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1.An expected EKG change after a myocardial infarction (MI) is:
a. Normal Q wave
b. Elevated ST segment
c. Prolonged OT interval
d. Prolonged PR interval

2. The most important therapeutic goal in the treatment of cardiogenic shock is to:
a. Increase afterload
b. Lower the BUN
c. Increase cardiac output
d. Decrease extracellular fluid volume

3. Elevation in cardiac iso-enzymes generally occur in all EXCEPT:
a. Congestive Heart Failure
b. Pericarditis
c. Closed chest injury
d. Cardiac Surgery

4. Mrs. Jackson will receive tissue plaminogen activitator (TPA) 3 hours after a
heart attack, when would you discontinue the infusion:
a. PVCs
b. Bleeding gums
c. Oozing at the insertion site
d. Change in mental status

5. After you remove an arterial catheter you should apply direct pressure to the artery:
a. For two minutes
b. 5-10 minutes
c. Until the oozing from the site stop
d. Until a pressure dressing is applied

6. This tracing represents that a Swan Ganz catheter is in which position:

a. Right atrium
b. Right ventricle
c. Pulmonary artery
d. Pulmonary artery wedge

7. Which of these wave patterns represent ideal functioning of an arterial line:

a.

b.

c.

d.

8. A central venous pressure (CVP) reflects pressure in:
a. Left atrium
b. Right atrium
c. Left ventricle
d. Pulmonary artery

9. Elevated CVP may indicate:
a. Right heart failure
b. Low hematocrit
c. Dehydration
d. Peripheral vasodilation

10. The PCWP reflects pressure in the
a. Right ventricle
b. Left ventricle
c. Right atrium
d. Vena cava

11.Normal values for pulmonary artery pressure is:
a.10-20 / 0-4 mean 5-10
b. 21-30 / 5-15 mean 11-20
c.31-35 / 16-20 mean 21-30
d. 36-45 / 21-25 mean 31-35

12.Normal PAWP is:
a.1-3
b.4-12
c.15-20
d. 21-26

13. A elevated PAWP may indicate:
a. Hypovolemia
b. Peripheral blood pooling
c. Systemic hypotension
d. Left ventricular failure

14. A QRS complex wider than 0.12 indicates:
a. Normal conduction
b. Bundle branch block
c. Second degree heart block
d. MI

15. Normal PR interval is:
a..04-.10
b. .12-.20
c. .22-.26
d. .26-.32

16. The following strip represents:

17.The following strip represents:

18.A patient is in ventricular tachycardia and has a pulse, you give
a. Isuprel 1.0mg in 250ml D5W drip
b. Epinephrine 1.0mg IV push
c. Atropine .5mg IV push
d. Lidocaine 1-1.5mg/kg IV push

19. The following strip represents:

20.The drug of choice for symptomatic bradycardia is:
a. Atropine
b. Lidocaine
c. Quinidine
d. Digoxin

21. If a patient is in Atrial Flutter with a rate of greater than 150 beats /min you would:
a. Digoxin, Diltiazem, Cardiovert
b .Lidocaine, Cardiovert
c. Lidocaine, Pacemaker
d. Isordil, Nitropaste

22.What is the correct energy level (joules) for someone in ventricular fibrillation?
a.25-30
b. 50
c. 100
d. 200

23.All of these would be signs of cardiac tamponade EXCEPT:
a. Distended neck veins
b. Pulsus paradoxis
c. Decrease in systolic blood pressure
d. Bradycardia

24. A patient on a monitor shows no respirations or pulse the drug of choice is:
a. Calcium Gluconate
b. Atropine
c. Epinephrine
d. Lidocaine

25. What would be an excessive amount of chest tube drainage (cc)?
a.150cc/hr
b. 75cc/hr
c.50cc/hr
d.30cc/hr

26. A blood gas that shows: PH 7.40,PO2 98,PCO2 38, HCO3 25 reflects:
a. Metabolic acidosis
b. Metabolic Alkalosis
c. Normal values
d. Respiratory Alkalosis

27.Before you suction a patient you must:
a. Have 120mm hg of vacuum
b. Have suction at highest setting
c. 40mm Hg of vacuum
d. 10mm Hg below the systolic

28. A post op patient with a chest tube on the left side needs chest PT, upon auscultation you hear diminished breath sounds at the left posterior base, this may indicate:
a. Pleuritis
b. Consolidation
c. Atelectasis
d. The chest tube

29. A patient on a ventilator sounds the low expiratory volume alarm, this is due to:
a. Pulmonary edema
b. Decreased lung compliance
c. A disconnected tube
d. Biting the tube

30. When checking for proper position of a ET tube, the best nursing response:
a. Listen for cuff leaks
b. Listen for bilateral breath sounds
c. Check for chest expansion
d. Check the tidal volume indicator on the ventilator

31.The most likely reason for a deviated trachea in an accident victim is:
a. Edema from a fractured clavicle
b. Cervical dislocation
c. Tension pneumothorax
d. Bronchial hemorrage

32. A 4 day post-op fracture of the right femur, develops shortness of breath:
a. Fat embolus
b. Atelectasis
c. Pleural effusion
d. Pulmonary edema

33. A burn patient's most important treatment during the first 24 hours is:
a. Wound culture
b. Antibiotic prophylaxis
c. Pain relief
d. Fluid replacement

34. Nursing care of a patient on a hypothermia blanket includes:
a. Administering vasodilators to prevent shivering
b. Avoid moving patient to provide maximum cooling
c. Remove blanket q2hrs to prevent overcooling
d. Observe skin to prevent injury

35. The MOST important nursing care for a patient with cervical spinal injury is:
a. Keep patient flat
b. Immobilize head and neck
c. Assess reflexes
d. Monitor for dysrhythmias

36.Early signs of intracranial pressure are:
a. Changes in response to pain
b. Level of consciousness changes
c. Unequal pupils
d. Respiratory Rate

37. Increase intracranial pressure exhibits all EXCEPT:
a. Decrease in pupil reaction
b. Increase in blood pressure
c. Decrease in pulse pressure
d. Decrease in level of consciousness

38. The following is used to reduce intracranial pressure
a. Aldomet
b. Phenobarbitol
c. Mannitol
d. Dilantin

39.A positive Babinski response in an adult:
a. Indicates lower motor disease
b. Is Normal
c. Is Abnormal
d. Is associated with flexion of the toes

40. Signs of diabetic ketoacidosis include:
a .Dry warm skin, fruity breath
b. Vomiting, hyperactivity
c. Slow and shallow breaths, pallor
d. Dilated pupils, coma, flushed skin

41. Impending insulin shock should be suspected if:
a. Decreased skin turgor abdominal pain, fever
b. Flushed skin, tachycardia, Kussmaul breathing
c. Thirst, hypotension, fruity odor to the breath
d. Weakness, headache, diaphoresis

42. A patient in ketoacidosis coma may receive all of the below EXCEPT:
a. Dextrose .50% IV
b. Insulin IV drip
c. Potassium replacement
d IV fluid administration

43. Patients with diabetes mellitus who are acutely ill require:
a. Higher dose of insulin
b. Lower calorie intake
c. Higher fat intake
d. Lower dose of insulin

44.The following insulin has a peak action within 2-4 hrs
a. Lente
b. NPH
c. Ultralente
d. Regular

45. A patient receives a dose of NPH at 7am but is NPO, You expect insulin reaction:
a.1-2 hrs
b. 4-6 hrs
c.8-12 hrs
d. 14-24 hrs

46. A patient with acute renal failure, acceptable urine output is:
a. 60cc/hr
b.45cc/hr
c. 30cc/hr
d. 10cc/hr

47. Sudden shortness of breath, sinus tachycardia and rales may indicate:
a. Hyperkalemia
b. Pulmonary embolus
c. Fluid overload
d. Infection

48.In hyperkalemia the EKG shows:
a. Narrow QRS, inverted T wave
b. Narrow QRS flat P wave
c. Wide QRS, inverted T wave
d. Wide QRS, tall peaked T wave

49. When giving Dopamine IV you need to be careful of:
a. Tissue necrosis due to infiltration
b. High doses produce bradycardia
c. Precipitation may occur if dextrose is used
d. Low doses decrease renal perfusion

50. When giving IV nitroprusside all the below is done EXCEPT:
a. Protect solution from light
b. Monitor for decrease in blood pressure
c. Possible hypertensive crisis
d. Use of fresh solution at appropriate intervals.