressors to "squeeze the pipes." - -D) initiating vasopressors to squeeze the
pipes
-The concentration of epinephrine given SQ or IM in anaphylaxis is:
A) 1:1,000
B) 1:10,000 - -A) 1: 1000
-Multiorgan dysfunction in sepsis can be prevented by:
A)
maintaining adequate oxygenation and perfusion to cells.
B)
getting the patient to ICU in 4 hours.
C)
keeping the patient on bedrest for 12 hours.
D)
, monitoring serum glucose every 2 hours. - -A) maintaining adequate oxygenation and
perfusion to cells
-Abrupt alcohol cessation can result in:
A)
euphoria and exaggerated feeling of well-being.
B)
reduced self-control and sedation.
C)
irritability, tremors, and potential seizures.
D)
hypotension and falls. - -C) irritability, tremors, and potential seizures
-Rodney, a 55-year-old male presents to the ED with a wound on his arm requiring
suturing. After being in the waiting room for a few hours he is moved to the rapid
assessment zone (where you are working) for treatment. You notice he appears shaky and
diaphoretic. His radial pulse is rapid but strong, his skin feels hot, and his blood pressure is
170/92. He is complaining of nausea. You ask about his alcohol use and he admits to being
a heavy drinker (12-16 beer per day) and his last drink was 5 hours ago. What
signs/symptoms does Rodney have that are indicative of early alcohol withdrawal
syndrome?
1. Diaphoresis2. Tremors3. Nausea4. Tachycardia5. Hyperthermia
a)
1, 2, and 3
b)
2, 3, and 4
c)
2, 3, 4, and 5
d)
1, 3, and 5
e)
1, 2, 3, 4, and 5 - -E) 1, 2, 3, 4, 5
-Kate is eating a meal in a restaurant. She is allergic to shellfish and suddenly feels tingling
in her mouth and increasing tightness in her throat. When she arrives at the hospital she
states she feels short of breath, has tongue swelling, and has difficulty swallowing. A co-
worker can see that Kate is distressed and offers help. You are starting an IV at the point of
"C" in your assessment. What can your co-worker do that will be priority care for this
patient?
A)
gather and prepare the anticipated medications the doctor will order STAT
B)
check blood glucose level
C)
apply an allergy band to Kate
D)
