Question 1

You are preparing to give a patient a transfusion. The patient states that in previous transfusions he has always developed a rash. What medication do you suspect the physician will order prior to the transfusion?

Accepted Answer

A)  Diphenhydramine (Benadryl) 
B)  Acetylsalicylic acid (ASA, aspirin) 
C)  Acetaminophen (Tylenol) 
D)  Ibuprofen (Motrin)  A

Question 2

Your patient has been stung by a bee. What signs and symptoms would you see if the patient had an allergic reaction to the sting?

Accepted Answer

A)  Normal respiratory rate
B)  Prolonged expiratory phase
C)  Wheezing on inspiration
D)  Decreased respiratory rate B

Question 3

An elderly patient comes into the emergency department to rule out stroke. On admission, vital signs are pulse 90, blood pressure 150/100 and respirations 20. Upon reassessment 30 minutes later, vital signs are pulse 78, blood pressure 170/90 and respirations 24 and irregular. What should be the nurse's first priority?

Accepted Answer

A)  Have the patient describe how they are feeling.
B)  Check the patient's Dilantin level.
C)  Decrease fluids.
D)  Encourage the patient to drink. C

Question 4

Which finding would make you suspect that your patient might be in cardiogenic shock?

Accepted Answer

A)  Decreased or muffled heart sounds
B)  A cardiac index greater than 2.2 L/min
C)  Bounding pulses
D)  Increased cardiac output

Question 5

You are caring for a patient who was brought into the emergency department unresponsive, hypotensive and tachypneic. Upon further assessment, you realize that the patient's temperature is 106 degrees Fahrenheit. You suspect heat stroke. What would your priority nursing intervention be?

Accepted Answer

A)  Obtain a history from the patient.
B)  Take oral temperature to monitor effectiveness of treatment.
C)  Call the family for consent to treat.
D)  Take off the patient's clothing, wrap him or her in wet towels and place a fan on the patient.

Question 6

You are caring for a patient who has been in a multiple trauma that has lead to severe blood loss. What type of device will you need to acquire to transfuse several units of blood quickly?

Accepted Answer

A)  Cardiac monitor
B)  Pulse oximetry
C)  Blood warming device
D)  Infusion controller

Question 7

Your patient is in cardiogenic shock and has had an intraaortic balloon pump placed through the left femoral artery. On assessment you note that the left foot is cool and mottled and the pedal pulse weak. What is the priority for this patient?

Accepted Answer

A)  Document the data because it is expected.
B)  Reevaluate in an hour.
C)  Increase the rate on the nitroglycerin drip.
D)  Notify the physician.

Question 8

You are caring for a patient who has been taking methylergonovine maleate (Methergine) for postpartum hemorrhage. It is not helping to control the hemorrhage. What procedure will most likely be ordered for this patient?

Accepted Answer

A)  Dilatation and curettage
B)  Laparotomy
C)  Hysterotomy
D)  Hysterectomy

Question 9

You are caring for a patient in cardiogenic shock who has a multilumen pulmonary artery catheter in place. What cardiac output (CO) and pulmonary capillary wedge pressure (PCWP) would you see if the patient were unstable?

Accepted Answer

A)  CO 5 L/min, PCWP low
B)  CO 4 L/min, PCWP high
C)  CO 3 L/min, PCWP high
D)  CO 2 L/min, PCWP low

Question 10

What would the nurse do to prevent a woman who had a cesarean birth from having early postpartum hemorrhage?

Accepted Answer

A)  IV fluids at 125 mL/hr
B)  Assess uterus every 15 minutes
C)  Abdominal dressing for drainage
D)  Monitor urinary output

Question 11

You are caring for a patient with a gunshot wound. As a result of the patient's Coumadin therapy, the prothrombin time is twice the normal amount. Which blood product do you expect the physician to order?

Accepted Answer

A)  Fresh frozen plasma
B)  Random donor platelets
C)  Red blood cells
D)  Crystalloids

Question 12

You are caring for a patient in hypovalemic shock who will require plasma expansion. What do you suspect the physician will order?

Accepted Answer

A)  Cryoprecipitate
B)  Packed red blood cells
C)  Albumin
D)  Platelets

Question 13

What would you want to assess your patient for if they have a myocardial infarction that is developing into cardiogenic shock?

Accepted Answer

A)  Ventricular dysrhythmia
B)  Bradycardia
C)  Rising diastolic blood pressure
D)  Falling central venous pressure

Question 14

You are caring for a patient in shock. Which parameter would you want to monitor to determine if treatment is effective?

Accepted Answer

A)  Cardiac output
B)  Respiratory rate
C)  Peripheral pulse rate
D)  Central venous pressure

Question 15

You are caring for a patient who has been stung by a bee. The patient has dyspnea, pruritis and localized swelling on the arm where he was stung. What would your priority intervention be for this patient?

Accepted Answer

A)  Remove the stinger.
B)  Place blankets over the patient.
C)  Listen for stridor and check the patient's tongue for swelling.
D)  Put the patient in the Trendelenburg position.

Question 16

Your patient has come into the emergency department with a self-inflicted wrist laceration that has severe bleeding. You have begun to apply pressure to the wound. What would your immediate priority be?

Accepted Answer

A)  See to the patient's need for psychiatric evaluation.
B)  Lower the patient's body temperature to decrease circulation.
C)  Place the extremity below the level of the heart.
D)  Monitor the patient for signs of shock.

Question 17

You determine that the patient you are caring for is having a transfusion reaction. You stop the blood immediately. Which action would you take next?

Accepted Answer

A)  Notify a physician.
B)  Determine the patient's white blood cell count.
C)  Administer normal saline at KVO.
D)  Administer normal saline bolus.

Question 18

You are caring for a patient who has been receiving a blood transfusion for the last 30 minutes. On assessment, you find the patient to be dyspneic and show bilateral crackles and a heart rate of 110. Which of the following complications do you suspect the patient is experiencing?

Accepted Answer

A)  Immune response
B)  Hypovolemia
C)  Fluid overload
D)  Polycythemia vera

Question 19

Your patient came in to the emergency department with chest pain. Over the last hour the patient's blood pressure has dropped, pulse has increased and respirations have increased. What do you suspect these changes indicate?

Accepted Answer

A)  Cardiogenic shock
B)  Cardiac tamponade
C)  Pulmonary embolism
D)  Aortic aneurysm

Question 20

You are caring for an infant with a diagnosis of sepsis. Which is the priority assessment for this infant?

Accepted Answer

A)  Skin integrity
B)  Temperature
C)  Jaundice
D)  Respiratory function

Exam 6: Shock