Course Name: Critical Nursing Theor

Academic Year:2022/ 2023

Exam / midterm Semester: 1 Level:3
Date: …6 /12 /2022 Total Mark: 45 degrees
Time Allowed: 1 hours Assist Prof. Mariam Sabry Shehab
Assist prof. Asmaa Abouda Soultan
Part I: Multiple choice questions: (45 Marks) ( 2 mark for the right answer)
Read the following statement and circle the right answer:
1. Which of the following professional organizations best supports critical care nursing
practice?
a. American Association of Critical-Care Nurses
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine

2. A critical care nurse is a nurse who works with patients with _____ medical problems.
a. Mild
b. Typical
c. Life-threatening
d. Multiple

3. Sally, an experienced nurse, gradually begins to fatigue easily. She also becomes
emotionally exhausted, asking herself, "Why did I ever become a nurse?" What
syndrome is Sally experiencing?
a. Compassion fatigue
b. Burnout
c. Stress management
d. Depression

4. Nurse patient ratio in ICU

a. 1nurse :1patient
b. 2 nurse :1patient
c. 3 nurse :1patient
d. 4 nurse :1patient

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5. What two organs in the body serve as a compensatory function to maintain acid base
balance?
a. Kidneys and Lungs
b. Lungs and Spleen
c. Heart and Liver
d. Gallbladder and Appendix

6. A client’s ABG analysis reveals a pH of 7.18, PaCO2 of 72 mm Hg, PaO2 of 77 mm Hg,

and HCO3- of 24 mEq/L. What do these values indicate?
a. Metabolic acidosis
b. Respiratory alkalosis
c. Metabolic alkalosis
d. Respiratory acidosis

7. What are appropriate nursing interventions for the patient with delirium in the ICU
a. Use clocks and calendars to maintain orientation.
b. Encourage round-the-clock presence of caregivers at the bedside.
c. Decrease time of patient rest and sleep
d. D. Silence all alarms, and avoid conversations around the patient.

8. A patient who received a kidney transplant returns for a follow-up visit to the outpatient
clinic and reports a lump in her breast. Transplant recipients are:
a. At increased risk for tumors because of the kidney transplant
b. At decreased risk for cancer, so the lump is most likely benign
c. Consumed with fear after the life-threatening experience of having a transplant
d. At increased risk for cancer due to immunosuppression caused by cyclosporine

9. You suspect kidney transplant rejection when the patient shows which symptoms?
a. Diminished urine output and hypotension
b. Fever, weight gain, and diminished urine output
c. Pain in the incision, general malaise, and depression
d. Pain in the incision, general malaise, and hypotension

10. Signs and symptoms of chronic rejection of the kidney are caused by
a. Recurrence of the original kidney disease
b. Gradual occlusion of the renal blood vessels
c. T-cytotoxic cell attack on the foreign kidney
d. Destruction of kidney tissue by sensitized antibodies
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11. Your patient has a deep vein thrombosis in the left lower extremity. The patient is
prescribed continuous IV Heparin. Select all the nursing interventions that are appropriate
for this patient:
a. Apply cool compresses to affected extremity
b. Encourage frequent ambulation
c. Massage affected extremity
d. Elevate affected extremity above heart level

12. Which statement below is incorrect about a deep vein thrombosis (DVT)?*
a. "Veins that are most susceptible to a deep vein thrombosis are the peroneal, posterior
tibial, popliteal and superficial femoral."
b. "DVTs tend to mostly occur in the lower extremities but can occur in the upper
extremities too."
c. "A deep vein thrombosis in the lower extremity has a low probability of becoming a
pulmonary embolism."
d. "A DVT is a type of venous thromboembolism (VTE), which is a blood clot that starts
in the vein."

13. When caring for a client with a pulmonary embolism, which priority intervention will
the nurse use to reduce anxiety?
a. Remain with the client and provide oxygen in a calm manner.
b. Have the client breathe into a brown paper bag using pursed lips.
c. Offer the client a mild sedative.
d. Allow a family member to remain in the room

14. The nurse is reviewing the medical record of a client with pulmonary embolism (PE).
What priority does the nurse set after reviewing the blood gas result below? pH 7.46,
PaCO2 30 mm Hg, HCO3– 26 mEq/L (26 mmol/L), PaO2 62 mm Hg
a. Have the client breathe rapidly and deeply
b. Apply oxygen
c. Administer sodium bicarbonate
d. Collaborate with the provider to increase the pH

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15. The nurse is caring for a group of clients on a Telemetry unit. When providing client
education, which client will the nurse determine most needs information regarding
preventing pulmonary embolism(PE)?
a. A woman who has deep vein thrombosis in lower leg
b. A man who works on a farm
c. A man admitted for a myocardial infarction
d. A woman with a bleeding disorder

16. The nurse prepares the client for insertion of cardiac catheter. The nurse teaches the
client that the catheter will be inserted to provide information about:
a. Stroke volume
b. Cardiac output
c. Tidal volume
d. Left ventricular functioning

17. When preparing a client before surgery for a CABG. the nurse should teach the client
that:
a. Ampicillin, penicillin, furosemide should not stop
b. Aspirin and non-steroid anti-inflammatory must be stopped at least 7 to 10 days prior to
operation
c. Digoxin withheld one to 2 weeks before surgery
d. Nitrate , beta adrenergic blocking and calcium channel blocker should be stop

18. When evaluating the effectiveness of preoperative teaching with a patient scheduled for
coronary artery bypass graft (CABG) surgery using the internal mammary artery, the
nurse determines that additional teaching is needed when the patient says which of the
following?
a. "They will circulate my blood with a machine during the surgery."
b. "I will have small incisions in my leg where they will remove the vein."
c. "They will use an artery near my heart to go around the area that is blocked."
d. "I will need to take an aspirin every day after the surgery to keep the graft open.

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19. Which of the following are possible complications following a Percutaneous
Transluminal Coronary Angioplasty (PTCA)? Select all that apply: (3 degree)
a. Bleeding formation
b. Pulmonary Failure
c. Hypothermia
d. Bradycardia
e. Shock

20. The client has just returned from a cardiac catheterization. Which assessment data
would warrant immediate intervention from the nurse?
a. The client's BP is 110/70 and pulse is 90
b. The client's groin dressing is dry and intact
c. The client refuses to keep the leg straight
d. The client denies any numbness and tingling

21. A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the
following assessments is most critical before the procedure?
a. Intake and output
b. Baseline peripheral pulse rates
c. Height and weight
d. Allergy to iodine

22. Sudden elevation in pulmonary artery pressure or central venous pressure in a

hemodynamically monitored patient occur in patient wit:
a. Mild pulmonary embolism
b. Massive pulmonary embolism
c. Embolism in Intensive Care
d. Mild pulmonary embolism

Question is ended
Best wishes
Assist Prof. Asmaa Abouda Soultan
Assist Prof. Mariam Sabry Shehab