BKAT study guide (1)

Question 1

What does MONA stand for in the initial measures for treating angina?

Answer 1

• Morphine
• Oxygen
• Nitroglycerin
• Aspirin

These are the key medications used in the management of angina.

Question 2

The most appropriate nursing action for a patient who is depressed in the first few days after having an MI is to: _______.

Answer 2

Encourage the patient to ventilate feelings and concerns

This approach helps address emotional well-being post-MI.

Question 3

What should the nurse do if a post-MI patient’s heart rate increases from 80’s to 90’s when getting out of bed?

Answer 3

Check vital signs

Monitoring vital signs is crucial for assessing the patient’s stability.

Question 4

The major therapeutic goal in the treatment of cardiogenic shock is to?

Answer 4

Increase in cardiac output

This goal is essential for improving tissue perfusion.

Question 5

Elevated cardiac enzymes occur in all of the following except: _______.

Answer 5

CHF

Elevated enzymes are typically seen in trauma, CABG, and pericarditis.

Question 6

What is the classic EKG change in an MI?

Answer 6

ST segment elevation

This change is a key indicator of myocardial infarction.

Question 7

After an arterial catheter is removed, direct pressure should be applied for how long?

Answer 7

5-10 minutes

This is important to prevent bleeding at the site.

Question 8

A CVP reading directly measures pressure where?

Answer 8

Right atrium

This measurement is used to assess right heart function.

Question 9

You can use an arterial line for all the following except: _______.

Answer 9

Administration of drugs

Arterial lines are primarily for monitoring blood pressure.

Question 10

What is a normal pulmonary capillary wedge pressure?

Answer 10

4-12 diastolic

This pressure helps assess left heart function.

Question 11

Normal pulmonary artery pressure is _______.

Answer 11

8-20

The average is typically around 11-20.

Question 12

Elevated Central Venous Pressure shows: _______.

Answer 12

Right sided heart failure

This indicates fluid overload in the right heart.

Question 13

Pulmonary capillary wedge pressure shows pressure in: _______.

Answer 13

Left ventricle

This measurement is crucial for assessing left ventricular function.

Question 14

If the pulmonary capillary wedge pressure is elevated, it can indicate: _______.

Answer 14

Left sided heart failure

This is particularly indicative of left ventricular failure.

Question 15

The wave in the cardiac cycle that shows atrial depolarization is: _______.

Answer 15

P Wave

This wave is essential for understanding cardiac electrical activity.

Question 16

The P-R interval is how long?

Answer 16

0.12 – 0.2

This interval measures the time between atrial and ventricular depolarization.

Question 17

A QRS complex longer than 0.12 may indicate: _______.

Answer 17

Bundle branch block

This condition affects the conduction of electrical impulses in the heart.

Question 18

What does failure to sense look like?

Answer 18

Pacing spike within QRS

This indicates that the pacemaker is not detecting the heart’s intrinsic activity.

Question 19

What is the initial drug treatment for ventricular tachycardia?

Answer 19

Lidocaine 50-100 mg

This medication is used to stabilize the heart rhythm.

Question 20

Why is A-flutter so dangerous?

Answer 20

It can cause the ventricular rate to increase

This can lead to decreased cardiac output and other complications.

Question 21

A drug given in complete heart block is: _______.

Answer 21

Atropine

This medication helps increase heart rate in bradycardic patients.

Question 22

What is the correct setting to defibrillate?

Answer 22

200-300 joules

This range is typically used for effective defibrillation.

Question 23

Signs and symptoms of cardiac tamponade include all except: _______.

Answer 23

Bradycardia

Common signs include hypotension and muffled heart sounds.

Question 24

You have a patient that is apneic and the monitor is showing asystole. What drug is initially given?

Answer 24

Epinephrine

This is a critical medication for managing cardiac arrest.

Question 25

To avoid **sepsis** when dealing with a central venous catheter, the most important thing you can do is: _______.

Answer 25

Use aseptic care when dealing with the catheter ## Footnote This practice is essential for infection prevention.

Question 26

What is the earliest sign of an increase in **ICP**?

Answer 26

Changes in LOC ## Footnote This is a critical indicator of increased intracranial pressure.

Question 27

Increased ICP is characterized by all except: _______.

Answer 27

Decreased pulse pressure ## Footnote Increased ICP typically presents with Cushing's triad.

Question 28

The drug used to decrease **ICP** is: _______.

Answer 28

Mannitol ## Footnote This osmotic diuretic helps reduce intracranial pressure.

Question 29

What are the **normal ABG values**?

Answer 29

* pH 7.35-7.45 * PCO2 35-45 * PO2 80-100 ## Footnote These values are essential for assessing respiratory and metabolic function.

Question 30

Patient on a ventilator with a **low volume alarm** likely indicates: _______.

Answer 30

A tube disconnection ## Footnote This situation requires immediate assessment and correction.

Question 31

What is the most important intervention to prevent **aspiration** in a patient on continuous tube feedings?

Answer 31

Check the position of the feeding tube Q4 hours ## Footnote Ensuring proper placement is crucial for patient safety.

Question 32

What is the **peak time** of rapid acting insulin?

Answer 32

1 to 2 hours ## Footnote This timing is critical for managing blood glucose levels.

Question 33

What is the **acceptable amount of urine output** per hour in a patient with renal failure?

Answer 33

30 cc ## Footnote This is a guideline for monitoring renal function.

Question 34

What is the **most common symptom** of toxic blood level of lidocaine?

Answer 34

Metal taste ## Footnote This side effect indicates potential toxicity.

Question 35

Which body system is most useful to determine the correct dosage of **lidocaine**?

Answer 35

Hepatic ## Footnote Liver function affects drug metabolism and clearance.

Question 36

How many **micrograms** are in 1 milligram?

Answer 36

1000 mcg ## Footnote This conversion is important for medication dosing.

Question 37

What is the **earliest detection of bleeding** in a patient who has a gastric tube?

Answer 37

Observing the color of the gastric contents ## Footnote This observation is crucial for identifying potential GI bleeding.

Question 38

What is the **initial drug treatment** for ventricular tachycardia?

Answer 38

Lidocaine 50-100 mg ## Footnote This medication is used to stabilize the heart rhythm.

Question 39

Monitor is showing the correct pattern for a pulmonary capillary wedge pressure. You can do all the following except:

Answer 39

Flushing the line.

Question 40

What is the purpose of enclosing a pacemaker generator in a rubber glove:

Answer 40

Prevents electrical interference with the pacemaker.

Question 41

If the RN sees ventricular fibrillation, they should first:

Answer 41

Establish unresponsiveness.

Question 42

A patient has atrial flutter with a ventricular response into the 150’s. Use:

Answer 42

Cardioversion, Verapamil, or Digoxin.

Question 43

You get a patient back with a chest tube system in place following thoracic s/s. What would be considered an excessive amount of fluid over the next few hours?

Answer 43

150

Question 44

When setting up to suction a patient, you should adjust negative pressure to

Answer 44

-120mmHg

Question 45

Chest physical therapy on a post op patient with a chest tube in the LEFT side. Breath sounds are decreased in the RIGHT base of his lungs. This indicates

Answer 45

atelectasis.

Question 46

Chest percussion and postural drainage would be contraindicated in:

Answer 46

Pulmonary hemorrhage.

Question 47

Assessing endotracheal tube position. The most appropriate action an RN can take is:

Answer 47

Listen bilaterally to breath sounds.

Question 48

Your patient has an endotracheal tube in place and you ask if he’s doing okay this morning. He responds with an audible voice saying “Yes.”

Answer 48

Check the functioning of the cuff.

Question 49

A high-pressure alarm on a ventilatory can be triggered by all of the following except:

Answer 49

leaky cuff

Question 50

Patient comes in from a motor vehicle accident with closed chest trauma and a deviated trachea. The most likely reason is:

Answer 50

tension pneumothorax.

Question 51

Patient is 3 days post op with a fractured LEFT femur. They suddenly become short of breath. Likely:

Answer 51

fat embolism.

Question 52

Patient is admitted with severe burns. The most important treatment in the next 24 hours is:

Answer 52

fluid replacement

Question 53

One of the most dangerous side effects in rewarming a hypothermic patient is

Answer 53

decreased CO

Question 54

You have a patient that is on a hypothermia blanket

Answer 54

observe frequently to ensure there is no tissue injury.

Question 55

Patient is admitted with cervical spine injury – the most important thing to do is:

Answer 55

hold c-spine/immobilize the head.

Question 56

Most important body system observation for patient with c-spine injury

Answer 56

respiratory.

Question 57

Positive Babinski reflex in adults is:

Answer 57

abnormal

Question 58

Caring for a patient in the acute period of a stroke includes all except

Answer 58

increasing sensory input

Question 59

in doing hourly neuro checks you do all except:

Answer 59

urinary output

Question 60

DKA s/s:

Answer 60

fruity breath, rapid deep breathing, dry warm skin

Question 61

Insulin shock (hypoglycemia) s/s:

Answer 61

weakness, diaphoresis, headache

Question 62

In treating a patient with DKA in a coma you could do all the following except:

Answer 62

give dextrose 50% IV

Question 63

You have a diabetic patient on regular insulin scale and he is complaining of being nervous and feeling faint – you should do all of the following except:

Answer 63

use PRN orders for regular insulin

Question 64

Patient who is acutely ill with DM will usually need

Answer 64

a higher dose of insulin

Question 65

Physiologic response to stress in an acutely ill patient will usually show changes in HR, urine output, and BP in which direction:

Answer 65

increased HR, decreased urinary output, increased BP

Question 66

Peak times of insulin:

Answer 66

rapid acting 1 to 2 hours; short acting 2 to 3 hours; intermediate 4 to 12 hours; long acting 12 to 24 hours

Question 67

how many hours after giving NPH (intermediate) on NPO patient would you expect a reaction to occur:

Answer 67

4-6

Question 68

Thyroid storm s/s:

Answer 68

delirium, elevated temp, tachycardia

Question 69

Post-op craniotomy patient fasting BG of 100 c/o extreme thirst and urine specific gravity is 1.001 – you should suspect:

Answer 69

diabetes insipidus (cannot regulate fluid volume/dilute urine/often deficient in hormone vasopressin – helps control water retention in kidneys)

Question 70

You will be given a picture of a urine gravity reading around .015 in a cylinder with a measure in it – it will ask you what it indicates: .

Answer 70

.015 is a normal urine concentration

Question 71

Which lab test is not a good indicator of renal function

Answer 71

catecholamines (epinephrine/norepinephrine – stress response)

Question 72

Patient with acute renal failure – medications that are normally excreted through the kidneys will probably be:

Answer 72

decreased in dosage

Question 73

Enteral feeding in an acute renal failure patient includes

Answer 73

low sodium, low K, and restricted protein

Question 74

Acute renal failure patient suddenly develops dyspnea, breath sounds-rales, and tachycardia – most likely indicates

Answer 74

fluid overload

Question 75

Patient with hyperkalemia would show what on EKG

Answer 75

wide QRS and peaked T waves

Question 76

Peritoneal dialysis patients’ solutions do not contain

Answer 76

creatinine

Question 77

Peritoneal dialysis complications include all except:

Answer 77

hyperkalemia

Question 78

Peritoneal dialysis fluid change to a brown color in the drainage system

Answer 78

characteristic of peritonitis

Question 79

Nursing considerations for a patient on peritoneal dialysis include all the following except:

Answer 79

maintaining immobility

Question 80

Hyperosmolar non-ketoic dehydration coma can be prevented in a patient on parenteral nutrition therapy early by:

Answer 80

checking blood sugar

Question 81

Patient has a Blakemore tube in place to control bleeding from esophageal varices – most important part of nursing care is:

Answer 81

maintain pressure in the balloons

Question 82

Low intermittent suction is used to remove gastric contents in all the following situations except:

Answer 82

controlling bleeding

Question 83

Acute GI bleed in critically ill patients can occur because of:

Answer 83

the body’s response to stressors

Question 84

Regarding all patients reviving gastric lavage to control acute GI bleeding include all of the following except:

Answer 84

using distilled water for lavage

Question 85

Patient is post cholecystectomy and you notice coffee ground emesis coming from NG tube

Answer 85

test drainage for blood

Question 86

Patient is actively bleeding from the GI tract and getting a blood transfusion. If the patient’s body temperature suddenly increases, you should:

Answer 86

stop the transfusion

Question 87

IV Dopamine should be administered carefully because

Answer 87

it’s a vesicant and infiltration can lead to tissue necrosis.

Question 88

Dilantin will crystalize in all IVF except

Answer 88

NS

Question 89

In using nitroprusside, precautions need to be taken – except

Answer 89

for alertness to hypertensive crisis

Question 90

Which drug needs to be tapered off slowly to prevent adrenal insufficiency

Answer 90

cortisone

Question 91

Digitalis toxicity can cause side effects except:

Answer 91

rapid A-V conduction (it would slow it)

Question 92

Patient is bradycardic and the Dr does not want to order Atropine – what other medication can they order to increase HR:

Answer 92

Isuprel

Question 93

Caring for a patient where body fluid exposure is probable, it would be important to observe

Answer 93

universal precaution

Question 94

You are caring for a patient who is intubated who needs frequent suctioning – most appropriate precautions are:

Answer 94

gloves and mask