NURS 4350 Exam 1 Review Critical Care
UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
List trends affecting patient management in the ICU - CORRECT
ANSWER Complexity of illness inc
Aging population
Family inclusion
Ethical issues
Staff intensivists (doc on unit all time)
E-ICUs (online monitoring)
Early transfers
Control costs & quality
Cafe Seec
Do protocols and order sets mean we cannot give individualized/holistic care? - CORRECT
ANSWER NO, protocols + order sets are the bare minimum
basic criteria to ID pt. admitted to ICU - CORRECT ANSWER -ABC problems or
potential problems
-vulnerable, unstable, complex
-needs vigilant nursing care
-therapies
,How does the body's stress response affect blood glucose levels? - CORRECT
ANSWER SNS is activated and signals for epi and norepi and cortisol to be released
which INCREASE BG levels
ID 2 abnormal responses to critical illness that require medical workup - CORRECT
ANSWER depression & delirium
steps in ECG monitoring - CORRECT ANSWER 1. HR: # complexes in 6 seconds (30
lg. boxes) x 10
2. R-R intervals: reg or irreg
3. ID P waves (yes lots)
4. Measure PR interval (.12-.20s)
5. QRS: wide or narrow (<.12s)
ID NSR - CORRECT ANSWER HR: 60-100 bpm
R-R: regular
P waves: present, upright, one before each QRS
PR interval: 0.12-0.20 sec
QRS: narrow (<0.12 sec)
Key: Everything normal → NSR
ID Sinus Bradycardia - CORRECT ANSWER HR: <60 bpm
R-R: regular
P waves: present, normal
PR interval: 0.12-0.20 sec
QRS: narrow
, Key: Slow rate but otherwise normal sinus rhythm
ID Sinus Tachycardia - CORRECT ANSWER HR: >100 bpm
R-R: regular
P waves: present, normal
PR interval: 0.12-0.20 sec
QRS: narrow
Key: Fast rate but otherwise normal sinus rhythm
ID A Fib - CORRECT ANSWER HR: can be slow, normal, or fast
R-R: irregularly irregular
P waves: absent; replaced by fibrillatory waves (fine or coarse)
PR interval: can't measure
QRS: narrow (usually)
Key: No P waves + irregular R-R → hallmark of AFib
ID PVC - CORRECT ANSWER HR: varies depending on underlying rhythm
R-R: irregular due to early beat
P waves: absent or not associated with QRS in PVC
PR interval: absent for PVC
QRS: wide and bizarre (>0.12 sec)
Key: Early, wide QRS "skipped beat"
ID V Tach - CORRECT ANSWER HR: 100-250 bpm
R-R: usually regular
P waves: usually absent
PR interval: not measurable
QRS: wide (>0.12 sec), monomorphic or polymorphic
Key: Fast, wide, regular QRS → dangerous ventricular rhythm
UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
List trends affecting patient management in the ICU - CORRECT
ANSWER Complexity of illness inc
Aging population
Family inclusion
Ethical issues
Staff intensivists (doc on unit all time)
E-ICUs (online monitoring)
Early transfers
Control costs & quality
Cafe Seec
Do protocols and order sets mean we cannot give individualized/holistic care? - CORRECT
ANSWER NO, protocols + order sets are the bare minimum
basic criteria to ID pt. admitted to ICU - CORRECT ANSWER -ABC problems or
potential problems
-vulnerable, unstable, complex
-needs vigilant nursing care
-therapies
,How does the body's stress response affect blood glucose levels? - CORRECT
ANSWER SNS is activated and signals for epi and norepi and cortisol to be released
which INCREASE BG levels
ID 2 abnormal responses to critical illness that require medical workup - CORRECT
ANSWER depression & delirium
steps in ECG monitoring - CORRECT ANSWER 1. HR: # complexes in 6 seconds (30
lg. boxes) x 10
2. R-R intervals: reg or irreg
3. ID P waves (yes lots)
4. Measure PR interval (.12-.20s)
5. QRS: wide or narrow (<.12s)
ID NSR - CORRECT ANSWER HR: 60-100 bpm
R-R: regular
P waves: present, upright, one before each QRS
PR interval: 0.12-0.20 sec
QRS: narrow (<0.12 sec)
Key: Everything normal → NSR
ID Sinus Bradycardia - CORRECT ANSWER HR: <60 bpm
R-R: regular
P waves: present, normal
PR interval: 0.12-0.20 sec
QRS: narrow
, Key: Slow rate but otherwise normal sinus rhythm
ID Sinus Tachycardia - CORRECT ANSWER HR: >100 bpm
R-R: regular
P waves: present, normal
PR interval: 0.12-0.20 sec
QRS: narrow
Key: Fast rate but otherwise normal sinus rhythm
ID A Fib - CORRECT ANSWER HR: can be slow, normal, or fast
R-R: irregularly irregular
P waves: absent; replaced by fibrillatory waves (fine or coarse)
PR interval: can't measure
QRS: narrow (usually)
Key: No P waves + irregular R-R → hallmark of AFib
ID PVC - CORRECT ANSWER HR: varies depending on underlying rhythm
R-R: irregular due to early beat
P waves: absent or not associated with QRS in PVC
PR interval: absent for PVC
QRS: wide and bizarre (>0.12 sec)
Key: Early, wide QRS "skipped beat"
ID V Tach - CORRECT ANSWER HR: 100-250 bpm
R-R: usually regular
P waves: usually absent
PR interval: not measurable
QRS: wide (>0.12 sec), monomorphic or polymorphic
Key: Fast, wide, regular QRS → dangerous ventricular rhythm
