Critical Care Nursing Practice NCLEX Exam

 

1. Which of the following medications is expected in the management of Increased Intracranial Pressure? Select all that apply.

A. Mannitol
B. Succinylcholine
C. Phenobarbital
D. Theophylline
E. Aluminum hydroxide

2. Which of the following patients fits the profile of a client suffering from elder abuse? Select all that apply.

A. A 43 years old female with multiple visits to the ER.
B. An elderly client with delayed treatment for a dermal pressure ulcer.
C. A 67 years old client who had withdrawn from normal activities and is showing signs of depression.
D. A 50 years old client who states he no longer wants to work at his current place of employment.
E. A 51 years old client who has poor personal hygiene when visiting her medical doctor.

3. Which of the following would the nurse expect to find when treating a partial thickness second degree burn? Select all that apply.

A. White, gray dry skin
B. Little to no pain
C. Heals in 2-3 weeks
D. Moist blisters
E. Painful
F. Requires surgical graft


4. A nurse receives report on four clients admitted to the emergency room. Who should she assess first?

A. A client with cherry red skin who has been waiting 15 minutes.
B. A client with a blood pressure of 180/76 on 2L of oxygen via NC.
C. A client vomiting profusely from a heroine overdose.
D. A client with asthma receiving treatment from respiratory therapy.


5. A nurse is caring for a client who has thermal burns to 20% of her body surface. The critical care nurse is aware which hormone will directly affect the client’s metabolic rate.
A. Cortisol
B. Anti-diuretic
C. Catecholamine
D. Renin
E. Aldosterone

6. A critical care nurse is schedule to administer Valpropic acid (Depakene) to a client. Which of the following are expected side effects of this medication?

A. Gastrointestinal disturbances, hypersalivation, liver toxicity, weight gain
B. Nausea, vomiting, anorexia, headache
C. Dizziness, fatique, skin rash, insomnia
D. Nausea, diplopia, skin rash, bleeding gums

7. An acute care nurse is caring for a client who received an angiography emobolization. Which of the following orders would the nurse call for clarification?

A. Place angioseal on groin area at site of surgical incision.
B. Keep head of the bed at 45 degrees.
C. Do neurovascular checks q 30-60 minutes.
D. Administer Mucomyst per physican orders.


8. A nurse is caring for a newly admitted client with disseminated intravascular coagulation (DIC). Which of the following lab values should she expect? Select all that apply.

A. Increased PT/PTT/INR
B. Decreased Fibrin split products
C. Decreased platelets
D. Decreased hemoglobin/hematocrit
E. Positive D dimer

9. A nurse is caring for a client admitted to the medical intensive care unit with acute respiratory distress syndrome (ARDS). Which of the following would be characteristic of the arterial blood gas results in the primary stages of acute respiratory distress syndrome?

A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis

10. A client arrives in the emergency department with ventricular fibrillation. The nurse anticipates which medication after epinephrine 1 mg IVP is administered without results.

A. Atropine 1mg IV
B. Vasopressin 40 units IV
C. Lidocaine 1-1.5 mg IVP
D. Magnesium 40 units IV


Answers

1. A, B, C. Management of ICP includes diuretics (Mannitol), Neuromuscular blockers (Succinylcholine) and Barbiturates for drug induced comas
2. B, C. Typical victim profile for elder abuse: Over age 65, female, lives alone, has physical or mental disability, multiple visits to ER. They also can have delayed treatment for medical problems.
3. Burn Characteristics
First degree –Partial Thickness
Affects Epidermis only
Pink or red
Painful
Heals in a few days

Second degree-Partial Thickness
Affects entire epidermis and portion of dermis
Red
Capillary refill present
Moist
Painful
Blisters
Heals in 2-3 weeks
Prone to scarring

Third degree-Full Thickness
Affects entire epidermis and dermis
White, gray
Dry, leathery
No hair
Absent capillary refill
Less pain

4. A. Cherry red skin is seen in 50% of clients with carbon monoxide poisoning. This clients needs 100% oxygen right away.
5. C. Catecholamines have marked metabolic effects, particularly on glucose metabolism.
6. A. These are the side effects of Valproic acid (Depakene)
7. B. After angiography HOB should be less than 30 degrees. Mucomyst is given to protect kidneys against angiography diet. Neurovascular checks should be done q 30-60 minutes. Angioseal should be placed over surgical groin site.
8. A, C, E. DIC is a condition of accelerated blood coagulation. The following are expected Lab values for NCLEX
• Increased INR/PT/PTT
• Decreased Platelets
• Increased Fibrin split products-Do you know what this is? If not LOOK IT UP!
• Decreased HGB, HCT
• Positive D dimer
9. Respiratory alkalosis is seen in the early finding of ARDS due to blowing off too much CO2
Respiratory acidosis can be seen later as ventilator failure progresses, resulting in client retaining CO2
10. B is the treatment along with epinephrine for ventricular fibrillation