Which principle is most important to remember when administering tPA?

The nurse understands which EKG finding to be indicative of myocardial ischemia?

All of the following are consistent with the above EKG tracing except:

The nurse understands the administration of propranolol to a patient with angina is contraindicated in all of the following circumstances except:

The nurse would expect to administer which of the following medications to a hypotensive patient in severe congestive heart failure?

The nurse understands which of the following 12 Lead EKG changes is strongly suggestive of high-risk unstable angina?

The nurse understands which of the following routine medications will be given to patients receiving tPA therapy?

While awaiting transfer to the coronary care unit, your patient becomes tachycardic but his blood pressure remains stable. Which nursing action is most appropriate at this point?

Appropriate nursing diagnoses for a patient with angina include all of the following except:

The nurse interprets the EKG tracing above as indicating:

Which nursing diagnostic category is most appropriate for a patient with a dissecting aortic aneurysm and a blood pressure of 220/100 mmHg in the right arm and 140/100 mmHg in the left arm?

Which assessment finding would be typical for a patient with an abdominal aortic aneurysm?

The nurse understands that most aneurysms usually occur in the:

The nurse understands that the most helpful studiesin diagnosing aortic aneurysms include:

A 61-year-old man is transferred to the ED by ambulance from his physician’s office with a diagnosis of a possible abdominal aortic aneurysm. When eliciting the patient’s history, the nurse keeps in mind that one of the most common factors predisposing a patient to abdominal aortic aneurysm is:

Aneurysms are classified according to all except:

Which signs would the nurse typically note when assessing a patient with a proximal dissecting aortic aneurysm?

A patient who is experiencing an acute MI suddenly becomes unresponsive and pulseless while speaking with the nurse. The nurse notes the EKG rhythm above and responds by calling for help and:

Which problem is represented by the EKG tracing above?

Which action should the nurse take first if she/he witnessed the patient’s EKG rhythm shows the configuration above?

The above EKG tracing was taken from a patient who is asymptomatic. The pulse indicates perfusion of all beats.The nurse identifies this rhythm to be:

The nurse understands that the treatable causes of persistent ventricular fibrillation may include:

A patient’s ventricular fibrillation continues. His arterial blood gas levels are pH 7.25, PCO2 35 mmHg, PO2 60 mmHg, and HCO3 – 15 mEq/L. At this time, the nurse should expect to administer:

The nurse notes the rhythm above while monitoring a patient with a temporary pacemaker. Which nursing action would be unsafe in this situation?

The nurse recognizes that the above EKG tracing is representative of:

The nurse observes a patient’s cardiac rhythm converts to sinus bradycardia with a rate of 30 beats/minute and notes that he is exhibiting frequent PVCs. The patient complains of feeling lightheaded and nauseous. Which of the following isthe treatment of choice in this situation?

The nurse understands that one of the therapeutic effects of propranolol is:

Which drug is usually infused after termination of ventricular fibrillation or ventricular tachycardia?

A 26-year-old man with a long history of IV drug abuse enters the ED complaining of fever, shaking, chills, and severe night sweats. The physician diagnoses his condition as endocarditis. Which procedure would be considered the nurse’s lowest priority when assessing a patient with endocarditis?

The nurse would expect the laboratory studies of a patient with endocarditis to reveal:

Which laboratory study is a definitive diagnostic tool and will guide patient treatment for a patient with diagnosed with endocarditis?

Which nursing diagnostic category is most appropriate for a patient on ACE inhibitors whose condition has been stabilized?

The nurse would expect to administer which of the following medications to a hypotensive patient in severe congestive heart failure?

Which intervention would the nurse know to be inappropriate for a patient with left ventricularfailure?

The triage nurse assesses an anxious and diaphoretic 54-year old man who arrives at the ED complaining of severe, left-sided pressure like chest pain, and left arm numbness. The pain began 2 hours ago and is unrelieved by rest. He has no significant medical history. After initiating cardiac monitoring, the nurse administers oxygen at 2 liters/minute and establishes an IV line of dextrose 5% in water (D5W) at a KVO rate. The patient’s vital signs are blood pressure 120/60 mmHg, pulse rate 88 beats/minute and irregular, and respirations 20 breaths/minute. The cardiac rhythm shows normal sinus rhythm with occasional unifocal premature ventricular contractions (PVCs). The triage nurse suspects that this patient is exhibiting signs of a myocardial infarction (MI) because the chest pain:

The physician orders Amiodarone (Cordarone) at a loading dose of 150 mg IV bolus over 10 minutes at 15 mg/min. Then a maintenance infusion of 360 mg over 6 hours at 1mg/min. Amiodarone (Cordarone) is indicated because it:

The physician orders an ACE inhibitor to be added to the patient’s medication regimen for treatment of congestive heart failure. The nurse understands the pharmacologic effects of ACE inhibitors to include:

When caring for a patient with an MI, the nurse understands all of the following statements to be true except:

Which should be the nurse’s primary goal when planning the care of a patient with an acute MI:

The nurse understands that the physical assessmentfindings of a patient with right ventricular failure would typically include:

The 12-lead EKG demonstrates ST elevation in leads V1 through V3. The nurse interprets this as an acute MI involving the:

Which EKG finding would the nurse expect for a patient whose potassium level is 6.5 mEq/L?

A 50-year-old man arrives at the ED complaining of headache, nausea, vomiting, and blurred vision. His blood pressure is 210/144 mmHg. When asked about his medication history, the patient states that he usually takes clonidine hydrochloride (Catapres) but that he hasn’t taken it for 2 days because he ran out of medication. The nurse suspects this patient is in a hypertensive crisis, which is probably the result of:

The nurse understands that one of the therapeutic effects of propranolol is:

Nitroprusside sodium (Nipride) is commonly used in hypertensive emergencies. The nurse understands that this medication:

The nurse understands that a rapid IV infusion of nitroprusside may cause the patient to experience:

A 50-year-old man arrives at the ED complaining of headache, nausea, vomiting, and blurred vision. His blood pressure is 210/144 mmHg. When asked about his medication history, the patient states that he usually takes clonidine hydrochloride (Catapres) but that he hasn’t taken it for 2 days because he ran out of medication. Which assessment finding is least important in alerting the nurse to the patient’s need for prompt medical attention?

A 63-year-old man arrives at the ED in an ambulance, complaining of a persistent, dull epigastric pain radiating to the interscapular region; the pain began 2 days ago. The nurse notes that he is alert and has good coloring and that his skin is warm and dry. Vital signs include right-arm blood pressure (BP) 120/60 mmHg, left-arm BP 220/100 mmHg, right radial pulse 2+, and left radial pulse 3+. The nurse notes bilateral basilar crackles and a systolic cardiac murmur at the second right intercostal space. The patient has a 33-year history of hypertension, for which he is taking medications. The physician prescribes an antihypertensive agent for the patient. The main objective of therapy is to maintain:

The nurse understands that the most serious adverse effect of IV nitroglycerin therapy is:

The nurse understands that the most common cause of hypertension is:

Initially, administering IV fluid to a patient with acute cardiac tamponade would:

The nurse understands that all of the following are common complications of pericardiocentesis except:

A 20-year-old man is admitted to the ED after being removed from a serious automobile accident. He sustained severe chest injuries as a result of not wearing his seat belt while driving. Chest x-rays reveal fractures to the second, third and fourth ribs on the left side. The physician diagnoses cardiac tamponade. The nurse should assess for which sign in a patient with suspected cardiac tamponade?

Which is the most important nursing intervention during pericardiocentesis?

The nurse knows that the most common cause of acute cardiac tamponade is:

Which treatment would receive the highest priority in a patient with cardiac tamponade?

The nurse would anticipate preparing this patient for all of the following procedures except:

A 32-year-old woman is admitted to the ED with complaints of sudden, severe pain in the right leg. After a thorough assessment, the physician diagnoses her condition as acute arterial occlusion of the right leg. Which history finding is atypical of a patient with acute arterial occlusion?

An appropriate action for the ED nurse caring for a patient with an arterial occlusion is to:

Which symptom would the nurse expect to assess in a patient with acute arterial occlusion?

A 20-year-old man is admitted to the ED after being removed from a serious automobile accident. He sustained severe chest injuries as a result of not wearing his seat belt while driving. Chest x-rays reveal fractures to the second, third and fourth ribs on the left side. The physician diagnoses cardiac tamponade. The nurse should assess for which sign in a patient with suspected cardiac tamponade?

A 32-year-old man, the driver of an automobile involved in an accident, is brought to the ED by ambulance. He is complaining of chest pain and shortness of breath. EKG tracings show sinus tachycardia with frequent PVCs. Based on the presenting signs and symptoms, the nurse suspects that the patient has:

Which assessment finding is the earliest indication of impending shock?

A 32-year-old man, the driver of an automobile involved in an accident, is brought to the ED by ambulance. He is complaining of chest pain and shortness of breath. EKG tracings show sinus tachycardia with frequent PVCs. Based on the presenting signs and symptoms, the nurse suspects that the patient has:

Which therapy would be contraindicated for a patient with a myocardial contusion?

The nurse understands that blunt chest trauma commonly results in damage to the:

Which drug would be contraindicated for a patient with complications from a myocardial contusion?

While assessing a patient, the nurse notes a sharp decrease in systolic pressure, dyspnea, and bilateral crackles. Which nursing action holds the highest priority at this time?

When caring for a patient with an acute MI, which early assessment finding may indicate the development of cardiogenic shock?

Which of the following is a beneficial effect of vasodilator therapy in a patient in cardiogenic shock?

While the nurse is completing the initial physical assessment and history of a patient with abdominal pain, the patient becomes increasingly restless and confused. The nurse obtains a second set of vital signs and notifies the physician. The vital signs: BP 90/58 mmHg, weak peripheral pulses at a rate of 134 beats/minute, temperature 96.6° F (35.9° C) with a cool skin surface, and respirations 16 breaths/minute and shallow. The nurse would know that this is likely development of:

Which patient is at lowest risk for developing cardiogenic shock?

Which of the following is a therapeutic outcome following use of inotropic agents in a patient in cardiogenic shock?

The nurse knows that the evaluation of renal function in a patient with early circulatory failure does not reveal

Which treatment for a patient in cardiogenic shock is least effective in protecting the myocardium from further damage?

Clinical manifestations of cardiogenic shock include all of the following except

Which of the following should be administered if IVfluids are insufficient in correcting hypotension?

Which information should the nurse plan to include in the discharge instructions for this patient?

In which condition is small-airway obstruction usually irreversible?

Which statement about the aspiration of gastric contents is true?

Which factor should be the nurse’s most important consideration in efforts to prevent aspiration?

Which term best describes the condition of a patient with the above medical history and evidence of alveolar destruction?

Nursing assessment of a patient with emphysema typically reveals barrel chest, which results from:

Which assessment finding is indicative of hypoxia?

When writing discharge instructions for a patient diagnosed with an acute asthmatic episode, the nurse should include information on the importance of:

When auscultating a patient, the nurse notes decreased vesicular breath sounds. This is an indication of:

At 3 am, a 13-year-old girl is brought to the ED by her mother because of coughing and severe dyspnea. Her medical history reveals allergic rhinitis and eczema since early childhood. The nurse notes that the patient is wheezing and talking with effort. When questioned about precipitating factors, the mother states that her daughter had put on a new acrylic sweater to go to a makeup demonstration at a friend’s house the previous evening and that she also had worn a new down jacket, which she is wearing now. The physician diagnoses acute asthmatic attack. Which term best describes the type of asthma precipitated by a known allergen?

The nurse would assess the following ABG: pH 7.38, PaO2 83, SaO2 96%, CO2 37, HCO3 25 as:

At 3 am, a 13-year-old girl is brought to the ED by her mother because of coughing and severe dyspnea. Her medical history reveals allergic rhinitis and eczema since early childhood. The nurse notes that the patient is wheezing and talking with effort. When questioned about precipitating factors, the mother states that her daughter had put on a new acrylic sweater to go to a makeup demonstration at a friend’s house the previous evening and that she also had worn a new down jacket, which she is wearing now. The physician diagnoses acute asthmatic attack. Which term best describes the type of asthma precipitated by a known allergen?

The patient complains of increased dyspnea and tightnessin her chest. The nurse knows that these symptoms of asthma may result from all of the following except:

The nurse would suspect dyspnea in a patient with a stab wound in the left upper abdominal quadrant to result from:

Which of the following is likely to contribute to the onset of acute extrinsic asthma attack?

At 3 am, a 13-year-old girl is brought to the ED by her mother because of coughing and severe dyspnea. The physician diagnoses acute asthma attack. Which additional findings would the nurse expect to note during assessment of this patient?

The physician diagnoses a 19-year-old male with acute asthma attack. Which early treatment is likely to improve this patient’s condition most rapidly?

When assessing a patient with cor pulmonale resulting from COPD:

Which nursing diagnostic category would be appropriate for a patient with COPD?

The nurse would expect the physician to order all of the following treatments for a patient with COPD except:

Acute respiratory failure in a patient with essentially normal lung tissue usually is indicated by:

When auscultating a patient, the nurse notes decreased vesicular breath sounds. This is an indication of:

The nurse assesses a patient at risk for respiratory failure. All of the following are early signs of respiratory failure except:

The nurse knows that cor pulmonale is a complication of COPD secondary to:

The patient wonders aloud whether it is too late to quit smoking. The nurse correctly explains that if the patient stops smoking now:

Nursing assessment of a patient with emphysema typically reveals barrel chest, which results from:

The nurse knows that chronic bronchitis is classified as COPD because of which pathogenic occurrence?

Which action would be the nurse’s highest priority when a nurse witnesses a patient suddenly go into respiratory arrest?

Which assessment findings are commonly associated with epiglottitis?

The pregnant patient’s respiratory status changes during gestation; her ABG would reveal:

Which statement about endotracheal intubation for a patient in respiratory arrest is true?

A patient is not intubated successfully, the nurse would expect to:

Which of the following is the most common cause of airway obstruction in the elderly?

Which statement about airway management is true?

Which assessment finding is a symptom of complete upper airway obstruction?

In a patient with atelectasis, the nurse would expect to hear bronchial breath sounds over the:

Which statement about esophageal obturator airway management is true?

Which size chest tube should be prepared for a suspected hemothorax in an adult?

Autotransfusion usually is indicated for a patient with which condition?

When the patient arrives in the ED, a chest tube is inserted. The tube is connected to a water-seal bottle that has a moderate air and fluid leak seen on expiration. When the patient is taken to the radiology department, the bottle is accidently broken. Which nursing action should be taken?

A 64-year-old man with emphysema is admitted to the ED because of a sudden attack of dyspnea. Auscultation reveals no breath sounds over the right lung. The physician diagnoses spontaneous pneumothorax and inserts a chest tube. The patient’s chest tube is ordered to be on suction, at -20 cm of water pressure. When checking the chest tube drainage system at the start of the shift, the nurse notices continuous bubbling in the suction chamber. The nurse correctly interprets this to mean:

The nurse knows that an increase in negative pressure inside the pleural space will result in:

After thoracotomy for a tension pneumothorax, the patient’s condition does not improve despite assisted ventilation with 100% oxygen and rapid infusion of crystalloids. Which other condition causes similar symptoms?

Development of sudden subcutaneous emphysema and a crunching or crackling sound associated with auscultation of the apical heart rate is indicative of:

Which signs and symptoms are characteristic of tension pneumothorax?

The nurse’s discharge instructions for a patient with a rib contusion and a minor rib fracture include information on the need to report fever, dyspnea on exertion, sputumproduction, or chest pain should any of these symptoms occur. These symptoms are indicative of:

A 26-year-old man diagnosed with spontaneous pneumothorax is being monitored in the holding room overnight. Because the patient had limited symptoms and lung involvement, decompression of the pleural cavity was not initiated. Which assessment finding should the nurse report immediately to the physician?

Which finding would be least useful in evaluating recurrence of a pneumothorax?

A paramedic radios data to the base station regarding the status of a 64-year-old man who is showing signs and symptoms of an acute tension pneumothorax after involvement in an automobile accident. The paramedics are instructed to perform a needle thoracotomy. The nurse anticipates that the paramedic will correctly insert the needle:

A patient is status post insertion of a chest tube for pneumothorax, now has a well expanded lung, and the chest tube is positioned to allow for water-seal drainage without suction. The nurse should anticipate that the water-seal level would:

Acute respiratory failure in a patient with essentially normal lung tissue usually is indicated by:

When assessing a patient with acute respiratory failure resulting from impaired ventilation, the nurse would initially expect to note:

Which term best describes the condition of a patient with the above medical history and evidence of alveolar destruction?

The nurse assesses a patient at risk for respiratory failure. All of the following are early signs of respiratory failure except:

While percussing a patient’s lung fields, the nurse notes consolidated areas. These areas typically produce which sound?

The nurse would define anatomic dead space (VD) as:

The nurse practitioner orders heparin therapy for a patient diagnosed with pulmonary embolism. Which statement about the use of heparin therapy for pulmonary embolism is true?

A 70-year-old man was admitted to the hospital 2 months ago with a diagnosis of pulmonary embolism. He had been treated with heparin and discharged on warfarin sodium (Coumadin) therapy after the embolism resolved. Earliertoday, he became confused and ingested 100 mg of warfarin. He is now being readmitted with hematemesis and bright-red rectal bleeding. During the initial assessment of this patient, the emergency department (ED) nurse should be particularly alert for:

When the nurse dorsiflexes the patient’s foot, the patient complains of calf pain. The nurse correctly interprets this response as an indication of a positive:

Which nursing diagnosis would be the highest priority for a patient with a diagnosis of pulmonary embolism?

Which electrocardiographic finding would the nurse expect to find in a patient with pulmonary embolism?

A 50-year-old man is admitted to the ED with a diagnosis of suspected pulmonary embolus. He is dyspneic and anxious. The physician plans to start heparin therapy. Which laboratory test results are consistent with a diagnosis of pulmonary embolism?

The nurse would anticipate initial emergency treatment for a patient with mild to moderate respiratory distress secondary to chronic obstructive pulmonary disease (COPD) to include:

The ED nurse is examining a 19-month-old boy with respiratory distress. The child’s mother reports that he has had a temperature of 101°F (38.3°C), fatigue, and hoarseness for the past 2 days, during which time the hoarseness and fatigue have progressively increased. The patient developed a barkingcough during the night. The physician diagnoses laryngotracheobronchitis (croup). The nurse knows that management of a child with croup is primarily directed toward:

A patient is not intubated successfully, the nurse would expect to:

Which nursing intervention would be appropriate for a patient with respiratory distress secondary to COPD?

A 65-year-old man with a history of chronic obstructive pulmonary disease and laryngeal carcinoma is being examined in the ED. He is currently undergoing radiation therapy and has symptoms of acute respiratory distress. Assessment reveals inspiratory stridor, dyspnea, increasing apprehension, and facial flushing. The most appropriate nursing action would be to:

In a patient with a massive flail chest, all of the following factors are indications for ventilatory support except:

A side-effect of Naloxone (Narcan) when administered rapid IV push is:

In a patient with multiple rib fractures, which nursing intervention would be appropriate to encourage optimal ventilation?

Which is the most common cause of impaired gas exchange after blunt chest trauma?

The nurse knows that flail chest is easiest to assess:

Fracture of the scapula or first or second rib indicates a serious force of injury and a high probability of underlying tissue damage. The nurse knows that, in the emergent phase of care, pulmonary contusion is best indicated by:

When assessing a patient with acute respiratory failure resulting from impaired ventilation, the nurse would initially expect to note:

In a patient with atelectasis, the nurse would expect to hear bronchial breath sounds over the:

Which injury constitutes flail chest?

Acute respiratory failure in a patient with essentially normal lung tissue usually is indicated by:

Which rationale best supports the use of mannitol in treating increased ICP?

The nurse should include avoidance of which activity in the care plan of a patient with increased ICP?

Although several nursing diagnostic categories would be applicable for a patient with increased ICP, which category is most appropriate for this patient?

When planning the care of a patient with increased ICP, the nurse includes appropriate interventions to prevent further worsening of the patient’s condition. The nurse realizes that the patient’s condition may worsen with the development of:

Which sign is typically the first indication of increased ICP?

While caring for a patient with a head trauma, the nurse would assess for signs of uncal herniation. Which sign is an early indication of this condition?

Which independent nursing intervention bestrelieves increased ICP?

Which method of determining ICP is considered unsafe in a patient with a head injury?

Which physiologic event precipitates most neurologic emergencies?

The nurse is aware that signs of increased ICP include:

The nurse is caring for an infant that has been diagnosed with meningitis. The infant is irritable with a high pitched cry, and the nurse notes bulging fontanels and distended scalp veins. Which of the following interventions are appropriate for this infant? Select all that apply.

The nurse knows that in which of the following clinical scenarios would a lumbar puncture be contraindicated? Select all that apply.

A nurse is discharging a 7-year-old after being treated for bacterial meningitis. Which of the following client needs should the nurse include in the discharge teaching?

An adolescent has presented to the emergency room with meningeal symptoms and is assigned a nurse. The nurse knows to expect which of the following symptoms for this client? Select all that apply.

The nurse is caring for a neonate that is diagnosed with early onset Group B-Streptococcus meningitis. Which of the following antibiotics will the nurse plan on administering?

The nurse typically begins to assess level of consciousness by using:

Which information regarding phenytoin should the nurse include in discharge teaching?

Which life-threatening situation would the nurse expect to occur if phenytoin is administered by rapid IV bolus?

Which nursing diagnostic category reflects the clinical problems associated with this patient’s seizures?

Which statement about eclampsia is true?

What phase of a tonic-clonic, often referred to as gran mal, seizure is a patient having if she is having violent and severe muscle body contractions accompanied by a loss of continence?

A 60-year-old man with a history of seizures is brought to the ED because of recurrent seizure activity. While in the ED, he develops tonic-clonic movements of the right arm and leg. The nurse correctly determines that this patient is exhibiting a:

Which of the following is least likely to precipitate a seizure?

A 60-year-old man with a history of seizures is brought to the ED because of recurrent seizure activity. While in the ED, he develops tonic-clonic movements of the right arm and leg. Which postictal manifestation should the nurse anticipate and adjust for in the patient’s plan of care?

Which method is the best way of determining a patient’slevel of consciousness in the emergency department (ED)?

A patient is admitted to the ED with possible spinal cord injury between T4 and T12. Which clinical finding would the nurse not expect to note?

Which drug is the treatment of choice to prevent seizures from traumatic head injury?

A man is brought to the ED by emergency medical service after involvement in a motor vehicle accident. He is suspected of having a spinal cord injury. Spinal X-rays confirm a lesion at the C5 to C6 level. The nurse anticipates that the patient has:

When planning discharge instructions for a patient with a cerebral concussion, the nurse should anticipate telling the patient that he can expect all neurologic symptoms to subside within:

A man arrives at the ED via ambulance after sustaining a hemi-section of the spinal cord from a stab wound to the right side of the back. He experiences loss of movement on the right side and loss of pain and temperature sensations on the left.The nurse knows that this syndrome is called:

A patient admitted to the ED after a motor vehicle accident is found to have a basal skull fracture with middle meningeal artery damage. The nurse would expect a patient who sustained damage to the middle meningeal artery to develop:

A 23-year-old man is brought to the ED after suddenly feeling ill while exercising with weights at a local health spa. While in the ED, he complains of a sudden, explosive headache. The nurse suspects:

Which nursing diagnosis would be the highest priority for a patient with a cervical spinal cord injury?

The nurse knows that loss of motor function in the right arm and leg may indicate a lesion in the:

Which method is the best way of determining a patient’slevel of consciousness in the emergency department (ED)?

The nurse knows that all of the following conditions contribute to the development of neurogenic shock except

A 45-year-old patient, who sustained a neck injury from a fall off a ladder, complains of decreased sensation in his whole body. His HR is 54 and BP is 82/34. Which kind of shock is this client likely experiencing?

The assessment findings with a patient who has neurogenic shock, would include:

A 26-year-old man was involved in an automobile accident. Approximately 20 minutes elapsed between the time of the accident and the arrival of the paramedics. He sustained severe abdominal injuries, spinal cord injury, and multiple fractures. On arrival at the ED, the patient’s vital signs are blood pressure 80/50 mmHg, heart rate 120 beats/minute, and respiratory rate 30 breaths/minute. Which nursing action is inappropriate during the initial stabilization of this patient?

All of the following interventions are appropriate for the patient in neurogenic shock except:

Which pathophysiologic alteration is responsible for the clinical manifestations of neurogenic shock?

A 54-year-old male is brought to the ED in neurogenic shock, which of the following findings would the nurse anticipate?

Which nursing action is inappropriate during the management of a patient with neurogenic shock resulting from a spinal cord injury?

Which assessment findings indicate neurogenic shock?

While the nurse is completing the initial physical assessment and history of a patient with abdominal pain, the patient becomes increasingly restless and confused. The nurse obtains a second set of vital signs and notifies the physician. The vital signs: BP 90/58 mmHg, weak peripheral pulses at a rate of 134 beats/minute, temperature 96.6° F (35.9° C) with a cool skin surface, and respirations 16 breaths/minute and shallow. The nurse would know that this is likely development of:

Which assessment finding would be typical for a patient with an abdominal aortic aneurysm?

While in the ED, which is the best parameter for evaluating expected patient outcomes for the above nursing diagnosis:

The patient’s abdominal X-ray reveals a fusiform infrarenal non-dissecting aortic aneurysm. Which nursing diagnosis would be the highest priority for this patient?

Which is the correct sequence for assessing and evaluating a patient’s abdomen:

What condition could be the cause of the following symptoms seen together in the same patient: chronic nighttime cough, earache, dysphagia, hoarseness, and epigastric pain?

Which assessment finding is characteristic of acute appendicitis?

When compared with older children and adults, young children have a higher incidence of perforation of the appendix with ensuing peritonitis because they typically have:

Which of the following can cause chemical peritonitis in a patient with a perforated gastric ulcer:

Which of the following signs is a symptom of peritonitis?

In assessing the patient’s health status, the nurse should know that hematemesis is most commonly caused by:

Perforated ulcers occur most commonly in the:

All of the following assessment findings would lead the nurse to suspect a perforated gastric ulcer except:

Which of the following can cause chemical peritonitis in a patient with a perforated gastric ulcer:

The nurse knows that such abdominal emergencies as obstruction, perforation, and acute intractable hemorrhage are typically treated by:

Anticholinergic drugs, commonly used to treat peptic ulcer disease, typically produce which pharmacologic action:

A patient is admitted to the ED after a high-speed, head-on automobile accident. He is conscious and alert; his skin is cool and dry. Vital signs are: BP 110/70 mmHg, pulse rate 100 beats/minute, and respirations 24 breaths/minute. The on-scene paramedic reports severe front-end damage to the car and a broken steering wheel. After assessing the patient’s airway, breathing, and circulation, the nurse’s primary concern would be to:

Which diagnostic test would the nurse anticipate for a patient with lower gastrointestinal bleeding?

In a patient with prolonged bleeding, anemia is a potential complication. The nurse assesses for anemia by noting signs of pallor in the patient’s:

Which sign is not an indication for IVP?

Lower GI bleeding is characterized by bleeding from:

The nurse knows that a patient on long-term anticoagulant therapy must be carefully monitored for potential hemorrhagic complications that most commonly affect the:

The patient’s BP suddenly drops to 88/60 mmHg and his pulse increases to 130 beats/minute. After administration of 500 mL of Lactated Ringer’s solution, the patient’s BP increases to 100/70 mmHg and his pulse rate decreases to 100 beats/minute. The nurse’s priority at this time would be to:

An elderly man is brought to the ED by his daughter after an episode of rectal bleeding. After initial treatment in the ED, the patient will probably be:

The nurse knows that such abdominal emergencies as obstruction, perforation, and acute intractable hemorrhage are typically treated by:

Which assessment finding would be typical for a patient with an abdominal aortic aneurysm?

A woman in the 38th week of pregnancy arrives at the emergency department (ED) complaining of painless vaginal bleeding that occurred, without warning, upon arising this morning. Her abdomen is soft, and her uterus is nontender. The fetal heart rate is assessed at the umbilical level at 120 bears/minute. Based on the patient history and physical findings, the nurse would suspect that the patient has:

Nursing care of the patient with a three-lumen, double balloon esophageal tube includes all of the following except:

The nurse recognizes which is a common cause of esophageal varices?

In assessing the patient’s health status, the nurse should know that hematemesis is most commonly caused by:

A two-year-old is brought in by his parents with severe abdominal pain and bright red blood in his diaper. The nurse caring for this child knows that these care clinical manifestations of which of the following diagnosis?

The nurse caring for a one-year-old with intussusception knows which of the following are signs of peritonitis? Select all that apply.

The nurse is caring for a three-year-old with intussusception who is waiting for surgery. The nurse knows to notify the provider of which of the following clinical findings?

The parents of an 18-month-old who has just been diagnosed with intussusception and signs of peritonitis are concerned and want to know how this can be treated. The nurse accurately tells them which of the following? Select all that apply.

Which condition is the primary cause of large-bowel obstruction in an adult?

The nurse knows that such abdominal emergencies as obstruction, perforation, and acute intractable hemorrhage are typically treated by:

The nurse understands that bowel obstruction occurs most commonly in extremely young and old patients and that the hallmark signs and symptoms include:

A 74-year-old man is brought to the hospital by his nephew after complaining of severe abdominal cramping and swelling. He claims to have had a stomach virus for the past few days. His symptoms include nausea, anorexia, mild discomfort, and constipation. Within the last 12 hours, his pain has increased in intensity, and he has vomited small amounts of greenish liquid several times. The physician diagnoses his condition as a possible bowel obstruction. An appropriate nursing diagnosis for this patient would be:

When a patient is undergoing emergency endoscopy, the nurse should assess for all of the following potential complications except:

The nurse knows that pancreatitis also may occur as a complication of a perforated duodenal ulcer when:

Over the course of several months of caring for various patients with pancreatitis, the nurse would expect the physician to order broad-spectrum antibiotics:

The nurse should assess the patient for all of the following symptoms of hemorrhagic pancreatitis except:

Of the following history findings, the most likely cause of pancreatitis is:

Which nursing diagnosis is most appropriate for a patient at risk for complications from pancreatitis?

Nursing interventions for a patient with acute hemorrhagic pancreatitis include all of the following except:

The nurse normally assesses a patient with acute pancreatitis for elevated levels of serum:

The patient is being admitted to the medical-surgical unit for further treatment and observation. Which dietary regimen would the nurse expect for a patient with pancreatitis?

Which type of solution would the nurse expect to infuse to restore circulatory dynamics in a patient with blunt abdominal injury?

During the assessment, the nurse notes a large mass in the left upper abdominal quadrant, displacement of the stomach, and associated rib fractures in the left lower thorax. The nurse identifies the patient’s primary nursing diagnosis as:

A patient is admitted to the ED after a high-speed, head-on automobile accident. He is conscious and alert; his skin is cool and dry. Vital signs are: BP 110/70 mmHg, pulse rate 100 beats/minute, and respirations 24 breaths/minute. The on-scene paramedic reports severe front-end damage to the car and a broken steering wheel. After assessing the patient’s airway, breathing, and circulation, the nurse’s primary concern would be to:

Results of a diagnostic peritoneal lavage may be falsely negative in a patient with a:

A young woman is brought into the ED after a motor vehicle accident. She is complaining of severe pain in her abdomen and left shoulder. Upon exam, you note ecchymosis around her navel. You should be most concerned about:

A 61-year-old man is transferred to the ED by ambulance from his physician’s office with a diagnosis of a possible abdominal aortic aneurysm. When eliciting the patient’s history, the nurse keeps in mind that one of the most common factors predisposing a patient to abdominal aortic aneurysm is:

During a patient assessment, the nurse notes a large mass in the left upper abdominal quadrant, displacement of the stomach, and associated rib fractures in the left lower thorax. These signs are consistent with injury to the:

Which statement regarding the spleen is false?

Which internal organ is typically injured in a patient with a blunt abdominal trauma?

The patient’s BP suddenly drops to 88/60 mmHg and his pulse increases to 130 beats/minute. After administration of 500 mL of Lactated Ringer’s solution, the patient’s BP increases to 100/70 mmHg and his pulse rate decreases to 100 beats/minute. The nurse’s priority at this time would be to:

In a patient diagnosed with a UTI, the nurse practitioner writes prescriptions for Bactrim and Pyridium. Which statement best reflects that the patient needs further discharge instructions?

The nurse is assessing a patient with a hard scrotal mass that cannot be transilluminated. This finding most likely indicates:

A 35-year-old man arrives at the ED with pain in the right flank that began 2 hours ago, spontaneously abated, and then suddenly recurred. The pain is severe, sharp, and radiates to the groin. Physical examination reveals tenderness in the right costovertebral angle. The patient’s pulse rate is 110 beats/minute, blood pressure 150/94 mmHg, temperature 100o F (37.8oC), and respiratory rate 24 breaths/minute. Laboratory results indicate a WBC count of 10,000/mm3 , normal hemoglobin and hematocrit levels, and normal serum electrolyte, BUN, and glucose levels. Urinalysis reveals an RBC count greater than 100 cells via high-powered field. An indwelling urinary catheter is inserted, and 800 mL of urine is obtained. The patient is sent for an emergency IVP. The nurse knows that management of a patient with obstructive uropathy is directed primarily toward:

Which assessment data are characteristic of UTI?

Which organism is the most common cause of UTI?

A 26-year-old woman arrives at the ED complaining of dysuria, fever of 101o F (38.3oC), and urinary frequency. She has had these symptoms for 36 hours. Physical examination reveals suprapubic tenderness but no flank pain. No history of UTI or urologic instrumentation is evident. She informs the nurse that she had sexual intercourse 12 hours before the onset of symptoms. She has no significant medical history and takes no medications. Her complete blood count, serum electrolyte, BUN, and glucose levels are normal. A tentative diagnosis of UTI is made, and urine specimens for analysis and culture are sent to the laboratory. When taking the health history, the nurse should remember to ask the patient about:

In caring for a patient with an indwelling urinary catheter, strategies to reduce the risk of infection would include all except:

Which diagnostic study would be necessary if a patient had hematuria?

Which information about a UTI should the nurse include in the discharge teaching for a patient:

Which of the following is not seen in a patient with prostatitis?

Which action should be the nurse’s priority when treating a patient with renal colic?

Which procedure would the nurse most likely expect to see used to confirm a diagnosis of renal calculi?

If a kidney were partially obstructed by a calculus, the nurse would expect the patient’s urine output to:

Which medication should be avoided if renal calculi are suspected?

Which of the following would not be commonly seen in a patient suffering from kidney stones?

A 24-year-old man is brought to the emergency department (ED), after having sustained blunt trauma to the left kidney during a boxing match. He is awake and alert. His chief complaint is flank tenderness. Urinalysis reveals microscopic hematuria. All other laboratory values are within normal limits. Vital signs are blood pressure 130/70 mmHg, pulse rate 76 beats/minute, and respiratory rate 20 breaths/minute. He is scheduled for transfer to the medical-surgical unit as soon as a bed is available. Which assessment findings indicate renal trauma:

Which statement regarding the assessment or treatment of urethral trauma is true?

Which injury resulting from blunt renal trauma typically resolves without surgery?

The nurse would anticipate a penile fracture to be treated by:

Besides providing pain relief, which nursing action should be included in the plan of care for a patient who has sustained testicular trauma?

The nurse would expect a patient with a ruptured bladder to exhibit which signs and symptoms:

Which statement regarding urethral trauma is true:

Anuria is a common symptom of:

Which question typically elicits the most valuable information from a patient complaining of flank pain?

In a patient with renal contusion, if the patient’s pain increases, the nurse’s main priority would be to: