Prophecy General ICU RN A v2 updated 2022.
The patient’s ABG is : pH 7.25, pCO2 40, pO2 90, HCO3 20mEq/L . What type of
acid imbalance does he have.
- Metabolic Acidosis
Common complications of massive transfusions are - Dilutional Coagulopathy, DIC, hypothermia, and fibrinolysis
Long term use of TPN may lead to: - Liver Failure
Which of the following is a potential complication of high PEEP - Pneumothorax
What is a common assessment finding for a patient returning from a small bowel
resection? - Hypoactive bowel sounds
Your patient suddenly becomes diaphoretic, anxious, tachycardic, and has clammy
skin. Which of the following would you suspect. - A)WRONG Hypoxemia
B) *Wrong * Acute MI
C) Panic Attack
D) Hypoglycemia
The staff nurse asks the nursing assistant to check on a patient. The nursing
assistant reports back that the patient is experiencing chest pain and is diaphorectic.
Which of the following can the staff nurse delegate to the assistant? - A) WRONG Calling the physician
B) Wrong Gathering vitals and assessing the cause for the change in status
C) Informing the charge nurse that a patient needs attention
D) Obtaining a medication for the nurse to administer to the patient
Your patient returned from PACU after surgery and is very drowsy. She attempts
to eat a candy bar and begins to choke. The physician is unable to clear the airway.
You would expect to prepare for which of the following. emergency procedures?
- C) Tracheostomy
The initial insulin therapy for a patient with acute DKA is usually administered by
which route - Intravenous bolus followed by a continuous infusion
Screening tests for DIC include: - D-Dimer and FDPs
Which of the following hormones is secreted by the hypothalamus in an effort to
regulate water balance? - ADH
Which of the following IV sedatives would most likely be ordered for a nonintubated patient? - Precedex
Your patient is in bed and eating lunch when they begin to cough and gag.
Suddenly they become dyspneic and bradycardic with excessive salivation. What
do you suspect happened? - Aspiration
Which of the following is a response of the cardiovascular system to early sepsis? –
Increased cardiac output and reduced systemic vascular resistance
Which patient would you expect to be extubated? - Patient is awake, follow commands with RR of 14, FiO2 40%, and PEEP 5
Your patient is in a Hypertensive crisis. What medication can you expect the
doctor to order. - Nicardipine
Prophecy general ICU A V3 Questions & Answers; Fall 2022.
One of your patients coded but is now stabilized and you are catching up on
charting. The step-down unit calls to get report on your other patient who is
to be transfered. The nurses near you do not appear busy. How should you
prioritize your time?
Correct Ans- Give report and ask the nurses to prepare the patient for
transfer.
Your patient was intubated but still has oral medications on their list of
medications. How should you ensure they receive their medications?
Correct Ans- Ask the provider to update the route of administration.
What laboratory value should you monitor closely if your patient is vomiting
coffee ground emesis?
Correct Ans- Hemoglobin
What ECG finding is indicative of hyperkalema?
Correct Ans- peaked T wave
You witness a patient that is not assigned to you fall out of bed and begin
crying for help but you do not see the assigned nurse to assist the patient.
What should you do first?
Correct Ans- Check on the patient’s status and call for assistance.
When assessing for fever in your intubated patient, placement of the
thermometer in which area would be most accurate?
Correct Ans- Pulmonary artery or bladder
Your patient has just completed IV potassium replacement. When should you
collect their repeat potassium level?
Correct Ans- 30-60 min
Your patient is receiving an antiarrhythmic agent. Which of the following
assessment parameters is the MOST important for you to evaluate?
Correct Ans- ECG
Your patient is undergoing a weaning trial from the ventilator. Fifteen minutes
into the trial the patient’s heart rate increases to 140 bpm and they start to
grab at their oxygen and IV tubing. What should you do NEXT?
Correct Ans- C. Stop weaning and rest the patient
While assessing a patient just admitted to the hospital, he admits to drinking
12 cans of beer a day, with the last drink being right before admission. What is
the expected onset of delirium tremens?
Correct Ans- Within 48-72 hours
You have administered a pain medication that has a half-life of 120 minutes,
onset of action 6 min, tmax of 15 minutes, and is mostly excreted in the uring.
when can the patient expect the medication to start working
Correct Ans- 6 minutes
A lethargic but oriented patient is being admitted for sepsis and their family
member is in the waiting area. Their belonging include a ring, cell phone, and
wallet. The patient asks if they can keep the ring on and phone at bedside.
What is your BEST response?
Correct Ans- It is best if your family takes your belongings.
What is a significant complication of imaging studies performed with iv
contrast
Correct Ans- Acute kidney injury
What respiratory support would an alert patient with an acute COPD
exacerbatiobn likely receive FIRST?
Correct Ans- Bipap
Your intubated and unresponsive patient is scheduled for surgery in the
morning. Who is the most appropriate person to make decisions for your
patient?
Correct Ans- The healthcare POA
When administering a titratable infusion what information must you check on
the medication IV bag to confirm the correct dose is being administered?
Correct Ans- Concentration
Prophecy ICU RN A v1 Exam.
Meperidine (Demerol) 12.5mg every 15 minutes, IV prn is ordered for shivering in the
PACU. Meperidine is available in 50mg/1ml. How many mililiters should be given?
- 0.25 mililiters
Upon inspecting a patient’s epidural insertion site, you notice swelling around the
catheter. What should you do? - A) Position the patient on their side
B) Place the patient in a prone position
C) Check the epidural line for kinks
***D) Contact the anesthesia provider
What set of findings indicates a patient is likely to be ready for phase 1 discharge? - A) Has received discharge instructions, pain level 9 out 10, shortness of breath
B) Drowsy, blood pressure returned to preoperative levels, on 6 liters oxygen via face
mask
***C) Drowsy, oxygen saturation of 96%, able to cough, and move all extremities
D) Fully alert, shallow breathing, on 3 liters via T-piece, can move 2 extremities
What do you consider to be a safe dose of intravenous fentanyl for an adult who does
not have tolerance to opioids? - A) 1.5 miligrams
***B) 25 micrograms
C) 100 micrograms
D 25 miligrams
Your patient in the PACU has a blood pressure of 171/92 mmHg, a heart rate of 120,
respiratory rate of 24, is grimacing, restless, and moaning in bed. What medication
should you prepare to give FIRST? - A) 10 mg hydralazine IV push
***B) 50 mcg fentanyl IV push
C) 2 mg lorazepam IV push
D) 5 mg metoprolol IV push
You are about to discharge a day surgery patient with aphasia and you discover the
family members are not available for the discharge instructions and are not responding
to your phone calls. Business hours are over and the PACU is about to close. How will
you handle the situation? - ***A) Wait until the family returns
B) Leave the discharge education on voicemail and discharge patient
C) Discharge patient with non-emergency transport
D) Take patient home yourself
You received a patient from OR post hip replacement surgery. The anesthesiologist is
planning a nerve block in PACU, but the patient did not sign the consent for the nerve
block. How will you proceed?
- A) Wake up the patient to sign the consent
B) Ask a friend to sign the consent
***C) Obtain the consent from medical POA
D) Proceed with the procedure
What position would help alleviate headaches after spinal anesthesia? - A) Prone
B) Trendelenburg
C) Semi-fowlers
***D) Flat to supine
**WRONG**
What is a physical manifestation of neuromuscular blockade (Roc, succinylcholine)? - A) Decreased consciousness
B) Decreased pupillary light reflex
C) Decreased respiratory effort
WRONGD) Decreased sensation of pain
The surgeon has ordered ampicillin (Ancef) for a patient. When you check their chart,
you see an allergy to penicillin. What is the BEST action? - A) Administer the medication with diphenhydramine
B) Ask the patient to describe their reaction to penicillin
C) Contact the pharmacist to clarify the order
***D) Contact the provider to question the order
You are receiving report for a patient who had a percutaneous transluminal angioplasty
for right lower extremity peripheral vascular disease and is now recovering in the PACU.
What type of surgical dressing do you expect to find for this patient? - A) JP drain sutured in place near the lateral calf
B) Several small incisions in calf groin covered with gauze
***C) Clear dressing applied to the right groin
D) 3 in incision on the right upper thigh with bulky dressing
You are receiving a report on a post op patients from the OR nurse and during the
report when you asked for clarifications, the OR nurse became angry, belligerent, and
rude. She ended up not answering your question. How will you proceed? - ***A) Report the incident to your charge nurse
B) Refuse to take the patient
C) Take the report as she gave it to you
D) Figure out the clarifications from computer