ICU EXAM 3| TOP SCORES MADE SIMPLE | TRUSTED
TEST SOLUTIONS!
QUALITY CONTENT YOU CAN RELY ON!
Which injury is considered blunt trauma?
A. Gunshot wound
B. Stab caused by a knife
C. Impalement on a pitchfork
D. Neck injury from a car crash Answer: Neck injury from a car crash
Which condition is associated with Grey-Turner sign?
A. Spleen injury
B. Cardiac Tamponade
C. Retroperitoneal bleeding
D. Blunt traumatic aortic injury Answer: Retroperitoneal bleeding- purplish discoloration of
the flanks and is associated with Retroperitoneal bleeding or pancreatic injury
Within which time frame should enteral nutrition be initiated for all trauma patients?
A. Within 6 hours
B. Within 12 hours
C. Within 24 hours
D. Within 48 hours Answer: Within 48 hours
Which of the following medications should the nurse question for a patient with acute liver
failure experiencing hepatic encephalopathy?
A. Famotidine
B. Mannitol
C. Propofol
D. Metronidazole Answer: Propofol
Which of the following is the most common cause of GI hemorrhage?
A. Peptic ulcer disease
B. Esophageal varices
C. Perforation
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,D. Stress related mucosal disease Answer: Peptic ulcer disease
What is the mechanism of action of Octreotide (Sandostatin) when used for active GI
bleeding?
A. Inhibit gastric secretion and stimulate mucus and bicarb production
B. Direct injection into the vessels causes potent vasoconstriction
C. Blocks histamine induced gastric acid secretion from the parietal cells
D. Reduces splanchnic blood flow, platelet clumping and gastric acid sections Answer:
Reduces splanchnic blood flow, platelet clumping and gastric acid secretions
Which statement best described the mechanism of Famotidine?
A. It blocks histamine-2 receptors to decrease gastric acid secretions
B. It lines the stomach by adhering to ulcer sites and protects them from acids, enzymes,
and bile salts
C. It stimulates mucus and bicarbonate secretion
D. It reduced stomach acid production by inhibiting the proton pump Answer: It blocks
histamine-2 receptors to decrease gastric acid secretions
Which of the following may be done for cancer of the distal esophagus and
gastroesophageal junction?
A. Whipple Procedure
B. Roux-en-Y procedure
C. Esophagectomy
D. Sengstaken-Blakemore Answer: Esophagectomy
A patient in the ICU for septic shock and an AKI is on multiple pressors and mechanical
ventilation and suddenly develops a massive upper GI bleed. Which underlying condition is
most likely?
A. Peptic ulcer disease
B. Stress related mucosal disease
C. Esophageal varices
D. Acute liver failure Answer: Stress related mucosal disease
Which medications are used in stress related mucosal disease (SRMD) management?
2
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,A. IV PPIs and H2 blockers
B. IV prostaglandin and anticholinergics
C. IV octreotide and acetaminophen
D. Antacids and laxatives Answer: IV PPIs and H2 blockers
Which relatively safe diagnostic procedure uses a radioactive tracer to evaluate
cholecystitis, biliary obstruction and bile leaks?
A. Abdominal ultrasound
B. M2A Enteroscopy
C. Endoscopic retrograde cholangiopancreatography (ERCP)
D. Hepatobiliary scintigraphy (HIDA) Answer: Hepatobiliary scintigraphy (HIDA)
Which lab findings are expected with acute liver failure? Select all that apply.
A. High AST/ALT
B. Low bilirubin
C. Low ammonia
D. High albumin
E. High alkaline phosphate
F. High serum lactate
G. Hyperglycemia
H. Prolonged PT/INR Answer: High AST/ALT, High alkaline phosphate, High serum lactate,
Prolonged PT/INR- high bilirubin, high ammonia, low albumin, hypoglycemia
When caring for a patient in acute liver failure, which nursing intervention has the highest
priority?
A. Monitor blood glucose every shift
B. Restrict fluids to <500 mL/day
C. Assess for changes in level of consciousness
D. Provide a low protein diet Answer: Assess for changes in level of consciousness
A patient with portal hypertension develops an upper GI bleed with massive Hematemesis.
What is likely the underlying pathophysiology?
A. Arterial rupture in the stomach wall lining from SRMD
3
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, B. Varices rupture from exposure to gastric contents
C. Decreased mucosal blood flow to the duodenum
D. Peptic ulcer perforation Answer: Varices rupture from exposure to gastric contents
What causes ascites in end stage liver disease?
A. Increased urinary sodium excretion
B. Excess aldosterone production leading to fluid retention in the lungs
C. Hypoproteinemia and portal hypertension causing fluid shift into the peritoneum
D. Impaired bile flow increasing osmotic pressure Answer: Hypoproteinemia and portal
hypertension causing fluid shift into the peritoneum
During a paracentesis, which complication should the nurse monitor for?
A. Bradycardia
B. Hyperproteinemia
C. Fever
D. Hypotension Answer: Hypotension
What nursing intervention is appropriate for a patient post liver biopsy?
A. Strict bed rest with HOB <10 degrees and extremity straight
B. Monitoring for the return of a gag reflex
C. Monitoring for rectal bleeding
D. Applying a pressure dressing and placing the patient on their right side for 2 hours
Answer: Applying a pressure dressing and placing the patient on their right side for 2 hours
In a patient with suspected acute pancreatitis, which nursing action has highest priority?
A. Begin TPN
B. Begin IV fluid resuscitation with LR and pain control
C. Place NG tube and drain to gravity
D. Collect blood cultures and begin IV antibiotics Answer: Begin IV fluid resuscitation and
pain control
What is the Pathophysiology of stress related mucosal disease?
A. Acute, widespread gastric ischemia and erosive injury following shock and
catecholemine release
4
APPHIA - Crafted with Care and Precision for Academic Excellence.
TEST SOLUTIONS!
QUALITY CONTENT YOU CAN RELY ON!
Which injury is considered blunt trauma?
A. Gunshot wound
B. Stab caused by a knife
C. Impalement on a pitchfork
D. Neck injury from a car crash Answer: Neck injury from a car crash
Which condition is associated with Grey-Turner sign?
A. Spleen injury
B. Cardiac Tamponade
C. Retroperitoneal bleeding
D. Blunt traumatic aortic injury Answer: Retroperitoneal bleeding- purplish discoloration of
the flanks and is associated with Retroperitoneal bleeding or pancreatic injury
Within which time frame should enteral nutrition be initiated for all trauma patients?
A. Within 6 hours
B. Within 12 hours
C. Within 24 hours
D. Within 48 hours Answer: Within 48 hours
Which of the following medications should the nurse question for a patient with acute liver
failure experiencing hepatic encephalopathy?
A. Famotidine
B. Mannitol
C. Propofol
D. Metronidazole Answer: Propofol
Which of the following is the most common cause of GI hemorrhage?
A. Peptic ulcer disease
B. Esophageal varices
C. Perforation
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
,D. Stress related mucosal disease Answer: Peptic ulcer disease
What is the mechanism of action of Octreotide (Sandostatin) when used for active GI
bleeding?
A. Inhibit gastric secretion and stimulate mucus and bicarb production
B. Direct injection into the vessels causes potent vasoconstriction
C. Blocks histamine induced gastric acid secretion from the parietal cells
D. Reduces splanchnic blood flow, platelet clumping and gastric acid sections Answer:
Reduces splanchnic blood flow, platelet clumping and gastric acid secretions
Which statement best described the mechanism of Famotidine?
A. It blocks histamine-2 receptors to decrease gastric acid secretions
B. It lines the stomach by adhering to ulcer sites and protects them from acids, enzymes,
and bile salts
C. It stimulates mucus and bicarbonate secretion
D. It reduced stomach acid production by inhibiting the proton pump Answer: It blocks
histamine-2 receptors to decrease gastric acid secretions
Which of the following may be done for cancer of the distal esophagus and
gastroesophageal junction?
A. Whipple Procedure
B. Roux-en-Y procedure
C. Esophagectomy
D. Sengstaken-Blakemore Answer: Esophagectomy
A patient in the ICU for septic shock and an AKI is on multiple pressors and mechanical
ventilation and suddenly develops a massive upper GI bleed. Which underlying condition is
most likely?
A. Peptic ulcer disease
B. Stress related mucosal disease
C. Esophageal varices
D. Acute liver failure Answer: Stress related mucosal disease
Which medications are used in stress related mucosal disease (SRMD) management?
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
,A. IV PPIs and H2 blockers
B. IV prostaglandin and anticholinergics
C. IV octreotide and acetaminophen
D. Antacids and laxatives Answer: IV PPIs and H2 blockers
Which relatively safe diagnostic procedure uses a radioactive tracer to evaluate
cholecystitis, biliary obstruction and bile leaks?
A. Abdominal ultrasound
B. M2A Enteroscopy
C. Endoscopic retrograde cholangiopancreatography (ERCP)
D. Hepatobiliary scintigraphy (HIDA) Answer: Hepatobiliary scintigraphy (HIDA)
Which lab findings are expected with acute liver failure? Select all that apply.
A. High AST/ALT
B. Low bilirubin
C. Low ammonia
D. High albumin
E. High alkaline phosphate
F. High serum lactate
G. Hyperglycemia
H. Prolonged PT/INR Answer: High AST/ALT, High alkaline phosphate, High serum lactate,
Prolonged PT/INR- high bilirubin, high ammonia, low albumin, hypoglycemia
When caring for a patient in acute liver failure, which nursing intervention has the highest
priority?
A. Monitor blood glucose every shift
B. Restrict fluids to <500 mL/day
C. Assess for changes in level of consciousness
D. Provide a low protein diet Answer: Assess for changes in level of consciousness
A patient with portal hypertension develops an upper GI bleed with massive Hematemesis.
What is likely the underlying pathophysiology?
A. Arterial rupture in the stomach wall lining from SRMD
3
APPHIA - Crafted with Care and Precision for Academic Excellence.
, B. Varices rupture from exposure to gastric contents
C. Decreased mucosal blood flow to the duodenum
D. Peptic ulcer perforation Answer: Varices rupture from exposure to gastric contents
What causes ascites in end stage liver disease?
A. Increased urinary sodium excretion
B. Excess aldosterone production leading to fluid retention in the lungs
C. Hypoproteinemia and portal hypertension causing fluid shift into the peritoneum
D. Impaired bile flow increasing osmotic pressure Answer: Hypoproteinemia and portal
hypertension causing fluid shift into the peritoneum
During a paracentesis, which complication should the nurse monitor for?
A. Bradycardia
B. Hyperproteinemia
C. Fever
D. Hypotension Answer: Hypotension
What nursing intervention is appropriate for a patient post liver biopsy?
A. Strict bed rest with HOB <10 degrees and extremity straight
B. Monitoring for the return of a gag reflex
C. Monitoring for rectal bleeding
D. Applying a pressure dressing and placing the patient on their right side for 2 hours
Answer: Applying a pressure dressing and placing the patient on their right side for 2 hours
In a patient with suspected acute pancreatitis, which nursing action has highest priority?
A. Begin TPN
B. Begin IV fluid resuscitation with LR and pain control
C. Place NG tube and drain to gravity
D. Collect blood cultures and begin IV antibiotics Answer: Begin IV fluid resuscitation and
pain control
What is the Pathophysiology of stress related mucosal disease?
A. Acute, widespread gastric ischemia and erosive injury following shock and
catecholemine release
4
APPHIA - Crafted with Care and Precision for Academic Excellence.
