NMNC 4410 – Evidence-Based Practice | University of New Mexico | Exam 3: Application of
EBP, Quality Improvement, and Implementation Science
The nurse is caring for a patient admitted with a urinary tract infection and sepsis. Which
information obtained in the assessment indicates a need for a change in therapy?
a. The patient is restless and anxious.
b. The patient has a heart rate of 134.
c. The patient has hypotonic bowel sounds.
d. The patient has a temperature of 94.1° F. d. The patient has a temperature of 94.1° F.
Norepinephrine (Levophed) has been ordered for the patient in shock. Before administering the
drug, the nurse ensures that the
a. patient's heart rate is less than 100.
b. patient has received adequate fluid replacement
.c. patient's urine output is within normal range.
d. patient is not receiving other sympathomimetic drugs. b. patient has received adequate
fluid replacement
While assessing a patient in shock who has an arterial line in place, the nurse notes a drop in
the systolic BP from 92 mm Hg to 76 mm Hg when the head of the patient's bed is elevated to
75 degrees. This finding indicates a need for
a. additional fluid replacement
.b. antibiotic administration.
c. infusion of a sympathomimetic drug.
d. administration of increased oxygen. a. additional fluid replacement
When caring for a patient who has just been admitted with septic shock, which of these
assessment data will be of greatest concern to the nurse?
a. BP 88/56 mm Hg
,b. Apical pulse 110 beats/min
c. Urine output 15 ml for 2 hours
d. Arterial oxygen saturation 90% c. Urine output 15 ml for 2 hours
A 70-year-old man presents to the emergency department with a 2-day history of fever, chills,
cough, and right-sided pleuritic chest pain. On the day of admission, the patient's family noted
that he was more lethargic and dizzy and was falling frequently. The patient's vital signs are:
temperature, 101.5°F; heart rate, 120 bpm; respiratory rate, 30 breaths/min; blood pressure,
70/35 mm Hg; and oxygen saturation as measured by pulse oximetry, 80% without oxygen
supplementation. A chest radiograph shows a right lower lobe infiltrate.This patient's condition
can best be defined as which of the following?
(A) Multi-organ dysfunction syndrome (MODS)
(B) Sepsis
(C) Septic shock
(D) Severe sepsis
(E) Systemic inflammatory response syndrome(SIRS) (D) Severe sepsis
Which of the following is an indication for using corticosteroids in septic shock?
(A) Acute respiratory distress syndrome (ARDS)
(B) Necrotizing pneumonia
(C) Peritonitis
(D) Sepsis responding well to fluid resuscitation
(E) Vasopressor-dependent septic shock E) Vasopressor-dependent septic shock.
An inappropriate cortisol response is not uncommon in patients with septic shock. Low-dose IV
corticosteroids (hydrocortisone 200-300 mg/day) are recommended
The nurse is caring for an infant who is recovering from bronchiolitis. The parents ask if there
will be any future risk for the child. Which condition should the nurse describe?
,A. Decreased lung capacity
B. Asthma
C. Chronic respiratory infections
D. Chronic obstructive pulmonary disease (COPD) B. Asthma
The nurse is examining a child with bronchiolitis. Which symptom should the nurse interpret as
a sign of dehydration? (Select all that apply.)
A. Intercostal muscle retractions
B. Weak peripheral pulses
C. Decreased urine output
D. Dry, sticky mucous membranes
E. Delayed capillary refill B. Weak peripheral pulses
C. Decreased urine output
D. Dry, sticky mucous membranes
E. Delayed capillary refill
The nurse is teaching the parents of a 9-month-old client with respiratory syncytial virus (RSV)
about ways to help the child recover quickly from the disorder. Which information should the
nurse include? (Select all that apply.)
A. Provide frequent, small meals throughout the day.
B. Use a bulb syringe to clear the nose before giving a bottle.
C. Help the child to blow the nose to clear the airway.
D. Wash hands thoroughly after caring for the child.
E. Permit the child to rest and nap throughout the day. A. Provide frequent, small meals
throughout the day.
B. Use a bulb syringe to clear the nose before giving a bottle.
E. Permit the child to rest and nap throughout the day.
, The nurse is speaking with a parent who is sharing that her child has not been eating well at
home since being sick with respiratory syncytial virus (RSV). Which should be the reason for
consulting with a dietitian to work with this family? (Select all that apply.)
A. Provide healthy snacks.
B. Place a nasogastric tube.
C. Assess fluid intake.
D. Discuss the importance of frequent, small meals.
E. Assess the caloric intake. C. Assess fluid intake.
D. Discuss the importance of frequent, small meals.
E. Assess the caloric intake.
The nurse is working with a group of new nurses and discussing the importance of maintaining
fluid balance in an infant with respiratory syncytial virus (RSV). Which statement demonstrates
an understanding of maintaining fluid balance in infants?
A. "We should encourage the parents to monitor sleeping."
B. "We should encourage the parents to add proteins into the diet."
C. "We should encourage the parents to force fluids."
D. "We should encourage the parents to count diapers." D. "We should encourage the
parents to count diapers."
The nurse is discussing with a parent the signs of dehydration to look for in a child with
respiratory syncytial virus (RSV). Which manifestation should the nurse include? (Select all that
apply.)
A. Bluish tint to skin
B. Poor skin elasticity
C. Decreased urinary output
D. Dry mucous membranes
EBP, Quality Improvement, and Implementation Science
The nurse is caring for a patient admitted with a urinary tract infection and sepsis. Which
information obtained in the assessment indicates a need for a change in therapy?
a. The patient is restless and anxious.
b. The patient has a heart rate of 134.
c. The patient has hypotonic bowel sounds.
d. The patient has a temperature of 94.1° F. d. The patient has a temperature of 94.1° F.
Norepinephrine (Levophed) has been ordered for the patient in shock. Before administering the
drug, the nurse ensures that the
a. patient's heart rate is less than 100.
b. patient has received adequate fluid replacement
.c. patient's urine output is within normal range.
d. patient is not receiving other sympathomimetic drugs. b. patient has received adequate
fluid replacement
While assessing a patient in shock who has an arterial line in place, the nurse notes a drop in
the systolic BP from 92 mm Hg to 76 mm Hg when the head of the patient's bed is elevated to
75 degrees. This finding indicates a need for
a. additional fluid replacement
.b. antibiotic administration.
c. infusion of a sympathomimetic drug.
d. administration of increased oxygen. a. additional fluid replacement
When caring for a patient who has just been admitted with septic shock, which of these
assessment data will be of greatest concern to the nurse?
a. BP 88/56 mm Hg
,b. Apical pulse 110 beats/min
c. Urine output 15 ml for 2 hours
d. Arterial oxygen saturation 90% c. Urine output 15 ml for 2 hours
A 70-year-old man presents to the emergency department with a 2-day history of fever, chills,
cough, and right-sided pleuritic chest pain. On the day of admission, the patient's family noted
that he was more lethargic and dizzy and was falling frequently. The patient's vital signs are:
temperature, 101.5°F; heart rate, 120 bpm; respiratory rate, 30 breaths/min; blood pressure,
70/35 mm Hg; and oxygen saturation as measured by pulse oximetry, 80% without oxygen
supplementation. A chest radiograph shows a right lower lobe infiltrate.This patient's condition
can best be defined as which of the following?
(A) Multi-organ dysfunction syndrome (MODS)
(B) Sepsis
(C) Septic shock
(D) Severe sepsis
(E) Systemic inflammatory response syndrome(SIRS) (D) Severe sepsis
Which of the following is an indication for using corticosteroids in septic shock?
(A) Acute respiratory distress syndrome (ARDS)
(B) Necrotizing pneumonia
(C) Peritonitis
(D) Sepsis responding well to fluid resuscitation
(E) Vasopressor-dependent septic shock E) Vasopressor-dependent septic shock.
An inappropriate cortisol response is not uncommon in patients with septic shock. Low-dose IV
corticosteroids (hydrocortisone 200-300 mg/day) are recommended
The nurse is caring for an infant who is recovering from bronchiolitis. The parents ask if there
will be any future risk for the child. Which condition should the nurse describe?
,A. Decreased lung capacity
B. Asthma
C. Chronic respiratory infections
D. Chronic obstructive pulmonary disease (COPD) B. Asthma
The nurse is examining a child with bronchiolitis. Which symptom should the nurse interpret as
a sign of dehydration? (Select all that apply.)
A. Intercostal muscle retractions
B. Weak peripheral pulses
C. Decreased urine output
D. Dry, sticky mucous membranes
E. Delayed capillary refill B. Weak peripheral pulses
C. Decreased urine output
D. Dry, sticky mucous membranes
E. Delayed capillary refill
The nurse is teaching the parents of a 9-month-old client with respiratory syncytial virus (RSV)
about ways to help the child recover quickly from the disorder. Which information should the
nurse include? (Select all that apply.)
A. Provide frequent, small meals throughout the day.
B. Use a bulb syringe to clear the nose before giving a bottle.
C. Help the child to blow the nose to clear the airway.
D. Wash hands thoroughly after caring for the child.
E. Permit the child to rest and nap throughout the day. A. Provide frequent, small meals
throughout the day.
B. Use a bulb syringe to clear the nose before giving a bottle.
E. Permit the child to rest and nap throughout the day.
, The nurse is speaking with a parent who is sharing that her child has not been eating well at
home since being sick with respiratory syncytial virus (RSV). Which should be the reason for
consulting with a dietitian to work with this family? (Select all that apply.)
A. Provide healthy snacks.
B. Place a nasogastric tube.
C. Assess fluid intake.
D. Discuss the importance of frequent, small meals.
E. Assess the caloric intake. C. Assess fluid intake.
D. Discuss the importance of frequent, small meals.
E. Assess the caloric intake.
The nurse is working with a group of new nurses and discussing the importance of maintaining
fluid balance in an infant with respiratory syncytial virus (RSV). Which statement demonstrates
an understanding of maintaining fluid balance in infants?
A. "We should encourage the parents to monitor sleeping."
B. "We should encourage the parents to add proteins into the diet."
C. "We should encourage the parents to force fluids."
D. "We should encourage the parents to count diapers." D. "We should encourage the
parents to count diapers."
The nurse is discussing with a parent the signs of dehydration to look for in a child with
respiratory syncytial virus (RSV). Which manifestation should the nurse include? (Select all that
apply.)
A. Bluish tint to skin
B. Poor skin elasticity
C. Decreased urinary output
D. Dry mucous membranes
