Download BKAT 9R EXAM -With 100% Verified Solutions- Latest Update and more Exams Nursing in PDF only on Docsity! BKAT 9R EXAM -With 100% Verified Solutions- Latest Update The following monitor would indicate that the pulmonary artery (Swan Ganz) catheter is in which position? 1. Superior vena cava 2. Right ventricle 3. Pulmonary artery 4. Pulmonary artery occlusion (wedge) Pulmonary artery occlusion (wedge) A systolic murmur that is auscultated at the 2nd intercostal space, right sternal border is called: 1. aortic insufficiency 2. aortic stenosis 3. pulmonary insufficiency 4. pulmonic stenosis aortic stenosis Which of the following wave patterns indicates proper functioning of an arterial line? High to low After an arterial catheter is removed, direct pressure should generally be applied to the artery: 1. For 2 full minutes 2. For 8-10 minutes 3. Until the oozing of blood from the puncture site slows 4. Until a pressure dressing is applied For 8-10 minutes A central venous pressure CVP reading directly reflects pressure in the: 1. Left atrium 2. Right atrium 3. Left ventricle 4. Pulmonary artery Right atrium An elevated CVP reading may indicate: 1. Right heart failure 2. A fall in blood pressure 3. Acute dehydration 4. Onset of left ventricle failure Right heart failure The pulmonary artery occlusive (wedge) pressure (PAOP) reflects pressure in the: 1. aorta 2. left ventricle 3. right atrium 4. vena cava left ventricle The normal pulmonary artery pressure is: 1. (10-20)/(0-4) mean 5-10 2. (21-30)/(5-15) mean 11-20 3. (31-35)/(16-20) mean 21-30 4. (36-45)/(21-23) mean 31-33 11-2 How many mm Hg is the normal PAOP 1. 1-3 2. 6-12 3. 15-20 4. 21-26 6-12 1. Isuprel 1.0 mg in 250 ml D5W drip 2. Epinephrine 1.0 mg IV push 3. Atropine 0.5 mg IV push 4. Amiodarone 150 mg IV over 10 mn Amiodarone 150 mg IV over 10 min The rhythm strip below is: Vfib The cardiac rhythm of atrial flutter is: 1. benign condition in most people 2. normal following AMI 3. hazardous, as the ventricular ate may suddenly increase 4. hazardous, as it may progress to second degree heart block Hazardous, as the ventricular rate may suddenly increase Upon recognizing ventricular fibrillation in an ICU, the next thing the nurse should do is: 1. perform a precordial thump 2. establish unresponsiveness 3. give amiodarone IV 4. check the ECG leads Establish unresponsiveness The treatment in an emergency situation for complete heart block is: 1. a trial of atropine 2. preparing for transcutaneous pacing 3. doing cardiac compressions 4. using digoxin Preparing for transcutaneous pacing Your patient has atrial flutter with a ventricular response of 150 beats per minute. Therapy for this rhythm includes: 1. Digoxin, a temporary pacemaker, potassium chloride 2. Lidocaine, sodium bicarb, cardioversion 3. Amiodarone, cardizem, cardioversion 4. Isordil, nitropaste, pronestyl Amiodarone, cardizem, cardioversion Signs of cardiac tamponade do not include which response below? 1. distended neck veins 2. pulsus paradoxus 3. decreased systolic pressure 4. bradycardia bradycardia In the patient with ventricular fibrillation, the correct energy setting for the first defibrillation when using a biphasic defibrillator is how many joules? 1. 240 2. 360 3. 150 4. 80 150 A patient becomes apneic and pulseless. The monitor shows asystole. The drug that would most likely be used initially is: 1. verapamil 2. atropine 3. epinephrine 4. amiodarone Epinephrine The antidote for heparin is: 1. Protamine sulfate 2. Narcan 3. Glucagone hydrochloride 4. vitamin K Protamine sulfate The most important step in preventing central venous catheter related sepsis is: 1. Use of a transparent membrane dressing 2. Scrubbing access ports with alcohol 3. using antibiotic ointment under the dressing 4. thorough hand washing Thorough hand washing An excessive amount of chest tube drainage in the first few hours following thoracic surgery is how many ml's per hour? 1. 150 2. 75 3. 50 4. 30 150 A routine check of your patient's blood gas values show a pH of 7.40, pO2 of 98 mm Hg, pCO2 of 38 mm Hg, and HCO3 of 25 mEq. These results reflect: 1. metabolic acidosis 2. metabolic alkalosis 3. normal values 4. respiratory compensation normal values A moderately burned trauma patient is admitted to your unit. The most important treatment related to the burns during the first 24 hours after injury is: 1. fluid replacement 2. accurate administration of antibiotics 3. pain relief measures 4. early wound cultures fluid replacement Your trauma patient, who is 4 days post fracture of the right femur, suddenly develops shortness of breath. The most likely cause is: 1. Fat embolus 2. Pneumonia 3. Pleural effusion 4. Pulmonary edema Fat embolism To help prevent ventilator acquired pneumonia (VAP), the most important nursing action would be to: 1. keeping FIO2 at 60% 2. changing the ventilator tubing qshift 3. careful hand-washing and use of gloves when suctioning 4. treat low peak-inspiratory pressures Careful hand-washing and use of gloves when suctioning The most important nursing activity for a patient admitted with the diagnosis of cervical spinal cord injury is: 1. keeping the patient flat 2. immobilizing the head 3. noting change in feeling extremities 4. doing hourly neuro checks Immobilizing the head In a patient with cervical spine injury, the most important observations the nurse makes concerns which of the following physiological parameters? 1. heart rate 2. respirations 3. urinary output 4. pupillary response to light respirations The earliest sign of increased intracranial pressure generally involves changes in: 1. response to pain 2. level of consciousness 3. equality of pupillary reactions 4. respiratory rate level of consciousness 53. Deepening intracranial pressure is characterized by: 1. tachycardia 2. pinpoint pupils 3. widened pulse pressure 4. increasing respirations Widened pulse pressure The drug of choice used to reduce increased intracranial pressure is: 1. the calcium channel blocker 2. phenobarbital 3. Mannitol 4. Furosemide (Lasix) Mannitol A positive Babinski response in an adult: 1. Indicates depressed reflexes 2. Is an expected finding 3. Is plantar flexion (curling under) of the toes 4. Indicates an abnormal finding Indicates an abnormal finding The nursing care of patient during the acute phase of a stroke does not include which response below? 1. Providing a quiet environment for the patient and family 2. Control of airway breathing and secretions 3. Initiating t-PA, if within first 8 hours post stroke 4. Alertness to any bleeding that might occur Initiating t-PA, if within first 8 hours post stroke The most important part of a neuro check is: 1. Testing strength of grip 2. Assessing pupillary response to light 3. Evaluating the level of consciousness 4. Comparing any change in speech patterns Evaluating the level of consciousness 4. sudden rise in blood pressure vasodilation and hypotension Mrs.Smith, who is post-operative craniotomy patient has a fasting blood sugar of 100mg, complains of extreme thirst, and has a urine greater than 1,000 ml's over two hours. You should suspect: 1. Increasing intracranial pressure 2. Overproduction of ADH 3. Acute adrenal insufficiency 4. Diabetes insipidus Diabetes Insipidus Mrs. Reece, a 64 yo woman with acute renal failure and oliguria, was admitted with congestive heart failure. Which of the following tests is abnormal? 1. BUN of 18 mg/dl 2. Urine specific gravity of 1.026 3. Creatinine of 1.0 mg/dl 4. Potassium of 5.8 mEq/L Potassium 5.8 mEq/L A patient is admitted with a probable diagnosis of acute renal failure. The normal ml's of urine output for this 150 pound person per hour is: 1. 75 2. 100 3. 30 4. 10 30 Practices to decrease catheter associated urinary tract infections does not include which response below? 1. Having a protocol for limiting urinary catheter use 2. Use of a reminder system for removal of urinary catheters 3. Discontinuing enteral tube feeding if diarrhea occurs 4. Providing perineal care during each nursing shift Discontinuing enteral tube feeding if diarrhea occurs Your patient has acute renal failure. Medications that are normally excreted through the kidneys will probably be: 1. Decreased in dosage 2. Administered as usual 3. Discontinued 4. Increased in frequency Decrease dosage Enteral feeding in acute renal failure commonly includes: 1. High protein, low potassium, low sodium 2. Restricted protein, high potassium, low sodium 3. No protein, high potassium, high sodium 4. Restricted protein, low potassium, low sodium Restricted protein, low potassium, low sodium Sudden development of dyspnea and sinus tachycardia in an acute renal failure patient would most likely indicate which of the following? 1. Hyperkalemia 2. Pulmonary embolism 3. Fluid overload 4. Infection Fluid overload ECG changes commonly seen in hyperkalemia are: 1. narrow QRS, inverted T wave 2. narrow QRS, high P wave 3. wide QRS, inverted T wave 4. wide QRS, tall peaked T wave Wide QRS, tall peaked T wave When feeding a patient using continuous tube feedings, the most important intervention in preventing aspiration is to: 1. Keep the head of the bed elevated 2. Aspirate stomach contents Q4-6h for residual 3. check the position of the tube feeding each shift 4. turn the patient frequently keep the head of the bed elevated Low intermittent suction of gastric contents is not generally used in which response below? 1. to decompress abdominal distention 2. to prevent aspiration 3. when bowel sounds are absent 4. to control bleeding To control bleeding The safe placement of a nasogastric tube in an unconscious patient can be best assessed by: 1. instilling 30ml of normal saline through the tube 2. aspirating gastric content Mr. Clark was admitted to the ICU with burns to his back, legs, and feet following an explosion at his job. He tells you that his wife was health care power of attorney for him. The document gives Mr. Clark's wife the right/responsibility to: 1. make decisions regarding his care in the ICU 2. Decide if Mr. Clark is acting normally 3. sign the informed consent for any skin grafting 4. decide on her husband's care, if he loses consciousness Decide on her husband's care, if he loses consciousness Examples of spiritual care for a seriously ill, conscious patient does not generally include which response below? 1. staying with or being with the patient 2. listening to the patient's concerns 3. telling the patient that everything is going to be all right 4. calling for a clergyman to visit the patient Telling the patient that everything is going to be alright Initial measure for the treatment of angina pectoris does not include which response below? 1. resting 2. beta blockers 3. oxygen 4. nitroglycerine beta blockers The classical ECG change with muscle injury in acute myocardial infarction is: 1. presence of a Q wave 2. ST segment elevation 3. myocardial electrical irritability 4. a peaked T wave ST segment elevation Elevated cardiac iso-enzyme generally does not occur in which response below? 1. Closed chest injury 2. pericarditis 3. congestive heart failure 4. cardiac surgery Congestive heart failure The major therapeutic goal in the treatment of cardiogenic shock is to: 1. Increase the afterload 2. Improve renal perfusion 3. Increase cardiac output 4. Decrease fluid volume Increase cardiac output You receive orders to starte Nipride and Dobutamine in your patient with end-stage cardiomyopathy. How will this treatment regimen affect cardiac output? 1. Increase preload and reduces afterload 2. Reduces preload and increases afterload 3. Reduces preload and afterload and improves contractility 4. Reduces preload and improves contractility Reduces preload and afterload and improves contractility In dealing with a depressed patient during the first days post AMI the most appropriate nursing action would be: 1. Encourage to patient to ventilate his/her concerns 2. Provide for privacy so the patient can rest 3. Limit visits only to family members 4. Provide a quiet environment for the patient Encourage the patient to ventilate his/her concerns Mr. Seamore is receiving thrombolytics (TPA) 3 hours after an AMI. Which of the following would most likely require discontinuing the infusion? 1. PVCs 2. Bleeding gums 3. Oozing at the insertion site 4. Change in mental status Change in mental status