6360300
Pregunta 1
Pregunta
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?
Respuesta
-
Malignant hyperthermia
-
Anaphylaxis
-
Disseminated intravascular coagulation
-
Medullary depression
Pregunta 2
Pregunta
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?
Respuesta
-
Malignant hyperthermia
-
Anaphylaxis
-
Disseminated intravascular coagulation
-
Medullary depression
Pregunta 3
Pregunta
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?
Respuesta
-
A rise in body temperature
-
Hypercarbia, tachypnea, and tachycardia
-
Hypercarbia, bradypnea, and bradycardia
-
Hypercarbia, tachypnea, and bradycardia
Pregunta 4
Pregunta
What is the most common cause of post-operative hypoxemia?
Respuesta
-
Pulmonary edema
-
Pneumonia
-
Atelactasis
-
Early ambulation
Pregunta 5
Pregunta
Most common immediate post-op complication include:
Respuesta
-
Hypotension
-
Hypertension
-
Dysrhythmias
-
Pneumonia
-
Atelectasis
Pregunta 6
Pregunta
Which of the following are interventions to prevent deep vein thrombosis and pulmonary emboli?
Respuesta
-
Leg exercises
-
Elastic stockings or compressive devices
-
Unfractionated or low-molecular weight heparin
-
Early ambulation
Pregunta 7
Pregunta
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?
Respuesta
-
Paralytic ileus
-
Postoperative ileus
Pregunta 8
Pregunta
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?
Respuesta
-
Paralytic ileus
-
Postoperative ileus
Pregunta 9
Pregunta
Meaghan, 26, should remain NPO after her abdominal surgery until
Respuesta
-
return of gag reflex
-
return of level of consciousness
-
return of bowel sounds
-
return of flatus
Pregunta 10
Pregunta
If no catheter, the post-operative patient is expected to void __________ within 6-8 hours after surgery.
Respuesta
-
150 mL
-
300 mL
-
100 mL
-
200 mL
Pregunta 11
Pregunta
Drainage from surgical wounds should change from sanguineous to serosanguineous to serous with progressively less output with surgical wound healing.
Respuesta
- True
- False
Pregunta 12
Pregunta
Infants and the elderly are at a higher risk for fluid-related problems/imbalances.
Respuesta
- True
- False
Pregunta 13
Pregunta
Potassium's normal range lab values are [blank_start]3.5[blank_end] - [blank_start]5.0[blank_end] mmol/L.
Respuesta
-
3.5
-
5.0
Pregunta 14
Pregunta
Sodium's normal range lab values are [blank_start]135[blank_end] - [blank_start]145[blank_end] mmol/L.
Respuesta
-
135
-
145
Pregunta 15
Pregunta
Normal arterial plasma pH is [blank_start]7.35[blank_end] - [blank_start]7.45[blank_end]
Respuesta
-
7.35
-
7.45
Pregunta 16
Pregunta
In arterial blood gases, a normal range for PaCO2 is [blank_start]35[blank_end] - [blank_start]45[blank_end] mmHg.
Respuesta
-
35
-
45
Pregunta 17
Pregunta
In arterial blood gases, a normal range for HCO3 is [blank_start]21[blank_end] - [blank_start]28[blank_end] mmol/L.
Respuesta
-
21
-
28
Pregunta 18
Pregunta
When using arterial blood gases and pH to determine acid-base imbalances, remember the acronym ROME: respiratory opposite metabolic equal.
Respuesta
- True
- False
Pregunta 19
Pregunta
Hypotonic solution results in cellular [blank_start]swelling[blank_end].
Respuesta
-
swelling
-
shrinking
Pregunta 20
Pregunta
Hypertonic solution results in cellular [blank_start]shrinking[blank_end].
Respuesta
-
shrinking
-
swelling
Pregunta 21
Pregunta
Serum creatinine levels [blank_start]increase[blank_end] when renal function decreases.
Respuesta
-
increase
-
decrease
Pregunta 22
Pregunta
Sudden body weight change is an excellent indicator of overall fluid volume. One litre of water weighs ______.
Respuesta
-
1 lb.
-
1 kg
-
1 mg
-
2 lbs.
Pregunta 23
Pregunta
The average daily urine output is 1500 mL, or 1 mL/kg/hr.
Respuesta
- True
- False
Pregunta 24
Pregunta
These are clinical presentations of fluid volume deficit, or hypovolemia:
Respuesta
-
dry mucous membranes
-
poor skin turgor
-
tachycardia
-
postural hypotension
-
distended neck veins
-
confusion
-
concentrated urine
-
weak, rapid heart rate
Pregunta 25
Pregunta
These are clinical presentations of fluid volume excess, or hypervolemia:
Respuesta
-
edema
-
distended neck veins
-
adventitious lung sounds
-
weak, rapid heart rate
-
tachycardia
-
weight loss
-
increased urine output
Pregunta 26
Pregunta
[blank_start]Hyponatremia[blank_end] is a frequently overlooked cause of confusion in the elderly.
Respuesta
-
Hyponatremia
-
Hypokalemia
-
Hypernatremia
-
Hyperkalemia
Pregunta 27
Pregunta
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.
Respuesta
-
Hypocalcemia
-
Hypokalemia
-
Hyperkalemia
-
Hypernatremia
Pregunta 28
Pregunta
Which medication, in hyperkalemia, binds to potassium for excretion in feces?
Respuesta
-
Kayexalate
-
Naloxone
-
Dantrolene sodium
-
Vitamin K
Pregunta 29
Pregunta
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.
Respuesta
-
Chvostek's sign
-
Trousseau's sign
-
Trousseau's sign
-
Chvostek's sign
Pregunta 30
Pregunta
Metabolic acidosis is most commonly caused by renal failure. With acidosis, hyperkalemia may occur as potassium shifts out of the cell.
Respuesta
- True
- False
Pregunta 31
Pregunta
Metabolic alkalosis is most commonly caused by severe vomiting or excessive gastric suction. Hypokalemia will produce alkalosis.
Respuesta
- True
- False
Pregunta 32
Pregunta
Respiratory acidosis is always caused by a respiratory problem (hypoventilation) with inadequate excretion of CO2. Treatment is aimed at improving ventilation.
Respuesta
- True
- False
Pregunta 33
Pregunta
Respiratory alkalosis is caused by hyperventilation.
Respuesta
- True
- False
Pregunta 34
Pregunta
The RPN should not take blood pressures, nor should blood draws be done, on the extremity with the PICC line.
Respuesta
- True
- False
Pregunta 35
Pregunta
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.
Respuesta
- True
- False
Pregunta 36
Pregunta
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.
Respuesta
- True
- False
Pregunta 37
Pregunta
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.
Respuesta
- True
- False
Pregunta 38
Pregunta
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.
Respuesta
- True
- False
Pregunta 39
Pregunta
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.
Respuesta
- True
- False
Pregunta 40
Pregunta
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.
Respuesta
- True
- False
Pregunta 41
Pregunta
For blood product administration, a larger diameter cannula is needed, usually 18-20 gauge.
Respuesta
- True
- False
Pregunta 42
Pregunta
For most IV therapy a 22 gauge catheter is sufficient.
Respuesta
- True
- False
Pregunta 43
Pregunta
The RPN should monitor the client and IV site _______ for signs of systemic and local complications related to peripheral IV therapy.
Respuesta
-
every 1-2 hours
-
every 4-6 hours
-
every half hour
-
qshift
Pregunta 44
Pregunta
Total parenteral nutrition tubing should be changed every 24 hours.
Respuesta
- True
- False
Pregunta 45
Pregunta
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.
Respuesta
-
24
-
96
-
36
-
48
Pregunta 46
Pregunta
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...
Respuesta
-
Hemorrhage
-
Orthostatic hypotension
-
Emergent delerium
-
Hypovolemic shock
Pregunta 47
Pregunta
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).
Respuesta
-
Cardiogenic
-
Hypovolemic
-
Anaphylactic
-
Neurogenic
Pregunta 48
Pregunta
Signs & symptoms of ____________ shock include narrowing pulse pressure, tachycardia, tachypnea with crackles, hypotension and peripheral hypoperfusion.
Respuesta
-
Cardiogenic
-
Hypovolemic
-
Anaphylactic
-
Neurogenic
Pregunta 49
Pregunta
Signs & symptoms of ____________ shock include hypotension, bradycardia, skin dry with poikilothermia, temperature and dysregulation (risk for hypothermia).
Respuesta
-
Cardiogenic
-
Hypovolemic
-
Anaphylactic
-
Neurogenic
Pregunta 50
Pregunta
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.
Respuesta
-
Cardiogenic
-
Hypovolemic
-
Anaphylactic
-
Neurogenic
Pregunta 51
Pregunta
Septic shock manifests with tachypnea/hyperventilation, temperature dysregulation, decreased urine output, altered neurological status, GI dysfunction, and respiratory failure is common.
Respuesta
- True
- False
Pregunta 52
Pregunta
Normal pulse pressure is 30-40 mmHg.
Respuesta
- True
- False
Pregunta 53
Pregunta
A modified Trendelenburg position (head elevated, feet elevated 30 degrees) is recommended for hypovolemic shock to promote venous return and increases circulating blood volume.
Respuesta
- True
- False
Pregunta 54
Pregunta
Blood is infused within 30 mins of pickup from blood bank and over 6 hours with Y-tubing.
Respuesta
- True
- False
Pregunta 55
Pregunta
Blood transfusion is recommended when Hgb is below 70 g/L.
Respuesta
- True
- False
Pregunta 56
Pregunta
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.
Respuesta
- True
- False
Pregunta 57
Pregunta
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.
Respuesta
- True
- False
Pregunta 58
Pregunta
________ 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.
Respuesta
-
TRALI
-
TACO
-
Febrile non-hemolytic
-
Acute hemolytic
Pregunta 59
Pregunta
____________ 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.
Respuesta
-
TRALI
-
TACO
-
Acute hemolytic
-
Febrile non-hemolytic
Pregunta 60
Pregunta
Which of the following should the RPN teach the patient to avoid 72 hours prior to a fecal occult blood test?
Respuesta
-
Red meat
-
Vitamin C
-
NSAIDs
-
Poultry/fish
Pregunta 61
Pregunta
Post procedural education for a barium enema includes teaching the patient that bowel movements should change from chalky white/gray progressively to normal colour.
Respuesta
- True
- False
Pregunta 62
Pregunta
Ileostomy pouch should be emptied when _____ full.
Respuesta
-
1/3
-
almost
-
3/4
-
1/4
Pregunta 63
Pregunta
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.
Respuesta
- True
- False
Pregunta 64
Pregunta
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
Respuesta
- True
- False
Pregunta 65
Pregunta
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.
Respuesta
- True
- False
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