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    Exam Review

    1. When the ventilator alarm sounds, the nurse finds the ICU patient lying in bed holding the endotracheal tube (ET). Which action would the nurse take first?
      A)
      Assess for respiratory distress and offer reassurance to the patient.
      B)
      Support oxygenation as needed by applying a nasal cannula or manually ventilating the patient with 100
      C)
      Immediately call the health care provider and assess the need to reintubate.
      D)
      Provide sedation and place patient on their left side.
    2. A patient with an oral endotracheal (ET) tube has tube feeding in progress. To address the risk for aspiration, the nurse will perform which intervention for this patient?
      A)
      Keep head of bed elevated at least 30-45 degrees.
      B)
      Maintain cuff pressure to prevent gastric secretions from entering trachea.
      C)
      Remove the bite block and perform oral hygiene every 2 hours.
      D)
      Use chest physiotherapy to allow secretions to be suctioned.
    3. A nurse entering a patient's room assesses the patient to be non-responsive. The cardiac rhythm looks to be normal sinus rhythm but the nurse does not feel a pulse. What is the correct term for this rhythm?
      A)
      Ventricular tachycardia.
      B)
      Pulseless electrical activity.
      C)
      Sudden cardiac death.
      D)
      Premature ventricular contractions (PVC).
    4. The nurse is caring for a patient with a pulmonary artery catheter. The nurse assesses the pressure monitoring system and would immediately correct which finding?
      A)
      The pressure bag is inflated to 100mmHg.
      B)
      Normal saline is used for the flush bag.
      C)
      The transducer is zeroed with good waveform noted.
      D)
      The connections are secure.
    Page 1 of 11

    Exam Review

    1. The nurse is monitoring the Pulmonary Artery (PA) catheter and notes a central venous pressure reading of 15mmHg. The nurse anticipates administering the patient which medication?
      A)
      Ativan 1 mg intravenous bolus now.
      B)
      Albumin 20
      C)
      Furosemide 40 mg intravenous bolus now.
      D)
      Digoxin 0.25 mg intravenous bolus now.
    2. The nurse is assisting with a patient being intubated at the bedside. After endotracheal tube insertion and the cuff inflation, what are the next appropriate actions to confirm placement before securing the airway? Select all that apply.
      (SATA)
      A)
      Administer a sedative and paralytic agent.
      B)
      Order a chest x-ray.
      C)
      Use an end-tidal CO2 detector.
      D)
      Auscultate for bilateral breath sounds.
      E)
      Obtain ABGs.
    3. All of the following patients require intravenous push (IVP) medications. The nurse would administer which patient's medication first?
      A)
      A scheduled dose of IVP furosemide for a patient displaying signs of shortness of breath.
      B)
      PRN IVP diphenhydramine for a patient complaining of itching.
      C)
      PRN IVP morphine for a patient complaining of moderate pain.
      D)
      A scheduled dose of IVP digoxin for a patient in atrial fibrillation.
    4. A patient sustained trauma to the chest that caused severe impairment of the primary pacemaker cells of the heart. The nurse understands that which area of the cardiac system received the greatest damage?
      A)
      Sinoatrial (SA) node.
      B)
      Atrioventricular (AV) node.
      C)
      Bundle of His.
      D)
      Purkinje fibers.
    Page 2 of 11

    Exam Review

    1. The ICU nurse identifies asystole on the patient's monitor. What is the initial action taken by the nurse?
      A)
      Administer Epinephrine 1 mg IVP per ACLS protocol.
      B)
      Prepare for immediate intubation.
      C)
      Assess the rhythm in more than one lead before treating.
      D)
      Administer Atropine 0.5 mg bolus per ACLS protocol.
    2. An RN is observing a nursing student who is performing closed suctioning on a hospitalized patient with an endotracheal (ET) tube in place. Which actions by the student require the RN to intervene? Select all that apply.
      (SATA)
      A)
      Applies suction while inserting the catheter.
      B)
      Adjusts wall suction to 100-120 mm Hg.
      C)
      Adds air to the ET tube and slightly deflates the cuff.
      D)
      Hyperoxygenates the patient with 100
      E)
      Inserts the catheter until resistance is met.
    3. A patient presents to the Emergency Department in Supraventricular Tachycardia (SVT). The patient is assessed with complaints of chest pain and a BP of 80/40. Synchronized cardioversion is ordered by the MD. What does the nurse do?
      A)
      Set sync with discharge on the P wave.
      B)
      Defibrillate at 360 joules.
      C)
      Defibrillate at 100 joules.
      D)
      Select sync with discharge on the R wave.
    4. A nurse is participating in a Code Blue. Which actions are important to maintain therapeutic communication during the code? Select all that apply.
      A)
      Announce interventions given.
      B)
      Repeat orders three times.
      C)
      Control tone of voice.
      D)
      Speak clearly.
      E)
      Use closed-loop communication.
    Page 3 of 11

    Exam Review

    1. The nurse admits a patient to the ICU with a gastrointestinal bleed and a week long history of vomiting and diarrhea. The patient has a Pulmonary Artery (PA) catheter in place. A fluid bolus is initiated to treat which underlying issue?
      A)
      Decreased preload.
      B)
      Decreased afterload.
      C)
      Increased preload.
      D)
      Increased afterload.
    2. The health care provider orders positive end expiratory pressure (PEEP) to be added to the settings of a mechanically ventilated patient. Which is the most important information for the nurse to obtain when monitoring for the effectiveness of this intervention?
      A)
      Oxygen saturation.
      B)
      Tidal volume.
      C)
      Respiratory rate.
      D)
      Arterial blood pressure.
    3. The nurse is analyzing the patient's arterial waveform. The dicrotic notch on the descending limb of the waveform signifies which action?
      A)
      Closure of the aortic valve.
      B)
      Opening of the aortic valve.
      C)
      Closure of the mitral valve.
      D)
      Opening of the mitral valve.
    4. Prescribed: Amiodarone hydrochloride 5 mg/kg as IV push now. Available: Amiodarone hydrochloride 150 mg/3 mL. Patient weight: 80 kg. How many mL will the nurse administer for the prescribed dose?
    Page 4 of 11

    Exam Review

    1. The nurse obtains a 6 second EKG strip on a patient. The nurse interprets this strip as what rhythm?
      A)
      Premature ventricular contraction (PVC).
      B)
      Ventricular tachycardia (VT).
      C)
      Ventricular fibrillation (VF).
      D)
      Premature atrial contraction (PAC).
    2. A nurse is caring for a patient with a right radial arterial line. Which action should the nurse take?
      A)
      Ensure the pressure bag around the flush solution is inflated to 300 mm Hg.
      B)
      Flush the line before administering antibiotics.
      C)
      Instruct the patient to bear down when readings are obtained.
      D)
      Position the patient in Trendelenburg to obtain readings.
    3. The nurse notes that a patient's endotracheal tube (ET), which was at the 21-cm mark, is now at the 24-cm mark and the patient appears anxious and restless. Which action should the nurse take first?
      A)
      Notify the patient's health care provider.
      B)
      Bag the patient at an FiO2 of 100
      C)
      Offer reassurance to the patient.
      D)
      Listen to the patient's lung sounds.
    4. The nurse recognizes third-degree AV block on a patient's EKG strip. What does the nurse expect the treatment to be?
      A)
      Diltiazem (Cardizem) IV.
      B)
      Insertion of a permanent pacemaker.
      C)
      Observation for progression to higher degree block.
      D)
      Procainamide (Pronestyl) IV.
    Page 5 of 11

    Exam Review

    1. The ACLS certified nurse determines a patient is in PEA. CPR is in progress. Three minutes after epinephrine 1 mg is given, PEA continues. Which action should the nurse do next?
      A)
      Initiate transcutaneous pacing.
      B)
      Administer atropine 1 mg IVP.
      C)
      Give epinephrine 1 mg IVP.
      D)
      Start a dopamine IV 2-10 mcg/kg/min.
    2. The nurse notes that a patient's endotracheal tube (ET), which was at the 21-cm mark, is now at the 24-cm mark and the patient appears anxious and restless. Which action should the nurse take first?
      A)
      Notify the patient's health care provider.
      B)
      Bag the patient at an FiO2 of 100
      C)
      Offer reassurance to the patient.
      D)
      Listen to the patient's lungs.
    3. The nurse reviews the mixed venous sample from the pulmonary artery catheter and notes the SvO2 to be 70 The nurse understands the meaning of this value to be which of the following?
      A)
      Balanced O2 supply and demand.
      B)
      Hypoxic respiratory failure.
      C)
      Decreased O2 supply and increased demand.
      D)
      Hypercapnic respiratory failure.
    4. A patient is intubated and placed on continuous mechanical ventilation. Which equipment is most important for the nurse to keep at this patient's bedside?
      A)
      Pulse oximeter.
      B)
      Nasal cannula.
      C)
      Manual resuscitation bag.
      D)
      Chest tube drainage set-up.
    Page 6 of 11