Tiêu đề PB3 - NP 3 - STUDENT COPY.docx ✅

2 | Page D. Cyanosis of the lips 14. Balloon valvuloplasty is primarily performed to: A. Remove thrombi B. Treat arrythmias C. Improve blood flow D. Dissolve valve calcifications 15. Following the balloon valvuloplasty, which of the following is the priority assessment? A. Peripheral pulses and capillary refill in the catheterized limb B. Assessing bowel sound and abdominal distention for signs of ileus C. Noting pupillary response and level of consciousness q8h D. Monitoring of input and output to prevent fluid overload Situation: Nurse Jim is responsible for preoperative preparation, intraoperative support, and post- procedure monitoring for a patient scheduled for a diagnostic cardiac catheterization to assess for coronary artery disease. 16. Before the procedure, Nurse Jim is reviewing the preoperative checklist. Which of the following actions must be completed as a legal and ethical requirement? A. Ask the patient to empty the bladder to prevent discomfort B. Ensure the patient has removed all jewelry and dentures C. Confirm that the patient has signed the informed consent form D. Assess allergy to iodine and shellfish 17. During a left-sided cardiac catheterization, the cardiologist plans to insert the catheter to assess coronary artery function. As nurse Jim prepares the patient, it is essential to know the most common vascular access site used for this procedure. Which site is typically chosen for left heart catheterization? A. Radial Artery B. Jugular Vein C. Subclavian Vein D. Femoral Artery 18. A critically ill patient is admitted to the ICU and a Swan- Ganz catheter is inserted via the jugular vein to provide continuous hemodynamic monitoring. Nurse Jim understands that this catheter allows direct measurement of which of the following? A. Coronary artery blockages and thrombus location B. Pulmonary artery pressure and central venous pressure C. Arterial oxygen saturation D. Left ventricular ejection fraction 19. What is the main advantage of cardiac catheterization in diagnosing coronary artery disease? A. It provides direct visualization of coronary artery blockages B. It permanently opens blocked arteries without the need for stents C. It is less invasive compared to other imaging methods D. It is safe for all patients Situation: Prompt and proper nursing actions improve outcomes in patients presenting with chest pain. 20. Nurse Rory is caring for a patient with sudden onset chest pain described as crushing and radiating to his left arm. He appears pale, anxious, and slightly diaphoretic. Which order should be performed first? A. Administer meperidine B. Apply oxygen C. Obtain ECG D. Start IV access 21. How should Nurse Rory instruct the patient in using sublingual Nitroglycerin properly? A. “Take the tablet only when your chest pain feels severe enough to worry you, and rest afterward.” B. “Swallow the tablet quickly with water to and lie flat to avoid feeling dizzy” C. “Place one tablet under your tongue then you make take another tablet every 5 minutes, up to three tablets” D. “Take one tablet, then three more every 5 minutes, and call emergency services.” Situation: Nurse Christopher is assessing heart failure patients and monitoring for complications and treatment effects. 22. Which of the following would most likely support a diagnosis of right-sided heart failure? A. Crackles heard in bilateral lung bases B. Frothy pink sputum on coughing C. Jugular vein distention and dependent edema D. Decreased oxygen saturation levels during exertion 23. Nurse Christopher is reviewing lab results for a female patient taking furosemide for fluid overload. Which of the following findings would require immediate intervention? A. Hematocrit of 45% B. Serum potassium of 2.1 mmol/L C. Serum Magnesium of 1.7 mEq/L D. BUN of 18 mg/dL 24. A patient with pitting edema has a dent in the skin that lasts for more than a minute after palpation. How should this be classified based on standard grading? A. +1 B. +2 C. +3 D. +4 26. Digoxin is prescribed in heart failure primarily to: A. Reduce afterload B. Increase heart rate C. Increase myocardial contractility D. Decrease preload Situation: Nurse Luke is caring for a critically ill patient with signs of low cardiac output. 27. Which of the following best describes cardiogenic shock? A. Inadequate tissue perfusion due to hypovolemia B. A sudden drop in blood pressure from spinal injury C. Impaired tissue perfusion due to the heart’s inability to pump effectively D. Reduced perfusion caused by systemic allergic reaction 28. Which of the following findings would Nurse Luke expect when assessing a patient in cardiogenic shock? A. Warm, flushed skin and bounding pulses B. Bradycardia and increased urine output C. Hypertension and increased jugular vein pressure D. Hypotension and decreased urine output 29. Which of the following diagnostic findings best supports the diagnosis of cardiogenic shock? A. Mean arterial pressure of 95 mmHg and urine output of 60ml/hour B. Pulmonary artery wedge pressure of 20 mmHg and cardiac output of 2.5 L/min C. Central venous pressure of 2mmHg and cardiac output of 6.5L/min D. Pulmonary artery wedge pressure of 10 mmHg and oxygen saturation of 75% 30. What is the priority nursing intervention in the initial management of cardiogenic shock? A. Rapidly infuse large amounts of intravenous fluids B. Encourage early ambulation C. Give Fosinopril as ordered D. Administer Dopamine as prescribed 31. Which of the following conditions most commonly leads to cardiogenic shock? A. Myocardial infarction B. Severe sepsis C. Pulmonary embolism D. Anaphylaxis Situation: Nurse Heme is assessing the patient's respiratory system during a routine physical exam.

4 | Page 50. Which of the following conditions is not classified as an obstructive airway disease? A. Asthma B. Bronchitis C. Emphysema D. Pneumonia Situation: Nurse Jo is assigned to a patient with confirmed right sided pneumothorax. A chest tube is inserted on the patient’s right side and is connected to a closed chest drainage system. 51. On assessment, Nurse Jo performs chest percussion over the right lung field. Which finding is expected with a pneumothorax? A. Dullness B. Flatness C. Resonance D. Hyperresonance 52. Later in the shift, the patient develops worsening shortness of breath. Nurse Jo suspects a mediastinal shift. Which finding supports this suspicion? A. Tracheal deviation towards the affected side B. Tracheal deviation towards the unaffected side C. Hypotension and bradycardia D. Absent breath sounds 53. Nurse Jo evaluates the chest tube drainage system. Which observation indicates that the system is functioning properly? A. No fluctuation in the water seal chamber B. Tidaling in the wet system C. Constant bubbling in the water seal chamber D. Drainage container above chest level Situation: A 45-year-old male, diabetic and hypertensive, is admitted in the emergency department for dyspnea. Physical examination reveals BP 160/80, RR 30, (+) JVD, crackles, grade 2 edema. Laboratory results confirm: Na 118 mEq/L, K 7.0, Mg 2.8. Creatinine 6.8. ABG: pH 7.20, HCO₃ 15, PaO₂ 50. 54. Which electrolyte imbalances are present? A. Hyponatremia, hypokalemia, hypermagnesemia B. Hypernatremia, hypokalemia, hypermagnesemia C. Hyponatremia, hyperkalemia, hypermagnesemia D. Drainage container above chest level 55. Based on the ABG results, what is the correct acid-base interpretation? A. Uncompensated respiratory acidosis B. Compensated respiratory acidosis C. Uncompensated metabolic acidosis D. Uncompensated metabolic alkalosis 56. A patient with serum sodium of 160 mEq/L appears confused and restless. What is the priority nursing action? A. Initiate fluid restriction B. Monitory urine specific gravity C. Monitor the patient’s input and output D. Initiate seizure precautions 57. A patient is advised to take spironolactone (Aldactone) daily. What electrolyte imbalance should the nurse monitor for? A. Hypokalemia B. Hyperkalemia C. Hypercalcemia D. Hypocalcemia 58. A patient is advised to take hydrochlorothiazide. What is a known electrolyte effect of this drug? A. Hypocalcemia B. Hyperkalemia C. Hyponatremia D. Hypercalcemia Situation: A nurse is performing health teaching regarding acid-base balance. 59. What organs are primarily responsible for maintaining acid- base balance? A. Lungs and kidneys B. Adrenal glands and pancreas C. Heart and adrenal glands D. Stomach and intestines 60. Which is an expected finding in respiratory alkalosis? A. Lightheadedness and paresthesia B. Shallow, irregular breaths C. Decreased pH D. Kussmaul’s breathing 61. In respiratory acidosis, the kidneys attempt to compensate by retaining bicarbonate. Which of the following findings indicates that renal compensation is occurring? A. Decreased respiratory rate B. Decreased serum bicarbonate C. Increased urine acidity D. Increased serum bicarbonate 62. Which of the following is not expected in metabolic acidosis? A. Kussmaul’s breathing B. Low HCO₃ C. Decreased pH D. Increased PaCO₂ 63. A chronic renal failure patient presents with the following arterial blood gas results: pH 7.36, PCO₂ 31 mmHg, HCO₃ 17 mEq/L. How does the nurse interpret these ABG findings? A. Compensated metabolic acidosis B. Compensated respiratory acidosis C. Uncompensated metabolic acidosis D. Uncompensated respiratory alkalosis Situation: Nurse Ben is assigned to the medical surgical ward where several patients are diagnosed with acute kidney injury (AKI). Understanding the different types and their underlying causes is essential for accurate assessment and nursing intervention. 64. A patient with severe vomiting and diarrhea for 3 days is admitted with low blood pressure, dry mucous membranes, and elevated BUN and creatinine. This type of acute kidney injury is classified as: A. Pre Renal B. Intra Renal C. Post Renal D. Chronic Renal 65. A patient with bladder cancer develops anuria. This type of kidney injury is classified as: A. Pre Renal B. Intra Renal C. Post Renal D. Chronic Renal 66. A patient is brought to the ER after a vehicular accident with suspected kidney trauma. CT findings reveal renal parenchymal laceration. What type of AKI is most likely expected? A. Pre Renal B. Intra Renal C. Post Renal D. Chronic Renal 67. Which of the following diagnostic tests is commonly ordered to assess kidney function in suspected AKI? A. Serum bilirubin B. AST/ ALT C. Serum Creatinine D. SGOT/ SGPT 68. A patient with AKI is being prepared for a dietary plan. Which of the following is appropriate? A. High calorie, low protein diet B. Low calorie, high potassium diet C. Regular diet with increased fluids D. High calorie, high protein diet Situation: Nurse Riza is assigned to patients with different kidney problems. Knowing the hallmark signs and appropriate nursing management is essential for providing quality care. 69. What is the hallmark clinical sign of nephrotic syndrome? A. Gross hematuria with soda-colored urine B. Generalized edema and massive proteinuria C. Hypertension and periorbital swelling D. Increased serum albumin and decreased urine output