EXAM (ACTUAL 2026) – 199
QUESTIONS AND VERIFIED
ANSWERS GRADED A+
Coopernail's Sign - answer-bruising of the scrotum or labia
-indicating pelvic bleeding/ abdominal bleeding
-pelvic fx
Halstead's Sign - answer-Marbled abdomen- bleeding
Cullen's sign - answer-ecchymosis in umbilical area, seen with pancreatitis
Murphy's Sign - answer-pain with palpation of the RUQ during inspiration
-indicative of cholecystitis
Factors fetal well-being - answer-1.) Viability (most important)
2.) Fetal Heart rate
3.) Fetal movement
PEEP (positive end expiratory pressure) - answer--Causes increased pulmonary
vascular resistance
-Can cause hypotension over 15 cmH2O
-Normal: 5 cmH2O
- lowest pressure the lungs will see
steps in resuscitation of the neonate - answer-Dry, warm, position to open airway,
suction mouth then nose
,Tactile stimulation (HR<100 or apnea/IR breath rub back and put)
Oxygen near the face
Bag valve mask - unresponsive to tactile stim within a few sec (40-60bpm)
reposition head, reapply mask, suction again prn, if no response in 30 sec
Intubate - if HR < 60 after PPV for 30 sec, then
Chest compressions - 3:1 ratio (90 compressions / 30 breaths)
Drugs - epinephrine 0.1-0.3ml/kg of 1:10,000, through et tube or (preferably) through
umbilical venous line, volume loss give 10ml/kg NS
pulmonary contusion - answer-Chest pain
bruising over sternum
Progressive dyspnea
decreased breath sounds on one side
rales
low sats despite being on o2
hemoptysis
irregular pulse-dysrthymia
ruptured diaphragm - answer-abd contents herniate into the thoracic cavity
compressing the lung
s/s: dyspnea, dysphagia, abd pain, sharp epigastric or chest pain radiating to L shoulder
(Kehr sign), bowel sounds heard in the lung fields on injured side, decreased breath
sounds on injured side.
Tracheobronchial injury - answer-1. hemoptysis
2. subcutaneous emphysema
3. air leak (PNEUMOTHORAX) + PNEUMEDIASTINUM even after chest tube
placement***
,- advance ETT below level of injury into Right mainstem
esophageal perforation - answer--fever
-hematemesis
Fat embolus - answer-can form when a long bone is fractured and fat cells from yellow
bone marrow are released into the blood
-fever
-rash after fracture
Blood loss from humerus fracture - answer-750 ml
blood loss from femur fracture - answer-1500 ml
PAWP (pulmonary artery wedge pressure) - answer-- Looks at the left side of the heart
- If elevated can indicate pulmonary congestion, CHF, cardiogenic shock
- Do not keep wedged for more than 30 seconds
- Make sure balloon is deflated and have patient cough forcefully
-Normal: 8-12
Adult ETT depth - answer-3 x ETT size or average 19.23 cm
Peds ETT depth - answer-10 + age in years (cm)
Neonate ETT depth - answer-6 + wt in kg (cm)
Adjust vent to change Co2 - answer-adjust rate and tidal volume
, Adjust vent to change oxygenation - answer-adjust PEEP, PAP
infant rule of nines - answer-Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
back - 13%
butt/genitals - 6%
each leg - 13.5%
Sodium Bicarbonate - answer--acidosis
-drug choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq needed
Digoxin - answer--cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
treatment for fetal distress - answer--Left lateral recumbent position
-O2
-Correct contributing factors
-keep reassessing
CHF considerations - answer--many are relatively hypovolemic
-be careful with diuretics
CVP catheter placement outside line markers - answer-RA/CVP: 25-30 cm