Endocrine – Disk 1 (Endocrine/Hematology/Gastrointestinal/Renal/Integumentary = 20%

!"at is t"e e##ect o# $DH on urine #ormation

$& Retention
Retention o# sodium
sodium and 'ater
'ater e)cretion
e)cretion o# *otassi
*otassium
um
+& E)cretion
E)cretion o# sodium
sodium and 'ater
'ater e)cretion
e)cretion o# *otassi
*otassium
um
,& Retention
Retention o# 'ater
'ater concentr
concentration
ation o# urine
urine
D& E)cretion
E)cretion o# 'ater
'ater diluti
dilution
on o# urine
urine

-"e releasing stimulus #or $DH is normally.

$& Decreased
Decreased serum
serum 'all
'all myocardial
myocardial in#arct
in#arction
ion
+& Increas
Increased
ed serum
serum osmo
osmolar
larity
ity
,& $n eleate
eleated
d circulat
circulating
ing corti
cortisol
sol leel
D& Increased
Increased serum *otassium
*otassium leels
leels

-"e normal range o# serum osmolarity is.

$& 11
+& 20020
,& 2324
D& 5253

6I$DH is mani#est clinically as a.

$& Hy*eros
Hy*erosmol
molarar state
state
+& 7o'
7o' out
out*u
*utt sta
state
te
,& 8y)e
8y)ede
dema
ma sta
state
te
D& !ater into)i
into)icat
cation
ion state
state

In addition to its e##ect on 9ody 'ater e:uili9rium

e: uili9rium $DH
$DH is also a.
$& ;aso*r
so*resesso
sor 
r 
+& ,ard
,ardio
ioto
toni
nicc
,& +eta
+eta stim
stimula
ulato
tor 
r 
D& ,ar9oni
,ar9onicc an"ydra
an"ydrasese in"i9i
in"i9iter 
ter 

-"e sym*tomatology you 'ould assess in t"e *atient 'it" 6I$DH results #rom.
$& Eleate
Eleatedd *otass
*otassium
ium leel
leelss
+& !ater into)i
into)icat
cation
ion
,& Increas
Increased
ed seru
serum
m osmol
osmolali
ality
ty
D& <reci*i
<reci*itat
tating
ing #actor
#actorss o# 6I$DH

-"e cardinal sign o# 6I$DH is.

$& Diluti
Dilutiona
onall "y*onat
"y*onatrem
remia
ia
+& >rinary
>rinary out*ut
out*ut o# 10l
10l *er
*er day
day
,& Hy*o
Hy*otetens
nsio
ion
n
D& 6yst
6ystem
emicic edem
edemaa

!"ic" o# t"e #ollo'ing la9oratory #indings 'ould 9e *resent in a *atient 'it" 6I$DH
$& 7o'
7o' ser
serum
um sodi
sodium
um
+& 6erum
6erum osmo
osmolal
lality
ity o# 50
,& >rine
>rine s*eci#
s*eci#ic
ic grai
graityty o# 1&00
1&0055
D& Decrea
Decreased
sed urinary
urinary osmol
osmolari
arity
ty

-"e *atient 'it" 6I$DH may *resent 'it".

$& Increas
Increased
ed urina
urinary
ry out*u
out*utt
+& 6ei?ure
ures
$s a sta## nurse in I,> you are assigned to a *atient recently admitted 'it" di& !"ic" o# t"e #ollo'ing *atients
'ould 9e likely to deelo* di
$& $n elderly *atient receiing t"ia?ides
+& $ young 'omen 'it" seere *neumonia
,& $ 0 y/o man 'it" eso*"ageal arices on <itressin
D& $ "ead trauma *t 'it" a skull #racture

During your assessment '"ic" o# t"e #ollo'ing #indings 'ould 9e *resent in a *atient 'it" DI
$& 6erum osmolality o# 20
+& 6erum sodium leel o# 1@
,& >rinary out*ut o# less t"an @00cc in 2 "ours
D& >rine s*eci#ic graity o# 1&02

-"e nurse understands a maAor com*lication o# DI is.

$& Hy*oolemic s"ock 
+& 6ei?ures
,& ,ongestie "eart #ailure
D& ,ardiac arr"yt"mias

Ealuation o# la9oratory #indings in a *atient 'it" DI 'ould s"o'.

$& Increased urine osmolality
+& >rine s*eci#ic graity 9et'een 1&001 to 1&00
,& Decreased serum sodium
D& Decreased serum osmolarity

-"e most dangerous com*lication o# DI is.

$& Dilutional "y*onatremia
+& Hy*oolemia
,& ,ongestie "eart #ailure
D& !ater into)ication syndrome

Dia9etes insi*idus is c"aracteri?ed 9y all 9ut '"ic" o # t"e #ollo'ing

$& >rine s*eci#ic graity o# 1&01
+& -ac"ycardia
,& >rinary out*ut o# 2000 cc in t"ree "ours
D& +< 40/0

!"ic" o# t"e #ollo'ing is c"aracteristic o# DI

$& 7o' urinary osmolarity
+& 6erum osmolarity increased
,& 6erum sodium eleated
D& $ll o# t"e a9oe

$ @@ yo is admitted 'it" a 9lood sugar o# 1200 s"e is seerely de"ydrated res*irations are 1B *er minute and
s"allo'. you 'ould #irst sus*ect
$& Hy*erosmolar coma
+& Dia9etic ketoacidosis
,& Eit"er o# t"e a9oe
D& Ceit"er a or 9
 It is im*ortant #or t"e nurse to identi#y t"ose *atients at risk #or deelo*ing HHC& !"ic" condition 'ould not
 *redis*ose a *atient to deelo* HHC
$& <ancreatitis
+& -"ia?ide o# steroid t"era*y
,& -<C t"era*y
D& ,ere9roascular accident

 Conketotic "y*erosmolar coma (HHC is not usually associated 'it".

$& De#ects in $DH secretion
+& 8ild dia9etes o# recent onset
,& lder age
D& >se o# diuretics steroids and "y*ertonic solutions

-"e nurse understands t"at t"e *rimary cause o# t"e classical mani#estations in HHC is.
$& Ra*id decrease in *lasma osmolarity
+& 8arkedly eleated serum glucose
,& Intraascular de"ydration
D& 6erum electrolyte a9normality

-"e altered mental status in a *atient in HHC results #rom.

$& Hy*erosmolaity o# *lasma
+& Intracere9ral de"ydration
,& 6eere osmotic diuresis #rom "y*erglycemia
D& Intraascular de"ydration

!"ic" o# t"e #indings 'ould not 9e *resent in HHC

$& ussmaulFs res*irations o# 2B/min
+& 6erum glucose leel a9oe @0 and o#ten greater t"an 1000
,& 6erum osmolarity a9oe 50
D& 6eere de"ydration and t"e a9sence o# ketoacidosis

Ealuation o# a *atientFs la9oratory alues 'it" HHC 'ould include.

$& $ serum sodium o# 125
+& $ serum osmolarity o# 50
,& $ urinary sodium o# @0
D& $ 9icar9onate leel o# 12

urt"er assessment o# diagnostic data in a *atient 'it" HCC 'ould re#lect.

$& $+G 'it" a *H o# 3&10
+& our *lus ketone in t"eir urine
,& $?otemia
D& Hematocrit o# 24%

!"ic" o# t"e #ollo'ing la9oratory #indings is not likely to 9e seen in *atients 'it" D$
$& <" 3&14
+& <co2 
,& +ase de#icit 1
D& 6erum k &

!"ic" o# t"e #ollo'ing diagnostic data in a *atient 'it" HHC 'ould re#lect.
$& $+G 'it" a *H o# 3&10
+& our *lus ketone in t"eir urine
,& $?otemia
 Ceuro – Disk 2 (86/Ceuro/<syc"osocial = 15%

-"e single most im*ortant inde) o# neurological state is t"e.

$& 7eel o# consciousness
+& <u*illary reaction
,& E)tremity moement and strengt"
D& ;ital signs

uick rotation o# t"e "ead 9ack and #ort" '"ile "olding t"e eyes o*en causing t"e eyes o# t"e comatose *atient to
rotate o**osite t"e side to'ard '"ic" t"e "ead is turned is a *ositie res*onse kno'n as.
$& E)traocular o*"t"almo*legia
+& Intranuclear e)traocular o*"t"almo*legia
,& culoce*"alic re#le)
D& DysconAugate lateral re#le)

-"e res*onse elicited '"en t"e neck is #le)ed *roducing #le)ion o# 9ot" t"ig"s at t"e "i*s as 'ell as #le)ion
moements o# ankles and knees is called.
$& ernigs sign
+& +a9inskis sign
,& +rud?inskis sign
D& -rousseaus sign

-"e res*iratory *attern seen in u**er 9rainstem lesions (mid9rain is.

$& Hy*erentilation
+& $ta)ia
,& ,luster 
D& $*neustic

$ 2@year old male is com*laining o# seere "eadac"e& n assessment "e "as nuc"al rigidity and a *ositie
ernigs sign& !"ic" o# t"e #ollo'ing conditions is most likely *resent
$& E*idural "ematoma
+& 6u9dural "ematoma
,& 6u9arac"noid "emorr"age
D& Increased intracranial *ressure

-"e classic cardioascular signs o# increasing intracranial *ressure kno'n as ,us"ings triad include
$& Decreasing *ulse 'idening *ulse *ressure *eri*"eral asoconstriction
+& Decreasing *ulse increasing systolic +< 'idening *ulse *ressure
,& Decreasing *ulse decreasing +< 'idening *ulse *ressure
D& Decreasing systolic +< central cyanosis !<<

;entricular #luid *ressure is t"e most sensitie indicator o# increased intracranial *ressure& -"e normal entricular
#luid *ressure is.
$& 1@0 mmHg
+& 010 mmHg
,& 1@1 mmHg
D& $9oe @0 mmHg

$ *atient "as a su9arac"noid scre' inserted to monitor "is intracranial *ressure (I,< and cere9ral *er#usion
 *ressure (,<<& -"e I,< and ,<< are 9ot" 5 mmHg& -"is means t"at t"e *atients.
$& Intracranial enous *ressure is decreased
+& ,ondition is sta9le
 !"ic" o# t"e #ollo'ing *arameters are graded '"en using t"e Glasgo' ,oma 6cale in t"e assessment o# t"e
 *atient 'it" an altered state o# consciousness
$& Eye o*ening sensory leel and er9al res*onse
+& 8otor res*onse *u*illary signs and orientation
,& <u*illary signs orientation and +<
D& Eye o*ening motor res*onse and er9al res*onse

+lindness is one "al# o# 9ot" isual #ields #ollo'ing a ,;$ is re#erred to as.
$& Homonymous "emiano*ia
+& $stereognosis
,& Homonymous "emignosia
D& *tic "emiano*ia

<atients 'it" inAury to t"e le#t cere9ral "emis*"ere may e)" i9it.
$& 7e#t "emi*aresis or "emi*legia
+& Deiation o# t"e eye to t"e le#t
,& 7e#t "omonymous "emiano*ia
D& $ll o# t"e a9oe

<in*oint *u*ils t"at react to lig"t i# ie'ed ' it" a magni#ying glass are indicated o#.
$& $ lesion in t"e *ons
+& $ lesion in t"e 9asal ganglia
,& culomotor dys#unction
D& 6ym*at"etic nerous stimulation

-"e nurse caring #or a *atient 'it" a su*ratentorial "erniation understands t"at t"e earliest sign 'ould 9e.
$& Decere9rate *osturing
+& !ide and #i)ed *u*ils
,& 7et"argy and stu*or 
D& I*silateral dilated *u*il

!"ic" o# t"e #ollo'ing treatment modalities 'ould t"e nurse consider to 9e ina**ro*riate #or t"e entilator
de*endent *atient 'it" increased intracranial *ressure
$& 8aintaining t"e ,2 leel 9et'een 2455
+& eeding t"e *atient ia an CG-
,& $dministering D! at 3 cc an "our 
D& 7og roll '"en turning t"e *atient

!"ile assessing t"e la9oratory data o# a *atient 'it" "ead trauma '"ic" #inding necessitates noti#ication o# t"e
 *"ysician
$& $ serum osmolarity o# 23
+& $ serum sodium leel o# 15B
,& $ urine s*eci#ic graity o# 1&00
D& $ urine osmolarity o# 00

 $ 9asal skull #racture a##ecting t"e middle #ossa may cause '"ic" o# t"e #ollo'ing
$& ,ranial nere inAuries
+& +attles sign
,& ,6 otorr"ea or r"inorr"ea
D& $ll o# t"e a9oe
!"at s"ould t"e nurse do '"en "is/"er *atient 'it" a 9asilar skull #racture 9egins to "ae clear #luid draining #rom
one ear
$& <ack t"e e)ternal auditory canal 'it" sterile cotton and noti#y t"e doctor
+& $**ly a loose sterile dressing oer t"e ear and call t"e doctor
,& $**ly an occlusie sterile dressing oer t"e ear and c"ange it #re:uently
D& 6uction t"e ear 'it" a sterile cat"eter

-o determine i# 9loody "ead drainage contained ,6 a nurse 'ould *ut some on a gau? e and o9sere.
$& $9sence o# a clear line o# demarcation 9et'een t"e serum and 9lood
+& $ 9lood clot in t"e middle 'it" a yello' ring around it
,& $ yello' ring 'it" t'o 9loody rings around it
D& $9sence o# t"e clot 9ut one 9loody ring at t"e center o# t"e gau?e

$ *atient '"o "as a neurological inAury t"at results in i*silateral motor loss and contralateral loss o# *ain and
tem*erature is said to "ae.
$& $ total transection
+& $nterior cord syndrome
,& +ro'n6e:uard syndrome
D& ,entral cord syndrome

E)amination o# t"e ,6 in 9acterial meningitis 'ill reeal all 9ut '"ic" o# t"e #ollo'ing
$& ,loudiness
+& Increased '"ite 9lood cells
,& Decreased *rotein
D& Increased *ressure and decreased glucose

!"ic" statement is accurate regarding t"e di##erentiation o# ,6 in 9acterial and iral meningitis
$& Hig"er leel o# *rotein in 9acterial meningitis t"an iral
+& 7o' sugar content seen in 9acterial meningitis usually normal in iral
,& ,6 is *urulent and tur9id in 9acterial may 9e clear in iral
D& $ll o# t"e a9oe
Gastrointestinal Disk 2 J 1.0@ K Disk 5

In order to most accurately esta9lis" t"at your *atient " as no 9o'el sounds you must listen in eac" :uadrant #or at
least.
$& 50 seconds
+& 1 #ull minutes
,& 11/2 minutes
D& 2 minutes

-"e usual order #or carrying out *" ysical assessment o# a9domen is.
$& <al*ation ins*ection auscultation *ercussion
+& $uscultation *ercussion *al*ation ins*ection
,& Ins*ection auscultation *ercussion *al*ation
D& <ercussion auscultation ins*ection *al*ation

-"e #unction o# t"e lier includes all o# t"e #ollo'ing e)ce*t.

$& ormation o# ammonia to remoe urea #rom t"e 9lood
+& He*atocytes secrete 9ile
,& 6ynt"esi?es amino acids and al9umin
D& 6ynt"esi?es *rot"rom9in #i9rinogen and al9umin

 Cursing interentions #or t"e *atent 'it" "e*atic #ailure include.

$& Restrict *rotein in t"e diet
+& $oid use o# narcotics sedaties and tran:uili?ers
,& $dminister lactulose and neomycin as *rescri9ed
D& $ll o# t"e a9oe

-"e underlying cause o# most 9leeding eso*"ageal arices is.

$& $cid *e*sin erosion secondary to gastroeso*"ageal re#lu)
+& <ortal "y*ertension due to lier disease
,& Hig" enous *ressure at t"e eso*"agogastric Aunction due to systemic "y*ertension
D& -raumatic eso*"ageal damage

-"e rationale #or t"e use o# neomycin in t"e setting o# lier #ailure is to.
$& <reent t"e likeli"ood o# se*sis in t"e eent o# seere gastrointestinal 9leed
+& <romote t"e manu#acture o# *rot"rom9in actiating itamin  
,& In"i9it t"e *roduction o# ammonia 9y intestinal 9acteria
D& Esta9lis" a 9lood leel o# anti9iotic in antici*ation o# surgery

-"e administration o# aso*ressin s"ould 9e most care#ully monitored in *atients '"o "ae.
$& Dia9etes Insi*idus
+& ,oronary artery disease
,& Hy*otension secondary to G&I& +leeding
D& Dia9etes 8ellitus

>rea is #ormed 9y t"e lier to rid t"e 9ody o#.

$& ,reatinine
+& +icar9onate
,& +iliru9in
D& $mmonia
-"e ina9ility o# t"e lier to conAugate '"at su9stance is a *rimary contri9utor to "e*atic co ma
$& $mmonia
+& >rea
,& atty $cids
D& +iliru9in

!"ic" o# t"e #ollo'ing may *reci*itate t"e onset o# "e*atic ence*"alo*at"y in *atients 'it" seere lier
dys#unction
$& Diuretics
+& $cute in#ection
,& GI +leeding
D& $ll o# t"e a9oe

!"ic" o# t"e #ollo'ing may contri9ute to t"e *reci*itation o# ence*"alo*at"y in t"e *atient 'it" lier #ailure
$& GI +leeding
+& Hy*okalemia
,& Hy*otension
D& $ll o# t"e a9oe

Ecc"ymosis around t"e um9ilicus indicatie o# *eritoneal 9leeding is called.

$& ,"osteks sign
+& Grey -urners sign
,& ,ullens sign
D& -rousseaus sign

<ulmonary com*lications o# acute *ancreatitis may include.

$& $dult res*iratory distress syndrome
+& Eleation o# t"e dia*"ragm and 9ilateral 9asilar rales
,& $telectasis es*ecially o# t"e le#t 9ase
D& $ll o# t"e a9oe

!"ic" o# t"e #ollo'ing analgesics is t"e drug o# c"oice in managing t"e *ain o# acute *ancreatitis
$& Demerol
+& 8or*"ine
,& ,odeine
D& Dilaudid

$ 9luis"green 9ro'n discoloration in t"e #lank and groin due to retro*eritoneal 9leeding is called.
$& Grey-urners sign
+& ,ullens sign
,& ernigs sign
D& !elc"s sign

<atient assessment #indings indicatie o# a 9o'el in#arction 'ould include.

$& Hy*oactie 9o'el sounds and leukocytosis
+& Hy*erresonance and a9dominal tenderness
,& $9sence o# dullness in t"e lier area
D& $ll o# t"e a9oe
Renal 6ystem –Disk 5 (J52.00

$ 'eig"t gain o# one kilogram in 2 "ours may indicate #luid retention o# at least.
$& 20 ml
+& 00 ml
,& 1000 ml
D& 2000 ml

6igns o# ra*idlydeelo*ing alkalosis may include $77 +>- !HI,H o# t"e #ollo'ing.
$& Cerous irrita9ility
+& 9tundation
,& 8uscle tremors
D& 6ei?ures

!"ic" o# t"e #ollo'ing drugs actually remoes *otassium #rom t"e 9ody in "y*erkalemic *atients in acute renal
#ailure
$& 6odium 9icar9onate
+& ,alcium c"loride
,& Glucose and insulin in#usion
D& aye)alate and 6or9ital

-"e electrolyte a9normality t"at *roduces a > 'ae a de*ressed 6- segment and entricular irrita9ility is.
$& Hy*ernatremia
+& Hy*erkalemia
,& Hy*okalemia
D& Hy*ocalcemia

!"ic" EG #inding 'ould not 9e o9sered in t"e *resence o# "y*erkalemia

$& <rolonged <R interal
+& $9sence o# < 'aes
,& ;entricular irrita9ility
D& !idened R6 com*le)es

-"e glomerular #iltration rate (GR can 9e 9est measured 9y ealuating t"e *atients.
$& 6erum creatinine
+& +lood urea nitrogen
,& 6erum osmolality
D& ,reatinine clearance

$**ro)imately @0B0% o# sodium and 'ater rea9sor9ed #rom t"e glomerular #iltrate at t"e.
$& <ro)imal tu9ule
+& 7oo* o# Henle
,& Distal -u9ule
D& ,ollecting tu9ules

-"e maAor #unction o# t"e loo* o# Henle is t"e.

$& Rea9sor*tion o# electrolytes
+& ,oncentration or dilution o# urine
,& Rea9sor*tion o# 'ater under t"e control o# $DH
D& 6ecretion o# "ydrogen ion ammonia and *otassium
!"ic" o# t"e #ollo'ing actiities is *er#ormed at t"e distal conoluted tu9u le
$& ,oncentration o# urine
+& $ctie rea9sor*tion o# Ca,l 'it" *assie 'ater rea9sor*tion
,& !ater rea9sor*tion under $DH control
D& Rea9sor*tion o# glucose amino acids *"os*"ates uric acid and *otassium

$ *atient "as a urinary out*ut o# 1000 cc in 2 "ours 'it" a urine sodium leel o# 2 mE:/liter& -"ese #indings
 *ro9a9ly indicate.
$& -"e *atient is on a salt#ree diet
+& -"e *atients kidneys "ae a decreased 9lood *er#usion
,& -"e *atient is in t"e 9eginning o# renal #ailure
D& -"e *atient is *rogressing to t"e *rerenal *"ase

Isc"emia inAury to t"e kidney 'ill usually commence '"en t"e mean arterial 9lood *ressure #alls 9elo'.
$& 100 mmHg #or 50 minutes
+& 40 mmHg #or 2 "ours
,& @0 mmHg #or 0 minutes
D& @0 mmHg #or 2 "ours

-"e t'o most common causes o# acute renal #ailure or ($-C are.
$& Ce*"roto)ic su9stances and isc"emia
+& Isc"emia and urologic o9structions
,& Ce*"roto)ic drugs and "eay metals
D& Im*aired renal *er#usion and "e*atorenal causes

-"e *atient 'it" acute tu9ular necrosis is di##erentiated #rom a *atient 'it" decreased renal *er#usion 9ecause
C7L in decreased renal *er#usion.
$& -"e urine olume is lo' and t"e kidneys #ail to res*ond to 7asi)
+& -"e urine osmolality is greatly reduced
,& -"e urine sodium is 0 to 100 mE:/7
D& -"e +>C to creatinine ratio is at least 20.1

-"e oliguric stage o# acute renal #ailure !>7D C- include '"ic" o# t"e #ollo'ing.
$& +>C 20mg%
+& ,reatinine 4mg%
,& 6igns o# ,H
D& <otassium 3 mE:/7

In $-C caused 9y ne*"roto)ic drugs 7asi) 'ill.

$& Increase to)icity
+& ,ause diuresis t"us correcting oliguria
,& Increase 9lood #lo' to t"e kidneys
D& Im*roe t"e *atients renal status
Hematological – Disk 5 (J1.21

+ cells are res*onsi9le #or.

$& Humoral immunity
+& ,ellular immunity
,& -y*e I "y*ersensitiity reactions
D& ,ellmediated "y*ersensitiity

-"e most common immunoglo9ulin '"ose *rimary e##ect against 9acterial disease is.
$& Ig8
+& IgE
,& Ig$
D& IgG

!"ic" o# t"e #ollo'ing statements regarding cellular immunity s -R>E

$& It #unctions in concert 'it" immunoglo9ulins
+& It is im*ortant in deelo*ment o# autoimmune disease K gra#t reAection
,& $ signi#icant res*onse *roduces leuko*enia
D& $ll o# t"e a9oe

-"e immediate administration o# '"ic" o# t"e #ollo'ing is E66EC-I$7 in t"e initial management o# ana*" yla)is
$& E*ine*"rine 0& – 1 ml o# 1.1000 solution
+& )ygen
,& ;olume re*letion
D& ,orticosteroids and amino*"ylline

!"ic" o# t"e #ollo'ing 9lood *roducts contains only #actors ;III #i9rinogen and MIII and is utili?ed in "emo*"ilia
$ and DI,
$& <latelet concentrate
+& <lasmanate
,& res" #ro?en *lasma
D& ,ryo*reci*itate

Disseminated intraascular coagulo*at"y is.

$& >sually a *rimary disorder 
+& $ "emorr"agic e*isode #rom an initial lack o# clotting mec"anisms
,& !ides*read ina**ro*riate clotting t"at triggers 9leeding
D& Diagnosed 9y an increase leel o# clotting #actors

-"e *at"o*"ysiology o# disseminated intraascular coagulation includes.

$& In"i9ition o# t"rom9inolysins
+& En"anced *roduction o# intraascular t"rom9in resulting in increased #i9rin and *latelet aggregation
,& Diminis"ed *latelet ad"esieness and aggregation
D& En"ancement o# intraascular clots due to an oer*roduction o# clotting #actors

!"ic" o# t"e #ollo'ing la9oratory diagnostic #indings is C- likely to 9e seen in DI,
$& <- and <-- *rolonged
+& <latelet count decreased
,& i9rinogen increased
D& i9rin s*lit *roducts eleated
!"ic" o# t"e #ollo'ing la9oratory diagnostic #indings 'ill 86- 7IE7L 9e seen in DI,
$& <- and <-- *rolonged
+& i9rinogen increased
,& -"rom9in time decreased
D& <latelet count increased

-"e intrinsic system o# 9lood clot initiation is.

$& $ctiated 9y tissue t"rom9o*lastin
+& +est ealuated 9y *rot"rom9in time
,& De*endent u*on calcium and itamin  
D& $ctiated 9y endot"elial inAury

Release o# '"at su9stance into t"e circulation secon dary to retained dead #etus a9ru*tion *lacenta and stress may
cause DI,
$& i9rinolysin
+& -issue t"rom9o*lastin
,& He*arin
D& i9rin s*lit *roducts

-"e 9ene#icial e##ects o# "e*arin in DI, are t"oug"t to 9e due to its.

$& 6timulating e##ect on *latelet manu#acture
+& Ceutrali?ing o# #reecirculating t"rom9in
,& $nti#i9rinolysin actiity
D& In"i9ition o# *latelet #actor MII release
,ardioascular – Disk  and  (1B%

$ *atient 'it" a HR o#  com*lains o# di??iness and cool clammy e)tremities& !"at is t"e #irst drug o# c"oice
$& $tro*ine 0&mg  1mg
+& E*ine*"rine 1mg i *us"
,& Isu*rel in#usion 210mcg/kg/min
D& $denosine @ mg i *us"

Lou are treating a *atient 'it" a slo' "eart9eat& or '"ic" o# t"e #ollo'ing *atient 'ould atro*ine 9e e##ectie
$& $  y/o male 'it" seere c"est *ain and sinus 9radycardia at 5 9*m
+& $  y/o male 'it" 'eakness and 5rd degree H+
,& $  y/o male 'it" #atigue and a "eart trans*lant @ mont"s ago
D& $  y/o male 'it" 'eakness and acute sym*toms o# nausea/omiting 'it" a sinus HR o# 5

!"ic" o# t"e #ollo'ing t"era*ies is t"e most im*ortant interentions #or ;/*ulseless ;- 'it" t"e greatest e##ect
o# surial to "os*ital disc"arge
$& E*ine*"rine
+& De#i9rillation
,& )ygen
D& $miodarone

$ 3y/o *atient 'it" ra*id $ a**ro)imately 1@0 *er minute and irregular c/o *al*itations #or a 'eek& Co
eidence o# cardiac or circulatory #ailure& !"ic" 'ould 9e included in t"e initial orders
$& )ygen i monitor 
+& Immediate cardioersion
,& Co t"era*y is indicated
D& E*ine*"rine 1mg i eery 5 min

6ame *atient& His ital signs remain unc"anged +< 100/30 irregular HR o# 1@0& !"ic" o# t"e #ollo'ing 'ould 9e
t"e most a**ro*riate treatment #or $
$& I; digo)in
+& I; diltia?em to slo' entricular res*onse
,& I; amiodarone to conert $ to 6R 
D& 6ync"roni?ed cardioersion

2 y/o 'oman is 'it" <6;- *rior medical HM con#irmed reentry tac"ycardia no !<!& HR 1B09*m s"e is so9
and re*orts *al*itations& !"ic" 'ould 9e t"e ne)t most a**ro*riate interention
$& Dc cardioersion
+& I; diltia?em
,& I; *ro*ranolol
D& I; adenosine

 y/o m 'it" HM ,H K 7+++ deelo*s sustained 'ide com*le) tac"ycardia a#ter an e*isode o# ,< relieed 9y
 C-G& !"ic" o# t"e #ollo'ing is t"e most a**ro*riate initial med
$& I; lidocaine
+& I; adenosine
,& I; amiodarone
D& I; era*amil

!"ic" o# t"e #ollo'ing *ressures are 'it"in normal limits

$& <$< 5/2 <,!< 12
+& <$< 50/20 <,!< 10
!"ic" o# t"e #ollo'ing 'ould cause an eleated *ulmonary artery *ressure and normal 'edge *ressure
$& <ulmonary "y*ertension
+& <ulmonary edema
,& 7e#t entricular #ailure
D& ,onstrictie *ericarditis

$ large  'ae a**ears on t"e <,!< tracing o# a *atient 'it" an in#erior 'all myocardial in#arction& -"is #inding
is consistent 'it".
$& ,ardiogenic s"ock 
+& ,ongestie "eart #ailure
,& 8itral regurgitation
D& <ericarditis

6- eleation and a9sence o# an R 'ae in ;1; 'ould 9e indicatie o#.

$& $nteriorse*tal 'all in#arction
+& In#erior 'all isc"emia
,& $nterior  se*tal 'all isc"emia
D& $nterior  lateral 'all in#arction

!"ic" o# t"e #ollo'ing "emodynamic *arameters 'ould ind icate le#t entricular #ailure in a *atient 'it" co*d
$& <a* /22 <,!< 1 ,;< B
+& <a* B/2@ <,!< 1@ ,;< @
,& <a* 22/12 <,!< 2@ ,;< 1@
D& <a* B/2@ <,!< 20 ,;< 1@

-"e reci*rocal c"anges t"at occur 'it" an in#erior 'all mi are seen as 6- de*ression in leads.
$& II III $;
+& ;1;
,& II $;1
D& I $;1

!"ic" o# t"e #ollo'ing com*lications is most likely to occur in acute in#erior myocardial in#arction
$& 8o9it? ty*e I "eart 9lock ('enc"e9ac"
+& <aro)ysmal atrial tac"ycardia (*at
,& Rig"t 9undle 9ranc" 9lock (R+++
D& ,ardiogenic s"ock 

Lour *atient 'it" an in#erior 'all mi also "as a rig"t entricular in#arction K deelo*s rig"t entricular #ailure&
!"ic" data o9tained 'ould correlate 'it" t"is *atientFs condition
$& <a* 2B/10 <,!< 10 ,;< 1B
+& <a* 5B/22 <,!< 20 ,;< @
,& <a* /2B <,!< 1 ,;< 1
D& <a* 25/B <,!< 14 ,;< 20

-"e treatment modality #or a *atient 'it" R; #rom an in#erior 'all mi 'ould include.
$& Ci*ride and lo' dose do*amine
+& Cormal saline #luid c"allenge
,& 7asi) and *reload reducers
D& 7idocaine and a#terload reducers
 $& +< BB/@0 *a 1B/B <,!< 12
+& +< 30/0 *a 50/20 <,!< 22
,& +< 40/@0 *a 2/1B <,!< 2
D& +< 4/@ *a 0/22 <,!< 20

,linical mani#estations o# cardiogenic s"ock #ollo'ing an anterior 'all mi include all o# t"e #ollo'ing e)ce*t.
$& Distended neck eins
+& <ulmonary congestion rales
,& <resence o# an s5
D& 7o' ,;< reading

>nloading t"era*y 9y nitro*russide is 9ene#icial 9ecause it.

$& En"ances entricular em*tying
+& Diminis"es *eri*"eral ascular resistance or a#terload
,& Reliees *ulmonary congestion 9y *romoting enous *ooling o# 9lood
D& $ll o# t"e a9oe

!"ic" o# t"e #ollo'ing is an e)*ected outcome #rom I$+<

$& Decreased mean systemic +<
+& Increased cardiac out*ut
,& Increased <,!<
D& $ll o# t"e a9oe

-o 9e o*erating correctly t"e I$+< is timed to 'ork in '"ic" manner

$& In#late during systole de#late during diastole
+& In#late '"en t"e mean aortic *ressure #alls 9elo' a *reset limit
,& In#late '"en t"e "eart rate #alls 9elo' a *reset limit
D& In#late during diastole de#late during systole

$9solute contraindications to intraaortic 9alloon counter *ulsation include.

$& 8itral insu##iciency
+& $ortic insu##iciency
,& 6e*sis
D& emoral artery aneurysm

$ll *osto*eratie cardiac surgery *atients deelo*.

$& <ericarditis
+& Electrolyte im9alances
,& Hy*o)ia
D& $telectasis

!"ic" o# t"e #ollo'ing kinds o# s"ock is c"aracteri?ed 9y increased enous ca*acitance and *ooling
$& Hy*oolemic s"ock
+& ,ardiogenic s"ock
,& Distri9utie s"ock (se*tic
D& 9structie s"ock 

Early stages o# se*tic s"ock are c"aracteri?ed 9y.

$& ;asoconstriction 'it" t"e release o# "istamine
+& Increased cardiac out*ut 'it" *eri*"eral asoconstriction
,& ;asodilation 'it" #luid loss and t"e release o# leukocytes
D& Increased cardiac out*ut 'it" decreased ascular resistance
 +& 6e*tic
,& Hy*oolemic
D& ,ardiogenic

$ *atient admitted to t"e I,> in t"e early stages o# se*tic s"ock *resents 'it".
$& !eak t"ready *ulses and lo' +<
+& Decreased >
,& !arm #lus"ed skin
D& Hy*er*nea 'it" *ulmonary congestion

!"ic" o# t"e #ollo'ing signs is not c"aracteristic o# cardiac tam*onade

$& !idening *ulse *ressure
+& Rising ,;<
,& !ide mediastinum on MR$L
D& $ #all in systolic +< o# more t"an 10mm"g during ins*iration

-"e *lacement o# mcl electrodes is.

$& N electrode t" I,6 r sternal 9order  electrode 9elo' outer 5rd o# l claicle
+& N electrode t" I,6 r sternal 9order  electrode l lo'er $+D
,& N electrode l s"oulder  electrode r s"oulder
D& N electrode l mida)illary line t" I,6O  electrode 9elo' outer 5rd o# le#t claicle

-"e most serious EG #inding associated 'it" anterior 'all mi is.
$& ascicular 9locks and tac"ycardia
+& R+++ and second degree 9locks
,& e' entricular ecto*ic 9eats
D& Ra*id su*raentricular r"yt"ms

-"e "emodynamic *arameter t"at clinically measures a#terload is.

$& ,;<
+& 8a*
,& 6;R  
D& 7e#t entricular enddiastolic *ressure

$ll o# t"e #ollo'ing su**ort t"e diagnosis o# cardiac tam*onade e)ce*t.

$& !idening *ulse *ressure
+& <ulsus *arado)us
,& Enlarged "eart on MR$L
D& E:uali?ation o# rig"t and le#t "eart *ressures

$ *atient 'it" +< o# 200/12 'ould "ae '"ic" o# t"e #ollo'ing #orms o# H-C
$& Essential H-C
+& $ccelerated H-C
,& 8alignant H-C
D& Hy*ertensie ence*"alo*at"y
!"ic" o# t"e #ollo'ing statements regarding esicular 9reat" sounds is true
$& -"ese are medium intensity sound "eard oer t"e large mainstem 9ronc"i
+& -"ey are "eard longer on e)"alation
,& -"ey are decreased or a9sent '"en air#lo' to t"e area o# lung is diminis"ed
D& -"ey are auscultated o# t"e trac"

!"ic" o# t"e #ollo'ing c"est auscultation #indings is a9normal

$& ;esicular 9reat" sounds oer lung *eri*"ery
+& +ronc"ial 9reat" sounds "eard oer large air'ay
,& ;esicular 9reat" sounds "eard during ins*iration and e)*iration
D& +ronc"oesicular sounds adAacent to t"e sternum

!"ic" o# t"e #ollo'ing *atient #indings 'ill contri9ute a s"i#t to t"e le#t 'it" im*aired tissue unloading o# o)ygen
$& <" 3&B
+& -em* 105#  
,& <$,2 0mm"g
D& Increased "emoglo9in 2 5 D<G

!"ic" o# t"e #ollo'ing *atient #indings 'ill contri9ute to a s"i#t to t"e rig"t 'it" im*roed unloading o# o)ygen at
t"e tissues
$& <" 3&@
+& -em* 4@#  
,& <$,2 
D& Decreased "emoglo9in 2 5 D<G

<atient in ,,> *ost cardiac arrest. I2 0&B <H 3&51 <,2 2 <2 @0 2 6$- B% and H,5 1B.
$& ,om*ensated meta9olic acidosis
+& >ncom*ensated res*iratory acidosis
,& >ncom*ensated meta9olic acidosis
D& >ncomensated meta9olic acidosis

<atient *resents 'it" agitation and tingling o# t"e #ingers. I2 R$ <H 3&4 <,2 2 2 6$- 4B% H,5 22.
$& Cormal acid9ase 9alance
+& >ncom*ensated res*iratory alkalosis
,& >ncom*ensated res*iratory acidosis
D& >ncom*ensated meta9olic alkalosis

 Ce'ly admitted mi *atient on t"ia?ide diuretics at "ome #or "y*ertension "as an $+G. I2 0&@ <H 3&B <,2
5@ <2 30 2 6$- 40% H,5 5
$& >ncom*ensated meta9olic alkalosis
+& >ncom*ensated res*iratory alkalosis
,& >ncom*ensated meta9olic acidosis
D& ,om*ensated meta9olic alkalosis

<ulmonary consolidation (lo9ar *neumonia 'ill cause '"ic" o# t"e #ollo'ing *"ysical #indings oer t"e diseased
area
$& Dull *ercussion note
+& Decreased tactile #remitus
,& +ronc"ial 9reat" sounds
D& +ot" a and c
 +& -enaciousness
,& ,o*ious nature
D& $9sence

$n ominous #inding in t"e *atient 'it" status ast"maticus 'ould 9e.

$& $ res*iratory rate o# 5
+& 7oud e)*iratory '"ee?ing
,& $ ,2 o# 
D& >se o# accessory muscles

$ *atient 'it" status ast"maticus is admitted& His 9reat" sounds are diminis"ed t"roug"out "is lung #ields& RR=0&
$#ter giing your *atient an aerosol 9ronc"od ilator your *atient sounds 'orse as t"ey are no' louder& -"is
indicates.
$& -"e *atient "as gotten 'orse
+& -"e need #or anest"esia to 9e *resent stat
,& -"e *atient is getting 9etter 
D& -"e *atient does not "ae ast"ma

!"en adAusting t"e initial settings on a olume  entilator #or an adult in res*iratory #ailure t"e tidal olume is
usually set at.
$& $t least 10ml *er kg or t'ice normal
+& 120 ml *er kg or t'ice normal
,& 00 ml #or all *atients
D& 50000 ml

$ 30 kg *atient entilated 'it" I2 o# % ;- o# B00 I8; o# B& <atients res*irations are 10/min& $9g results.
2 B% ,2  '"at entilator *arameter s"ould 9e c"anged
$& I2
+& I8;
,& ;-
D& $ll o# t"e a9oe

-"e normal $a gradient (aleolar to arterial gradient #or o)ygen #or an adult 9reat"ing room air is less t"an.
$& 10 mmHg
+& 20 mmHg
,& 100 mmHg
D& 200 mmHg

$dministration o# 100% 2 'ill not im*roe t"e <$2 in "y*o)ia caused 9y.
$& ;/ im9alance
+& Rig"t to le#t s"unting
,& $leolar "y*oentilation
D& Im*aired di##usion

!"ic" o# t"e #ollo'ing diseases states does not cause "y*o)ia due to a *rimary mec"anism o# /: mismatc"ing
$& +ronc"os*astic disease
+& <ulmonary em*"ysema
,& $dult res*iratory distress syndrome
D& <ulmonary em9oli?ation
 +& 6"unting
,& Hy*oentilation
D& Decreased I2

!"ic" o# t"e #ollo'ing statements regarding $RD6 is true

$& -"ere is decreased ca*illary *ermea9ility
+& -"ere is damage to ty*e II *neumocytes 'it" a decreased o# sur#actant
,& -"ere is an increase in lung com*liance
D& -"ere is an increase in #unctional residual ca*acity

$ssessment #indings indicatie o# $RD6 in t"e early stage 'ould include all o# t"e #ollo'ing e)ce*t.
$& -ac"y*nea
+& Cormal <,!<
,& Res*iratory alkalosis
D& Hy*erca*nia

-"e "allmark o# adult res*iratory distress syndrome ($RD6 is.

$& Re#ractory "y*erca*nia
+& Re#ractory "y*o)emia
,& 7o' #unctional residual ca*acity
D& Increased com*liance secondary

-"e nurse considers '"ic" interention to 9e ina**ro*riate '"ile caring #or t"e *atient 'it" ards
$& $dminister small doses 7asi) as ordered 9y md
+& In#usion o# normal saline ra*idly in order to maintain "ydration
,& <ulmonary toileting
D& re:uent *osition c"anges&

-"e *lan o# t"era*eutic attack in t"e care o# $RD6 *atients may include.
$& >se o# ent 'it" "ig" *ressure and "ig" #lo' c"aracteristics
+& Diuretics and #luid restriction
,& >se o# *ee*
D& $ll o# t"e a9oe

<al*ation o# trac"eal s"i#t to t"e le#t may indicate.

$& $ tension *neumot"ora) on t"e rig"t
+& 8assie atelectasis to t"e rig"t
,& $ tension *neumot"ora) on t"e le#t
D& Di##use air'ays o9struction

Initial nursing assessment #indings in t"e *atient 'it" an acute *ulmonary e m9olism includes.
$& ,"est *ain 6- c"anges *ulmonary edema
+& Rales r"onc"i tac"ycardia
,& ,"est *ain dys*nea coug"
D& -ac"y*nea 9radycardia rales

!"ic" assessment #inding 'ould not 9e *resent in t"e *atient 'it" a massie *ulmonary em9olism
$& Increased ,;< reading
+& <ulmonary rales
,& Distended neck eins
D& 7ier enlargement