Urden Critical Care Nursing

MULTIPLE CHOICE 1. A patient with diabetic ketoacidosis (DKA) has an insulin drip infusing, and the nurse has just administered subcutaneous insulin. The nurse is alert for signs of hypoglycemia, which would include what findings? a. Kussmaul respirations and flushed skin b. Irritability and paresthesia c. Abdominal cramps and nausea d. Hypotension and itching ANS: B Irritability and paresthesia are seen in hypoglycemia. PTS: 1 DIF: Cognitive Level: Applying REF: p. 742 | Box 3...

MULTIPLE CHOICE 1. Preprocedural teaching of a patient undergoing a liver scan should include which instruction? a. Drink at least 500 mL of fluids before the procedure. b. Remain flat in bed for 12 hours after the procedure. c. Stay flat and still during the procedure. d. Sedation will be provided during the procedure. ANS: C The patient may need to maintain NPO (nothing by mouth) status for 2 to 4 hours before the procedure. Sedation is usually not required, but the patient must b...

MULTIPLE CHOICE 1. A patient is receiving total parenteral nutrition (TPN). During rounds the dietitian states “the patient is getting too much glucose.” In which one area is excess glucose stored as glycogen? a. Pancreas b. Hepatic cells c. Gallbladder d. Stomach ANS: B Excess glucose in the form of glycogen is stored in the hepatic and muscle cells for use as fuel at a later time. PTS: 1 DIF: Cognitive Level: Remembering REF: p. 706 | p. 707 | Box 30-1 OBJ: Nursing Proce...

MULTIPLE CHOICE 1. The nurse is caring for a patient with acute liver failure. The patient has elevated ammonia levels. Which medication would the nurse expect the provider to order for this patient? a. Insulin b. Vitamin K c. Lactulose d. Lorazepam ANS: C Lactulose, a synthetic ketoanalogue of lactose split into lactic acid and acetic acid in the intestine, is given orally through a nasogastric tube or as a retention enema. The result is the creation of an acidic environment that r...

MULTIPLE CHOICE 1. A patient was admitted with acute kidney failure. Which urinalysis value reflects a decreased ability of the kidneys to concentrate urine? a. pH of 5.0 b. Specific gravity of 1.000 c. No casts d. Urine sodium of 140 mEq/24 h ANS: B Specific gravity measures the density or weight of urine compared with that of distilled water. The normal urinary specific gravity is 1.005 to 1.025. For comparison, the specific gravity of distilled water is 1.000. Because urine is co...

MULTIPLE CHOICE 1. What is the main function of bile? a. Emulsify fat globules b. Serve as a reservoir for bilirubin c. Maintain triglyceride levels in the blood d. Aid in detoxification of drugs in the liver ANS: A Bile emulsifies fat globules and absorbs fat-soluble vitamins. PTS: 1 DIF: Cognitive Level: Remembering REF: p. 665 OBJ: Nursing Process Step: General TOP: Gastrointestinal MSC: NCLEX: Physiologic Integrity 2. A patient has been admitted in acute liver failur...

MULTIPLE CHOICE 1. The practitioner has ordered continuous renal replacement therapy (CRRT) for a patient with acute kidney injury. The patient needs both the removal of fluids and a moderate amount of solutes. Which type of CRRT would the nurse anticipate being started on this patient? a. Slow continuous ultrafiltration (SCUF) b. Continuous venovenous hemofiltration (CVVH) c. Continuous venovenous hemodialysis (CVVHD) d. Continuous venovenous hemodiafiltration (CVVHDF) ANS: B Conti...

MULTIPLE CHOICE 1. Considering anatomic location, which cranial nerve will be affected first by downward pressure onto the infratentorial structures? a. III b. VI c. IX d. X ANS: A With the location of the oculomotor nerve (cranial nerve [CN] III) at the notch of the tentorium, pupil size, and reactivity play a key role in the physical assessment of intracranial pressure changes and herniation syndromes. In addition to CN III compression, changes in pupil size occur for other reason...

MULTIPLE CHOICE 1. Which condition would result in an increased release of renin? a. Increased release of angiotensin I b. Increased release of angiotensin II c. Increased amount of sodium in the distal convoluted tubule d. Reduced pressure in the glomerulus ANS: D Renin is released in response to reduced pressure in the glomerulus, sympathetic stimulation of the kidneys, and a decrease in the amount of sodium in the distal convoluted tubule. Renin is converted to angiotensin I, whi...

MULTIPLE CHOICE 1. A patient has been experiencing drowsiness, confusion, and slight focal deficits for several days. The initial noncontract computed tomography (CT) findings are negative. The patient is being prepared for a lumbar puncture. What appearance does the nurse anticipate that the cerebrospinal fluid (CSF) would look? a. Cloudy b. Bloody c. Yellow d. Clear ANS: B If the initial computed tomography findings are negative, a lumbar puncture is performed to obtain cerebrospi...