Critical Care Nursing A Holistic Approach 10th Edition Morton Fontaine Test Bank
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Below you will find some free nursing test bank questions from this test bank:
|1.||A patient has been admitted to the CCU after surgery to remove a brain tumor. What nursing assessment indicates development of a significant complication?|
|A)||Gradually improving level of consciousness|
|B)||Serum sodium levels 138 to 142 mEq/L|
|C)||Minimal serous drainage on dressing|
|D)||Sudden onset of confusion|
|2.||A patient with a probable leak from a cerebral aneurysm is scheduled for surgical repair. What is the priority of nursing care in the preoperative period?|
|A)||Administration of prescribed stool softener medication|
|B)||Awaken every hour to assess neurologic status|
|C)||Encourage ambulation and exercise to tolerance|
|D)||Keep on high-fiber and low-calorie diet|
|3.||The patient has a cerebral aneurysm leak. While awaiting surgical repair, the patient has an episode of extreme light-headedness and is found to have a mean arterial pressure less than 55 mm Hg. The patient’s urinary output has been excessive and increasing over the past several hours. What is the best nursing intervention for this patient?|
|A)||Enforce complete bed rest|
|B)||Cautious volume replacement|
|C)||Intravenous diuretic therapy|
|D)||Continuous seizure precautions|
|4.||A patient is admitted to the CCU after aneurysm clipping. What is the best nursing strategy to prevent complications?|
|A)||Group care tasks to allow longer rest periods|
|B)||Keep head elevated and in neutral position|
|C)||Suction every 30 minutes to maintain airway|
|D)||Keep monitor alarm volume on “high”|
|5.||The patient has had a stroke or brain attack, believed to be ischemic in nature. The causes of an ischemic stroke are least likely to include which of the following?|
|A)||Thrombus of a cerebral artery|
|B)||Embolus of a cerebral artery|
|C)||Ruptured cerebral aneurysm|
|6.||A patient is being cared for in the CCU after a ruptured cerebral aneurysm. The nurse finds new onset of hemiparesis, slight lethargy, and complaints of diplopia. What complication does the nurse suspect?|
|B)||Increased intracranial pressure|
|C)||Cerebral artery vasospasm|
|D)||Carbon dioxide retention|
|7.||While shopping, a nurse’s friend experiences sudden unilateral weakness and slurred speech. What is the most important nursing intervention?|
|A)||Activate the emergency response system|
|B)||Observe for return of neurologic stability|
|C)||Notify close family members of the victim|
|D)||Stabilize airway and cervical spine|
|8.||A patient is in the emergency department being treated for an ischemic stroke. What is the nursing priority of care?|
|A)||Refer for rehabilitation care|
|B)||Initiate fibrinolysis within 3 hours|
|C)||Initiate intravenous glucose therapy|
|D)||Administer 100% oxygen mask|
|9.||A patient has been diagnosed with partial seizures. What behaviors during this patient’s seizures that would not occur during a generalized seizure does the nurse expect?|
|A)||Aura prior to seizure|
|B)||Twitching confined to one arm|
|C)||Absence of purposeful movement|
|D)||Postictal period or state|
|10.||A patient with seizure disorder is being treated with oral phenytoin (Dilantin). To prevent undesirable side effects of this medication, what is a nursing priority?|
|A)||Monitor all seizure activity|
|B)||Use seizure precautions|
|C)||Give medication with milk|
|D)||Teach good oral care|
|11.||Three weeks after a viral illness, a patient has an onset of weakness in the lower extremities that is progressing to the arms. The patient is admitted to the CCU with a diagnosis of rapidly progressing Guillain-Barré syndrome. What is the nursing care priority?|
|A)||Monitor respiratory system closely|
|B)||Prevent hazards of immobility|
|C)||Emotional support for patient and family|
|D)||Control musculoskeletal pain|
|12.||A patient with myasthenia gravis is being treated with corticosteroids. What symptom would indicate an undesirable side effect of the corticosteroid therapy?|
|A)||Increased weakness with activity|
|C)||Inability to swallow|
|D)||Stool positive for guaiac|