Question 1

If the patient has temp >38 degree centigrade or subnormal rectal temperature < 36 degress centigrade, tachypnea or PaCO₂ < 32 mm of Hg, what is the diagnosis? A)Systemic inflammatory response syndrome B)Septic shock C)Neurogenic shock D)None of the above

Accepted Answer

The patient is suffering from systemic inflammatory response syndrome, because it is ageneralized inflammatory response of the body including many systems,in this temp > 38 degree centigrade or subnormal rectal temperature, moreover there is tachypnea, tachycardia. Its features also include leukocytosis or leucopenia.

Question 2

A patient presents in the cardiac emergency department with left-sided chest pain. His ECG shows ST segment elevations. Patient complains that this pain occurs cyclically, i.e., at the same time each day and during rest period. What is the most likely treatment?
A)Calcium channel blockers
B)Beta blockers
C)Alpha blockers
D)ACE inhibitors

Accepted Answer

The most likely treatment for this case is the Variant Angina. This type of angina is due to the spasm of the coronary arteries. In this case, the most likely treatment for Variant angina is calcium channel blockers. Calcium channel blockers are arterial vasodilators and have affect both the coronary and the peripheral arteries.

Question 3

The most common cause or type of cerebral aneurysms is:
A)Congenital
B)Direct trauma
C)Infection
D)Connective tissue disorder

Accepted Answer

The most common cause or type of cerebral aneurysms is congential. Cerebral Aneurysm is only the weakening of the cerebral artery due to any trauma. The most common cause or type of cerebral aneurysms is congenital. This type occurs at the bifurcation of the Circle of Willis and grows from the base to the stem.

Question 4

A known hypertensive man presented with severe headache, altered state of consciousness and a claim that this is the worst headache he has ever experienced. What is the cause?
A)Intracranial bleed
B)Subarachnoid headache
C)Stroke
D)All of the above

Accepted Answer

Subarachnoid headache the cause in this case. A known hypertensive man who presents with severe headache, altered state of consciousness and claims that this is the worst headache ever, has the characteristics of a subarachnoid headache.

Question 5

A young man had a motorcycle accident and sustained major injury to the head. He was brought in this condition to the accident and emergency department. The monitor showed that he was having alternating bradycardia and tachycardia, his BP was 180/110 mm of Hg and he was in an altered state of consciousness. What would be the first step in saving the life of this patient?
A)Checking airway
B)Checking breathing
C)Checking circulation
D)None of the above

Accepted Answer

The first step to save the life of the patient is to check his breathing, followed by checking his breathing, and then his circulation.

Question 6

Understanding Jehovah's Witnesses is an example of:
A)cultural competence
B)cultural sensitivity
C)response to diversity
D)none of the above

Accepted Answer

Understanding Jehovah's Witnesses is an example of cultural sensitivity. Jehovah's Witnesses religiously have not allowed for blood transfusions and blood products.

Question 7

A young man presented to medical emergency in a state of unconsciousness which had so far lasted for 16 minutes. According to his relatives, he has absolutely normal half an hour back, when he suddenly started having spastic tonic and clonic movements, convulsions and frothing from the mouth. After this episode, he went unconscious. What is the most likely diagnosis?
A)Epilepsy
B)Parkinsonism
C)Alzheimer's disease
D)Psychosis

Accepted Answer

The most likely diagnosis for the young man who has been unconscious for the last 16 minutes, having been normal half an hour earlier and then suddenly having spastic tonic and clonic movements, along with convulsions and frothing from the mouth is epilepsy.

Question 8

In Q wave Myocardial Infarction, the peak CK levels occur in:
A)30 hours
B)12 hours
C)36 hours
D)27 hours

Accepted Answer

In Q wave Myocardial Infarction, the peak CK levels occur in 27 hours. Myocardial Infarction occurs due to the imbalance in the demand and supply of oxygen to the heart. Q-wave MI is the transmural infarction in which the infarction and necrosis is prolonged and the peak CK levels occur in 27 hours.

Question 9

A known diabetic and hypertensive presented in medical emergency with acute onset of right-sided hemiplegia, altered level of consciousness and inability to speak. On examination, gag reflex was absent, plantars were upgoing and the power on the right side was markedly decreased. What is the likely diagnosis?
A)Stroke
B)Epilepsy
C)Parkinsonism
D)Dementia

Accepted Answer

Stroke is the likely diagnosis. In cases of hemiplegia, altered level of consciousness, inability to speak and difficulty in swallowing due to loss of gag reflex, the most likely diagnosis would be Stroke. Also, plantar reflex is upgoing in the case of Stroke.

Question 10

A nurse is monitoring a client who was recently admitted to the unit after a cardiac catheterization. Which of the following ordered assignments is the nurse's priority?
A)Assess the client's heart rate
B)Monitor the client's urinary output
C)Assess pulses distal to insertion site
D)Assess pulses proximal to the insertion site

Accepted Answer

After the procedure, the client is at risk of clot formation. Weakened or absent pulses distal to the insertion site may suggest its occurrence. Options A and B are also assessed, but assessment of the pulses distal to the insertion site is the priority. Option D is not correct.

Question 11

The nurse is caring for a 59-year-old male client with a known case of chronic obstructive pulmonary disease. The client had an appendectomy a day before. Which of the following is a priority intervention in preventing respiratory complications?
A)Maintain the flow of oxygen at 4 to 5 L at all times
B)Help client to turn to sides every 2 hours and ambulate around the room
C)Have the client perform deep breathing exercises every morning and before sleeping
D)Ensure that hourly nebulization is done

Accepted Answer

Hypostatic pneumonia is a dangerous complication of surgery. Frequent turning and early ambulation ensure that secretions do not pool in the lungs. Administering oxygen does not prevent respiratory complications. Option C is incorrect. The client should perform this exercise at least once every hour. Option D is unnecessary unless the condition has worsened.

Question 12

In the approaches to teaching, internet modules are suitable for:
A)academic or detailed information
B)small groups
C)independent learners
D)giving targeted instructions for individuals

Accepted Answer

Internet modules are suitable for independent learners. There are different approaches to teaching, and the teacher must prepare, present, and coordinate a wide range of educational workshops, lectures and discussions.

Question 13

All of the following are contraindications to thrombolytic therapy in case of stroke except:
A)Evidence of cerebral or subarachnoid hemorrhage
B)Recent stroke head trauma or surgery
C)Uncontrolled hypertension or seizures
D)Low RBC count

Accepted Answer

All of the following are contraindications to thrombolytic therapy in case of stroke except low RBC count. Low RBC count is in no way contraindicated to thrombolytic therapy. All the other causes are absolute contraindications because thrombolysing in any of the above mentioned conditions may lead to hemorrhage and further deterioration of stroke.

Question 14

A nurse is monitoring a client's chest tube drainage system. The following findings are not a cause of concern except:
A)Intermittent bubbling in the water seal
B)Gentle bubbling in the suction control chamber
C)Continuous bubbling during inspiration and expiration in the water seal chamber
D)The water in the water seal bottle moves up as the client inhales and moves down as the client exhales

Accepted Answer

Continuous bubbling during inspiration and expiration in the water seal indicates a possible air leak. The other findings are normal.

Question 15

Ideally, the thrombolytic medication should be given to the patient of stroke within:
A)1 hour
B)2 hours
C)3 hours
D)4 hours

Accepted Answer

Thrombolytic medication should be given to the stroke patient within 3 hours. Medications that dissolve blot clots (for example streptokinase, tissue plasminogen activator or TPA and urokinase) are called Thrombolytic medication.

Question 16

The most common cause of gastrointestinal bleed is:
A)Trauma
B)Endoscopy procedures
C)Peptic ulcer
D)Alcohol intake

Accepted Answer

The most common cause of gastrointestinal bleed is peptic ulcer. A peptic ulcer, also known as ulcus pepticum, PUD or peptic ulcer disease, is an ulcer (defined as mucosal erosions equal to or greater than 0.5 cm) of an area of the gastrointestinal tract that is usually acidic and thus extremely painful.

Question 17

A client comes to the emergency department complaining of left substernal chest pain. Which of the following orders is a priority?
A)Administration of sublingual nitroglycerin
B)Assessing the client's ECG tracing
C)Administration of supplemental oxygen, as ordered
D)Providing a calm and quiet environment

Accepted Answer

Administration of supplemental oxygen is the priority action of the nurse. The client is most likely experiencing the effect of insufficient oxygen supply to the myocardium and further delay may cause irreversible damages to the heart.

Question 18

Occlusion of circumflex coronary artery results in:
A)Posterior wall infarction
B)Inferior MI
C)Anterior MI
D)Left Lateral MI

Accepted Answer

Occlusion of circumflex coronary artery results in Left Lateral MI. The Myocardial Infarction most commonly damages the left ventricle and its associated septum. Right ventricle damage is only if there is any occlusion of the supplying vessel. Occlusion of circumflex coronary artery results in Left Lateral MI because circumflex artery supplies left lateral wall of the heart. This also causes damage to the anterior wall of the heart.

Question 19

What would be identified on the arterial blood gas results as a reflection of acute respiratory distress syndrome? A)Low PaO₂ levels B)High PaO₂ levels C)Decreased PaCO₂ D)Increased HcO3

Accepted Answer

The result of the arterial blood gas that would reflect the presence of acute respiratory distress syndrome would be a low PaO₂ level. The paCO₂ will initially decrease but increase as the patient becomes more fatigued.

Question 20

A female client with diabetes mellitus II comes to the facility complaining of weakness and dizziness. Initial assessment reveals a heart rate of 105 beats per minute, cold extremities, and pallor. The client reported that she had her insulin shot about 2 hours ago. Which of the following actions of the nurse is the least appropriate?
A)Check the client's blood glucose
B)Offer ½ can of orange juice
C)Prepare insulin
D)Offer about 4 Lifesavers

Accepted Answer

Based on the findings, the client is experiencing hypoglycemia. Insulin must not be administered because it can further decrease the client's blood sugar levels. The nurse should offer foods that contain about 10 to 15 grams of glucose, such as ½ can of juice, 4 Lifesavers, and 4 teaspoons of sugar.

Quiz 1: Progressive Care Nursing (PCCN)

If the patient has temp >38 degree centigrade or subnormal rectal temperature < 36 degress centigrade, tachypnea or PaCO2 < 32 mm of Hg, what is the diagnosis?

A patient presents in the cardiac emergency department with left-sided chest pain. His ECG shows ST segment elevations. Patient complains that this pain occurs cyclically, i.e., at the same time each day and during rest period. What is the most likely treatment?

The most common cause or type of cerebral aneurysms is:

A known hypertensive man presented with severe headache, altered state of consciousness and a claim that this is the worst headache he has ever experienced. What is the cause?

Understanding Jehovah's Witnesses is an example of:

In Q wave Myocardial Infarction, the peak CK levels occur in:

A nurse is monitoring a client who was recently admitted to the unit after a cardiac catheterization. Which of the following ordered assignments is the nurse's priority?

The nurse is caring for a 59-year-old male client with a known case of chronic obstructive pulmonary disease. The client had an appendectomy a day before. Which of the following is a priority intervention in preventing respiratory complications?

In the approaches to teaching, internet modules are suitable for:

All of the following are contraindications to thrombolytic therapy in case of stroke except:

A nurse is monitoring a client's chest tube drainage system. The following findings are not a cause of concern except:

Ideally, the thrombolytic medication should be given to the patient of stroke within:

The most common cause of gastrointestinal bleed is:

A client comes to the emergency department complaining of left substernal chest pain. Which of the following orders is a priority?

Occlusion of circumflex coronary artery results in:

What would be identified on the arterial blood gas results as a reflection of acute respiratory distress syndrome?

If the patient has temp >38 degree centigrade or subnormal rectal temperature < 36 degress centigrade, tachypnea or PaCO₂ < 32 mm of Hg, what is the diagnosis?