SOLVED

 Question 11 A patient with cardiac decompensation is started on dobutamine at 1 mcg/kg/min with an order to titrate to effect. After receiving this dose for several minutes the patient develops tachycardia and occasional premature ventricular contractions. What nursing intervention is indicated? 1. Increase the dose to 1.5 mcg/kg/min. 2. Discontinue the infusion. 3. Decrease the infusion to 0.5 mcg/kg/min. 4. Contact the prescriber immediately. Question 12 The nurse is monitoring a patient at risk for development of left ventricular failure and cardiogenic shock. Which findings would the nurse immediately discuss with the primary health care provider? 1. Development of an S3 heart sound 2. Sustained systolic hypertension 3. Development of bilateral crackles 4. Decrease in PAWP 5. Decrease in cardiac index Question 13 A patient who had a myocardial infarction this morning is now developing cardiogenic shock. Which nursing intervention is indicated? 1. Increase IV fluids. 2. Administer vasoconstricting drugs. 3. Provide care in a calm, reassuring manner. 4. Withhold oral fluids and nutrition. Question 14 A patient has been admitted to the emergency department with bleeding from a traumatic amputation of the leg. Which findings would the nurse interpret as indicating this patient’s blood loss is severe? 1. Heart rate is 120. 2. Blood has soaked the dressing applied by first responders. 3. Blood pressure is 78/50. 4. Mild anxiety is present. 5. Heart rate is 50. Question 15 A patient who sustained a gunshot wound walks into the emergency department and collapses. Which priority directions should the nurse who assumes this patient’s care give to those coming to assist? 1. Check the airway. 2. Bring a wheelchair. 3. Put direct pressure on the leg wound. 4. Check for identification. 5. Check the pulse. Question 16 A patient hospitalized for treatment of a severe urinary tract infection may be developing septic shock. The nurse would monitor for the development of which finding associated with early septic shock? 1. Cold extremities 2. Increase in serum lactate levels 3. Decreased SCVO2 4. Widening of pulse pressure Question 17 A patient being evaluated for septic shock has a serum lactate level of 5 mmol/L. What intervention does the nurse anticipate? 1. Decreasing the amount of oxygen being given 2. Immediate initiation of fluid resuscitation 3. Repeat of the testing in 4 hours 4. Bedside fingerstick level of blood glucose Question 18 A patient being treated for a severe infection has a temperature of 35.8°C. Which additional finding would indicate to the nurse that initiation of treatment for sepsis is likely? 1. A shift to the left on the white blood cell differential 2. Heart rate 88 3. Respiratory rate 10 4. Acute alteration in mental status Question 19 A patient admitted to the emergency department following chest trauma has tracheal deviation to the left. The nurse would prepare for which emergency medical intervention? 1. Open thoracotomy 2. Placement of a chest tube 3. Open excision of the pericardial sac 4. Immediate cardiopulmonary resuscitation Question 20 Which finding would cause the nurse to be concerned that a patient who sustained chest trauma is experiencing cardiac tamponade? 1. Distant heart sounds 2. Decrease of right arterial pressure 3. Sudden development of hypertension 4. Development of an S3 heart sound