NURS 4350 Exam 1 UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
List trends affecting patient management in the ICU - CORRECT ANSWER 1.
Increasing complexity of illness
2. Aging population
3. More ethical issues
4. Control of costs and quality
5. Rapidly changing technology
6. Early transfer from ICU
7. Staff intensitivists
8. E-ICUs
9. Inclusion of family in all aspects of care
What are some basic criteria used to identify patients who should be admitted to an ICU? -
CORRECT ANSWER -Have or at risk for unstable airway
-Have or at risk of poor breathing
-Have or at risk for poor circulation
-Need constant supervision and monitoring
How does the body's stress response affect blood glucose levels? - CORRECT
ANSWER -Physiologic stress stimulates release of cortisol and epinephrine from
adrenal glands, further stimulating glucagon
-Circulating glucagon can be increased 5x causing hyperglycemia in critical illness
Identify two abnormal responses to critical illness that require medical workup - CORRECT
ANSWER *Depression and delirium* are difficult to assess and are overlooked and
should be addressed
List the basic steps used to analyze heart rhythm - CORRECT ANSWER 1. Determine
heart rate: number of complexes in 6 sec x 10
, 2. Determine heart rhythm: regular or irregular, look at R to R intervals
3. Identify P waves: 1 p wave to each QRS complex?
4. Measure PR interval: .12-.2 seconds
5. Evaluate QRS complex: (<.12 sec), narrow or wide
6. Additional: QT interval, <50% R-R interval, male <.42, female <.43
How would you identify normal sinus rhythm? - CORRECT ANSWER 1. Rate: 60-100
2. Rhythm: regular
3. P-waves: present
4. PR interval: .12-.2 sec
5. QRS: <.12, narrow
How would you identify sinus bradycardia? - CORRECT ANSWER -Meets criteria for
normal sinus rhythm, but rate is <60 bpm
-Bradycardia decreases CO due to fewer ejections
How would you identify sinus tachycardia? - CORRECT ANSWER -Meets all the
criteria for normal sinus rhythm, but rate is >100 bpm
-Tachycardia decreases diastolic filling and stroke volume because no time for heart to fill
How would you identify atrial fibrillation? - CORRECT ANSWER -Most frequent
dysrhythmia
-Rate: supraventricular tachycardia >150, otherwise 60-100
-Rhythm: Irregular
-P wave: no
-QRS complex: narrow
-Can occur with RVR (tachycardia), sinus, flutter, or supraventricular tachycardia
QUESTIONS AND CORRECT ANSWERS
List trends affecting patient management in the ICU - CORRECT ANSWER 1.
Increasing complexity of illness
2. Aging population
3. More ethical issues
4. Control of costs and quality
5. Rapidly changing technology
6. Early transfer from ICU
7. Staff intensitivists
8. E-ICUs
9. Inclusion of family in all aspects of care
What are some basic criteria used to identify patients who should be admitted to an ICU? -
CORRECT ANSWER -Have or at risk for unstable airway
-Have or at risk of poor breathing
-Have or at risk for poor circulation
-Need constant supervision and monitoring
How does the body's stress response affect blood glucose levels? - CORRECT
ANSWER -Physiologic stress stimulates release of cortisol and epinephrine from
adrenal glands, further stimulating glucagon
-Circulating glucagon can be increased 5x causing hyperglycemia in critical illness
Identify two abnormal responses to critical illness that require medical workup - CORRECT
ANSWER *Depression and delirium* are difficult to assess and are overlooked and
should be addressed
List the basic steps used to analyze heart rhythm - CORRECT ANSWER 1. Determine
heart rate: number of complexes in 6 sec x 10
, 2. Determine heart rhythm: regular or irregular, look at R to R intervals
3. Identify P waves: 1 p wave to each QRS complex?
4. Measure PR interval: .12-.2 seconds
5. Evaluate QRS complex: (<.12 sec), narrow or wide
6. Additional: QT interval, <50% R-R interval, male <.42, female <.43
How would you identify normal sinus rhythm? - CORRECT ANSWER 1. Rate: 60-100
2. Rhythm: regular
3. P-waves: present
4. PR interval: .12-.2 sec
5. QRS: <.12, narrow
How would you identify sinus bradycardia? - CORRECT ANSWER -Meets criteria for
normal sinus rhythm, but rate is <60 bpm
-Bradycardia decreases CO due to fewer ejections
How would you identify sinus tachycardia? - CORRECT ANSWER -Meets all the
criteria for normal sinus rhythm, but rate is >100 bpm
-Tachycardia decreases diastolic filling and stroke volume because no time for heart to fill
How would you identify atrial fibrillation? - CORRECT ANSWER -Most frequent
dysrhythmia
-Rate: supraventricular tachycardia >150, otherwise 60-100
-Rhythm: Irregular
-P wave: no
-QRS complex: narrow
-Can occur with RVR (tachycardia), sinus, flutter, or supraventricular tachycardia
