STAFF NURSE EXAM TOUGH QUESTIONS

1. Mr. Sing has a massive GI bleed from a gastric ulcer. Following 12 units of packed cells and 4 units of
fresh frozen plasma, he has the following labs: Hb 80 Platelets 82,000 INR 1.9 aPTT 58 and fibrinogen 0.4 g/L (normal 2-4 g/L). Which one of the following interventions is the priority?
a. Potassium bolus
b. Octoplex
c. Cryoprecipitate
d. Protamine sulphate

2. Ms. Tirani is on FiO2 0.5 PEEP 5 and PS 15. She has a total minute volume of 12 L and her RR has
increased to 36 from 22. She is restless and agitated. Blood gases are:
PaO2 69
PCO2 49
pH 7.36
HCO3 30

Which one of the following interventions is most appropriate?
a. Increase her FiO2
b. Convert to AC
c. Increase her Pressure Support
d. Increase her sedation

3.. Calculate Cerebral Perfusion Pressure (CPP) based on the following data:
HR 75
BP 120/80 (MAP 65)
CVP 12
ICP 15
RR 25
Minute Volume 10.5 L/min

 a. 60
 b. 50
c. 105
d. 52
4. Mrs. Butovsky develops sepsis due to an infected prosthetic hip joint. She is started on antibiotic
therapy. Which lab test can be used to evaluate her response to antibiotic therapy?
a. Eosinophil Sedemenation Rate (ESR)
b. Protein C levels

ICU NURSE QUESTIONS

CASE 1
Mr. Jackle, 68 yrs old, is admitted with hypotension and respiratory distress requiring intubation following a large ST elevation anterior-lateral wall myocardial infarction.

1. Shortly after insertion of a rights subclavian catheter, he develops worsening shortness of breath and
bibasilar crackles. Blood is noted to be backing up from the central venous catheter and his oxygen
saturation decreases with supine positioning. Which one of the following problems is consistent with
these findings?
a. Pulmonary embolus
b. Right heart failure
c. Cardiac pulmonary edema
d. Hemopneumothorax

2. Mr. Jackle’s will be monitored for signs of reinfarction. Which one of the following lab tests would best
indicate reinfarction?
a. Creatinine kinase
b. Cardiac troponin
c. Lactate dehydrogenase
d. Venous oxygen saturation

3. Mr. Jackle develops cardiogenic shock, respiratory failure and acute kidney injury. He is receiving
epinephrine at 2 ug/min and is fully ventilated on an FiO2 .6 with PEEP 10. His SpO2 is 95%, HR 93
(sinus rhythm), BP 110/72 (MAP 66), CVP 14 mmHg, Hb 82 and central venous oxygen saturation
(ScvO2) 42%. Which one of the following interventions is most appropriate?
a. Metoprolol
b. Captopril
c. Increased FiO2
d. Packed cells

4. Mr. Jackle has a right chest tube inserted for a large pneumothorax. Immediately following insertion, the nurse notes that there is no fluctuation or bubbling in the underwater seal. Which one of the following interventions is the priority?
a. Increase the level of suction
b. Increase the volume in the water seal