CCRN Review Exam: 136 Questions with Correct Answers, Exams of Nursing

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CCRN Review Exam 136 Questions from Class with

Correct Answers.

Which of the following types of shock is incorrectly matched with its causes? Distributive: Anaphylactic Cardiogenic: Dysrhythmia Obstructive: Adrenal Insufficiency Hemorrhage: Plasma loss - Correct Answer C A patient having which condition is at higher risk for developing infective endocarditis? Cystic Fibrosis Hydrocephalus Patent ductus arteriosus Bronchopulmonary dysplasia - Correct Answer C Which hemodynamic pressures would be increased in mitral stenosis? Right atrial and central venous pressure Left atrial and pulmonary capillary wedge Left atrial and left ventricular Systemic arterial and pulmonary capillary wedge - Correct Answer B Cindy is diagnosed with Kawasaki's disease. While reviewing her clinical exam, the nurse should note which of the following characteristics of this disease? Fever > 5 days, unresponsive to antibiotics Fever > 5 days, unresponsive to antibiotics, rash, oral mucosal changes Bilateral conjunctivitis Cervical lymphadenopathy - Correct Answer B A child is admitted after sustaining a head injury. The most important aspect of the nurse's continuing neurological assessment is: Level of consciousness

Pupillary response Motor response Assessment of the cranial nerves - Correct Answer A For the patient in renal failure, potential metabolic derangements include all of the following except: Metabolic acidosis Hyperkalemia Hypocalcemia Metabolic alkalosis - Correct Answer D Betsy, age 13 is diagnosed as having a pheochromocytoma. Appropriate initial nursing care would include: Administration of large doses of xylometazoline to help control disease symptoms Close monitoring of Betsy's vital signs, especially blood pressure Preparing Betsy and her parents for imminent death Have the parents discuss the condition with the doctor before informing Betsy of the disease because of the protracted recovery period after treatment. - Correct Answer B An 11 year old patient admitted to the PICU in respiratory distress. Patient is sinus tachycardia at 150 BPM with a BP of 89/50 and RR at 48. Patient is diaphoretic and is unable to speak. Patient's parents are screaming in the background "help my child"! Chest X-ray has not been developed but there are no audible breath sounds on the left chest after auscultation. ABG reads: pH: 7.3, PaCo2: 75, PaO2: 50, HCO3: 26 This ABG reflects: Respiratory acidosis with metabolic compensation Respiratory acidosis with severe hypoxemia Combined respiratory and metabolic acidosis Respiratory alkalosis with severe hypoxemia - Correct Answer B Beyonce is a 15 year old female with nausea and vomiting times 24 hours. She is lethargic, with slow deep respirations and her lab values are K: 6.2, Bicarb 14, Glu: 455, Based on these findings the RN should anticipate the following treatments. D50 IV insulin, kayexalate

Normal saline infusion, SQ insulin Normal saline infusion, IV insulin Dextrose infusion, IV insulin - Correct Answer C Jason has had nausea and vomiting for several days prior to admission. He is diagnosed with acute tubular necrosis. Which of the following lab abnormalities would the critical care nurse expect? Hyperkalemia, acidosis, azotemia Hypocalcemia, alkalosis, anemia Hypercalcemia, hypertension, acidosis Hypokalemia, hypotension, alkalosis - Correct Answer A Primary pharmacological management of a septic patient would include: Vasodilators Analgesics Activated Protein C Antibiotics - Correct Answer D Early symptoms of fluid overload and pulmonary edema are: Rales hypoxia S3 heart sound and tachycardia Increased respiratory rate and subjective dyspnea Shortness of breath only - Correct Answer C Which of the following is NOT a contraindication to ECMO Grade 3 IVH Irreversible disease process Septic shock LRefusal to receive blood products - Correct Answer C Which of the following drugs can NOT be administered via the ETT? Lidocaine

Epi Vasopressin Amiodarone - Correct Answer D What level of EtCO2 general indicates inadequate compressions during CPR? < 5 mmHg <10 mmHg <20 mmHg <30 mmHg - Correct Answer B Which of the following electrolyte abnormalities is most associated with increased mortality in the setting of digoxin ingestion? Hyperkalemia Hypokalemia Hypermagnesemia Hypomagnesemia - Correct Answer A Simulation of the symptomatic nervous system has which effect on the cardiovascular system? a) Decreases stroke volume and increases blood pressure b_ increases stroke volumee and decreases blood pressure c) slows conduction throug the av node d) increases stroke volume and heart rate - Correct Answer D (the sns simulates a fight or flight reaction ARDS is best desribed as: A) Hypoxemia, congestive heart failure, bilateral diffuse infiltrates B) Hypoxemia, elevated wedge pressure in the absence of cardiac disease and bilateral diffuse infiltrates C) Hypoxemia, hyperinflation, bilater diffuse infiltrates D) Hypoxemia, normal pulmonary wedge pressures and bilateral diffuse infiltrates - Correct Answer D

Which of the following are not considered to be potential complication of the management of pediatric ARDS? A) Barotrauma, oxygen toxicity, secondary infections and siadh B) diminished cardiac output, air leaks, acute lung injury and pneumothorax C) Diminished cardiac output, tracheal ulceration and DI D) Oxygen toxicity, MOSF, pressure ulcers, pna - Correct Answer C The patient with acute respiratory distress syndrome would exhibit which of the following symptoms? A) Decreasing PaO2 levels despite increased FiO2 administration B) Elevated alveolar surfactant levels C) Increased lung compliance with increased fiO2 administration D) Respiratory acidosis associated with hyperventilation - Correct Answer A Intrapulmonary shunting refers to: A) Alveoli that are not perfused B) Blood that is shunted ferom the left side of the heart to the right and causes heart failure C) Blood that is shunted from the right side of the heart to the left without oxygenation D) Shunting of blood supply to only one lung - Correct Answer C When fluid is present in the alveoli A) Alveoli collapse and atelectasis occurs B) Diffusion of oxygen and carbon dioxide is impaired C) Hypoventilation occurs D) The patient is in heart failure - Correct Answer B Which of the following assessments indicates an early sign of hypoxemia? A) Clubbing of nail beds B) Cyanosis C) Hypoension

D) Restlessness - Correct Answer D The basic underlying pathophysiology of acute respiratory distress syndrome results from: A) A decrease in the number of WBCs available B) Damage to the right mainstem bronchus C) Damage to the type 2 pneumocytes which produce surfactant D) Decreased capillary permeability - Correct Answer C Baby Boy Joe is being ventilated with a positive end-expieratory pressure of 12, what complications may be associated with this therapy? A) Decreased cardiac output and increased venous return B) Decreased cardiac output and pneumothorax C) Increased cardiac output and hypertension D) Increased venous return and decreased renal perfusion - Correct Answer B Which of the following acid base disturbances commmonly occurs with the hyperventilation seen in acute exacerbation of asthma? A) Met Acidosis B) Met alkalosis C) Resp Acidosis D) Resp Alkalosis - Correct Answer D ADH has what mechanism of action? A) Causes an active retention of sodium which results in a passive retention of water B) Decreases the permeability of the glomerulus so that less filtrate is formed C) Increases the permeability of the collective ducts so that more water is reabsorbed D) Decreases sodium retention which increases urinary output - Correct Answer C Which of the following statements regarding DKA is true? A) An increase in urine ouptput results primarily from an increase in oral intake

B) Ketoacidosis is often associated with hyponatremia and hyperkalemia C) The patient in DKA has an increase in respiratory acids (pCO2) D) The seizure threshold is increased so stimulation should be minimized - Correct Answer B A 10yo boy has been admitted to the intensive care unit following a head injury from a skateboarding accident. He has a urine output of 11 cc/kg/hr, a urine spec grav of 1.003, a serum osmolality of 326, and serum sodium of 163. Which of the following signs and symptoms would the critical care nurse expect to find during the assessment of this child? A) Bounding pulses, tachycardia, seizures, and cyanosis B) Stupor, hypertension, mottling of extttremities C) Weak and thready pulse, hypotension, pale extremities D) Tachycardia, hypertension, thirst, equivocal pulses - Correct Answer C What would be the most immediate priority in treating this patient? A) restoration of intravascular fluid volume B) Administration of DDAVP C) Administration of anticonvulsant pharmacologic agents D) Restoration of normal serum sodium levels - Correct Answer A A 15yo girl develops SIADH following neurosurgery. Her serum sodium level is 128. Serum osmolality is 256, urine spec grav is 1.022, and urine output is 1 cc /kg/hr. Which of the following would be the treatment of choice? A) Fluid restriction of 50% of maintenance requirements B) Administration of 3cc/kg of 3% NaCl solution C) Lasix 3mg/kg D) Administration of hypertonic saline and diuretics - Correct Answer A All of the following are potential complications related to administration of stored blood except A) Hypocalcemia B) Hypokalemia

C) Bleeding D) Acidosis - Correct Answer B A neutropenic Patient is admitted showing signs of respiratory infection. Blood and sputum cultures are obtained. the RN should anticipate: A) Starting abx immediately B) Placing pt in iso C) No intervention until a causative organism is identified D) Transbronchial Biopsy - Correct Answer A Which of the following lab values places a patient at most risk for bleeding? A) Decreased albumin B) Decreased magnesium C) Decreased Calcium D) Decreased Potassium - Correct Answer A Which of the following is true of idiopathic thrombocytopenia purpura? A) Bleeding is increased as a result of an absence of clotting factor VIII B) Consumptive clotting results in excessive bleeding C) Bleeding occurs because platelets are not produced D) Bleeding occurs because platelets are rapidly destroyed - Correct Answer D When treating a critically ill patient with a bleeding disorder, which of the follwoing does the nurse need to be aware is not containued in fresh frozen plasma? A) Factor VIII B) Platelets C) Fibrinogen D) Thrombin - Correct Answer B A 6yo child has been admitted to the PICU in sickle cell crisis. The history includes six prior PICU admissions for sickle cell disease. Initial assessment reveals a nonpalpable spleen, hepatomegaly, fever, abdominal pain, mild hematuria

For which of the following is the patient at the greatest risk? A) Infection B) Respiratory distress syndrome C) Disseminated intravascular coagulation D) Consumptive coagulopathy - Correct Answer A Baby Girl Sami was admitted to the PICU 2 weeks ago with RSV. She was nasally intubated and mechanically ventilated soon after admission. Her respiratory status has significantly improved and she was extubated 2 days ago. She has had some minor bleeding from her naires but is otherwise doing well. 2 hours into your shift you notice that the bleeding from her nares has increased and that she has 2 large bruises on her chest and petechiae on all extremitties. The nurse notifies the critical care physician and sends off a CBC, coags, and D-Dimer. Lab findings are significant for: decreased Plt count, Pt/Ptt is normal, D-dimer is normal Based on this information you suspect that the patient may have developed which of the following? A) Disseminated Intravascular Coagulopathy (DIC) B) Thrombotic Thrombocytopenic Coagulation (TTC) C) Idiopathic Thrombocytopenia Purpura (ITP) D) Hemolytic Uremic Syndrome (HUS) - Correct Answer C Glomerula filtration is affected by all of the following factors. Which has the most significant effect on glomerular filtration rate? A) Osmotic pressure of the blood B) Hydrostatic pressure of the blood C) Dilation of the afferent arteriole D) Constriction of the efferent arteriole - Correct Answer B The kidneys help regulate acid base balance by all of the following mechanisms except: A) Reabsorption of bicarbonate ions B) Secretion of hydrogen ions C) Increased filtration of ions D) Productions of buffers - Correct Answer C

An example of a cause of prerenal failure would be: A) Potters Syndrome B) Hypovolemic shock C) Neurogenic Bladder D) Glomerulonephritis - Correct Answer B The kidneys conserve or eliminate water in the body primarily in response to levels of A) Potassium B) Antidiuretic hormone (ADH) C) Aldosterone D) Angiotensin II - Correct Answer B Creatinine level is a valuable iindicator of glomerular filtration rate for which reason? A) Once filtered in the glomerulus, creatinine is not reabsorbed in the tubular system B) Creatinine enters the glomerulus only when glomerular filtration pressures exceed 60 mmHg C) Creatinine filtration is unaffected by renal disease D) Creatinine is formed in the glomerulus and decreases only in filtration, causing creatinine levels to change - Correct Answer A During acidosis the kidneys compensate by: A) increasing bicarb excretion B) Forming ammonia C) Decreasing hydrogen ion excretion D) Decreasing urine pH - Correct Answer B (H+ ion excretion is buffered by phosphates and ammonia) Normal sodium is primarily regulated by: A) Aldosterone B) Antidiuretic hormone

C) Parathyroid hormone D) Glomerular filtration rate - Correct Answer A Esophageal varices occur as a result of A) Esophageal cancer B) Gastroesophageal reflex C) Peptic Ulcer Disease D) Portal Hypertension - Correct Answer D Patients with esophagel varices may be administered IV vasopressin (Pitressin). Besides stopping the bleeding vasopressin administration is associated with A) Diuresis B) Fluid retention C) High Serum Sodium D) Hypotension - Correct Answer B The patient with acute pancreatitis would likely have which of the following lab values? A) Elevated lipid levels, serum amylase, lipase, albumin B) Elevated serum amylase, lipase, low Ca and High Glu C) Low Hgb, ca, K, serum amylase, lipase D) low serum amylase, lipase, and albumin, hyperglycemia - Correct Answer B A patient with hepatic failure becomes increasingly confused. Which of the following lab values will assess this patient for encephalopathy? A) Hgb and Hct B) Liver enzymes C) Serum albumin D) Serum ammonia - Correct Answer D A 3mo is admitted to the PICU for respiratory compromise secondary to ascites and hepatosplenomegaly. The child is on oxygen per nasal cannula and is started on aggressive diuretic therapy

What is the most likely diagnosis for this infant? A) Tylenol oversode B) Biliary atresia C) Wilson's disease D) Hepatocellular carcinoma - Correct Answer B A 3mo is admitted to the PICU for respiratory compromise secondary to ascites and hepatosplenomegaly. The child is on oxygen per nasal cannula and is started on aggressive diuretic therapy What is the etiology of the ascites and hepatosplonmegaly? A) Portal HTN B) Hepatic Encephalopathy C) Jaundice D) Coagulopathy - Correct Answer A Clay colored stools may indicate A) Necrotizing enterocoliitis B) Liver disease C) Esophageal atresia D) Malrotation of the bowel - Correct Answer B Clay colored stools show liver or biliary tract disease. This comes from absence of bile in the stool. (Bilirubin is a major pigment in bile) The liver forms all of the following substances except: A) Cholesterol B) Vitamin K C) Iron D) Amino Acids - Correct Answer C Iron is stored in the liver.

Liver forms cholesterol, vitamin K, amino acids, albumin, globulins, and clotting factors Which of the following is the most common form of child maltreatment? A) Sexual abuse B) Child Neglect C) Physical Abuse D) Emotional Abuse - Correct Answer B Which of the following is the most important factor in regulating cerebral blood flow? A) PO B) PCO C) Acidosis D) Alkalosis - Correct Answer B After receiving a blow to the head, an 8yo is diagnosed with having an epidural bleed. This type of bleed is associated with: A) Arterial bleeding B) Venous Bleeding C) Bleeding into the brain tissue D) Intraventricular bleeding - Correct Answer A After returning from surgery for evacuation of the epidural bleed, the critical care nurse would first assess this child's____. A) Systemic perfusion B) Orientation C) Presence of reflexes D) Pupillary response - Correct Answer D Patient CC is in the intensive care unit following a motor vehicle crash. He is oriented to person, place, and time; he can move all extremities and follows commands. His pulse is

75 bpm, is BP is 120/70, and his respirations are 18 and regular. Which of the following is the earliest indicator that the patient's intracranial pressure is increasing A) He exhibits decorticate posturing B) He is oriented to person only C) His BP is 130/60, and his pulse is 58 D) His respirations are 10 and irregular - Correct Answer B Cushings triad is a late sign, change in LOC is a sooner sign A patient with a head injury has an ICP of 18, BP is 144/90, and MAP is 108. What is the CPP? A) 54 B) 72 C) 90 D) 126 - Correct Answer C Cerebral Perfusion Pressure (CPP) is the amount of pressure to perfuse the brain. Goal is

65. Body increases BP to perfuse brain when ICP climbs. CPP: MAP-ICP Which of the following nursing interventions will assist in preventing increased ICP in the patient who has a head injury? A) Draining a ventriculostomy whenever the ICP rises above 15 B) Providing rest periods between interventions C) Trendelenburg position with neck in alignment D) Using aseptic technique when changing ICP dressing - Correct Answer B The patient who suffers a basilar skull fracture is at risk for A) Battle sign B) Meningitis C) Stroke

D) Subdural hematoma - Correct Answer B A 21 yo male was hit on the head with a hammer. He was unconscious briefly at the scene but awake in the ED> Skull films show a linear right tempoparietal fracture. Approximately 6 hours after the injury, he complains of a headache. Additional symptoms include his right pupil being larger than his left pupil and no consensual response in the left eye. He quickly becomes unresponsive. These symptoms are likely caused by: A) Brainstem contusion B) Chronic subdural hematoma C) Epidural hematoma D) Post concussion syndrome - Correct Answer C CSF is formed by the: A) Choroid plexus B) Cerebral ventricles C) Arachnoid villae D) Pia mater - Correct Answer A The mechanism of the development of hydrocephalus is most commonly related to A) Increased flow of CSF B) Increased reabsorption of CSF C) Obstructed flow of CSF D) Decreased production of CSF - Correct Answer C What is the initial independent nursing intervention that should be used to maintain cerebral perfusion? A)Mannitol/Lasix B) Maintain head midline C) Transfuse with pRBC D) Sedate with morphine sulfate - Correct Answer B A 1week presents with a history of poor feeding, lethargy, and rapid breathing for 1 days. Examiination reveals a sick-appearing infant whose extremities are pale and mottle.d His

weight is 3kg. His vital signs are: rectal temp 33C, HR 145, RR: 48, BP: 64/40, pulses are equal in all extremities. His cap refill is 4 seconds. Multiple petechiae are noted on his trunk and extremities. His chest is clear to auscultation, his heart sounds are normal, and no abdnormality is noted on abdominal examination Pulse ox is 100%. IV access is obtained. Of the following, the most appropriate next step is: A) Endotracheal intubation B) Infusion of 60mL 0.9% saline over the next 20 mins C) Infusion of 60mL fresh frozen plasma over the next hour D) Infusion of dopamine at 5mcg/kg per minute E) Lumbar Puncture - Correct Answer B A 2 week old girl presents with poor feeding and rapid respirations for 1 day. Examination reveals pale, cool, and mottled extremities. Her vital signs are temp: 38, RR: 60, HR: 130, BP: 80/ Her pulses are equal in all extremities. Her lungs are clear to auscultation. A gallop rhythm is heard. Her liver is 4 cm below the right costal margin. Chest radiography shows mild cardiomegaly. You diagnose circulatory shock. Compared with adults, which of the following is more important to infants to increase cardiac output? A) Decreasing afterload B) Increasing BP C) Increasing HR D) Increasing myocardial contractility E) Increasing preload - Correct Answer C A 10yo girl has been undergoing chemotherapy for acute myelogenous leukemia. She has an indwelling catheter for long term vascular access. Over the last 12 hours, she has developed fever and shaking chills. In the emergency department, her VS are: 39.8C, HR: 148, RR: 22, BP: 68/ Her extremities are warm and well-perfused, with a capillary refill time of 1 second. Findings on the rest of the physical examination are unremarkable. After receiving 60 ml/kg 0.9% saline, her heart rate is 130 and BP is 70/

Appropriate antibiotic therapy has been instituted. IV infusion of which of the following is most appropriate next step in her management? A) Dopamine B) Milrinone C) Norepinephrine D) Phenylephrine E) Recombinant human activated protein C - Correct Answer A Dopamine and Norepi both increase BP Norepi increases BP more than dopa Dopamine increases CO more and increases renal and hepatosplanchnic blood flow You are caring for a patient in the early stages of hypovolemic shock. You would expect which of the following hemodynamic findings? A) Decreased HR B) Increased pulmonary occlusion pressure C) Decreased MAP D) Increase systemic vascular resistance - Correct Answer D 3 yo with eczema and asthma comes in febrile, tachycardic, hypertensive, and tachypneic. His pupils are dilated and his skin is dry and flushed. He appears agitated and his parents note that he has not been making much urine. What type of ingestion would be most consistent with this clinical presentation? A) Hallucinogen B) Serotonin Syndrome C) Sympathomimetic D) Anticholinergic - Correct Answer D Antidote for Acetaminophen - Correct Answer Mucomyst (N-acetylcystene) Antidote for Benzodiazepines - Correct Answer Flumazenil

Examples of benzos: ativan, diazepam Antidote for Botulism - Correct Answer Baby Big Antidote for Beta Blockers - Correct Answer Glucagon Antidote for Calcium Channel Blockers - Correct Answer Calcium Examples of CCB: amiodipine, nicardipine, verapimil Antidote for carbon monoxide - Correct Answer Hyperbaric O2, O Antidote for cyanide, Nitrites - Correct Answer Sodium Thiosulfate Antidote for Digoxin - Correct Answer Digibind Antidote for Ethylene Glycol - Correct Answer Ethanol Ethylene glycol is sweet and it is antifreeze Antidote for Heparin - Correct Answer Protamine Antidote for Iron - Correct Answer Deferoxamine Antidote for Lead - Correct Answer EDTA, BAL, DMSA Antidote for Methanol - Correct Answer Ethanol Antidote for Methemoglobin - Correct Answer Methylene Blue Antidote for Opioids - Correct Answer Narcan (Naloxone) Antidote for Tricyclic Antidepressants - Correct Answer NaHCO Example of tricyclic antidepressant: amitriptyline

Antidote for Warfarin - Correct Answer Vitamin K A 15 yo girl presents in the ED four hours after taking 20 extra strength tylenol. The ingestion was prompted by a flight with her boyfriend earlier that day. She has a history of attempted suicide in the past. She is awake and alert with stable vital signs. She complains of nausea and has had one episode of vomiting. Physical exam is normal. Baseline labs show normal electrolytes, with normal LFTs, normal coags, and a Tylenol level of 120 mcg/ml. What could you do for your patient? A) Call psychiatry to evaluate the patient for no medical intervention is required B) Administer 1g/kg of activated charcoal with sorbitol every 6 hrs and 17 doses of oral N- acetylcystene C) Administer one dose of activated charcoal with sorbitol followed by intravenous N- acetylcysteine for 21 hours D) Gastric lavage in an attempt to recover pill fragments - Correct Answer C Which of the following signs is commonly seen with a basilar skull fracture? A) Battle Sign B) Dependent Edema C) Retinal hemorrhage D) Sclera Hemorrhage - Correct Answer A You observe fluid fluctuations in the water seal chamber during respirations. Your next action would be: A) Milk the chest tube to remove clots B) Chart that drainage system is working normally C) Call XRAy as the patient is in respiratory distres D) Disconnect the system and replace the pleuravac - Correct Answer B On day 3 S/p head injury, serum Na is 128, serum osm is 265. Based uopon the lab data, what does the RN suspect is occurring at this time? A) Adrenal insufficiency

B) Central Diabetes Insipidus C) Effects of Mannitol therapy D) Syndrome of Inappropriate Antidiuretic Hormone - Correct Answer D Which of the following children is most likely to experience a typical febrile seizure? A) A 1 yo with otitis media and a fever of 104 B) A 3yo with unequal pupils and bulging fontanels C) A 11yo with fever of 101 who is on valproate for a seizure disorder D) A 5yo with bacterial meningitis - Correct Answer A

5. Which of the following is most likely to be the etiologic cause of bacterial meningitis? A) Nisseria meningitis B) E coli C) Listeria monocytogenes D) Haemophilus influenzae - Correct Answer A
6. The 3 cardinal signs of DI are: A) Polydipsia, edema, polyuria B) Hypernatremia, polyuria, decreased urine osm C) Hyponatremia, hypoosmolality, increased urine osmolality D) Polydipsia, polyuria, polyphagia - Correct Answer B Patients who are in SIADH are at risk for cerebral edema due to A) Hyponatremia, hypoosmololality B) Hypernatremia, hyperosmolality C) Polyuria, hypernatremia D) Hyperventilation, hyperglycemia - Correct Answer A A compensatory mechanism commonly identified in DKA is: A) Cheyne stokes respirations

B) Kussmaul breathing C) Hypoventilation D) Maintenance of normoventilation despite hypoxemia - Correct Answer B A child in DKA has a glucose of 350, one hour later, the glucose is 250, the nurse would anticipate the administration of: A) Potassium Chloride B) Sodium Bicarb C) Dextrose solution D) Subcutaneous insulin - Correct Answer C A 4yo has been admitted twice in the past six months for status asthmaticus. the parents smell of smoke when they come to the hospital, but state that they dont smoke in the house. the most appropriate discharge planning intervention would be to: A) Discuss with the parents how to avoid asthma triggers at thome B) Give the parents literature about smoking cessation treatment and support groups C) Cal CPS to report a medically unsafe home environment D) remind the parents that they shouldnt smoke around the child - Correct Answer B A 13 yo male with diabetes is admitted after collapsing in class. On admission, he is tachycardic, has shallow respirations, dilated pupils, and is hyperreflexic. The paln of care would be to administer A) Glucagon IM B) Naloxone (Narcan )IV C) 50% Dextrose IV D) regular insulin subcutaneously - Correct Answer C A 5yo boy is admitted after being involved in a MVA in which he did not wear a seat belt. He has numbness and tingling in his legs and feet, and has decreased sensation. Preliminary studies are normal. The CC nurse plans to include: A) Removing the cervical collar B) D/C log rolling to turn the patient

C) Administration of anti anxiety medications D) Continuation of spinal cord protective measures - Correct Answer D Which of the following may be a contraindication to performing a lumbar puncture? A) Increased ICP B) Suspected infection C) Intracranial hemorrhage D) Following seizures - Correct Answer A May cause herniation When receiving a transfer report from the ED, the CC nurse is told the patient is agitated and has a brudzinski's sign. This indicates: A) Increased ICP B) Meningeal irritation C) encephalitis D) IVH - Correct Answer B In prerenal failure, oliguria is the body's compensatory mechanism to: A) Conserve bicarb to alter the acid base balance B) INcrease the GFR C) Restore the intravascular volume to increase tissue perfusion D) Maintain the patency of the ductus arteriosus - Correct Answer C Beta blockers such as propanolol should not be used to treat SVT accompanied by CHF because: A) Beta blockers may decrease cardiac output B) Beta blockeers can increase ciruclating catecholamines C) SVT is refractory to treatment with beta blockers D) Cardioversion is the only effective treatment - Correct Answer B

Which statemnt about complete heart block is true? A) the atrial rate is lower than the ventricular rate B) The atrial rate paces the ventricles too slowly C) the atrioventricular node is the dominant pacemaker D) The atria and ventricles beat independently - Correct Answer D Symptomatic complete heart block is treated by: A) digoxin to increase the pumping of the heart B) Beta blocking agents to block abnormal impulses C) Temporary or permanent pacing D) Electrocardioversion - Correct Answer C Which symptom does not indicate SVT? A) Restlessness B) Poor feeding in infants C) Bounding pulses D) Tachypnea - Correct Answer C Upon initial assessment of your neurologically depressed patient, which lab values would lead you to suspect DKA? A) Hypoglycemia, hypokalemia, hypermagnesemia B) Hyperglycemia, metabolic acidosis, hypocarbia C) Metabolic acidosis, hypernatremia D) Hyperglycemia, hypernatremia, hypercarbia - Correct Answer B A patient with known addisons disease is addmitted to the PICU with urosepsis and hypotension. treatment will include: A) Antibiotics, thyroid suppression medications and beta blockers B) Meticulous hourly urine replacement C) Insulin administration to decrease serum glucose no faster than 50 - 100 mg/dl/hr

D) Stress dose steroids, fluid boluses, antibiotics and electrolyte replacement - Correct Answer D Cardiac defects associated with increased pulmonary blood flow place the infant at greatest risk for A) CHF B) Systemic air emboli C) Hypoxemia D) Syncope - Correct Answer A Which of the following CSF results represents untreated bacterial meningitis? A) Decreased leukocyte count, elevated protein, decreased glucose B) Decreased leukocyte count, decreased protein, and decreased glucose C) Increased leukocyte count, decreased protein, increased glucose D) Increased leukocyte count, elevated protein, decreased glucose - Correct Answer D Which condition is a common manifestation of cardiac involvement in kawasakis disease? A) Right ventricular hypertrophy B) Hypertrophic cardiomyopathy C) Aortic stenosis D) Coronary artery aneurysms - Correct Answer D vasodilators are prescribed to help improve cardiac function by: A) Increasing SVR B) Inotropic and chronotropic actions C) Decreasing afterload D) Improving renal function - Correct Answer C Which of the following would increase the ventilation/perfusion ratio? A) Atelectasis B) PUlmonary emboli

C) PUlmonary edema D) Meconium aspiration - Correct Answer B One of the most frequent causes of pancreatitis in children is: A) Alcoholism B) Gallstones C) Blunt abdominal trauma D) Vascular disease - Correct Answer C Pulse oximetry is effective in measuring: A) Hemoglobin oxygen saturation B) dissolved oxygen in plasma C) decreased perfusion from a low cardiac output D) Increased perfusion and ventilation - Correct Answer A Surfactant performs all but A) increasing surface tension to prevent alveolar collapse B) increases fluid clearance from alveoli C) Decreases surface tension to increase lung compliance D) Decreases opening pressure in lungs - Correct Answer A Which of the following factors does not enhance or increase pulmonary vasodilation? A) Alveolar hypoxia B) Alkalosis, respiratory and metabolic C) Inhaled NO D) Sedation - Correct Answer A The concept of permissive hypercapnea is that it is a strategy that allows A) higher paco2 with normal oxygenation, pH > 7.25, and no evidence of cerebral dysfunction B) a higher paco2 with a minimum paO2 of 50, pH> 7, normal mental status