Question #1. Mr. Veldman is admitted with decreased level of consciousness. His admission labs are: Blood glucose 56 mmol/L, Na 149 K 4.8 Cl 105 HCO3 22, ABGs PaO2 72 PCO2 45 pH 7.39 HCO3 23.
Which one of the problems is indicated by these findings?
a. Diabetic ketoacidosis
b. Glucagon overdose
c. Non-ketotic hyperosmolar coma
d. Adrenal crisis
Question #2. Ms. Saundarya is admitted with coma. She has a BP of 158/75 HR 52 (sinus) and requires intubation for level of consciousness and pulmonary edema. Her temperature is 34 (oral). Which of the following lab tests is the priority?
a. TSH, T3, T4
b. Serum and urine osmolalities
c. Cosyntropinin stimulation test
d. Serum renin and angiotensin levels
Question #3. Mrs. Sunitha has been on steroids for the past 6 years to treat severe rheumatoid arthritis. Which one of the following problems would you anticipate?
a. Hypercalcemia
b. Hyperkalemia
c. Hyperlipidemia
d. Hypoglycemia
Question #4 . Which one of the following factors increases the risk for central line infection?
a. Subclavian venous access
b. Chorhexidine skin prep
c. Tunneled catheters
d. TPN
Question #5. Ms. Stelina, 80 kg, drops her platelet count by >50% 10 days after starting subcutaneous heparin. She develops a swollen right calf and positive Homan’s sign. Which one of the following interventions
would you anticipate?
a. Change anticoagulant to dalteparin 15,000 units SC daily
b. Administer protamine sulphate and discontinue heparin
c. Initiate anticoagulation with fondaparinux
d. Stop all anticoagulation and initiate pneumatic compression stockings
Question #6 . Ms. Geetba is recovery from a prolonged critical illness. She is having tracheostomy-mask trials each day. She is withdrawn and sad, and tells the nurse she no longer has any control of her life. Which
one of the following interventions would best meet her needs?
a. Initiate antidepressant therapy
b. Administer sedation at bedtime
c. Develop a collaborative plan of care
d. Refer Mrs. Tam to a psychiatrist
Question # 7. Mrs. Asha George is admitted with cardiogenic shock following a myocardial infarction. She has the following findings:
HR 68 BP 80/55 CVP 24 SpO2 88%
Which one of the following interventions is the priority?
a. Levophed
b. Epinephrine
c. Lasix
d. Metoprolol
Question # 8. Identify the formula for minute volume.
a. Tidal volume X respiratory rate
b. Functional residual capacity – tidal volume
c. Forced vital capacity X respiratory rate
d. Cardiac Output X respiratory rate
b. Monitor for adequacy of exhalation
c. Introduce the PMV as soon as the tracheostomy is performed
d. Suction prn by passing the catheter through the centre of the PMV
Question #10. Mrs. Prabhavathi has advanced cancer. She has been extubated for two days, with orders for no reintubation. She develops increasing dyspnea. Which one of the following agents would best manage these symptoms?
a. Propofol (Diprovan)
b. Fentanyl
c. Midazolam (Versed)
d. Gabapentin
Which one of the problems is indicated by these findings?
a. Diabetic ketoacidosis
b. Glucagon overdose
c. Non-ketotic hyperosmolar coma
d. Adrenal crisis
Question #2. Ms. Saundarya is admitted with coma. She has a BP of 158/75 HR 52 (sinus) and requires intubation for level of consciousness and pulmonary edema. Her temperature is 34 (oral). Which of the following lab tests is the priority?
a. TSH, T3, T4
b. Serum and urine osmolalities
c. Cosyntropinin stimulation test
d. Serum renin and angiotensin levels
Question #3. Mrs. Sunitha has been on steroids for the past 6 years to treat severe rheumatoid arthritis. Which one of the following problems would you anticipate?
a. Hypercalcemia
b. Hyperkalemia
c. Hyperlipidemia
d. Hypoglycemia
Question #4 . Which one of the following factors increases the risk for central line infection?
a. Subclavian venous access
b. Chorhexidine skin prep
c. Tunneled catheters
d. TPN
Question #5. Ms. Stelina, 80 kg, drops her platelet count by >50% 10 days after starting subcutaneous heparin. She develops a swollen right calf and positive Homan’s sign. Which one of the following interventions
would you anticipate?
a. Change anticoagulant to dalteparin 15,000 units SC daily
b. Administer protamine sulphate and discontinue heparin
c. Initiate anticoagulation with fondaparinux
d. Stop all anticoagulation and initiate pneumatic compression stockings
Question #6 . Ms. Geetba is recovery from a prolonged critical illness. She is having tracheostomy-mask trials each day. She is withdrawn and sad, and tells the nurse she no longer has any control of her life. Which
one of the following interventions would best meet her needs?
a. Initiate antidepressant therapy
b. Administer sedation at bedtime
c. Develop a collaborative plan of care
d. Refer Mrs. Tam to a psychiatrist
Question # 7. Mrs. Asha George is admitted with cardiogenic shock following a myocardial infarction. She has the following findings:
HR 68 BP 80/55 CVP 24 SpO2 88%
Which one of the following interventions is the priority?
a. Levophed
b. Epinephrine
c. Lasix
d. Metoprolol
Question # 8. Identify the formula for minute volume.
a. Tidal volume X respiratory rate
b. Functional residual capacity – tidal volume
c. Forced vital capacity X respiratory rate
d. Cardiac Output X respiratory rate
Question # 9. When using a Passy-Muir Valve (PMV), which one of the following interventions is appropriate?
a. Ensure the cuff is always inflatedb. Monitor for adequacy of exhalation
c. Introduce the PMV as soon as the tracheostomy is performed
d. Suction prn by passing the catheter through the centre of the PMV
Question #10. Mrs. Prabhavathi has advanced cancer. She has been extubated for two days, with orders for no reintubation. She develops increasing dyspnea. Which one of the following agents would best manage these symptoms?
a. Propofol (Diprovan)
b. Fentanyl
c. Midazolam (Versed)
d. Gabapentin
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