Med-surg exam 1 multiple choice practice

question

Mechanical ventilation is commonly indicated in all of the following conditions except a. pneumothorax. b. drug overdose. c. status asthmaticus. d. thoracic surgery.
answer

A
question

During spontaneous breathing, air is drawn into the lungs by a. collapsing alveoli. b. low oxygen levels. c. negative pressure. d. positive pressure
answer

C
question

For a patient on mechanical ventilation, total collapse of the alveoli can be prevented by a. low tidal volumes. b. PEEP. c. an inspiratory/expiratory (I/E) ratio of 1:2. d. low FIO2.
answer

B
question

Use the lowest FIO2 that keeps your patient’s a. SaO2 below 90% and PaO2 below 60 mm Hg. b. SaO2 above 60% and PaO2 above 90 mm Hg. c. SaO2 above 60% and PaO2 below 90 mm Hg. d. SaO2 above 90% and PaO2 above 60 mm Hg.
answer

D
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Which of the following should always be kept at the bedside of a patient on mechanical ventilation? a. a fully stocked crash cart b. a T-piece c. a manual resuscitation bag and mask d. a spare orogastric tube
answer

C
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According to the Centers for Disease Control and Prevention guidelines, make sure the ventilator circuit is changed a. every shift. b. once a day. c. once a week. d. only when it’s visibly soiled or malfunctioning.
answer

D
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Unless contraindicated, which intervention best decreases VAP risk in a patient receiving enteral feedings? a. a nasogastric tube b. nasopharyngeal suctioning c. nebulizer therapy d. 30-degree elevation of the head of the bed
answer

D
question

An artificial airway like an endotracheal tube is used in the following type of ventilation A. Positive Pressure B. Negative pressure
answer

A
question

Pressure is applied to the abdomen and thorax to draw air into the lungs through the upper airway in the following type of ventilation A. Positive Pressure B. Negative pressure
answer

B
question

The mode of ventilation which allows the patient to breathe spontaneously at his or her own respiratory rate and depth between the ventilator breaths is A. Controlled Mandatory Ventilation B. Synchronous Intermittent Mandatory Ventilation C. Assist Control Mode D. Pressure Control Mode
answer

B
question

One of the following modes of ventilation has the risk of patient getting respiratory alkalosis A. Controlled Mandatory Ventilation B. Synchronous Intermittent Mandatory Ventilation C. Assist Control Mode D. Pressure Control Mode
answer

C
question

Minute ventilation is equal to A. FiO2 X PEEP B. FiO2/PEEP C. Tidal Volume X Respiratory Rate D. Tidal Volume/Respiratory Rate
answer

C
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One of the following modes of ventilation reduces the work of breathing by overcoming the resistance created by ventilator tubing. A. Controlled Mandatory Ventilation B. Synchronous Intermittent Mandatory Ventilation C. Assist Control Mode D. Pressure Control Mode
answer

D
question

Which of the following conditions require a higher PEEP to be applied in recruiting collapsed alveoli? A. Asthma B. Acute Respiratory Distress Syndrome C. Bronchietasis D. Emphysema
answer

B
question

A client is receiving mechanical ventilation. When the low pressure alarm sounds, which of the following actions should the nurse take? A. Suction the client. B. Check for an air leak. C. Administer the prescribed sedative. D. Determine if there is a kink in the tubing.
answer

B
question

The primary effects of intra-aortic balloon counterpulsation are: a. increased carotid perfusion and increased renal perfusion b. increased coronary perfusion and afterload reduction c. increased afterload and increased coronary perfusion
answer

B
question

Proper positioning of the intra-aortic balloon is: a. below the renal arteries and above the right subclavian b. distal to the common carotid and above the diaphragm c. below the left subclavian and above the renal arteries
answer

C
question

The phase of the cardiac cycle where the majority of myocardial oxygen is consumed is: a. the ventricular ejection b. isovolumetric contraction c. atrial systole
answer

B
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The phase of the cardiac cycle when the balloon is inflated is: a. systole b. diastole
answer

B
question

Isovolumetric relaxation is the beginning of diastole. T/F
answer

True
question

Occlusion of the coronary arteries can lead to a medical crisis and be an indication for the intra-aortic balloon pump. T/F
answer

True
question

Coronary arteries receive the majority of their flow during systole. T/F
answer

False
question

Which of the following are indications for the intra-aortic balloon? a. Cardiac support for high risk general surgery and coronary angiography/angioplasty patients. b. End stage cardiac disease c. Incompetent aortic valve d. Peripheral vascular disease e. Brain death f. Mechanical complications of acute MI g. Cardiogenic shock h. Ischemia related intractable ventricular arrhythmias i. Weaning from cardiopulmonary bypass
answer

a f g h i
question

Positive effects of IABP include which of the following. Select all that apply A. decreased afterload B. decreased preload C. decreased stroke volume D. increased coronary artery perfusion
answer

A, B, D
question

The most common complication of IABP therapy is: A. lower limb ischemia B. aortic dissection C. bleeding D. infection
answer

A
question

Urine output of pt on IABP suddenly drops, a suspected problem would be: A. infection B. anemia C. catheter migration D. balloon rupture
answer

C
question

Indications for IABP use include all of the following except: A. post-op cardiopulmonary bypass B. cardiogenic shock after acute MI C. mitral regurgitation with papillary muslce dysfunction D. uncomplicated MI
answer

D
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After removing the IABP catherer, the nurse should do all of the following except: A. explain to pt they cannot flex affected leg for next 8 hours B. hold pressure on the removal site for 30-45min C. check the site q2hrs only if blood noted on dressing D. check the site q30min for an hour, then q2hr for next 24hrs
answer

C
question

Which of the following is an absolute contraindication to IABP therapy? A. heart failure B. aortic insufficiency C. peripheral vascular disease D. myocardial infarction
answer

B

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