Deck 36: Intensive Care Management of Medical and Surgical Complications

Question 1

Which of the following is not a possible complication or side effect from prolonged endotracheal intubation?

A) Desaturation
B) Ulceration
C) Fibrosis
D) Laryngeal edema

Answer 1

A
Laryngeal edema,ulceration,and fibrosis are all possible results of prolonged intubation.Additionally,mechanical ventilation can rupture a bleb on the surface of the lung and produce a pneumothorax.

Question 2

Renal failure greatly compromises the chances of a patient's survival.Which is not a mechanism of how renal failure develops?

A) Hypertension
B) Gastrointestinal bleeding
C) Sepsis associated with shock
D) Drug-induced nephrotoxicity

Answer 2

A
Gastrointestinal bleeding,sepsis associated with shock,and drug-induced nephrotoxicity are all mechanisms of renal failure along with hypotension.

Question 3

A patient with acute lung injury presents with atelectasis and loss of lung compliance because of the impairment of the production of surfactant and pulmonary fluid that covers the alveolar epithelium.Which type(s)of alveolar cell is/are damaged?

A) Type I
B) Type II
C) Types I and II
D) Type III

Answer 3

B
Both types I and II alveolar cells result in atelectasis and loss of lung compliance.But the mechanism for type II is the impairment of the production of surfactant and pulmonary fluid covering the alveolar epithelium.

Question 4

Which of the following is not a cause of acute respiratory distress syndrome (ARDS)?

A) Insult to the lung and injury of the alveolar-capillary membrane
B) Inhaled toxins
C) Shock
D) Overwhelming pneumonia

Question 5

Which of the following is not a classical feature of shock?

A) Hyperventilation
B) Bradycardia
C) Hypotension
D) Reduced cardiac output

Question 6

Which of the following are common signs of fluid retention with prolonged mechanical ventilation?

A) Systemic edema, weight gain, increased pulmonary compliance, and reduced oxygen transport
B) Pulmonary edema, weight gain, increased pulmonary compliance, and reduced oxygen transport
C) Pulmonary edema, weight gain, decreased pulmonary compliance, and reduced oxygen transport
D) Systemic edema, weight loss, decreased pulmonary compliance, and reduced oxygen transport

Question 7

Which of the following is a complication from surgery that may arise with a patient in intensive care?

A) Pulmonary dysfunction
B) Cardiac dysrhythmias
C) Metabolic dysfunction
D) Deep vein thrombosis

Question 8

Which of the following is a not a condition that predisposes a patient to multiorgan system failure (MOSF)?

A) Sepsis
B) Overwhelming infection
C) Shock
D) Tissue perfusion deficits

Question 9

Which of the following signs and symptoms would be present in a patient you suspect has a pulmonary thromboembolism?

A) Sudden onset of tachypnea, radiating chest pain, and apparent anxiety
B) Sudden onset of tachypnea, radiating chest pain, and syncope
C) Sudden onset of tachycardia, radiating chest pain, and apparent anxiety
D) Sudden onset of tachycardia, radiating chest pain, and syncope

Question 10

Which of the following is a risk factor of a critical illness neuropathy or myopathy?

A) ICU stays of less than 7 days
B) Patients with hypoglycemia
C) The use of beta-blockers
D) Patients who have had organ transplants

Question 11

In a patient with sepsis,which of the following interventions might be considered to reduce excess metabolic demand?

A) Glucose control
B) Analgesia
C) Sedation
D) All of the above

Question 12

What is the best way to manage gastric dilation?

A) Intermittent suction and nasogastric tube
B) Constant suction and nasogastric tube
C) Intermittent suction only
D) Nasogastric tube only

Question 13

Which of the following methods would not reduce the risk of infection with use of a mechanical ventilator?

A) Drain condensation from the hose toward the ventilator.
B) Use a mask and gloves when connecting the patient to the ventilator.
C) Do not directly handle ventilator attachments that communicate with air flow channels.
D) Avoid draining condensation from the hose toward the patient.

Question 14

What position may have immediate benefits in remediating hypoxemia in patients with ARDS?

A) Supine
B) Side-lying
C) Prone
D) Semi-prone

Question 15

What mineral losses are most commonly associated with severe alkalemia?

A) Sodium and potassium
B) Sodium and chloride
C) Potassium and chloride
D) Potassium and calcium

Question 16

In what manner is a cardiac dysrhythmia in the presence of respiratory failure and absence of cardiac disease usually managed?

A) Use of Swan-Ganz catheter
B) Mechanical ventilation
C) Electrocardiographic monitoring
D) Correction of blood-gas abnormalities

Question 17

Which of the following would not be a treatment choice for a patient presenting with a thromboembolism?

A) Pneumatic pressure over the lower legs
B) Bed exercises of the lower legs
C) Compression stockings
D) Bed rest

Question 18

Facilitating mucociliary transport is a primary goal with postoperative patients.One way to reach this goal is with body positioning.Which positional treatment would not be beneficial?

A) Positioning the patient upright
B) Performing 360-degree axial turns
C) Performing multiple position changes throughout the day
D) All of these would be beneficial

Question 19

What is the cause of pulmonary edema that is cardiogenic in nature?

A) Accumulation of vascular fluid in interstitial spaces
B) Left ventricular failure
C) Right ventricular failure
D) Movement of water into alveolar spaces

Question 20

What are the clinical features of sepsis?

A) Fever and bradycardia
B) Bradycardia and tachypnea
C) Respiratory alkalemia and fever
D) Bradycardia and respiratory alkalemia