6360300
Frage 1
Frage
Which intraoperative complication is a widespread activation of the clotting cascade that results in the formation of clots in small blood vessels throughout the body, which as it consumes clotting factors and platelets disrupts normal clotting and can result in severe bleeding from various sites?
Antworten
-
Malignant hyperthermia
-
Anaphylaxis
-
Disseminated intravascular coagulation
-
Medullary depression
Frage 2
Frage
If detected, which catastrophic event in the OR will result in anesthesia and surgery being halted, 100% oxygen administered, and client will be treated with dantrolene sodium?
Antworten
-
Malignant hyperthermia
-
Anaphylaxis
-
Disseminated intravascular coagulation
-
Medullary depression
Frage 3
Frage
Malignant hyperthermia is a rare inherited disease where hyper metabolism of skeletal muscle resulting in altered control of intracellular calcium can occur in response to exposure to succinylcholine, a general anesthesia, but may also be triggered by trauma, heat and stress. This results in hyperthermia with rigidity of skeletal muscles. It can result in cardiac arrest and death. What is/are the first sign(s) of this occurring?
Antworten
-
A rise in body temperature
-
Hypercarbia, tachypnea, and tachycardia
-
Hypercarbia, bradypnea, and bradycardia
-
Hypercarbia, tachypnea, and bradycardia
Frage 4
Frage
What is the most common cause of post-operative hypoxemia?
Antworten
-
Pulmonary edema
-
Pneumonia
-
Atelactasis
-
Early ambulation
Frage 5
Frage
Most common immediate post-op complication include:
Antworten
-
Hypotension
-
Hypertension
-
Dysrhythmias
-
Pneumonia
-
Atelectasis
Frage 6
Frage
Which of the following are interventions to prevent deep vein thrombosis and pulmonary emboli?
Antworten
-
Leg exercises
-
Elastic stockings or compressive devices
-
Unfractionated or low-molecular weight heparin
-
Early ambulation
Frage 7
Frage
A transient cessation of bowel mobility that prevents effective passage of intestinal contents; typically resolves in 2-3 days with supportive treatment. Which condition is this?
Antworten
-
Paralytic ileus
-
Postoperative ileus
Frage 8
Frage
Small bowel obstruction that results when peristalsis stops; bowel lumen remains patent, but contents of intestine are not propelled forward, producing severe nausea and vomiting; may be caused by neurogenic or muscular impairment. Which condition is this?
Antworten
-
Paralytic ileus
-
Postoperative ileus
Frage 9
Frage
Meaghan, 26, should remain NPO after her abdominal surgery until
Antworten
-
return of gag reflex
-
return of level of consciousness
-
return of bowel sounds
-
return of flatus
Frage 10
Frage
If no catheter, the post-operative patient is expected to void __________ within 6-8 hours after surgery.
Antworten
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150 mL
-
300 mL
-
100 mL
-
200 mL
Frage 11
Frage
Drainage from surgical wounds should change from sanguineous to serosanguineous to serous with progressively less output with surgical wound healing.
Antworten
- True
- False
Frage 12
Frage
Infants and the elderly are at a higher risk for fluid-related problems/imbalances.
Antworten
- True
- False
Frage 13
Frage
Potassium's normal range lab values are [blank_start]3.5[blank_end] - [blank_start]5.0[blank_end] mmol/L.
Antworten
-
3.5
-
5.0
Frage 14
Frage
Sodium's normal range lab values are [blank_start]135[blank_end] - [blank_start]145[blank_end] mmol/L.
Antworten
-
135
-
145
Frage 15
Frage
Normal arterial plasma pH is [blank_start]7.35[blank_end] - [blank_start]7.45[blank_end]
Antworten
-
7.35
-
7.45
Frage 16
Frage
In arterial blood gases, a normal range for PaCO2 is [blank_start]35[blank_end] - [blank_start]45[blank_end] mmHg.
Antworten
-
35
-
45
Frage 17
Frage
In arterial blood gases, a normal range for HCO3 is [blank_start]21[blank_end] - [blank_start]28[blank_end] mmol/L.
Antworten
-
21
-
28
Frage 18
Frage
When using arterial blood gases and pH to determine acid-base imbalances, remember the acronym ROME: respiratory opposite metabolic equal.
Antworten
- True
- False
Frage 19
Frage
Hypotonic solution results in cellular [blank_start]swelling[blank_end].
Antworten
-
swelling
-
shrinking
Frage 20
Frage
Hypertonic solution results in cellular [blank_start]shrinking[blank_end].
Antworten
-
shrinking
-
swelling
Frage 21
Frage
Serum creatinine levels [blank_start]increase[blank_end] when renal function decreases.
Antworten
-
increase
-
decrease
Frage 22
Frage
Sudden body weight change is an excellent indicator of overall fluid volume. One litre of water weighs ______.
Antworten
-
1 lb.
-
1 kg
-
1 mg
-
2 lbs.
Frage 23
Frage
The average daily urine output is 1500 mL, or 1 mL/kg/hr.
Antworten
- True
- False
Frage 24
Frage
These are clinical presentations of fluid volume deficit, or hypovolemia:
Antworten
-
dry mucous membranes
-
poor skin turgor
-
tachycardia
-
postural hypotension
-
distended neck veins
-
confusion
-
concentrated urine
-
weak, rapid heart rate
Frage 25
Frage
These are clinical presentations of fluid volume excess, or hypervolemia:
Antworten
-
edema
-
distended neck veins
-
adventitious lung sounds
-
weak, rapid heart rate
-
tachycardia
-
weight loss
-
increased urine output
Frage 26
Frage
[blank_start]Hyponatremia[blank_end] is a frequently overlooked cause of confusion in the elderly.
Antworten
-
Hyponatremia
-
Hypokalemia
-
Hypernatremia
-
Hyperkalemia
Frage 27
Frage
Which electrolyte imbalance has the following clinical manifestations: fatigue, N/V, decreased bowel mobility; parenthesis, decreased reflexes, muscle weakness, leg cramps, polyuria; weak, irregular pulse; ECG changes; hyperglycemia.
Antworten
-
Hypocalcemia
-
Hypokalemia
-
Hyperkalemia
-
Hypernatremia
Frage 28
Frage
Which medication, in hyperkalemia, binds to potassium for excretion in feces?
Antworten
-
Kayexalate
-
Naloxone
-
Dantrolene sodium
-
Vitamin K
Frage 29
Frage
Chvostek's and Trousseau signs are used to detect hypocalcemia, which often presents with numbness and tingling in extremities and around the mouth, as well as hyper reflexes and muscle cramps. [blank_start]Chvostek's sign[blank_end] is the twitching of the facial muscles in response to tapping over the area of the facial nerve. [blank_start]Trousseau's sign[blank_end] is carpopedal spasm caused by inflating the blood-pressure cuff to a level above systolic pressure for 3 minutes.
Antworten
-
Chvostek's sign
-
Trousseau's sign
-
Trousseau's sign
-
Chvostek's sign
Frage 30
Frage
Metabolic acidosis is most commonly caused by renal failure. With acidosis, hyperkalemia may occur as potassium shifts out of the cell.
Antworten
- True
- False
Frage 31
Frage
Metabolic alkalosis is most commonly caused by severe vomiting or excessive gastric suction. Hypokalemia will produce alkalosis.
Antworten
- True
- False
Frage 32
Frage
Respiratory acidosis is always caused by a respiratory problem (hypoventilation) with inadequate excretion of CO2. Treatment is aimed at improving ventilation.
Antworten
- True
- False
Frage 33
Frage
Respiratory alkalosis is caused by hyperventilation.
Antworten
- True
- False
Frage 34
Frage
The RPN should not take blood pressures, nor should blood draws be done, on the extremity with the PICC line.
Antworten
- True
- False
Frage 35
Frage
Clinical manifestations of infiltration include swelling, pallor and coolness, and pain at insertion site. Treatment for the peripheral IV site complication of infiltration is to stop the infusion and discontinue the IV, then elevate the affected extremity.
Antworten
- True
- False
Frage 36
Frage
Extravasation, similar to infiltration but with an administration of a vesicant or irritant solution/medication into the surrounding tissues. Clinical manifestations are similar to infiltration, but blistering and necrosis of tissue can occur. Treatment for the peripheral IV site complication of extravasation is stopping the infusion and notifying the physician immediately, but leaving the IV cannula in place with warm or cold compresses based on the medication.
Antworten
- True
- False
Frage 37
Frage
Phlebitis, manifesting as pain, swelling and a reddened area around the insertion site or along the path of the vein is treated by discontinuing the IV and applying a warm moist compress.
Antworten
- True
- False
Frage 38
Frage
Thrombophlebitis is the presence of a clot plus inflammation. Manifests the same as phlebitis but client may experience immobility of the extremity because of pain, sluggish flow rate. Treatment is to discontinue the IV, initially apply cold compress followed by warm compress.
Antworten
- True
- False
Frage 39
Frage
Treatment for the peripheral IV site complication of a hematoma is to discontinue the IV, apply pressure with a sterile dressing and ice to prevent extension of the hematoma.
Antworten
- True
- False
Frage 40
Frage
Treatment for the peripheral IV site complication of an air embolism is clamping the cannula, placing the client on left hand side in Trendelenburg position, assessing vital signs, administering oxygen and notifying the physician.
Antworten
- True
- False
Frage 41
Frage
For blood product administration, a larger diameter cannula is needed, usually 18-20 gauge.
Antworten
- True
- False
Frage 42
Frage
For most IV therapy a 22 gauge catheter is sufficient.
Antworten
- True
- False
Frage 43
Frage
The RPN should monitor the client and IV site _______ for signs of systemic and local complications related to peripheral IV therapy.
Antworten
-
every 1-2 hours
-
every 4-6 hours
-
every half hour
-
qshift
Frage 44
Frage
Total parenteral nutrition tubing should be changed every 24 hours.
Antworten
- True
- False
Frage 45
Frage
IV line tubing should be changed no more frequently than at a _______ hour interval, but at least every 7 days or immediately if contamination occurs.
Antworten
-
24
-
96
-
36
-
48
Frage 46
Frage
You are caring for a 72-year-old female who underwent a hysterectomy, salpingo-oopherectomy, and bilateral pelvic lymph node dissection (LND). She is post-op day 2. You received handover this morning and the night nurse told you that the patient has had a low urine output. During your assessment, you notice that her extremities are cold, her BP is low, her HR is high, and she seems restless. You suspect that the patient may be experiencing...
Antworten
-
Hemorrhage
-
Orthostatic hypotension
-
Emergent delerium
-
Hypovolemic shock
Frage 47
Frage
Signs & symptoms of ______________ shock include narrowing pulse pressure, tachypnea, hypotension, decreased urinary output, weak & thready pulse, hypoactive or absent bowel sounds, decreased cerebral perfusion (anxiety, confusion) and skin hypoperfusion (pale, cool, clammy).
Antworten
-
Cardiogenic
-
Hypovolemic
-
Anaphylactic
-
Neurogenic
Frage 48
Frage
Signs & symptoms of ____________ shock include narrowing pulse pressure, tachycardia, tachypnea with crackles, hypotension and peripheral hypoperfusion.
Antworten
-
Cardiogenic
-
Hypovolemic
-
Anaphylactic
-
Neurogenic
Frage 49
Frage
Signs & symptoms of ____________ shock include hypotension, bradycardia, skin dry with poikilothermia, temperature and dysregulation (risk for hypothermia).
Antworten
-
Cardiogenic
-
Hypovolemic
-
Anaphylactic
-
Neurogenic
Frage 50
Frage
Signs & symptoms of ____________ shock include wheezing, stridor, flushing, pruritus, urticaria, respiratory distress and circulatory failure, sense of impending doom, chest pain, and swelling of the lips and tongue.
Antworten
-
Cardiogenic
-
Hypovolemic
-
Anaphylactic
-
Neurogenic
Frage 51
Frage
Septic shock manifests with tachypnea/hyperventilation, temperature dysregulation, decreased urine output, altered neurological status, GI dysfunction, and respiratory failure is common.
Antworten
- True
- False
Frage 52
Frage
Normal pulse pressure is 30-40 mmHg.
Antworten
- True
- False
Frage 53
Frage
A modified Trendelenburg position (head elevated, feet elevated 30 degrees) is recommended for hypovolemic shock to promote venous return and increases circulating blood volume.
Antworten
- True
- False
Frage 54
Frage
Blood is infused within 30 mins of pickup from blood bank and over 6 hours with Y-tubing.
Antworten
- True
- False
Frage 55
Frage
Blood transfusion is recommended when Hgb is below 70 g/L.
Antworten
- True
- False
Frage 56
Frage
Plasma is infused immediately after thawed, as rapidly as tolerated over 30-60 mins and is compatible for all with "O" type or own ABO group.
Antworten
- True
- False
Frage 57
Frage
Blood should be infused slowly to start, no greater than 2 mL/min for first 15 minutes as most reactions occur within first 50 mL of administration.
Antworten
- True
- False
Frage 58
Frage
________ reaction usually occurs when blood is transfused too quickly, presents with hypertension, bounding pulse, distended jugular veins, dyspnea, and restlessness/confusion. Nursing management is to stop transfusion, administer diuretics, apply O2 as needed and restart infusion slowly as directed.
Antworten
-
TRALI
-
TACO
-
Febrile non-hemolytic
-
Acute hemolytic
Frage 59
Frage
____________ reaction in blood transfusion typically occurs within 2 hours of infusion and usually resolves within 24-72 hours. Manifests as hypoxia and bilateral pulmonary edema. Nursing management is to stop the transfusion, provide O2, and mechanical ventilation is required in 75% of cases.
Antworten
-
TRALI
-
TACO
-
Acute hemolytic
-
Febrile non-hemolytic
Frage 60
Frage
Which of the following should the RPN teach the patient to avoid 72 hours prior to a fecal occult blood test?
Antworten
-
Red meat
-
Vitamin C
-
NSAIDs
-
Poultry/fish
Frage 61
Frage
Post procedural education for a barium enema includes teaching the patient that bowel movements should change from chalky white/gray progressively to normal colour.
Antworten
- True
- False
Frage 62
Frage
Ileostomy pouch should be emptied when _____ full.
Antworten
-
1/3
-
almost
-
3/4
-
1/4
Frage 63
Frage
Ostomy appliances should be changed ever 5-7 days and should be early in the morning before breakfast or 2-4 hrs after a meal.
Antworten
- True
- False
Frage 64
Frage
Patients receiving enteral feedings should have HOB elevated 30-45 degrees during meal and for at least 30 mins afterwards to prevent risk of aspiration
Antworten
- True
- False
Frage 65
Frage
Autonomic dysreflexia occurs in persons with an injury above T6. Symptoms include: severe pounding headache, sudden increase in blood pressure, profuse diaphoresis above level of injury, bradycardia.
Antworten
- True
- False
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