CCRN Questions with 100% Correct Answers

CCRN Questions with 100% Correct Answers A patient has had a large anterior myocardial infarction last month and developed a ventricular aneurysm. He now has episodes of ventricular tachycardia that are not prevented or converted with antidysrhythmic agents. An implantable cardioverter- defibrillator (ICD) is implanted. Four days after surgery he develops ventricular tachycardia. The ICD has delivered three shocks but has not converted the rhythm. He is pulseless and apneic. Cardiopulmonary resuscitation is in progress. What is the priority action now? A. Administer epinephrine IV. B. Administer amiodarone. C. Defibrillate. D. Reset the ICD. - Answer- Defibrillate A 28-year-old woman is admitted to the critical care unit from the emergency department with a diagnosis of asthma. Her initial arterial blood gases on a 28% Venturi mask are as follows: pH 7.48 PaCO2 30 mm Hg HCO3 24 mEq/L PaO2 64 mm Hg Which of the following repeat arterial blood gases on 40% oxygen indicate that the patient's condition is worsening? A. pH 7.48, PaCO2 30 mm Hg, PaO2 68 mm Hg B. pH 7.46, PaCO2 32 mm Hg, PaO2 61 mm Hg C. pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg D. pH 7.39, PaCO2 30 mm Hg, PaO2 60 mm Hg - Answer- C. pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg The case study shows stage II asthma. Option c shows stage III asthma. The patient is still breathing at a fast rate, but carbon dioxide is starting to be retained as evidenced by the increase of the PaCO2 into normal range. Options a and b are still stage II. Option d shows a respiratory alkalosis with a metabolic acidosis because you would have expected the pH to be in an alkalotic range with the PaCO2 of 30. A patient experiencing alcohol withdrawal syndrome describes the swirls in the wallpaper as being worms. This is an example of which of the following? A. Delusion B. Hallucination C. Illusion D. Visual impairment - Answer- C. Illusion An illusion is a misperception or misinterpretation of an actual external stimulus. Illusions and hallucinations (a perception that has no actual external stimulus) are common during alcohol withdrawal syndrome. A patient arrives in the emergency department with multiple gunshot wounds. He requires massive transfusion for blood loss from chest and abdominal wounds. The electrocardiogram should be observed closely for changes indicative of which of the following? A. Atrioventricular block B. Hyperkalemia C. Hypercalcemia D. Hypomagnesemia - Answer- Hyperkalemia Banked blood is high in potassium because of hemolysis. Look for tall, peaked T waves and widening of the QRS complex. Other considerations with massive transfusion of banked blood are hypocalcemia, hypothermia, and decreased tissue oxygen delivery caused by decreased levels of 2,3-diphosphoglycerate