BKAT 9R QUESTIONS AND ANSWERS ALREADY PASSED

BKAT 9R QUESTIONS AND ANSWERS ALREADY PASSED Initial measures for the treatment of angina pectoris do not include which response below? Beta Blockers The classical ECG change with muscle injury in acute myocardial infarction is: ST segment elevation Elevated cardiac iso-enzymes generally do not occur in which response below? CHF The major therapeutic goal in the treatment of cariogenic shock is to: Increased CO You receive orders to start nitroprusside and dobutamine in your patient with end-stage cardiomyopathy. How will this tx regimen affect CO? Reduces preload and after load and improves contractility In dealing with a depressed pt during the first days post AMI the most appropriate nursing action would be: Encourage the patient to ventilate his/her concerns Mr Seamore is receiving thrombolytics (TPA) 3 hrs after an AMI. Which of the following would most likely require discontinuing the infusion? change in mental status The following monitor pattern would indicate that the pulmonary artery (swan ganz) catheter is in which position? Pulmonary artery occlusion (wedge) A systolic murmur that is auscultated at the 2nd intercostal space, right sternal border is called: Aortic stenosis Which of the following wave patterns indicates proper functioning of an arterial line? High to low After an arterial catheter is removed, direct pressure should be applied to the artery for how long? 8-10 minutes A CVP reading directly reflects pressure in the: Right atrium An elevated CVP reading may indicate: Rt heart failure The pulmonary artery occlusive (wedge) pressure (PAOP) reflects pressure in the: Lt ventricle The normal pulmonary artery pressure is: 11-20 How many mmHg is the normal PAOP? 6-12 An elevated PAOP may indicate: Lt ventricular failure Mr Adams, a 68 yo pt, c/o feeling "a little funny in his chest". His ECG shows Afib/flutter. Which of the following meds could be used to tx his cardiac rhythm? Diltiazem A QRS complex wider that .12 sec most likely indicates: BBB Special care should be exercised when administering IV Dopamine because Infiltration leads to tissue necrosis A strong ventricular stimulus is potentially dangerous when it lands on the: T wave indication for use of external cardiac pacemaker includes symptomatic complete heart block Initial drug tx for sustained V tach when a pulse is present Amiodorone 150mg IV over 10 min The cardiac rhythm of A flutter is: Hazardous, as the ventricular rate may suddenly increase Upon recognizing V fib in an ICU, the next thing the nurse should do is: Establish Unresponsiveness The tx in an emergency situation for complete heart block is: Preparing for transcutaneous pacing Your pt has A flutter with a ventricular response of 150 bpm, therapy for this rhythm includes: Amiodarone, Cardizem, Cardioversion Signs of cardiac tamponade do not include which response below? Bradycardia In the pt with V fib, the correct energy setting for the first defibrillation when using a biphasic defibrillator is how many joules? 150 A pt becomes apnea and pulseless. The monitor shows systole. The drug that would most likely be used initially is: Epinephrine Antidote for Heparin Protamine sulfate Most important step in preventing central venous catheter related sepsis is: Thorough handwashing An excessive amount of chest tube drainage in the first few hrs following thoracic surgery is how many mL's/hr? 150 A routine check of your patient's blood gas values show a pH of 7.40, pO2 of 98 mmHg, pCO2 of 38 mmHg, and HCO3 25 mEq. These results reflect: Normal values Before suctioning a pt, you adjust the vacuum pressure so that it is: 120 mmHg of pressure Post op pt has a left anterior chest tube. When you auscultate the lung fields bilaterally, you hear diminished breath sounds in the right posterior bases. This would most likely be due to: Atelectasis Your pt is on a ventilator. The low volume alarm sounds. This may be due to: Disconnected tubing To assess for proper positioning of an endotracheal tube, the most appropriate nursing action would be to: Listen for bilateral breath sounds Mr Ray has an endotracheal tube. While you are making rounds, you ask his breathing is okay. In an audible tone, he says 'yes'. You should first: Check the functioning of the cuff The high pressure alarm on a volume respirator will not be triggered by which response below? Leaking cuff The most important reason for diminishing breath sounds in a MVC victim with closed chest trauma is: Development of a pneumothorax A moderately burned trauma pt is admitted to your unit. The most important tx related to the burns during the first 24 hrs after injury is: Fluid replacement Your trauma pt, who is 4 days post fracture of the right femur, suddenly develops SOB. The most likely cause is: Fat embolus To help prevent VAP, the most important nursing action would be to: Careful hand washing and use of gloves when suctioning The most important nursing activity for a pt admitted with the diagnosis of cervical spinal cord injury is: Immobilizing the head In a pt with cervical spine injury, the most important observations the nurse makes concerns which of the following physiological parameters? Respirations The earliest sign of increased ICP generally involves changes in: LOC Deepening ICP is characterized by: Widened pulse pressure Drug of choice used to reduce increased ICP is: Mannitol A positive Babinski response in an adult: Indicates an abnormal finding Nursing care of a pt during the acute phase of a stroke does not include which response blow? Initiating t-PA, if within first 8 hrs post stroke Most important part of neuro check is? Evaluating the LOC S/S of DKA Fruity breath, deep and rapid breathing Hypoglycemia should be suspected when the diabetic pt c/o or manifests: Weakness, HA, diaphoresis Measures that would be taken to tx a pt in DKA coma would not include which response below? Dextrose 50% IV infusion Pt's with DM who are acutely ill generally require a: Higher dose of insulin Psychophysiologic stress response for acute illness and being in an icu can result in decrease Urine output Which insulin when given sub-q will have a peak action within 2-4 hrs? Regular An unconscious trauma pt who was just admitted to the ICU is a diabetic who received his usual dose of sub-q NPH insulin at 7 am. In how many hrs after administration might you expect an insulin reaction to occur? 8-14 A dangerous effect of rapidly re-warming a hypothermic pt is: Vasodilation and hypotension Mrs Smith, who is a post-op craniotomy pt has a fasting blood sugar of 100 mg, c/o extreme thirst, and has a urine output > 1,000 mL's over 2 hrs. You should suspect: DI Mrs Reece, a 64 yo woman with acute renal failure and oliguria, was admitted with CHF. Which of the following tests is abnormal? K+ of 5.8 Pt admitted with a probable diagnosis of acute renal failure. The normal mL's of urine output for this 150 lb person per hr is: 30 Practices to decrease CAUTI does not include: Discontinuing enteral tube feeding if diarrhea occurs Your pt has acute renal failure. Meds that are normally excreted through the kidneys will probably be: Decrease dosage Enteral feeding in acute renal failure commonly includes: Restricted protein, low k+, low Na+ Sudden development of dyspnea and sinus tachycardia in an acute renal failure pt would most likely indicate which of the following? Fluid overload ECG changes commonly seen in hyperkalemia are: Wide QRS, tall peaked T wave When feeding a pt using continuous tube feedings, the most important intervention in preventing aspiration is to: Keep the HOB elevated Low intermittent suction of gastric contents is not generally used in which response below: To control bleeding Safe placement of NG tube in unconscious pt can be best assessed by: Obtaining radiographic confirmation While caring for a day 2 post op exploratory laparotomy pt, you notice 'coffee ground' material coming from her NG tube. You should: Have the drainage tested for blood Your pt, who is receiving a blood transfusion, has a sudden increase in body temp. Your first response is to: Stop the transfusion In a symptomatic sinus brady, which of the following could be used to increase the heart rate: Atropine Which of the following drugs will crystallize when given IV with D5S? Dilantin Precautions in using IV nitroprusside is not included in which response below? Alertness to the development of an acute hypertensive episode Dosage of which drug must be tapered off slowly to prevent acute adrenal insufficiency? Cortisone Which of the following is not a manifestation of dig toxicity? Rapid AV conduction Health care power of attorney has right to: Decide on husbands care if he loses consciousness Examples of spiritual care for a seriously ill, conscious pt does not generally include which response below? Telling the pt that everything is going to be alright