A patient's bedside ECG strips show the following changes
increased PR interval; increased QRS width; and tall, peaked T waves. Vital signs are T 98.2 F; HR 118 beats/min; BP 146/90 mm Hg; and RR 18 breaths/min. The patient is receiving the following medications: digoxin 0.125 mg PO every day; D51/2 normal saline with 40 mEq potassium chloride at 125 mL/hr; Cardizem at 30 mg PO q8h; and aldosterone at 300 mg PO q12h. The physician is notified of the ECG changes. What orders should the nurse expect to receive?
a. Change IV fluid to D51/2 normal saline and draw blood chemistry.
b. Give normal saline with 40 mEq of potassium chloride over a 6-hour period.
c. Hold digoxin and draw serum digoxin level.
d. Hold Cardizem and give 500 mL normal saline fluid challenge over a 2-hour period.
Question 2Diaphragmatic excursion is a measurement of the difference in the level of the diaphragm on inspiration and expiration determined by percussion. It is increased in
a. atelectasis and emphysema.
b. hepatomegaly and ascites.
c. atelectasis and paralysis.
d. pneumonia and pneumothorax.
Question 3A patient was admitted to the critical care unit after a left pneumonectomy. The patient is receiving 40 oxygen via a simple facemask. The morning chest radiography study reveals right lower lobe pneumoni
a. After eating breakfast, the patient suddenly vomits and aspirates. The patient becomes agitated, has decreased level of consciousness, and has an inability to maintain saturation. The nurse expects the next action will include
a. placing the patient on a mechanical ventilator.
b. change in antibiotics to control infection.
c. suctioning and repositioning.
d. administering a sedative to control anxiety.
Question 4A patient is admitted to the ICU after a positive exercise treadmill test with a diagnosis of CAD and stable angin
a. Radiographic test show that the patient has blockage in the left main coronary artery and four other vessels. The nurse anticipates that the patient will be scheduled for
a. medical therapy antianginal medications.
b. PCI.
c. TAVR.
d. CABG.
Question 5Preset positive pressure used to augment the patient's inspiratory effort is known as
a. positive end-expiratory pressure (PEEP).
b. continuous positive airway pressure (CPAP).
c. pressure control ventilation (PCV).
d. pressure support ventilation (PSV).
Question 6A client just involved in a motor vehicle accident has sustained blunt chest trauma as part of his injuries
The nurse assessment reveals absent breath sounds in the left lung field. A left-sided pneumothorax is suspected and is further validated when assessment of the trachea reveals
a. a shift to the right.
b. a shift to the left.
c. no deviation.
d. subcutaneous emphysema.
Question 7A critically injured patient can be aroused only by vigorous and continuous external stimuli. The patient's level of consciousness is considered
a. lethargic.
b. obtunded.
c. stuporous.
d. comatose.
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