Prophecy general ICU A V3
A code is initiated and the second nurse is observed not following ACLS protocol. What is the BEST
actionsto take? ans: Stop the nurse immediately and institute ACLS protocol
A lethargic but oriented patient is being admitted for sepsis and their family member is in the waiting
area. Their belonging include a ring, cell phone, and wallet. The patient asks if they can keep the ring on
and phone at bedside. What is your BEST response? ans: It is best if your family takes your belongings.
After turning a patient with CVP monitoring what should you do to ensure accuracy of the CVP reading?
ans: Zero the line at phlebostatic axis
An intubated patient with a GCS of 3 is admitted to the ICU from the ER after being found down for an
unknown amount of time at home. The CT scan reveals profuse cerebral edema. When is the BEST time
to notify organ donation services? ans: Within 24 hours of admission to the ICU
Besides the white blood cells, what laboratroy value is used in the diagnosis of sepsis? ans: Lactic acid
During cardiogenic shock what temporary intervention might be ordered to improve perfusion until
definitive treatment is provided? ans: Inotropic infusion
During the first hour of tPA infusion, how frequently should you monitor blood pressure? ans: Every 15
minutes
For a patient with septic shock, What would you monitor to objectively determine the effectiveness and
need to titrate a dobutamine infusion. ans: ScVo2
How is dopamine usually administered in the icu when given intravenously ans: Titratable continous
infusion
In a patient with septic shock, after fluid administration which of the following findings is MOST
suggestive of the need to start a vasopressor? ans: Mean arterial pressure 40-50 mmHg
One of your patients coded but is now stabilized and you are catching up on charting. The step-down
unit calls to get report on your other patient who is to be transfered. The nurses near you do not appear
busy. How should you prioritize your time? ans: Give report and ask the nurses to prepare the patient
for transfer.
The provider has ordered 2 units of FFP to be transfused. Your patient's religious beliefs prevent them
from accepting blood products. What is your BEST response? ans: Inform the provider and discuss
additional options.
What acid/base imbalance is MOST likely to be found in a patient with COPD ans: Respiratroy acidosis
What assessment tool is needed for a patient who has uncomplicated retrosternal hemorrhage? ans:
Follow up imaging test
, What cardiac condition shows cardiomegaly on chest x-ray ans: Systolic heart failure
What condition does the Confusion Assessment Method for ICU (CAM-ICU) detect? ans: Delirium
What ECG finding is indicative of hyperkalema? ans: peaked T wave
What information do you need from the provider to setup a cerebral intraventricular drainage system?
ans: Maximum ICP
What information is MOST important for you to confirm in smart IV pump settings? ans: Weight
What is a complication of long term TPN? ans: Liver injury
What is a significant complication of imaging studies performed with iv contrast ans: Acute kidney injury
What is an effective way to evaluate for cyanosis in a person of color ans: Check inner eyelids
What is the BEST way to determine a STEMI? ans: 12 Lead ECG
What is the normal cardiovasculat response to early sepsis? ans: Increased cardiac output
What IV sedative would MOST likely be ordered for a non-intubated patient? ans: Dexmedetkomidine
(precedex)
What laboratory value should you monitor closely if your patient is vomiting coffee ground emesis? ans:
Hemoglobin
What MUST you confirm before removing a cervical spine collar? ans: Presence of active order to
remove
What order is included in the pre-procedural checklist for patients at risk for acute kidney injury who are
to receive IV contrast? ans: Pre-hydration with IV Fluids
What respiratory support would an alert patient with an acute COPD exacerbatiobn likely receive FIRST?
ans: Bipap
What type of medication is used in the critical care setting to help manage the symptoms of alcohol
withdrawal? ans: Benzodiazepines
What ventilator adjustment do you expect when your patient's ABG is pH 7.40, PaCO2 112, BICARB 22?
ans: Decrease in FiO2
When administering a titratable infusion what information must you check on the medication IV bag to
confirm the correct dose is being administered? ans: Concentration
When assessing for fever in your intubated patient, placement of the thermometer in which area would
be most accurate? ans: Pulmonary artery or bladder
A code is initiated and the second nurse is observed not following ACLS protocol. What is the BEST
actionsto take? ans: Stop the nurse immediately and institute ACLS protocol
A lethargic but oriented patient is being admitted for sepsis and their family member is in the waiting
area. Their belonging include a ring, cell phone, and wallet. The patient asks if they can keep the ring on
and phone at bedside. What is your BEST response? ans: It is best if your family takes your belongings.
After turning a patient with CVP monitoring what should you do to ensure accuracy of the CVP reading?
ans: Zero the line at phlebostatic axis
An intubated patient with a GCS of 3 is admitted to the ICU from the ER after being found down for an
unknown amount of time at home. The CT scan reveals profuse cerebral edema. When is the BEST time
to notify organ donation services? ans: Within 24 hours of admission to the ICU
Besides the white blood cells, what laboratroy value is used in the diagnosis of sepsis? ans: Lactic acid
During cardiogenic shock what temporary intervention might be ordered to improve perfusion until
definitive treatment is provided? ans: Inotropic infusion
During the first hour of tPA infusion, how frequently should you monitor blood pressure? ans: Every 15
minutes
For a patient with septic shock, What would you monitor to objectively determine the effectiveness and
need to titrate a dobutamine infusion. ans: ScVo2
How is dopamine usually administered in the icu when given intravenously ans: Titratable continous
infusion
In a patient with septic shock, after fluid administration which of the following findings is MOST
suggestive of the need to start a vasopressor? ans: Mean arterial pressure 40-50 mmHg
One of your patients coded but is now stabilized and you are catching up on charting. The step-down
unit calls to get report on your other patient who is to be transfered. The nurses near you do not appear
busy. How should you prioritize your time? ans: Give report and ask the nurses to prepare the patient
for transfer.
The provider has ordered 2 units of FFP to be transfused. Your patient's religious beliefs prevent them
from accepting blood products. What is your BEST response? ans: Inform the provider and discuss
additional options.
What acid/base imbalance is MOST likely to be found in a patient with COPD ans: Respiratroy acidosis
What assessment tool is needed for a patient who has uncomplicated retrosternal hemorrhage? ans:
Follow up imaging test
, What cardiac condition shows cardiomegaly on chest x-ray ans: Systolic heart failure
What condition does the Confusion Assessment Method for ICU (CAM-ICU) detect? ans: Delirium
What ECG finding is indicative of hyperkalema? ans: peaked T wave
What information do you need from the provider to setup a cerebral intraventricular drainage system?
ans: Maximum ICP
What information is MOST important for you to confirm in smart IV pump settings? ans: Weight
What is a complication of long term TPN? ans: Liver injury
What is a significant complication of imaging studies performed with iv contrast ans: Acute kidney injury
What is an effective way to evaluate for cyanosis in a person of color ans: Check inner eyelids
What is the BEST way to determine a STEMI? ans: 12 Lead ECG
What is the normal cardiovasculat response to early sepsis? ans: Increased cardiac output
What IV sedative would MOST likely be ordered for a non-intubated patient? ans: Dexmedetkomidine
(precedex)
What laboratory value should you monitor closely if your patient is vomiting coffee ground emesis? ans:
Hemoglobin
What MUST you confirm before removing a cervical spine collar? ans: Presence of active order to
remove
What order is included in the pre-procedural checklist for patients at risk for acute kidney injury who are
to receive IV contrast? ans: Pre-hydration with IV Fluids
What respiratory support would an alert patient with an acute COPD exacerbatiobn likely receive FIRST?
ans: Bipap
What type of medication is used in the critical care setting to help manage the symptoms of alcohol
withdrawal? ans: Benzodiazepines
What ventilator adjustment do you expect when your patient's ABG is pH 7.40, PaCO2 112, BICARB 22?
ans: Decrease in FiO2
When administering a titratable infusion what information must you check on the medication IV bag to
confirm the correct dose is being administered? ans: Concentration
When assessing for fever in your intubated patient, placement of the thermometer in which area would
be most accurate? ans: Pulmonary artery or bladder
