Exam 5 Medsurge II

1. What is the nursing priority in hypovolemic shock? A. Fluid Resuscitation (PNS, PLR, 5% Albumin, Blood Plasma) B. Administer inotropes (Vasoactive medication) C. Provide glucose IV or IM glucagon D. Position the patient upright and administer epinephrine Correct Answer: A. 2. What is the nursing priority in cardiogenic shock? A. Administer broad-spectrum antibiotics B. Administer inotropes (Vasoactive medication) C. Provide glucose IV or IM glucagon D. Give epinephrine IM Correct Answer: B. Administer inotropes (Vasoactive medication) 3. What is the nursing priority in neurogenic shock? A. Provide glucose IV or IM glucagon B. Administer broad-spectrum antibiotics C. Give epinephrine IM D. Start isotonic IV fluids Correct Answer: A. Provide glucose IV or IM glucagon 4. What is the nursing priority in anaphylactic shock? A. Position upright and administer epinephrine IM B. Start isotonic IV fluids C. Provide glucose IV or IM glucagon D. Administer inotropes (Vasoactive medication) Correct Answer: A. Position upright and administer epinephrine IM 5. What is the nursing priority in septic shock? A. Administer broad-spectrum antibiotics B. Start isotonic IV fluids C. Provide glucose IV or IM glucagon D. Give epinephrine IM Correct Answer: A. Administer broad-spectrum antibiotics 6. What is the main problem in hypovolemic shock? A. Pump failure leading to decreased cardiac output B. Low blood Volume C. Hypotension and vasodilation D. Blood vessel damage Correct Answer: B. Low blood Volume 7. What is the main problem in cardiogenic shock? A. Pump failure leading to decreased cardiac output B. Severe fluid loss like dehydration C. Hypotension and vasodilation D. Blood vessel damage Correct Answer: A. Pump failure leading to decreased cardiac output 8. Main Problem in Distributive Shock? Loss of Vasomotor tone/symphatetic 9. What is the treatment of choice for anaphylactic shock? A. Isotonic IV fluids B. Epinephrine IM C. Glucagon IM D. Broad-spectrum antibiotics Correct Answer: B. Epinephrine IM 10. What is the IV fluid of choice for hypovolemia? A. Hypotonic solution B. Isotonic solution (Albumin 5%) C. Hypertonic solution D. Glucose IV Correct Answer: B. Isotonic solution (Albumin 5%) 11. Potential Complication of Meningococcemia? Answer: Kernig’s sign 12. What is the Renin-Angiotensin-Aldosterone System? Answer: Regulates blood pressure and fluid balance through vasoconstriction and sodium retention. 13. What is the primary difference between ARDS and cardiogenic pulmonary edema? A) ARDS is caused by fluid overload, while pulmonary edema is due to sepsis B) ARDS is non-cardiogenic Acute respiratory distress syndrome, while pulmonary edema is cardiogenic C) ARDS leads to bradycardia, while pulmonary edema causes tachycardia D) Pulmonary edema occurs from hypovolemia, while ARDS is from infection Answer: B) 14. What is the preferred drug for pulmonary edema? A. Furosemide (Lasix) B. Epinephrine C. Glucagon D. Broad-spectrum antibiotics Correct Answer: A. Furosemide (Lasix) 15. What is the immediate intervention for Dehiscence/Evisceration? A. Position flat with knees flexed B. Position upright C. Apply warm compress D. Administer broad-spectrum antibiotics Correct Answer: A. Position flat with knees flexed 16. What is the immediate intervention for increased ICP? A. Position Low Fowler's, administer mannitol, maintain airway B. Position upright and provide oxygen C. Give glucose IV D. Start IV fluids Correct Answer: A. Position Low Fowler's, administer mannitol, maintain airway 17. What is an early sign of increased ICP? A. Altered level of consciousness B. Bradycardia C. Hypertension D. Seizures Correct Answer: A. Altered level of consciousness 18. What is Cushing's Triad (SATA)? A. Hypertension (widened pulse pressure), bradycardia, bradypnea B. Tachycardia, hypotension, tachypnea C. Hyperthermia, hypertension, bradycardia D. Bradypnea, hypertension, tachycardia Correct Answer: A. Hypertension (widened pulse pressure), bradycardia, bradypnea 19. What is Virchow's Triad (SATA)? A. Blood stasis, hypercoagulability, damaged blood vessels B. Hypotension, tachycardia, hypoxia C. Hypertension, fluid overload, vessel constriction D. Hypercoagulability, decreased platelet count, increased WBCs Correct Answer: A. Blood stasis, hypercoagulability, damaged blood vessels 20. What is the primary use of Syrup of Ipecac? A) To neutralize stomach acid in cases of gastritis B) To induce vomiting in cases of certain poisonings C) To relieve nausea and vomiting in motion sickness D) To prevent dehydration in patients with diarrhea Answer: B) To induce vomiting in cases of certain poisonings 21. What is the purpose of an Intra-Aortic Balloon Pump (IABP)? A. It inflate during diastole to increase coronary artery perfusion and deflates during systole to reduce afterload, improving cardiac output. (Diastole Inflates, Systole Deflates) B. Induces hypertension to stabilize blood flow C. Reduces myocardial oxygen demand by lowering BP D. Provides mechanical ventilation support Correct Answer: A. 22. What are the triad of symptoms of shock? A. Hypotension, tachycardia, altered mental status B. Bradycardia, hypertension, altered breathing C. Seizures, fever, hypotension D. Hypoxia, bradycardia, cyanosis Correct Answer: A. Hypotension, tachycardia, altered mental status 23. What does a RED tag indicate in triage? A. Immediate treatment priority (e.g., airway obstruction, severe bleeding) B. Delayed treatment (serious but not life-threatening injuries) C. Minor injuries (walking wounded) D. Minimal chance of survival, no pulse, unresponsive Correct Answer: A. Immediate treatment priority (e.g., airway obstruction, severe bleeding) 24.What does a Yellow Tag indicate in a triage situation? A) The patient has minor injuries and can walk. B) The patient has life-threatening injuries and requires immediate treatment. C) The patient has serious but non-life-threatening injuries and treatment can be delayed. D) The patient is unlikely to survive and will receive comfort care. Answer: C) The patient has serious but non-life-threatening injuries and treatment can be delayed. 25. What does a Green Tag indicate in a triage situation? A) The patient has minor injuries and can walk. B) The patient has severe injuries and requires immediate intervention. C) The patient is unconscious with no pulse or response. D) The patient has internal bleeding and requires surgery. Answer: A) The patient has minor injuries and can walk. 26. What does a black tag indicate in triage? A. Immediate treatment priority B. Delayed treatment C. Minimal chance of survival, no pulse, unresponsive D. Minor injuries Correct Answer: C. Minimal chance of survival, no pulse, unresponsive 27. What is the primary pathophysiological difference between nephrotic and nephritic syndrome? A) Nephrotic syndrome is due to immune complex deposition, while nephritic syndrome is caused by podocyte damage. B) Nephrotic syndrome results from glomerular capillary permeability, massive protein loss or autoimmune disease Nephritic syndrome involves inflammation and damage to the glomerulus (Group A beta-Hemolytic Streptococus) Hematuria C) Nephrotic syndrome leads to acute kidney injury, while nephritic syndrome causes chronic kidney failure. D) Nephrotic syndrome is always caused by infections, while nephritic syndrome is autoimmune. Answer: B) Nephrotic syndrome results from glomerular capillary permeability, massive protein loss or autoimmune disease Nephritic syndrome involves inflammation and damage to the glomerulus (Group A beta-Hemolytic Streptococus) Hematuria 28. What are symptoms of the oliguric phase in renal failure (SATA)? A. Low urine output, hyponatremia, hypocalcemia, hyperkalemia B. High urine output, hypernatremia, hypocalcemia C. Tachycardia, hyperkalemia, hypercalcemia D. Hypernatremia, dehydration, increased urine output Correct Answer: A. Low urine output, hyponatremia, hypocalcemia, hyperkalemia 29.Symptoms of Diuretic Phase in Renal Failure (SATA)? Hyponatremia Hypokalemia Hypercalcemia Tachycardia, Thready pulse, weight loss, dehydration, 30. How do we measure the stages of CKD? A. Blood urea nitrogen (BUN) levels B. Measured using Glomerular Filtration Rate (GFR) C. Creatinine clearance test only D. Urine output per day Correct Answer: B. Measured using Glomerular Filtration Rate (GFR) 31. What is the principle of hemodialysis? A. Removes waste, excess fluid, and electrolytes via a semipermeable membrane B. Uses peritoneum as a filter for waste removal C. Increases urine output to remove toxins D. Inhibits sodium reabsorption in the kidneys Correct Answer: A. Removes waste, excess fluid, and electrolytes via a semipermeable membrane 32. What should you do in disequilibrium syndrome? A. Slow and stop dialysis, give small Mannitol B. Increase dialysis rate C. Administer sodium bicarbonate D. Give high-dose diuretics Correct Answer: A. Slow and stop dialysis, give small Mannitol 33. What should you do if a suspected air embolism occurs? A. Place patient in Trendelenburg on the left side B. Position the patient in supine position C. Provide oxygen and lay patient flat D. Administer epinephrine IM Correct Answer: A. Place patient in Trendelenburg on the left side 34. What is the principle of peritoneal dialysis? A. Tencoff Catheter and 2 Lumens B. Removes waste via a semipermeable membrane C. Requires an arteriovenous fistula for access D. Filters blood outside the body using a dialysis machine Correct Answer: A. Tencoff Catheter and 2 Lumens 35. What are normal signs of peritoneal fluid? A. Clear, blurry, and foggy B. Dark brown or red C. Cloudy with sediment D. Greenish discharge Correct Answer: A. Clear, blurry, and foggy 36. What are signs and symptoms of peritonitis? A. Urine color is cloudy B. Urine is bright yellow C. No changes in urine color D. High sodium content in urine Correct Answer: A. Urine color is cloudy 37. What is the nursing care for AV shunt/fistula? A. Auscultate bruit and palpate for thrill B. Apply pressure to stop bleeding C. Avoid checking pulses near fistula D. Elevate the arm above heart level at all times Correct Answer: A. Auscultate bruit and palpate for thrill 38. What is epoetin (Epogen) used for? A. Stimulates RBC production in CKD patients B. Lowers blood pressure in patients with hypertension C. Increases sodium retention D. Prevents protein loss in urine Correct Answer: A. Stimulates RBC production in CKD patients 39. What are contraindications for activated charcoal? A. Patients with bowel obstruction B. Patients with food poisoning C. Patients with fluid overload D. Patients with metabolic alkalosis Correct Answer: A. Patients with bowel obstruction 40. What is interventions should be performed before and after dialysis? A) Encourage increased fluid intake B) Monitor blood pressure and check weight C) Administer a high-protein meal D) Perform deep suctioning to prevent aspiration Answer: B) Monitor blood pressure and check weight 41. What are early signs and symptom of BPH (benign prostatic hyperplasia)? A. Nocturia, urinary frequency, dribbling B. Acute urinary retention and hematuria C. Severe pain and fever D. Complete anuria Correct Answer: A. Nocturia, urinary frequency, dribbling 43. What is finasteride used for? A. Decreases dihydrotestosterone (DHT) levels B. Increases urine output C. Inhibits sodium reabsorption D. Treats hyperkalemia Correct Answer: A. Decreases dihydrotestosterone (DHT) levels 44. What is tamsulosin used for? A. Relaxing muscle in prostate to improve or Increases urine flow B. Decreases urine production C. Treats kidney stones D. Increases blood pressure Correct Answer: A 45. What is the purpose of a TURP (Transurethral Resection of the Prostate)? A. Removes excess a portion of prostate tissue B. Completely removes the prostate C. Increases testosterone production D. Inhibits bladder contractions Correct Answer: A. 46. Cystoclysis or continuous bladder irrigation – Principle behind it 47. What should you do if clots are suspected in Continuous Bladder Irrigation (CBI)? A. Increase fluid, Manually irrigate with sterile saline B. Stop irrigation C. Administer heparin D. Increase urine acidity Correct Answer: A. Increase fluid, Manually irrigate with sterile saline 48. What to do with Cystoclysis if we suspect bleeding? Increase the flow to max until urine is clear 48. What is PSA (Prostate-Specific Antigen)? A. prostate Specific Antigen Test B. Indicator of kidney disease C. Used to diagnose diabetes D. Measures testosterone levels Correct Answer: A. prostate Specific Antigen Test What is DRE ? Digital Rectal Exam 49. What is a complication of CPAP/Positive Airway Pressure? A. Low cardiac output and Low BP B. Hypertension C. Hyperkalemia D. Increased urine production Correct Answer: A. Low cardiac output and Low BP 50 What tasks can be delegated to a PCA? A. Hygiene, feeding, vital signs, I&O monitoring B. Administering medications C. Changing sterile dressings D. Conducting patient assessments Correct Answer: A. Hygiene, feeding, vital signs, I&O monitoring 51. Which patient should be discharged first? A. Stable patient with a resolved issue B. Patient in respiratory distress C. Postoperative patient with fever D. Patient experiencing chest pain Correct Answer: A. Stable patient with a resolved issue 52. What is the best position for autonomic dysreflexia? A. Upright Fowler's position B. Supine position C. Trendelenburg position D. Prone position Correct Answer: A. Upright Fowler's position 54. What is the best position for a patient experiencing Autonomic Dysreflexia? A. Supine B. Trendelenburg C. Upright Fowlers D. Prone Correct Answer : C 55. Which task can be safely delegated to a PCA? A. Administering IV medications B. Performing hygiene care, Vital Sign, and feeding C. Conducting patient assessments D. Providing wound care Correct Answer: B 56. Which patient should be discharged first? A. Stable A patient with resolved issues and tolerating oral intake B. A patient requiring continuous IV medications C. A post-op patient with a fever D. A patient with unstable vitals Correct Answer: A