Advanced Clinical Concepts Questions
Advanced Clinical Concepts Questions
RESPIRATORY FAILURE:
3. Identify the condition that exists when the PO2 is less than 50 mmHg and FiO2
is greater than 60%.
- Hypoxemia
1. Define shock.
- Widespread, serious reduction of tissue perfusion which leads to generalized
impairment of cellular function.
12. List 4 measurable criteria that are the major expected outcomes of a shock
crisis.
- BP mean of 80 to 90 mmHg. PO2 >50 mmHg. CVP above 6 cm of H2O. Urine
output at least 30 cc/hr.
14. What is the effect of DIC on PT, PTT, platelets, FSPs (FDPs)?
- PT: prolonged. PTT: prolonged. Platelets: decreased. Fribin split products:
increased.
1. What is the first priority when a client with an unwitnessed cardiac arrest is
found?
- Begin CPR
3. What criteria should alert a client with known angina who takes nitroglycerin
tablets sublingually to call the EMS?
- Unrelieved chest pain after 3 nitroglycerin tabs in 15 minutes.
4. After calling out for help and asking someone to dial for emergency services,
what is the next action in CPR?
- According to American Heart Association guidelines published September 2000, you
should call for help first for unresponsive adults and then begin the ABC’s of CPR.
For unresponsive infants & children, CPR should be performed for 1 minute before
placing a 911 call for help.
7. What is the FIRST drug most likely to be used for an in-hospital cardiac arrest?
- Epinephrine
10. How would the nurse assess the adequacy of compressions during CPR? How
would the nurse assess for adequacy of ventilations during CPR?
- Check for a pulse. Watch for chest excursion and auscultate bilaterally for breath
sounds.
12. One should NEVER make blind sweeps into the mouth of a choking child or
infant. Why?
- Because the object might be pushed further down into the throat.
5. Cite the ABG normals for the following: pH, pCO2, HCO3.
- pH: 7.35-7.45. pCO2: 35 to 45 mmHg. HCO3: 22-26 mEq/L
PERIOPERATIVE CARE:
2. Why is a client with liver disease at increased risk for operative complications?
- Impairs ability to detoxify medications used during surgery. Impairs ability to
produce prothrombin to reduce hemorrhage.
4. What items should the nurse assist the client in removing before surgery?
- Contact lenses, glasses, dentures, partial plates, wigs, jewelry, prosthesis, make-up
and nail polish.
5. How and why is the client positioned in the immediate postoperative period?
- Usually on the side or with head to side in order to prevent aspiration of any emesis.
10. During the intraoperative period, what activities should the operating room
nurse do to ensure safety during surgery?
- Ascertain correct sponge, needle, and instrument count. Position client to avoid
injury. Apply ground during electrocautery use. Strict use of surgical asepsis.
HIV INFECTION:
1. Identify the way HIV is transmitted.
- Transmitted through blood and body fluids, e.g., unprotected sexual contact with an
affected person, sharing needles among drug abusing persons, infected blood products
(rare), maternal to fetus transmission through breast milk, or breaks in universal
precautions (needle sticks or similar occurrences).
PAIN:
1. What modalities are associated with the Gate control pain theory?
- Massage, heat and cold, acupuncture, TENS.
2. How does past experiences with pain influence current pain experience?
- The more pain experienced in childhood, the greater the perception of pain in
adulthood or with current pain experience.
4. What 6 factors should the nurse include when assessing the pain experience?
- Location, intensity, comfort measures, quality, chronology and subjective view of
pain.
10. Which route of administration for pain medications has the quickest onset and
the shortest duration?
- IV push or bolus.
11. List the 6 modalities that are considered non-invasive, non-pharmacologic pain
relief measures.
- Heat and cold applications. Transcutaneous electrical nerve stimulation (TENS).
Massage. Distraction. Relaxation techniques. Biofeedback techniques.
2. A client has been told of a positive breast biopsy report. She asks no questions
and leaves the healthcare provider’s office. She is overheard telling her
husband, :the doctor didn’t find a thing.” What coping style is operating at this
stage of grief?
- Denial
5. Mrs. Green lost her husband 3 years ago. She has not disturbed any of his
belongings and continues to set a place at the table for him nightly. Is this
response indicative of a normal or complicated grief reaction?
- This is a dysfunctional grief reaction. Mrs. Green has never moved out of the denial
stage of her grief work.
ELECTROCARDIOGRAM:
5. If the U wave is most prominent, what condition might the nurse suspect?
- Hypokalemia
6. Describe the calculation of the heart rate using an EKG rhythm strip.
- Count the number of the R-R intervals in the 30 large squares and multiply by 10
7. What is the most important assessment data for the nurse to obtain on a client
with arrythmia?
- Ability of the client to tolerate the arrhythmia
2. What symptoms might the nurse expect to see in an older person who has had an
overload of changes as well as a respiratory infection?
- Confusion.
6. How can a female nurse increase the older client’s ability to hear her speak?
- Lower the pitch or tone of her voice.
8. Describe the following conditions which occur in the elderly: Presbyopia, Arcus
senilis, Presbycusis.
- Presbyopia – decreased ability of the eye to accommodate for close work.
- Arcus senilis – glossy white ring encircling the periphery of the cornea
- Presbycusis – decrease in hearing acuity, auditory threshold, pitch and tone
discrimination, and speech intelligibility.
11. What are the 2 factors that cause decrease in excretion of drugs by the kidneys?
- Decrease in glomerular filtration and slowed organ functioning.