A patient with an external ventricular drain is noted to have a damped ICP waveform
on the monitor. Which of the following is indicated?
Lower the level of the collection drain
Flush the system with the transducer flush device
Check for air bubbles or debris in the drainage system
Change the transducer
Give this one a try later!
, Check for air bubbles or debris in the drainage system
A nurse observes that a patient admitted for trauma is lethargic, with PaO2 57 mm Hg.
The presence of which other factor should lead the nurse to anticipate endotracheal
intubation?
History of asthma
Impaired ability to swallow
PaCO2 42 mm Hg
RR 25
Give this one a try later!
Impaired ability to swallow
A patient underwent CABG with cardiopulmonary bypass. Which statement about
fluid requirements is true?
Due to vasoconstriction, IV fluids are not needed within the first 24 hours
Fluids should be given based on patient thirst
Because of SIRS, the need for IV fluids should be expected in the first 24 hours
Since cardioplegia was used, no additional fluids are required
Give this one a try later!
Because of SIRS, the need for IV fluids should be expected in the first 24
hours
,Which intervention prevents complications for a patient experiencing neuromuscular
blockade while undergoing mechanical ventilation?
Hold neuromuscular blockade for neurological assessment hourly
Ensure VTE and stress ulcer prophylaxis
Perform chest physiotherapy
Monitor Sedation level using the RASS
Give this one a try later!
Ensure VTE and stress ulcer prophylaxis
A nurse observes a patient's jugular venous distention, tachycardia, and hypotension
{BP 72/50 (57)}. ECHO identifies a large pericardial effusion and onset of atrial
collapse. What intervention should the nurse initially anticipate?
Administer vasopressor
Prepare for intubation and mechanical ventilation
Prepare for pericardiocentesis
Administer morphine IV push
Give this one a try later!
Prepare for pericardiocentesis
Which of the following central pain stimuli should the nurse use to assess motor
function in a patient who is unconscious and who has facial fractures?
Apply supraorbital pressure
Apply pressure to the nailbed
, Apply vigorous sternal rubbing
Apply trapezius squeeze
Give this one a try later!
Apply trapezius squeeze
Which assessment finding should the nurse anticipate in a patient with dilated
cardiomyopathy
Normal ECG tracing
Crackles on auscultation
Hyperactive bowel sounds
Urine output 0.5 mL/kg/hr
Give this one a try later!
Crackles on auscultation
Which of the following should the nurse perform immediately after insertion of the
ICP monitoring device is completed?
Position the patient flat
Assess neurologic status and compare to assessment before insertion.
Irrigate the insertion site with an antibiotic solution
Ensure that the transducer is at the level of the phlebostatic axis
Give this one a try later!
Assess neurologic status and compare to assessment before insertion.
on the monitor. Which of the following is indicated?
Lower the level of the collection drain
Flush the system with the transducer flush device
Check for air bubbles or debris in the drainage system
Change the transducer
Give this one a try later!
, Check for air bubbles or debris in the drainage system
A nurse observes that a patient admitted for trauma is lethargic, with PaO2 57 mm Hg.
The presence of which other factor should lead the nurse to anticipate endotracheal
intubation?
History of asthma
Impaired ability to swallow
PaCO2 42 mm Hg
RR 25
Give this one a try later!
Impaired ability to swallow
A patient underwent CABG with cardiopulmonary bypass. Which statement about
fluid requirements is true?
Due to vasoconstriction, IV fluids are not needed within the first 24 hours
Fluids should be given based on patient thirst
Because of SIRS, the need for IV fluids should be expected in the first 24 hours
Since cardioplegia was used, no additional fluids are required
Give this one a try later!
Because of SIRS, the need for IV fluids should be expected in the first 24
hours
,Which intervention prevents complications for a patient experiencing neuromuscular
blockade while undergoing mechanical ventilation?
Hold neuromuscular blockade for neurological assessment hourly
Ensure VTE and stress ulcer prophylaxis
Perform chest physiotherapy
Monitor Sedation level using the RASS
Give this one a try later!
Ensure VTE and stress ulcer prophylaxis
A nurse observes a patient's jugular venous distention, tachycardia, and hypotension
{BP 72/50 (57)}. ECHO identifies a large pericardial effusion and onset of atrial
collapse. What intervention should the nurse initially anticipate?
Administer vasopressor
Prepare for intubation and mechanical ventilation
Prepare for pericardiocentesis
Administer morphine IV push
Give this one a try later!
Prepare for pericardiocentesis
Which of the following central pain stimuli should the nurse use to assess motor
function in a patient who is unconscious and who has facial fractures?
Apply supraorbital pressure
Apply pressure to the nailbed
, Apply vigorous sternal rubbing
Apply trapezius squeeze
Give this one a try later!
Apply trapezius squeeze
Which assessment finding should the nurse anticipate in a patient with dilated
cardiomyopathy
Normal ECG tracing
Crackles on auscultation
Hyperactive bowel sounds
Urine output 0.5 mL/kg/hr
Give this one a try later!
Crackles on auscultation
Which of the following should the nurse perform immediately after insertion of the
ICP monitoring device is completed?
Position the patient flat
Assess neurologic status and compare to assessment before insertion.
Irrigate the insertion site with an antibiotic solution
Ensure that the transducer is at the level of the phlebostatic axis
Give this one a try later!
Assess neurologic status and compare to assessment before insertion.
