RCP 160 Midterm Exam Question And Correct Answers

RCP 160 Midterm Exam Question And Correct Answers Which of the following structures will result in the most radiopaque shadow on a CXR a. aorta b. heart c. lungs d. ribs - d. ribs Your patient just had an anteroposterior chest film taken. When you view the film, what may be a consideration? - The heart may appear larger than it really is. What is indicated by blunting of the costophrenic angles seen on a PA or lateral CXR? - Excess pleural fluid What chest x-ray view is best used to identify excess pleural fluid? - Lateral decubitus What term is used to describe the shadows seen on a CXR when the alveoli is filled with pus, fluid or blood? - Infiltrates X-Rays easily penetrate all of the following EXCEPT: - Consolidative lung tissue The imaging technique of choice for an initial evaluation of the lungs is - Conventional CXR Alveolar consolidation is a hallmark of - Pneumonia A pneumothorax would appear on a CXR as a - Dark area with out lung markings What two ACLS medications are used for asystole? - Epinephrine and Atropine A patient is in SVT with a heart rate of 198. What medication could be used to cardiovert this patient - Adenosine A 21 yo male is brought into the emergency room by ambulance after falling approximately 20 feet from a roof while at work. The patient is combative and unable to follow commands, He is noted to have a large hematoma on the right side of his forehead. HIs vitals are: HR 125 RR 32, BP 98/54. The ED physician decides to intubate for airway protection. What paralytic would be most appropriate for this patient? - Vecuronium Diazepam - Valium Lorazepam - Ativan Benzodiazepine Midazolam - Versed Benzodiazepine Sublimaze - Fentanyl Dilaudid is not good for patients with renal failure - False What is the maximum dose of Atropine? - 3 mg Choose all of the following benefits to sublimaze - Rapid onset Minimal effect on the cardiovascular system What medication is used to reverse the effects of opioids? - Narcan The goals of sedation in the ICU are - 1. patient comfort 2. control pain 3. facilitate mechanical ventilation 4. reduce oxygen consumption 1,2,3,4 Diazepam, Lorazepam, Midazolam - Benzodiazepines Which of the following are side effects of propofol? - 1. Unpredictable respiratory depression 2. Increased ICP 3. Significant hemodynamic effects 4. Bronchospasm 1,3 The Ramsay Score is used to monitor.. - Patients level of sedation Hypertension, tachycardia, sweating and pupillary dilation are all signs of pain - True Which opioid medication is the preferred drug but has a hypotension effect and potential for histamine release? - Morphine Ketamine - 1. Causes hypertension, hallucinations , nightmares 2. Is a potent bronchodilator 3. Reduces nausea and Morphine dependency in post op patients 4. Is a sedative and anesthetic 1,2,3,4 Dopamine is used for which heart rhythm? - Bradycardia with a pulse Which of the following is NOT part of the H's and T's ? - Hemothorax Sedation medication are a form of chemical restraint - True A patient is receiving mechanical ventilation as a result of an apparent tetanus infection. the patient is having tetanic contractions. What medications would be appropriate for this patient? - 1. Paralytic agents 2. Analgesics 3. Sedatives 4. Diuretics 1,2,3 Proper position of the patient, stabilization of fractures, elimination of irritating stimulation, proper positioning of the ventilator tubing to avoid traction on the ETT, are all nonpharmacologic interventions to improve patient comfort. - True The function of the transducer in the invasive vascular monitoring system is to do which of the following? - Convert the fluid pressure to an electrical signal The pulmonary artery catheter must be wedged in which of the following locations? - Zone 3 The hemodynamic measurement that is indicative of a patient with right heart failure is which of the following? - central venous pressure (CVP) = 16mmHg Systemic Vascular Resistance (SVR) can be elevated by which of the following disorders? - Hypovolemia An intubated patient with no known history of congestive heart failure is in the ICU. The patient is comatose and currently receiving mechanical ventilation via volume-controlled continuous mandatory ventilation (VC-CMV), set rate 12 bpm, set tidal volume (VT) 400 mL, positive-end-expiratory pressure (PEEP) 18 cm H2O, fractional inspired oxygen (FIO2) 0.35, and the patient is not assisting. Hemodynamic measurements show the following: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 33/20 mm Hg, and pulmonary artery occlusion pressure (PAOP) 16 mm Hg. Arterial blood gas (ABG) results are: pH 7.43, arterial partial pressure of carbon dioxide (PaCO2) 38 mm Hg, arterial partial pressure of oxygen (PaO2) 90 mm Hg. The physician asks for recommendations to improve this patient's hemodynamics. The most appropriate recommendation for this patient is which of the following? - Decrease the PEEP incrementally and recheck hemodynamic measurements A patient in the ICU has a CXR that shows bilateral infiltrates and has the following hemodynamic measurements: CVP 5 mm Hg, PAP 24/13 mm Hg, and PAOP 21 mm Hg, these findings are consistent with which of the following? - Cardiogenic pulmonary edema Absolute confirmation of placement of a central venous pressure catheter is done with which of the following? Chest x-ray Checking the centimeter mark Ensuring appropriate waveform Drawing a blood sample through the catheter - Chest x-ray Common complications of systemic artery catheterization include all but which of the following - Phlebitis The immediate complications that may occur during the insertion of a CVP line include all of the following EXCEPT - Infection The PCWP will likely be increased in a patient with left ventricular failure - True PCWP (pulmonary capillary wedge pressure) - 4-12 mmHg CVP (central venous pressure) - 2-6 mmHg Right atrial pressure - 4 - 12 cm H2O Pulmonary artery pressure - 25/8 mmhg at rest, 14 mean 30 mmhg during exercise is a sign of HTN left ventricle - 120/0 mmHg The most common site for arterial line placement is in the - Radial Artery What is a CVP line used for? - 1. To administer medications 2. to administer fluids 3. to obtain right atrial pressure How long should the balloon be inflated to obtain a PCWP pressure? - 15-30 sec A patient in the ICU has the following hemodynamic measurements: CVP 5 mmHg, PAP 18(mean), PCWP 4mmHg, BP 115/74. CO 4L/min. what is the disease process? - Pulmonary hypertension A patient presents to the ED with a chief complaint of severe abdominal pain. Upon examination, the patient was found to be pale and lethargic with a distended belly. His vitals and hemodynamics were as follows HR of 111 weak and thready, RR 10, SpO2 85% on RA, BP 77/35, CVP 1mmHg. PAP 20/7, PCWP 3 mmHg. What is the disease process the patient could be experiencing? - Possible GI bleed A patient with tricuspid valve stenosis would most likely have an increase in which hemodynamic pressure? - CVP Indications of an arterial line - 1. To obtain frequent ABGs 2. To continuously measure systemic BP Which paralytic has no hemodynamic effects? - Rocuronium Morphine is the drug of choice for patients with an unstable hemodynamic status - False Which of the following is a potential cause of PAH - Meth use Potential treatments for group 1 pulmonary hypertension include surgery as well as medications? - True Which of the following differentiates group 2 PH from the other groups - It is caused by left-sided heart disease which of the following is not a potential treatment of group 2 PH - Administration of Vecuronium Pulmonary Artery obstructions - Group 4 Unclear/ Multifactorial Mechanisms - Group 5 Lung disease/ hypoxia - group 3 arterial hypertension - group 1 Left heart disease - group 2 when caused by hypoxemia, oxygen therapy is the primary treatment for group 3 PH - true thromboendarterectomy surgery is not a possible treatment for group 4 PH - False What are the potential causes of group 5 PH - Polycythemia sarcoidosis vasculitis Signs and symptoms associated with PH - Dyspnea hemoptysis Ascites peripheral edema and venous distention iNO is a selective pulmonary vasodilator -