1.

RIGHT CORONARY SUPPLIES:

SINUS NODE: BRADYCARDIA
AV NODE: CHB, 3RD HB, AV DISSOCIATION
RA & RV: RV INFARCTION
MITRAL VALVE: MITRAL INSUFFICIENCY
INFERIOR WALL
2. LEFT ANTERIOR DECENDING SUPPLIES:
BUNDLE OF HIS: MOBITZ II
BUNDLE BRANCHES: RBBB
VENTRICULAR SEPTUM: VSD
ANTERIOR-SEPTAL WALL
3. CARDIAC TRAUMA
MYOCARDIAL CONTUSION
ST ELEVATION IN LEADS LOOKING AT THE INJURY
WORSE THAN PERICARDITIS
BROKEN BLOOD VESSELS THAT BLEED INTO THE HEART MUSCLE
DEAD TISSUE
PERICARDITIS
ST ELEVATION IN ALL LEADS
RISK OF CARDIAC TAMPONDE
4. PERICARDITIS CAUSES:
VIRAL
MI
POST-OP
RADIATION
IDIOPATHIC
TRAUMA
5. PERICARDITIS WATCH FOR:
CARDIAC TAMPONADE
HYPOTENTION
ELEVATED JVD
PULSUS PARADOXUS
6. DRESSLER'S SYNDROME - WHAT IS IT
SHARP, STABBING PAIN
INCREASES WITH INSPIRATION
LOW GRADE FEVER
DYSPNEA
COUGH
7. PACEMAKERS
SPIKES ON T-WAVES = FAILURE TO SENSE
SENSITIVITY TOO HIGH, BATTERY FAILURE, CATHETER MALPOSITION
FAILURE TO CAPTURE = SPIKES BUT NO BEAT
LEAD DISLODGEMENT, BATTERY FAILURE, FAULTY CONNECTION
8. SHOCK STAGES
COMPENSATORY STAGE
PROGRESSIVE STAGE
REFRACTORY STAGE

9. COMPENSATORY STAGE OF HYPOVOLEMIC SHOCK

BODY TRYING TO MAKE SHOCK BETTER
DECREASE IN CO = STIMULATES SYMPATHETIC NERVOUS SYSTEM
= ADRENALIN WHICH
INCREASES CO, BP, ADH AND VASOCONSTRICTION
ANXIOUS AND IRRITABLE
TACHYCARDIA, COOL AND PALE, DECREASED UO
10. PROGRESSIVE STAGE OF HYPOVOLEMIC SHOCK
VASODIALATION DUE TO LACTIC ACIDOSIS
DECREASE IN CO & BP HYPOTENSION
OBTUNDED AND STUPORUS
DECREASED CVP, PCWP, CO. INCREASED SVR
11. TREATMENTS FOR HYPOVOLEMIC SHOCK:
REPLACE VOLUME
CRYSTALLOIDS
FFP
RBCS
12. CARDIOGENIC SHOCK ETIOLOGY:
MI
CHF
ARRHYTHMIAS
CARDIAC TAMPONADE
PAPILLARY MUSCLE RUPTURE
13. CARDIAC SHOCK ASSESSMENT:
CONFUSED, RESTLESS
RAPID RESPIRATION
RALES
RAPID THREADY PULSE
NECK VEIN DISTENTION
NARROW PULSE PRESSURE
S3 AND S4
HYPOTENSION
OLIGURIA
DECREASED CO
ELEVATED CVP, SVR, PCWP
14. CARDIOGENIC SHOCK TREATMENTS
EARLY REPERFUSION
PTCA
THROBOLYTICS
CABG
IABP
INOTROPIC DRUGS
15. INTRA AORTIC BALLOON PUMP IABP - WHAT IT DOES
DECREASES AFTERLOAD
DECREASEES MYOCARDIAL O2 DEMAND
INCREASES CORONARY PERFUSION
IMPROVE CARDIAC OUTPUT

16. IABP
INFLATES DURING - DIASTOLE - WHEN BALLOON INFLATES IT PUSHES BLOOD DOWN. THIS IS
WHEN HEART MUSCLE RECEIVES BLOOD SUPPLY.
DEFLATES DURING - SYSTOLE - LV BLOOD PUSHES THROUGH AORTA
17. IABP
PT MUST LAY FLAT
ALWAYS CHACK PULSES
MONITOR FOR BLEEDING
18. USES OF IABP
SUPPORT ACUTE MI WITH CHOCK
CIRCULATORY SUPPORT CABG PTS
SUPPORT HIGH RISK CARDIAC CATHS
19. CONTRAINDICATIONS OF IABP:
AORTIC INSUFFICIENCY
PERIPHERIAL VASCULAR DISEASE
20. COMPLICATIONS OF IABP:
ISCHEMIA OF LIMB
DISSECTION OF AORTA
INFECTION
21. SEPTIC SHOCK
SEPSIS USUALLY CAUSED BY GRAM-NEGATIVE BACTERIA:
E.COLI
KIEBSIELLA
ENTEROBACTER
PSEUDOMONAS
SERRATIA MARCESCENS
22. PREDISPOSING FACTORS:
OLD AGE
GRANULOCYTOPENIA
SEVERE BURN INJURY
ALCOHOL & DRUB ABUSE
RECENT SURGICAL PROCEDURES
IMMUNOSUPPRESSION (HIV, CHEMO)
PROLONGED INTENSIVE CARE UNIT STAY
23. SEPTIC SHOCK
GRAM NEGATIVE BACTERIA --->
ENDOTOXIN --->
VASOACTIVE SUBSTANCES: CYTOKINES, BRADYKININS, INTERLEUKINS, HISTAMINES,
SERATONINS, TNF--->
VASODILATION
24. TWO STAGES OF SEPTIC SHOCK:
WARM STAGE
COLD STAGE

25. WARM STAGE OF SEPTIC SHOCK:

CONFUSION
INCREASED CO
INCREASED RR
BEST ABG
GOOD BP
INCREASED UO
NEEDS FLUIDS
26. COLD STAGE OF SEPTIC SHOCK:
STUPORUS & OBTUNDED
DECREASED CO
DECREASED UO
POOR ABG
METABOLIC ACIDOSIS
HYPOTENSION -----> ARDS, ATN, MSOF, DIC
27. SHOCK CHART
SHOCK
CARDIOGENIC
HYPOVOLEMIC
SEPTIC (WARM)
SEPTIC (COLD)
ANAPHYLACTIC

PRELOAD
INCREASED
DECREASED
DECREASED
DECREASED
DECREASED

AFTERLOAD
INCREASED
INCREASED
DECREASED
INCREASED
DECREASED

CARDIAC OUTPUT
DECREASED
DECREASED
INCREASED
DECREASED
DECREASED

28. WHICH OF THE FOLLOWING PRESSURES ARE WITHIN NORMAL LIMITS?

A. PAP 34/24 PCWB 12
B. PAP 30/20 PCWB 10
C. PAP 28/18 PCWP 20
D. PAP 24/14 PCWP 12
29. WHICH OF THE FOLLOWING WOULD CAUSE AN ELEVATED PULMONARY ARETERY
PRESSURE AND NORMAL WEDGE PRESSURE?
A. PULMONARY HYPERTENSION
B. PULMONARY EDEMA
C. LEFT VENTRICULAR FAILURE
D. CONSTRICTIVE PERICARDITIS
30. A LARGE V WAVE APPEARS ON THE PCWP TRACING OF A PATIENT WITH AN INFERIOR WALL
MYOCARDIAL INFARCTION. THIS FINDING IS CONSISTENT WITH:
A. CARDIOGENIC SHOCK
B. CONGESTIVE HEART FAILURE
C. MITRAL REGURGITATION
D. PERICARDITIS
31. ST ELEVATION AND ABSENCE OF AN "R" WAVE IN V1-V4 WOULD BE INDICATIVE OF:
A. ANTERIOR-SEPTAL WALL INFARCTION
B. INFERIOR WALL ISCHEMIA
C. ANTERIOR - SEPTAL WALL ISCHEMIA
D. ANTERIOR - LATERAL WALL INFARCTION

32. WHICH OF THE FOLLOWING HEMODYNAMIC PARAMETERS WOULD INDICATE LEFT

VENTRICULAR FAILURE IN A PATIENT WITH COPD?
A. PAP 54/22 PCWP 14 CVP 8
B. PAP 48/26 PCWP 16 CVP 6
C. PAP 22/12 PCWP 26 CVP 16
D. PAP 48/26 PCWP 20 CVP 16
33. THE RECIPROCAL CHANGES THAT OCCUR WITH AN INFERIOR WALL MI ARE SEEN AS ST
DEPRESION IN LEADS:
A. II, III, AVF
B. V1-V4
C. II, AVL
D. I, AVL
34. WHICH OF THE FOLLOWING COMPLICATIONS IS MOST LIKELY TO OCCUR IN ACUTE
INFERIOR MYOCARDIAL INFARCTION?
A. MOBITZ TYPE I HEART BLODK (WENCHEBACH)
B. PAROXYSMAL ATRIAL TACHYCARDIA (PAT)
C. RIGHT BUNDLE BRANCH BLOCK (RBBB)
D. CARDIOGENIC SHOCK
35. YOUR PATIENT WITH AN INFERIOR WALL MI ALSO HAS A RIGHT VENTRICULAR INFARCTION
& DEVELOPS RIGHT VENTRICULAR FAILURE. WHICH DATA OBTAINED WOULD CORRELATE
WITH THIS PATIENT'S CONDITION
A. PAP 28/10 PCWP 10 CVP 18
B. PAP 38/22 PCWP 20 CVP 6
C. PAP 54/28 PCWP 14 CVP 14
D. PAP 23/8 PCWP 19 CVP 20
36. THE TREATMENT MODAILITY FOR A PATIENT WITH RVF FROM AN INFERIOR WALL MI
WOULD INCLUDE:
A. NIPRIDE AN DLOW DOSE DOPAMINE
B. NORMAL SALINE FLUID CHALLENGE
C. LASIX AND PRELOAD REDUCERS
D. LIDOCAINE AND AFTERLOAD REDUCERS
2 INCREASING PRELOAD TO OVERSTRETCH THE RV TO GUARENTEE GETTING BLOOD TO THE
LEFT SIDE OF THE HEART.
37. ASYSTOLE - TEA
TRANSCUTANEOUS PACING
EPINEPHRINE
ATROPINE
38. BRADYCARDIA - ALL TRAINED DOGS EAT IAMS
ATROPINE
TRANSCUTANEOUS PACING
DOPAMINE
EPINEPHRINE
ISOPROTERENOL

39. A PATIENT IWTH A HR OF 45 COMPLAINS OF DIZZINESS AND COOL CLAMMY EXTREMITIES.

WHAT IS THE FIRST DRUG OF CHOICE?
A. ATROPINE 0.5MG - 1MG
B. EPINEPHRINE 1MG IV PUSH
C. ISUPREL INFUSION 2-10MCG/KG/MIN
D. ADENOSINE 6 MG IV PUSH
40. YOU ARE TREATING A PATIENT WITH A SLOW HEARTBEAT. FOR WHICH OF THE FOLLOWING
PATIENT SWOLD ATROPINE BE EFFECTIVE?
A. A 55 Y/O MALE WITH SEVERE CHEST PAIN AND SINUS BRADYCARDIA AT 35 BPM
B. A 55 Y/O MALE WITH WEAKNESS AND 3RD DEGREE HB
C. A 55 Y/O MALE WITH FATIGUE AND A HEART TRANSPLANT 6 MONTHS AGO
D. A 55 Y/O MALE WITH WEAKNESS AND ACUTE SYMPTOMS OF NAUSEA/VOMITING WITH A
SINUS HR OF 35
NOT WITH CP
ATROPINE WONT WORK WITH 3RD DEGREE HB
ATROPINE WONT WORK WITH HEART TRANSPLANT BECAUSE VAGUS NERVE CUT
41. PEA PULSELESS ELECTRICAL ACTIVITY
REVIEW CAUSES:
5 "H" S
5 "T" S
H - HYPOVOLEMIA, HYPOXIA, HYDROGEN IONS, HYPOTHERMIA, HYPERKALEMIA
T - TENSION PNEUMOTHROAX, THROMBOSIS, TAMPONADE, TOXINS
TREATMENTS: PEA
PROBLEM
EPINEPHRINE
ATROPINE
42. VF/ PULSELESS VT TREATMENT:
SHOCK 3X
EPINEPHRINE OR VASOPRESSIN
SHOCK X1
AMIODARONE, LIDOCAINE, MAGNESIUM, PROCAINAMIDE
SHOCK
BUFFERS (BICARB)
PLEASE, SHOCK SHOCK SHOCK, EVERYBODY SHOCK AND LET'S MAKE PATIENTS DANCE....
BETTER
43. WHICH OF THE FOLLOWING THERAPIES IS THE MOST IMPORTANT INTERVENTIONS FOR
VF/PULSELESS VT, WITH THE GREATEST EFFECT OF SURVIVAL TO HOSPITAL DISCHARGE?
A. EPINEPHRINE
B. DEFIBRILLATION
C. OXYGEN
D. AMIODARONE
44. PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA
VAGAL STIMULATION
PROCAINAMIDE
ADENOSINE
SOTALOL
PRESERVED HEART FUNCTION
DC CARDIOVERSION
AMIODARONE
EF <40%, CHF - NO BETA BLOCKERS OR CCB
BETABLOCKER
DC CARDIOVERSION
CA CHANNEL BLOCKERS
AMIODARONE
DIGOXIN
DILTIAZEM

45. WIDE COMPLEX TACHYCARDIAS OF UNKNOWN TYPE

DRUGS:
AMIODARONE & PROCAINAMIDE
HX HF: AMIODARONE & LIDOCAINE
46. WIDE COMPLEX TACHYCARDIAS OF UNKNOWN TYPE CONTRAINDICATED:
VERAPAMIL AND ADENOSINE
CCB, BETA BLOCKERS, DIGOXIN
47. STABLE VT
CARDIOVERSION
48. A 75Y/O PATIENT WITH RAPID AF, APPROXIMATELY 160 PER MINUTE AND IRREGULAR C/O
PALPITATIONS FOR A WEEK. NO EVIDENCE OF CARDIC OR CIRCULATORY FAILURE. WHICH
WOULD BE INCLUDED IN THE INITIAL ORDERS?
A. OXYGEN, IV, MONITOR
B. IMMEDIATE CARDIOVERSION
C. NO THERAPY IS INDICATED
D. EPINEPHRINE 1MG IV EVERY 3-5 MIN
49. SAME PATIENT. HIS VITALS SIGNS REMAIN UNCHANGED, BP 100/70, IRREGULAR HR OF 160.
WHICH OF THE FOLLOWING WOULD BE THE MOST APPROPRIATE TREATMENT FOR AF?
A. IV DIGOXIN
B. IV DILTIAZEM TO SLOW VENTRICULAR REPSONSE
C. IV AMIODARONE TO CONVERT AF TO SR
D. SYNCHRONIZED CARDIOVERSION
A,C,D MAY CONVERT. BEEN IN AF FOR A WEEK WILL SEND CLOTS FLYING
50. 25 Y/O WOMAN IS WITH PSVT, PRIOR MEDICAL HX CONFIRMED REENTRY TACHYCARDIA,
NO WPW. HR 180BPM, SHE IS SOB AND REPORTS PALPITATIONS. WHICH WOULD BE THE NEXT
MOST APPROPRIATE INTERVENTION?
A. DC CARDIOVERSION
B. IV DILTIAZEM
C. IV PROPRANOLOL
D. IV ADENOSINE
51. 55 Y/O M WITH HX CHF & LBBB DEVELOPS SUSTAINED WIDE COMPLEX TACHYCARDIA
AFTER AN EPISODE OF CP RELIEVED BY NTG. WHICH OF THE FOLLOWING IS THE MOST
APPROPRIATE INITIAL MED?
A. IV LIDOCAINE
B. IV ADENOSINE
C. IV AMIODARONE
D. IV VERAPAMIL
52. CLINICAL MANIFESTATIONS OF CARDIOGENIC SHOCK FOLLOWING AN ANTERIOR WALL MI
INCLUDE ALL OF THE FOLLOWING EXCEPT:
A. DISTENDED NECK VEINS
B. PULMONARY CONGESTION, RALES
C. PRESENCE OF AN S3
D. LOW CVP READING

53. "UNLOADING" THERAPY BY NITROPRUSSIDE IS BENEFICIAL BECAUSE IT:

A. ENHANCES VENTERICULAR EMPTYING
B. DIMINISHES PERIPHERAL VASCULAR RESISTANCE OR "AFTERLOAD"
C. RELIEVES PULMONARY CONESTION BY PROMOTING VENOUS POOLING OF BLOOD
D. ALL OF THE ABOVE
54. WHICH OF THE FOLLOWING IS AN EXPECTED OUTCOME FROM IABP?
A. DECREASED MEAN SYSTEMIC BP
B. INCREASED CARDIAC OUTPUT
C. INCREASED PCWP
D. ALL OF THE ABOVE
55. UNSTABLE TACHYCARDIA TREATMENT:
SYNCHRONIZED CARDIOVERSION
56. WHICH OF THE FOLLOWING GROUPS OF HEMODYNAMIC DATA REFLECTS CARDIOGENIC
SHOCK AS OPPOSED TO HYPOVOLEMIC SHOCK?
A. BP 88/60 PA 18/8 PCWP 12
B. BP 70/40 PA 30/20 PCWP 22
C. BP 90/60 PA 24/18 PCWP 25
D. BP 94/56 PA 40/22 PCWP 20
PCWP HIGH, PAP HIGH, IN 2 WEDGE IS HIGHER THAN PAD
57. TO BE OPERATING CORRECTLY, THE IABP IS TIMED TO WORK IN WHICH MANNER?
A. INFLATE DURING SYSTOLE, DEFLATE DURING DIASTOLE
B. INFLATE WHEN THE MEAN AORTIC PRESSURE FALLS BELOW A PRESET LIMIT
C. INFLATE WHEN THE HEART RATE FALLS BELOW A PRESET LIMIT
D. INFLATE DURING DIASTOLE DELFATE DURING SYSTOLE
58. ABSOLUTE CONTRAINDICATIONS TO INTRA-AORTIC BALLOON COUNTERPULSATION
INCLUDE:
A. MITRAL INSUFFICIENCY
B. AORTIC INSUFFICIENCY
C. SEPSIS
D. FEMORAL ARTERY ANEURYSM
59. ALL POSTOPERATIVE CARDIAC SURGERY PATIENTS DEVELOP:
A. PERICARDITIS
B. ELECTROLYTE IMBALANCES
C. HYPOXIA
D. ATELECTASIS
60. WHICH OF THE FOLLOWING KINDS OF SHOCK IS CHARACTERIZED BY INCREASED VENOUS
CAPACITANCE AND POOLING?
A. HYPOVOLEMIC SHOCK
B. CARDIOGENIC SHOCK
C. DISTRIBUTIVE SHOCK (SEPTIC)
D. OBSTRUCTIVE SHOCK
61. EARLY STAGES OF SEPTIC SHOCK ARE CHARACTERIZED BY:
A. VASOCONSTRICTION WITH THE RELEASE OF HISTAMINE
B. INCREASED CARDIAC OUTPUT WITH PERIPHERAL VASOCONSTRICTION
C. VASODILATION WITH FLUID LOSS AND THE RELEASE OF LEUKOCYTES
D. INCREASED CARDIAC OUTPUT WITH DECREASED VASCULAR RESISTANCE

62. THE SIGNS OF HYPERVENTILATION, DIMINISHED SENSORIUM, AND INCREASED CO ARE

OFTEN FOUND IN WHICH FORM OF SHOCK?
A. NEUROGENIC
B. SEPTIC
C. HYPOVOLEMIC
D. CARDIOGENIC
63. A PATIENT ADMITTED TO THE ICU IN THE EARLY STAGES OF SEPTIC SHOCK PRESENTS WITH:
A. WEAK THREADY PULSES AND LOW BP
B. DECREASED UO
C. WARM, FLUSHED SKIN
D. HYPERNEA WITH PULMONARY CONGESTION
64. WHICH OF THE FOLLOWING SIGNS IS NOT CHARACTERISTIC OF CARDIAC TAMPONADE?
A. WIDENING PULSE PRESSURE
B. RISING CVP
C. WIDE MEDIASTINUM ON XRAY
D. A FALL IN SYSTOLIC BP OF MORE THAN 10MMHG DURING INSPIRATION
65. THE PLACEMENT OF MCL, ELECTRODES IS:
A. + ELECTRODE, 4TH ICS, R STERNAL BORDER, - ELECTRODE, BELOW OUTER 3RD OF L
CLAVICLE
B. + ELECTRODE, 5TH ICS, R STERNAL BORDER, - ELECTRODE L LOWER ABD
C. + ELECTRODE, L SHOULDER, - ELECTRODE, R SHOULDER
D. + ELECTRODE, L MIDAXILLARY LINE, 5TH ICS; - ELECTRODE, BELOW OUTER 3RD OF
LEFT CLAVICLE
66. THE MOST SERIOUS EKG FINDING ASSOCIATED WITH ANTERIOR WALL MI IS:
A. FASCICULAR BLOCKS AND TACHYCARDIA
B. RBBB AND SECOND DEGREE BLOCKS
C. FEW VENTRICULAR ECTOPIC BEATS
D. RAPID SUPRAVENTRICULAR RHYTHMS
67. THE HEMODYNAMIC PARAMETER THAT CLINICALLY MEASURES AFTERLOAD IS:
A. CVP
B. MAP
C. SVR
D. LEFT VENTRICULAR END-DIASTOLIC PRESSURE
68. ALL OF THE FOLLOWING SUPPORT THE DIAGNOSIS OF CARDIAC TAMPONADE EXCEPT:
A. WIDENING PULSE PRESSURE
B. PULSUS PARADOXUS
C. ENLARGED HEART ON XRAY
D. EQUALIZATION OF RIGHT AND LEFT HEART PRESSURES
69. A PATIENT WITH BP OF 200/142 WOULD HAVE WHICH OF THE FOLLOWING FORMS OF HTN?
A. ESSENTIAL HTN
B. ACCELERATED HTN
C. MALIGNANT HTN
D. HYPERTENSIVE ENCEPHALOPATHY
70. ABGS NORMALS:

PH
ACID <---- 7.35 - 7.45 ------> ALKA
CO2
RESPIRATORY
ALKA<---- 35 - 45 -----> ACID
HCO3
METABOLIC
ACID <-----23 -27 ------>ALKA
71. ABGS - BABYS FIRST NAME
PH
CO2-RESPIRATORY
7.12
UNCOMP ACIDOSIS
7.55
UNCOMP AKLALOSIS
7.01
UNCOMP ACIDOSIS
7.23
UNCOMP ACIDOSIS
72. ABGS
COMPENSATED ABG 7.35-7.45
ACIDOSIS
7.35
7.40

HCO3-METABOLIC

ALKALOSIS
7.45

73. ABGS - BABYS FIRST NAME

PH
CO2-RESP
7.36
COMP. ACIDOSIS
7.45
COMP ALKALOSIS

HCO3-METABOLIC

74. ABG - LAST NAME MR. RESP MR. METABOLIC (MUST BE THE SAME AS BABYS FIRST NAME)
PH
CO2-MR. RESP HCO3-MR. META
7.12
28
11
UNCOMP META ACID
UN ACID ALKA
ACID
7.55
29
20
UNCOMP RESP ALKA
UN ALK ALKA
ACID
75. ABG - LAST NAME MR. RESP MR. METABOLIC (MUST BE THE SAME AS BABYS FIRST NAME)
PH
CO2-MR. RESP HCO3-MR. META
7.36
61
34
COMP RESP ACID
COM ACID ACID
ALKA
7.45
22
20
COMP RESP ALKA
COM ALKA ALKA
ACID
76. ABG - LAST NAME MR. RESP MR METABOLIC (MUST BE THE SAME AS BABYS FIRST NAME)
7.01
51
10
UNCOMP RESP ACID
UN ACID ACID
ACID
7.23
50
29
UNCOMP RESP ACID
UN ACID ACID
ALKA
77. CAUSES OF ACID-BASE IMBALANCES

RESPIRATORY ACIDOSIS
DRUGS, CARDIAC ARREST, MUSCLE WEAKNESS (MG, ALS, GB), PULMONARY DISEASE (COPD)
RESPIRATORY ALKALOSIS
HYPOXEMIA, CNS DISORDERS, SALICYLATE INTOXICATION, CIRRHOSIS, SEPSIS
78. CAUSES OF ACID-BASE IMBALANCES
METABOLIC ACIDOSIS
KETOACIDOSIS, LACTIC ACIDOSIS, GI LOSS (DIARRHEA), RENAL FAILURE
METABOLIC ALKALOSIS
BLOOD TRANSFUSIONS, HYPOKALKEMIA, GI LOSS (GASTRIC ACIDS), CONTRACTION
ALKALOSIS (TOO MUCH LASIX)
79. ACUTE REPIRATORY FAILURE
TYPE 1
HYPOCAPNIC FAILURE
DECREASED OXYGEN LEVEL WITH A NORMAL OR LOW CO2
VENTILATION - PERFUSION IMBALANCE
PULMONARY EDEMA, PULMONARY EMBOLISM, ASPIRATION PNEUMONIA, ASTHMA, ARDS
80. ACUTE RESPIRATORY FAILURE
TYPE 2
HYPERCAPNIC FAILURE
DECREASED OXYGEN LEVEL WITH A HIGH CO2 LEVEL
RESPIRATORY MECHANICAL PERFORMANCE
DRUG OVERDOSE, COPD, CVA, SPINAL CORD: ALS, GB, MG, PNEUMOTHORAX, DECREASED
PHOS
81. OXYHEMOGLOBIN DISSOCIATION CURVE
SHIFT TO R = LOWER SAT, LOWER O2 SAT, RBC RELEASING O2 ONTO TISSUE
DECREASED PH, INCREASED CO2, HYPERTHERMIC (COPD)
SHIFT TO L = HIGHER SAT, HIGH O2 SAT, RBC HOLDING ONTO O2
INCREASED PH, DECREASED CO2, HYPOTHERMIC, LOW LEVELS OF 2,3 DPG
82. V/Q MISMATCH
VENTILATION-PERFUSION IMBALANCE
COPD
ASTHMA
ATELECTASIS
EMPHYSEMA
HYPOVENTILATION
PULMONARY EDEMA
PULMONARY EMBOLISM
ASPIRATION PNEUMONIA
83. SHUNT
NO CONTACT BETWEEN BLOOD & ALVEOLI
ARDS

84.WHICH OF THE FOLLOWING STATMENTS REGARDING VESICULAR BREATH SOUNDS IS TRUE?

A. THESE ARE MEDIUM INTENSITY SOUND HEARD OVER THE LARGE MAIN-STEM BRONCHI

B. THEY ARE HEARD LONGER ON EXHALATION

C. THEY ARE DECREASED OR ABSENT WHEN AIRFLOW TO THE AREA OF LUNG IS
DIMINISHED
D. THEY ARE AUSCULATED OF THE TRACH
85. WHICH OF THE FOLLOWING CHEST AUSCULTATION FINDINGS IS ABNORMAL?
A. VESICULAR BREATH SOUNDS OVER LUNG PERIPHERY
B. BRONCHIAL BREATH SOUNDS HEARD OVER LARGE AIRWAY
C. VESICULAR BREATH SOUNDS HEARD DURING INSPIRATION AND EXPIRATION
D. BRONCHOVESICULAR SOUNDS ADJACENT TO THE STERNUM
86. PATIENT IN CCU POST CARDIAC ARREST: FIO2 0.8, PH 7.31, PCO2 42, PO2 60, O2 SAT 85% AND
HCO3 18:
A. COMPENSATED METABOLIC ACIDOSIS
B. UNCOMPENSATED RESPIRATORY ACIDOSIS
C. UNCOMPENSATED METABOLIC ACIDOSIS
D. UNCOMENSATED METABOLIC ACIDOSIS
87. PATIENT PRESENTS WITH AGITATION AND TINGLING OF THE FINGERS: FIO2 RA, PH 7.49,
PCO2, O2 SAT 98%, HCO3 22:
A. NORMAL ACID-BASE BALANCE
B. UNCOMPENSATED RESPIRATORY ALKALOSIS
C. UNCOMPENSATED RESPIRATORY ACIDOSIS
D. UNCOMPENSATED METABOLIC ALKALOSIS
88. NEWLY ADMITTED MI PATIENT ON THIAZIDE DIURETICS AT HOME FOR HYPERTENSION HAS
AN ABG: FIO2 0.6, PH 7.58, PCO2 36, PO2 70, O2 SAT 90%, HCO3 34
A. UNCOMPENSATED METABOLIC ALKALOSIS
B. UNCOMPENSATED RESPIRATORY ALKALOSIS
C. UNCOMPENSATED METABOLIC ACIDOSIS
D. COMPENSATED METABOLIC ALKALOSIS
89. WHICH OF THE FOLLOWING PATIENT FINDINGS WILL CONTRIBUTE A SHIFT TO THE LEFT
WITH IMPAIRED TISSUE UNLOADING OF OXYGEN?
A. PH 7.58
B. TEMP 103F
C. PACO2 50MMHG
D. INCREASED HEMOGLOBIN 2, 3, DPG
90. WHICH OF THE FOLLOWING PATIENT FINDINGS WILL CONTRIBUTE TO A SHIFT TO THE
RIGHT WITH IMPROVED UNLOADING OF OXYGEN AT THE TISSUES?
A. PH 7.46
B. TEMP 96F
C. PACO2 54
D. DECREASED HEMOGLOBIN 2, 3 DPG

91. PULMONARY CONSOLIDATION (LOBAR PNEUMONIA) WILL CAUSE WHICH OF THE

FOLLOWING PHYSICAL FINDINGS OVER THE DISEASED AREA?
A. DULL PERCUSSION NOTE
B. DECREASED TACTILE FREMITUS

C. BRONCHIAL BREATH SOUNDS

D. BOTH A AND C
92. A NOTABLE CHARACTERISTIC OF MUCUS WILL OFTEN BE PRESENT IN PATIENTS WITH
STATUS ASHTMATIC ATTACT IN ITS:
A. COLOR
B. TENACIOUSNESS
C. COPIOUS NATURE
D. ABSENCE
93. AN OMINOUS FINDING IN THE PATIENT WITH STATUS ASTHMATICUS WOULD BE:
A. A RESPIRATORY RATE OF 34
B. LOUD EXPIRATORY WHEEZING
C. A CO2 OF 55
D. USE OF ACCESSORY MUSCLES
94. A PATIENT WITH STATUS ASTHMATICUS IS ADMITTED. HIS BREATH SOUNDS ARE
DIMINISHTED THROUGHOUT HIS LUNG FIELDS. RR=40. AFTER GIVING YOUR PATIENT AN
AEROSOL BRONCHODILATOR, YOUR PATIENT SOUNDS WORSE AS THEY ARE NOW LOUDER.
THIS INDICATEDS:
A. THE PATIENT HAS GOTTEN WORSE
B. THE NEED FOR ANESTHEISIA TO BE PRESENT STAT
C. THE PATIENT IS GETTING BETTER
D. THE PATIENT DOES NOT HAVE ASTHMA
95. WHEN ADJUSTING THE INITIAL SETTINGS ON A VOLUME VENTILATOR FOR AN ADULT IN
RESPIRATORY FAILURE, THE TIDAL VOLUME IS USUALLY SET AT:
A. AT LEAST 10ML PER KG OR TWICE NORMAL
B. 15-20 ML PER KG OR TWICE NORMAL
C. 500 ML FOR ALL PATIENTS
D. 300-500 ML
96. A 70 KG PATIENT VENTILATED WITH FIO2 OF 45%, VT OF 800, IMV OF 8. PATIENTS
RESPIRATIONS ARE 10/MIN. ABG RESULTS: O2 85%, CO2 55, WHAT VENTILATOR PARAMETER
SHOULD BE CHANGED?
A. FIO2
B. IMV
C. VT
D. ALL OF THE ABOVE
97. ADMINISTRATION OF 100% O2 WILL NOT IMPROVE THE PAO2 IN HYPOXIA CAUSED BY:
A. V/Q IMBALANCE
B. RIGHT TO LEFT SHUNTING
C. ALVEOLAR HYPOVENTILATION
D. IMPAIRED DIFFUSION

98. WHICH OF THE FOLLOWING DISEASES STATES DOES NOT CAUSE HYPOXIA DUE TO A
PRIMARY MECHANISM OF V/Q MISMATCHING?
A. BRONCHOSPASTIC DISEASE
B. PULMONARY EMPHYSEMA

C. ADULT RESPIRATORY DISTRESS SYNDROME

D. PULMONARY EMBOLIZATION
99. THE ADMINISTRATION OF OXYGEN ALONE WILL NOT IMPROVE HYPOXIA DUE TO:
A. V/Q MISMATCH
B. SHUNTING
C. HYPOVENTILATION
D. DECREASED FIO2
100. WHICH OF THE FOLLOWING STATEMENTS REGARDING ARDS IS TRUE?
A. THERE IS DECREASED CAPILLARY PERMEABILITY
B. THERE IS DAMAGE TO TYPE II PNEUMOCYTES WITH A DECREASED OF SURFACTANT
C. THERE IS AN INCREASE IN LUNG COMPLIANCE
D. THERE IS AN INCREASE IN FUNCTIONAL RESIDUAL CAPACITY
101. ASSESSMENT FINDINGS INDICATIVE OF ARDS IN THE EARLY STAGE, WOULD INCLUDE ALL
OF THE FOLLOWING EXCEPT:
A. TACHYPNEA
B. NORMAL PCWP
C. RESPIRATORY ALKALOSIS
D. HYPERCAPNIA
102. THE HALLMARK OF ADULT RESPIRATORY DISTRESS SYNDROME (ARDS) IS:
A. REFRACTORY HYPERCAPNIA
B. REFRACTORY HYPOXEMIA
C. LOW FUNCTIONAL RESIDUAL CAPACITY
D. INCREASED COMPLIANCE SECONDARY
103. THE NURSE CONSIDERS WHICH INTERVENTION TO BE INAPPROPRIATE WHILE CARING FOR
THE PATIENT WITH ARDS?
A. ADMINISTER SMALL DOSES LASIX AS ORDERED BY MD
B. INFUSION OF NORMAL SALINE RAPIDLY IN ORDER TO MAINTAIN HYDRATION
C. PULMONARY TOILETING
D. FREQUENT POSITION CHANGES.
104. THE PLAN OF THERAPEUTIC ATTACT IN THE CARE OF ARDS PATIENTS MAY INCLUDE:
A. USE OF VENT WITH HIGH PRESSURE AND HIGH FLOW CHARACTERISTICS
B. DIURETICS AND FLUID RESTRICTION
C. USE OF PEEP
D. ALL OF THE ABOVE
105. PALPATION OF TRACHEAL SHIFT TO THE LEFT MAY INDICATE:
A. A TENSION PNEUMOTHORAX ON THE RIGHT
B. MASSIVE ATELECTASIS TO THE RIGHT
C. A TENSION PNEUMOTHORAX ON THE LEFT
D. DIFFUSE AIRWAYS OBSTRUCTION

106. INITIAL NURSING ASSESSMENT FINDINGS IN THE PATIENT WITH AN ACUTE PULMONARY
EMBOLISM INCLUDES:
A. CHEST PAIN, ST CHANGES, PULMONARY EDEMA
B. RALES, RHONCI, TACHYCARDIA,

C. CHEST PAIN, DYSPNEA, COUGH

D. TACHYPNEA, BRADYCARDIA, RALES
107. WHICH ASSESSMENT FINDING WOULD NOT BE PRESENT IN THE PATIENT WITH A MASSIVE
PULMONARY EMBOLISM?
A. INCREASED CVP READING
B. PULMONARY RALES
C. DISTENDED NECK VEINS
D. LIVER ENLARGEMENT
108. BURNS
FLUID SHIFTS FROM BLOOD TO INTERSTIAL AND INTRACELLULAR SPACES
MAY CAUSE INCREASE TISSURE PRESSURE, LEASING TO COMPARTMENT SYNDROME
HEMOCONCENTRATION, INCREASED HEMATOCRIT AND BLOOD VISCOSITY RESULTS
109. BURNS
DECREASE INTRAVASCULAR VOLUME - DECREASE BLOOD FLOW TO KIDNEYS
DECREASE CARDIAC OUTPUT FURTHER DECREASES ORGAN PERFUSION
RESULTS IN HYPOVOLEMIC SHOCK, METABOLIC ACIDOSIS AND HYPERKALEMIA
MICROVASCULAR LEAK WITH PULMONARY EDEMA, ARDS, ATN AND MYOGLOBINURIA
110. BURNS
SMOKE INHALATION:
OBSERVE FOR SIGNS OF OBSTRUCTION, STRIDOR, HOARSENESS, RESLESSNESS, BEHAVIORAL
CHANGES AND DECREASED LOC
111. POISIONING
IN COMATOSE PATIENT BE PREPARED TO GIVE:
DEXTROSE 50% 100ML
THIAMINE 100MG IV
NARCAN 2MG IV
ACTIVATED CHARCOAL 1 GRAM/KG OF WEIGHT
PROVIDE ANTIDOTE
112. TYLENOL OVERDOSE
ANTIDOTE:
NAC (MUCOMYST)
140MG/KG LOADING DOSE
70 MG/KG EVERY 4 HOURS FOR 17 DOSES
GIVE ACTIVATED CHARCOAL IF LESS THAN 4 HOURS SINCE INGESTION
(WAIT 1 HOUR BEFORE GIVIENG NAC IF CHARCOAL GIVEN)
113. ASA OVERDOSE
ANTIDOTE:
LAVAGE OR INDUCE EMESIS
ACTIVATED CHARCOAL
URINARY ALKALINIZATION - SODIUM BICARB
HEMODIALYSIS
OBSERVE FOR: RENAL TUBULAR ACIDOSIS
114. COCAINE OVERDOSE
MONITOR FOR SEIZURE ACTIVITY
115. MASSIVE BLOOD TRANSFUSIONS =

LOW CALCIUM LEVEL

116. TPN CAUSES
HYPOPHOSPHATEMIA
(MUSCLE WEAKNESS)
117. AMPHOGEN REDUCES
HYPERPHOSPHATEMIA
118. WHAT IS A VVI PACEMAKER?
V- CHAMBER PACED
V- CHAMBER SENSED
I - MODE THE PACER IS IN
119. HOW DO YOU DRAIN THE LEFT LOWER LUNG LOBE?
LEFT SIDE, HEAD DOWN
120. LEFT VENTRICULAR ASSIST DEVICE BLOOD IS DIVERTED FROM THE LEFT ATRIUM AND
RETURNED TO THE PATIENT VIA
ASCENDING AORTA
(BYPASS LEFT VENTRICLE)
121. IABP AUGMENTS THE CO BY 15%
122. TOUSADES DE POINTES TREATMENT:
MAGNESIUM
123. MVA BROKEN LEG IS AT RISK FOR:
FAT EMBOLI
124. COMPLICATION OF PEEP IS
BARATRAUMA
125. RENAL TRANSPLANT ACUTE REJECTION OCCURS WITHIN:
1-2 WEEKS
126. A-LINE, DICROTIC NOTCH =
CLOSURE OF THE AORTIC VALVE
127. MAP =
DIASTOLIC PULSE + 1/3 OF PULSE PRESSURE
150/90
90 +1/3 PP (60)
90+20 = 120
128. CARDIAC TROPONIN t AND i, MYOGLOBIN ARE
SENSITIVE CARDIAC MARKERS, RISE IN LESS THAN 6 HOURS
129. ACIDOSIS CAUSES POTASSIUM TO
RISE
130. ARDS KEEP PATIENT:
DRY (DECREASE FLUIDS)

131. SIADH - WHAT IS IT?

SYNDROME OF INAPPROPRIATE ADH
TOO MUCH ADH
132. ADH MAKES YOUR KIDNEYS DO WHAT?
HOLD ONTO WATER
133. DILUTIONAL HYPONATREMIA IS USUALLY ...
SIADH
134. SIADH CAUSES WHAT
DECREASED OSMOLARITY. SODIUM LEVEL X2
DECREASED SODIUM
135. WHAT ARE CAUSES OF SIADH
OAT CELL CARCINOMA
VIRAL PNEUMONIA
HEAD PROBLEMS
ANESTHESIA, ANALGESIC, STRESS
136. COMPLICATION OF SIADH IS
SEIZURE ACTIVITY
BECAUSE WITH DILUTIONAL HYPONATREMIA WATER GOES INTO CELLS (BRAIN CELLS)
CAUSING SEIZURES
137. TREATMENT FOR SIADH
FLUID RESTRICTION AND HYPERTONIC SOLUTION 3% NS, D5NS, D5 1/2 NS
NO HYPOTONIC SOLUTIONS!! 2.5 DEXTROSE, D5W, 0.33 SALINE
138. DIABETES INSIPIDUS
NO ADH
LOSES WATER
139. DI CAUSES
INCREASE IN NA LEVEL
INCREASE IN OSMOLARITY
140. CAUSES OF DI
HEAD PROBLEMS
DILANTIN
141. PTS WITH DI NEED TO BE WATCHED FOR:
SHOCK
142. TREATMENTS FOR DI
GIVE ADH (PITRESSIN)
GIVE FLUIDS
MONITOR CARDIAC MONITOR
MONITOR URINE SPECIFIC GRAVITY
143. HYPOGLYCEMIC
CVS
CNS
TACHY
CONFUSION
PALPITATIONS
LETHERGY

DIAPHORESIS
IRRITABLE
RESTLESS

SLURRED SPEECH
SEIZURES
COMA

144. IF ON A BETA BLOCKER AND HYPOGLYCEMIC WILL NOT HAVE

CARDIOVASCULAR SYMPTOMS
145. INITIAL SIGNS OF HYPOGLYCEMIA ARE CAUSED BY
ADRENALIN RELEASE
146. DKA DIABETIC KETOACIDOSIS BLOOD SUGARS ARE BETWEEN:
400-900
147. HHNK HYPERGLYCEMIC HYPEROSMOLAR NON-KETOTIC COMA. WHO GETS IT?
OLD AGE
DIET CONTROLLED DIABETIC
TPN
PANCREATITIS
148. HHNK BLOOD SUGARS ARE BETWEEN:
1000-2000
149. DKA CAUSES
DEHYDRATION
4-6 L
150. HHNK CAUSES
DEHYDRATION
6-8 L
151. IN DKA YOUR BODY IS DOING WHAT WITH INSULIN?
NOT MAKING ANY INSULIN
152. IN HHNK YOUR BODY MAKES INSULIN BUT
NOT ENOUGH
153. PEOPLE WHO HAVE DKA USUALLY ARE RECOGNIZED BECAUSE THEY ...
GO IN A COMA
154. PEOPLE WITH HHNK
CAN LIVE A COUPLE OF WEEKS WITH HHNK, THATS WHY THE BS GETS SOO HIGH
155. DKA CAUSES
ACIDOSIS AND KUSSMAUL BREATHING
156. HHNK CAUES
NO ACIDOSIS AND LITTLE TINY BABY BREATHS
157. TREATMENT FOR DKA
INSULIN THEN GIVE FLUIDS
158. TREATMENT FOR HHNK
GIVE FLUIDS FIRST THEN INSULIN BECAUSE THEY ARE SO DEHYDRATED

159. WHAT TYPE OF FLUIDS DO YOU GIVE PEOPLE WITH DKA AND HHNK
START WITH NS
THEN GIVE 0.45% NS
THEN GIVE D5 1/2
160. WHEN PEOPLE WITH DKA COME IN, WHAT DO YOU WANT THEIR POTASSIUM TO BE?
NORMAL OR HIGH POTASSIUM LEVEL
161. POTASSIUM AND PH ARE REOCIPROCAL
HYDROGEN WILL MOVE INTO THE CELL, THEN POTASSIUM WILL MOVE OUT OF THE CELL
162. AS YOU BECOME MORE ACIDOTIC, YOUR POTASSIUM INCREASES. THATS WHY IN DKA,
YOURE ACIDOTIC AND YOUR POTASSIUM WILL BE HIGH.
PH 7.45
K 4.5
PH 7.35
K 5.1
PH 7.25
K 5.7
PH 7.15
K 6.3
PH 7.05
K 6.9
163. BICARB GIVEN TO DKA PT WITH PH 7.05 AND K 4.0 IT INCREASES YOUR PH BUT DECREASES
YOU POTASSIUM
164. WHAT IS THE AFFECT OF ADH ON URINE FORMATION?
A. RETENTION OF SODIUM AND WATER, EXCRETION OF POTASSIUM
B. EXCRETION OF SODIUM AND WATER, EXCRETION OF POTASSIUM
C. RETENTION OF WATER, CONCENTRATION OF URINE
D. EXCRETION OF WATER, DILUTION OF URINE
165. THE RELEASING STIMULUS FOR ADH IS NORMALLY:
A. DECREASED SERUM WALL MYOCARDIAL INFARCTION?
B. INCREASED SERUM OSMOLARITY
C. AN ELEVATED CIRCULATING CORTISOL LEVEL
D. INCREASED SERUM POTASSIUM LEVELS
166. THE NORMAL RANGE OF SERUM OSMOLARITY IS:
A. 145-155
B. 200-250
C. 275-295
D. 325-375
167. SIADH IS MANIFEST CLINICALLY AS A:
A. HYPEROSMOLAR STATE
B. LOW OUTPUT STATE
C. MYXEDEMA STATE
D. WATER INTOXICATION STATE

168. IN ADDITION TO ITS AFFECT ON BODY WATER EQUILIBRIUM, ADH IS ALSO A:

A. VASOPRESSOR
B. CARDIOTONIC
C. BETA STIMULATOR

D. CARBONIC ANHYDRASE INHIBITER

169. THE SYMPTOMATOLOGY YOU WOULD ASSESS IN THE PATIENT WITH SIADH RESULTS
FROM:
A. ELEVATED POTASSIUM LEVELS
B. WATER INTOXICATION
C. INCREASED SERUM OSMOLALITY
D. PRECIPITATING FACTORS OF SIADH
170. THE "CARDINAL SIGN" OF SIADH IS:
A. DILUTIONAL HYPONATREMIA
B. URINARY OUTPUT OF 10L PER DAY
C. HYPOTENSION
D. SYSTEMIC EDEMA
171. WHICH OF THE FOLLOWING LABORATORY FINDINGS WOULD BE PRESENT IN A PATION
WITH SIADH?
A. LOW SERUM SODIUM
B. SERUM OSMOLALITY OF 350
C. URINE SPECIFIC GRAVITY OF 1.003
D. DECREASED URINARY OSMOLARITY
172. THE PATIENT WITH SIADH MAY PRESENT WITH:
A. INCREASED URINARY OUTPUT
B. SEIZURES
C. HYPERTENSION
D. INCREASED POTASSIUM LEVELS
173. AS A STAFF NURSE IN ICU YOU ARE ASSIGNED TO A PATIENT RECENTLY ADMITTED WITH
DI. WHICH OF THE FOLLOWING PATIENTS WOULD BE LIKELY TO DEVELOP DI?
A. AN ELDERLY PATIENT RECEIVING THIAZIDES
B. A YOUNG WOMEN WITH SEVERE PNEUMONIA
C. A 50 YO MAN WITH ESOPHAGEAL VARICES ON PITRESSIN
D. A HEAD TRAUMA PT WITH A SKULL FRACTURE
174. DURING YOUR ASSESSMENT, WHICH OF THE FOLLOWING FINDINGS WOULD BE PRESENT
IN A PATIENT WITH DI?
A. SERUM OSMOLALITY OF 250
B. SERUM SODIUM LEVEL OF 165
C. URINARY OUTPUT OF LESS THAN 600CC IN 24 HOURS
D. URINE SPECIFIC GRAVITY OF 1.025
175. THE NURSE UNDERSTANDS A MAJOR COMPLICATION OF DI IS:
A. HYPOVOLEMIC SHOCK
B. SEIZURES
C. COGESTIVE HEART FAILURE
D. CARDIAC ARRHYTHMIAS

176. EVALUATION OF LABORATORY FINDINGS IN A PATIENT WITH DI WOULD SHOW:

A. INCREASED URINE OSMOLALITY
B. URINE SPECIFIC GRAVITY BETWEEN 1.001 TO 1.005
C. DECREASED SERUM SODIUM

D. DECREASED SERUM OSMOLARITY

177. THE MOST DANGEROUS COMPLICATION OF DI IS:
A. DILUTIONAL HYPONATREMIA
B. HYPOVOLEMIA
C. CONGESTIVE HEART FAILURE
D. WATER INTOXICATION SYNDROME
178. DIABETES INSIPIDUS IS CHARACTERIZED BY ALL BUT WHICH OF THE FOLLOWING?
A. URINE SPECIFIC GRAVITY OF 1.015
B. TACHYCARDIA
C. URINARY OUTPUT OF 2000 CC IN THREE HOURS
D. BP 90/40
179. WHICH OF THE FOLLOWING IS CHARACTERISTIC OF DI?
A. LOW URINARY OSMOLARITY
B. SERUM OSMOLARITY INCREASED
C. SERUM SODIUM ELEVATED
D. ALL OF THE ABOVE
180. A 66 YO IS ADMITTED WITH A BLOOD SUGAR OF 1200, SHE IS SEVERLY DEHYDRATED,
RESPIRATIONS ARE 18 PER MINUTE AND SHALLOW: YOU WOULD FIRST SUSPECT?
A. HYPEROSMOLAR COMA
B. DIABETIC KETOACIDOSIS
C. EITHER OF THE ABOVE
D. NEITHER A OR B
181. IT IS IMPORTANT FOR THE NURSE TO IDENTIFY THOSE PATIENTS AT RISK FOR DEVELOPING
HHNK. WHICH CONDITION WOULD NOT PREDISPOSE A PATIENT TO DEVELOP HHNK?
A. PANCREATITIS
B. THIAZIDEOF SEROID THERAPY
C. TPN THERAPY
D. CEREBROVASCULAR ACCIDENT
182. NONKETOTIC HYPEROSMOLAR COMA (HHNK) IS NOT USUALLY ASSOCIATED WITH:
A. DEFECTS IN ADH SECREATION
B. MILD DIABETES OF RECENT ONSET
C. OLDER AGE
D. USE OF DIURETICS, STEROIDS AND HYPERTONIC SOLUTIONS
183. THE NURSE UNDERSTANDS THAT THE PRIMARY CAUSE OF THE CLASSICAL
MANIFESTATIONS IN HHNK IS:
A. RAPID DECREASE IN PLASMA OSMOLARITY
B. MARKEDLY ELEVATED SERUM GLUCOSE
C. INTRAVASCULAR DEHYDRATION
D. SERUM ELECTOLYTE ABNORMALITY

184. THE ALTERED MENATL STATUS IN A PATIENT IN HHNK RESULTS FROM:

A. HYPEROSMOLAITY OF PLASMA
B. INTRACEREBRAL DEHYDRATION
C. SEVERE OSMOTIC DIURESIS FROM HYPERGLYCEMIA
D. INTRAVASCULAR DEHYDRATION

185. WHICH OF THE FINDINGS WOULD NOT BE PRESENT IN HHNK?

A. KUSSMAUL'S RESPIRATIONS OF 28/MIN
B. SERUM GLUCOSE LEVEL ABOVE 650 AND OFTEN GREATER THAN 1000
C. SERUM OSMOLARITY ABOVE 350
D. SEVERE DEHYDRATION AND THE ABSENCE OF KETOACIDOSIS
186. EVALUATION OF A PATIENT'S LABORATORY VALUES WITH HHNK WOULD INCLUDE:
A. A SERUM SODIUM OF 123
B. A SERUM OSMOLARITY OF 340
C. A URINARY SODIUM OF 60
D. A BICARBONATE LEVEL OF 12
187. WHICH OF THE FOLLOWING LABORATORY FINDINGS IS NOT LIKELY TO BE SEEN IN
PATIENTS WITH DKA?
A. PH 7.19
B. PCO2 45
C. BASE DEFICIT -14
D. SERUM K 5.5