Critical Care Nursing, A Holistic Approach Test-Bank 10th edition by Patricia Gonce Morton, Dorris K.Fontaine

10Th_ED Test Bank Critical Care Nursing_A Holistic Approach by Patricia Gonce Morton_Dorris K.Fontaine

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Critical Care Nursing, A Holistic Approach Test-Bank 10th edition by Patricia Gonce Morton, Dorris K.Fontaine

What: TEST BANK

Authors: Patricia Gonce Morton, Dorris K.Fontaine

Edition: 10th

Product Description

10Th_ED Test Bank Critical Care Nursing_A Holistic Approach by Patricia Gonce Morton_Dorris K.Fontaine

1. An elderly patient is being treated after taking too much cardiac medication. The patient states, “I didn’t mean to do it. I can’t see as well as I used to and can’t see the writing on the medication labels.” What intervention by the discharge planning nurse would help prevent this from occurring again?

A) Transfer the patient to the nursing home where she will have her medications administered to her.

B) Call the patient’s family and tell them they must administer the medications to the patient when they are scheduled.

C) Make a home health referral for evaluation of resources and medication dispensing.

D) Encourage the health care provider to prescribe less toxic medication for this patient.

2. The nurse is assigned to a patient who has been in the hospital for 24 hours with a diagnosis of acute alcohol intoxication. The patient states, “I am so stressed out in my marriage and with my job. Drinking is the only way that I can relieve that stress.” What priority intervention would be beneficial for this patient?

A) Commit the patient to a state mental health facility.

B) Refer the patient to a comprehensive treatment program.

C) Make an appointment for the patient to see a psychiatrist.

D) Inform that there are other methods to relieve stress other than drinking alcohol.

3. An adolescent patient has arrived at the emergency department via ambulance after friends reported that she ingested a large quantity of unknown pills after having an argument with her boyfriend. The patient is combative and refuses to divulge the type of pills that she ingested. What lab studies should be performed at this time? Select all that apply.

A) Electrolyte studies

B) T3 and T4

C) Serum osmolality test

D) Liver panel

E) Lipid panel

F) Acetaminophen level

4. The nurse administers morphine sulfate IV to a patient for complaints of abdominal pain. The order was for 2 mg and the nurse realized that she gave the patient 10 mg. The patient’s respiratory rate is 10 and she is unresponsive. What is the nurse’s priority intervention at this time?

A) Call the charge nurse.

B) Administer a stat dose of 50% dextrose.

C) Administer naloxone (Narcan).

D) Fill out a risk management incident report.

5. A patient is receiving chelation therapy. What would the nurse explain to the patient is the purpose of chelation therapy?

A) “Chelation therapy will remove carbon monoxide from the blood.”

B) “Chelation therapy will help to reverse the effects of narcotics.”

C) “Chelation therapy will help promote bowel movements so that the medication will pass through the large intestine.”

D) “Chelation therapy will remove toxic levels of metals from the body.”

6. A patient in the intensive care unit is in acute renal failure secondary to acute tubular necrosis from a nephrotoxic medication and has an anion gap of 20 mEq/L. What does this laboratory value indicate?

A) The patient has metabolic acidosis.

B) The patient has metabolic alkalosis.

C) The lab value is within normal range for this patient.

D) The patient is in end-stage renal failure.

7. A toddler is being discharged from the hospital after being monitored for 24 hours due to a possible ingestion of household cleaner. What priority instruction should be provided to the parents before discharge?

A) The parents should be informed that if the toddler is brought to the hospital again, child protective services will be called.

B) Inform the parents that they were negligent in the care of their child and need to lock up the household cleaners.

C) Educate the parents on methods to child-proof the home so that the child will not have access to various harmful materials.

D) Tell the parents not to worry; many parents bring their children in for similar problems.

8. A patient has arrived at the emergency department via ambulance. The EMT states, “She is barely responsive. She took all of the Ativan in this bottle.” What medication should the nurse prepare to administer to the patient?

A) Naloxone (Narcan)

B) Physostigmine (Antilirium)

C) Methylene blue

D) Flumazenil (Romazicon)

9. The patient has been taking amitriptyline (Elavil) for neuropathic pain in the lower extremities. He comes into the emergency room stating, “I took 15 of them right before I got here. I was tired of it all but should never have done this. Someone help me!” What intervention can help prevent absorption of the medication?

A) Syrup of ipecac

B) Benzodiazepines

C) Gastric lavage

D) Hyperbaric oxygen therapy

10. The patient has been found to have a defective and leaking fentanyl (Sublimaze) patch used for severe pain from recurring migraine headaches. What observations by the nurse indicate complications from this defect?

A) Respirations 10 breaths per/minute

B) Blood pressure 96/68

C) Heart rate 106 beats/minute

D) Blood pressure 160/86

11. A patient is admitted to the emergency department after ingesting an unknown amount of a mixed substance containing cocaine and an opioid. What nursing assessment finding would indicate that the patient’s life is in immediate danger?

A) Agitation and combativeness

B) Tachycardia and elevated blood pressure

C) Depressed respiratory rate and volume

D) Hypoxemia and metabolic acidosis

12. A patient is admitted to the emergency department after ingesting a large amount of an unknown substance while at a beach party. The nurse finds delirium, dry and flushed skin, dilated pupils, fever, decreased bowel sounds, and tachycardia. Urinary catheter insertion shows urinary retention. What ingested substance does the nurse most suspect?

A) Malathion

B) Jimson weed

C) Opiates

D) Cocaine

13. During the initial treatment of a patient with a poisoning or overdose, treatments to prevent absorption and to enhance elimination of the agent are of primary importance. What substance does the nurse administer to enhance elimination of an orally ingested alkaline caustic substance?

A) Mild acid

B) Antivenin

C) Emetic

D) Activated charcoal

14. A 2-year-old has been resuscitated after ingestion of a cleaning solution. As part of discharge teaching, what is the most important information for the nurse to include?

A) Developmental characteristics of toddlers

B) Proper storage and labeling of poisons

C) Use of the poison control phone number

D) A list of most common household poisons

15. A patient has been admitted to the emergency department after ingesting an unknown substance. The nurse finds agitation, tachycardia, hypertension, and episodes of tonic-clonic muscle movements. Arterial blood gases reveal normal oxygenation and metabolic acidosis. What ingested substance does the nurse most suspect?

A) Antihistamine cold medication

B) Carbamate insecticide

C) Lomotil

D) Cocaine

16. The patient has been admitted to the CCU after taking a large amount of cocaine accompanied by large amounts of opioid. Initial detoxification was started in the emergency department. The patient is currently intubated and on mechanical ventilation. To identify life-threatening complications from these substances, what is the nursing priority?

A) Continuous cardiac monitoring

B) Assisting respirations with bag-mask device

C) Use of jaw thrust maneuver to protect airway

D) Monitor serum drug levels of opioids

17. The nurse is providing initial care for a patient who has experienced an ocular splash injury of a toxic liquid. What is the priority of care?

A) Irrigate eyes for 15 to 30 minutes with tap water.

B) Flush eyes with antidote to the substance.

C) Telephone the poison control center for instructions.

D) Obtain ophthalmology consult at bedside.

18. The patient has extensive dermal exposure to a dermal toxin. What is the nursing priority of care?

A) Remove clothing and shower for 15 to 30 minutes.

B) Irrigate affected area with an alkaline solution.

C) Include use of soap in initial shower.

D) Apply a topical soothing and moisturizing agent.

19. The nurse is caring for a patient who has inhaled an airborne toxin. What is the priority of care?

A) Protect the patient’s airway.

B) Administer supplemental oxygen.

C) Protect the airways of rescuers.

D) Administer antidote to toxin.

20. A child has ingested an unknown amount of household bleach, an alkaline substance. The child is currently tachypneic and lethargic. What is the nursing priority treatment?

A) Have the child drink 8 ounces of water.

B) Insert a nasogastric tube for lavage.

C) Administer a mild acid such as vinegar.

D) Administer supplemental oxygen.

21. A patient is admitted to the emergency department after ingesting a large number of tablets. Gastric lavage is ordered. What is the best nursing action during this procedure?

A) Insert a small-bore nasogastric tube to minimize aspiration risks.

B) Position the patient in the left lateral decubitus position with his head down.

C) Lavage the stomach with 200 mL of fluid until pill fragments are seen.

D) Initiate the lavage procedure no sooner than 2 hours after ingestion.

22. A patient has swallowed a large amount of pills. Activated charcoal, an adsorbent, is ordered to reduce toxic absorption. For best use of this substance, what action does the nurse initiate?

A) Administer via nasogastric tube to increase the speed of administration.

B) Verify that the ingested pills will be adsorbed by activated charcoal.

C) Administer the charcoal 4 hours after the pills were ingested.

D) Combine the charcoal with an emetic to increase elimination of toxins.

23. The patient has experienced an accidental salicylate overdose. Urine alkalinization with intravenous sodium bicarbonate solution is ordered. What symptom, if found by the nurse, most indicates a complication of this therapy?

A) Increased urine pH

B) Increased urine salicylate levels

C) Compensated metabolic alkalosis

D) Altered level of consciousness

Answer Key

1. C

2. B

3. A, C, D, F

4. C

5. D

6. A

7. C

8. D

9. C

10. A

11. C

12. B

13. D

14. B

15. D

16. A

17. A

18. A

19. C

20. B

21. B

22. B

23. D

 

 

10Th_ED Test Bank Critical Care Nursing_A Holistic Approach by Patricia Gonce Morton_Dorris K.Fontaine