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? - -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? - -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? - -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? - -Within 24 hours of admission to the ICU
- Besides the white blood cells, what laboratroy value is used in the
diagnosis of sepsis? - -Lactic acid
- During cardiogenic shock what temporary intervention might be
ordered to improve perfusion until definitive treatment is provided? - -
Inotropic infusion
- During the first hour of tPA infusion, how frequently should you monitor
blood pressure? - -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. - -
ScVo2
- How is dopamine usually administered in the icu when given
intravenously - -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? -
-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? - -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? - -Inform the provider and discuss additional options.
- What acid/base imbalance is MOST likely to be found in a patient with
COPD - -Respiratroy acidosis
- What assessment tool is needed for a patient who has uncomplicated
retrosternal hemorrhage? - -Follow up imaging test
- What cardiac condition shows cardiomegaly on chest x-ray - -Systolic
heart failure
- What condition does the Confusion Assessment Method for ICU (CAM-
ICU) detect? - -Delirium
- What ECG finding is indicative of hyperkalema? - -peaked T wave
- What information do you need from the provider to setup a cerebral
intraventricular drainage system? - -Maximum ICP
- What information is MOST important for you to confirm in smart IV
pump settings? - -Weight
- What is a complication of long term TPN? - -Liver injury
- What is a significant complication of imaging studies performed with iv
contrast - -Acute kidney injury
- What is an effective way to evaluate for cyanosis in a person of color -
-Check inner eyelids
- What is the BEST way to determine a STEMI? - -12 Lead ECG
- What is the normal cardiovasculat response to early sepsis? - -
Increased cardiac output
- What IV sedative would MOST likely be ordered for a non-intubated
patient? - -Dexmedetkomidine (precedex)
- What laboratory value should you monitor closely if your patient is
vomiting coffee ground emesis? - -Hemoglobin
- What MUST you confirm before removing a cervical spine collar? - -
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? - -Pre-
hydration with IV Fluids
A code is initiated and the second nurse is observed not following ACLS
protocol. What is the BEST actionsto take? - -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? - -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? - -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? - -Within 24 hours of admission to the ICU
- Besides the white blood cells, what laboratroy value is used in the
diagnosis of sepsis? - -Lactic acid
- During cardiogenic shock what temporary intervention might be
ordered to improve perfusion until definitive treatment is provided? - -
Inotropic infusion
- During the first hour of tPA infusion, how frequently should you monitor
blood pressure? - -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. - -
ScVo2
- How is dopamine usually administered in the icu when given
intravenously - -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? -
-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? - -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? - -Inform the provider and discuss additional options.
- What acid/base imbalance is MOST likely to be found in a patient with
COPD - -Respiratroy acidosis
- What assessment tool is needed for a patient who has uncomplicated
retrosternal hemorrhage? - -Follow up imaging test
- What cardiac condition shows cardiomegaly on chest x-ray - -Systolic
heart failure
- What condition does the Confusion Assessment Method for ICU (CAM-
ICU) detect? - -Delirium
- What ECG finding is indicative of hyperkalema? - -peaked T wave
- What information do you need from the provider to setup a cerebral
intraventricular drainage system? - -Maximum ICP
- What information is MOST important for you to confirm in smart IV
pump settings? - -Weight
- What is a complication of long term TPN? - -Liver injury
- What is a significant complication of imaging studies performed with iv
contrast - -Acute kidney injury
- What is an effective way to evaluate for cyanosis in a person of color -
-Check inner eyelids
- What is the BEST way to determine a STEMI? - -12 Lead ECG
- What is the normal cardiovasculat response to early sepsis? - -
Increased cardiac output
- What IV sedative would MOST likely be ordered for a non-intubated
patient? - -Dexmedetkomidine (precedex)
- What laboratory value should you monitor closely if your patient is
vomiting coffee ground emesis? - -Hemoglobin
- What MUST you confirm before removing a cervical spine collar? - -
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? - -Pre-
hydration with IV Fluids
