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CEN2 > BOOK QUESTIONS > Flashcards

BOOK QUESTIONS Flashcards

1
Q

SBP should be less than what to prevent rebleeding in patients with SAH?

A

<160 - prompt reduction in BP is critical

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2
Q

What is a SE of alendronate (Fosamax)

A

esophageal irritation - teach to sit/stand for 30 min after taking

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3
Q

What condition is associated with polymyalgia rheumatica?

A

Temporal arteritis

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4
Q

What is the blood loss from an unstable pelvic ring fracture? What class of hypovolemic shock is this?

A

3000ml +

Class IV

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5
Q

How do we emergently perform a periocardiocentesis?

A

Needle aspiration 1cm left of xiphocostal angle

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6
Q

What would indicate that an IO is placed correctly?

A

Red frothy substance (bone marrow)

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7
Q

Best way to assess patency of airway in patients with a GCS of 15?

A

Ask to talk - clear speech

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8
Q

Best indication that chest tube insertion has been successful in relieving tension PTX?

A

Improvement in hemodynamics

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9
Q

How should MAP be lowered for HTN emergency?

A

20-25% in first hour

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10
Q

Recommended pulse ox for COPD pt?

A

> 90%

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11
Q

This is an inherited sex-linked genetic disorder. Mother is usually carrier and active disease is usually expressed in males..

A

Hemophilia

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12
Q

What should never be put on a patient who is actively vomiting?

A

mask / NRB

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13
Q

Newborn target SpO2 after 1 minute?

3 minutes?

5 minutes?

10 minutes?

A

1 = 60-65%

3 = 70-75%

5 = 70-85%

10 = 85-95%

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14
Q

How do we administer TPA?

A

0.9mg/kg
Max dose 90mg
10% bolus over 1 minute
remainder given over 60 minutes

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15
Q

what are some things that may exclude pt from getting TPA?

A

Age >80, hx DM, prior CVA

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16
Q

What med should be given for SAH from an aneurysm to decrease vasospasm and possible cerebral infartion?

A

nimodipine

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17
Q

Skull fracture with highest risk for intracranial infection?

A

Basilar skull fracture

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18
Q

Priority action for ruptured bladder?

A

Give IVF

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19
Q

Peds defibrillation dose

A

initial 2 joules/kg, increase to 4, max 10

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20
Q

Intervention for snake bite

A

Immobolize area at or below level of heart
mark edges
avoid ice

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21
Q

When should critical incident stress management debriefing take place?

A

1-3 days after incident

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22
Q

START triage: what would put a patient in the red (immediate) category?

A

-RR >30 (>15, <45)
-cap refill >2 sec or no radial pulse
-unable to follow simple commands

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23
Q

What radiation particle can penetrate most objects and is most dangerous to life?

A

Neurons

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24
Q

Eye donation preparation

A

Elevate HOB 20 degrees, eyelids taped shut, artificial tears

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25
Q

Condition with too much ADH?

Condition with not enough ADH?

A

SIADH

DI

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26
Q

What is Trousseau’s sign? What does it indicate?

A

carpal spasm with BP cuff indicated hypocalcemia

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27
Q

What electrolyte abnormality causes hypoactive reflexes? Hyperactive?

A

Hypo = hypercalcemia

Hyper = hypocalcemia

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28
Q

Peds vomiting/diarrhea/gastroenteritis teaching

A

small amounts or clear liquid at frequent intervals, small amounts of glucose and electrolyte solution

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29
Q

Excessive artifact in leads II and III on EKG - change what electrode?

A

left leg

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30
Q

What may cause loss of ventricular capture for a patient with a transcutaneous pacemaker?

A

Lactic acidosis

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31
Q

Priority intervention pt with symptoms of endocarditis

A

antibiotics

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32
Q

What is the most common virus that causes pericarditis?

A

Coxsackie (hand/foot/mouth)

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33
Q

Characteristic sign of COPD

A

pursed lip breathing

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34
Q

C. Diff risk factors

A

-recent abx
-PPI use
-GI surgery
-long length of stay in healthcare setting
-immunosuppression

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35
Q

What is Kehr’s sign

A

LUQ pain radiating to the left shoulder - suggests diaphramatic irritation by peritoneal blood, as seen in splenic injuries

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36
Q

What is a side effect of trazodone?

A

priapism

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37
Q

Vent setting initially for ARDS

A

Pressure-controlled

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38
Q

Cor Pulmonale is a complication assoc with what?

A

COPD

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39
Q

Where do we hear bronchial breath sounds?

Bronchovesicular?

Vesicular?

A

B=over trachea/thorax

BV=over major bronchi

V=peripheral lung fields

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40
Q

Consists of the synthesis of revevant research, experience/expertise of practitioner, patient preferences and values

A

EBP

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41
Q

Medical errors esp medication errors are due to what?

A

inadequate communication

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42
Q

Radiation exposure injury with fatal outcome?

A

CNS syndrome

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43
Q

What do we do with a lost tooth?

A

Try to reimplant within 30 minutes

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44
Q

When do S&S of alcohol withdrawal often present?

A

6-8 hours after last drink was consumed

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45
Q

Lumbosacral strain muscle spasm d/c instructions?

A

HOB slightly elevated and knees flexed when resting in bed

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46
Q

How do we know when ready for wound closure after LET admin?

A

blanching around wound d/t vasoconstriction usually within 20 minutes

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47
Q

Symptoms assoc with catecholamine release d/t hypoglycemic episode

A

-diaphoresis
-anxiety
-dry mouth
-mydriasis
-tremors

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48
Q

Peds with sustained RR >___bpm are at risk for resp failure

A

60

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49
Q

What # motor score does a patient get when they localize pain by crossing the midline?

A

5

(6 = follows commands, 4 = withdraws)

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50
Q

What % of EACH SIDE burn BSA are head, chest, abdomen, legs?

Genitals?

Arms?

A

9%

1%

4.5%

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51
Q

What is the Parkland Burn Formula?

A

4ml LR x %BSA x weight (kg)

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52
Q

What electrolyte imbalance do hydroflouric acid burns have?

A

Hypocalcemia

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53
Q

Disaster management phase that includes actions to prevent or reduce cause, impact, consequences of disasters, includes hazard map

A

Mitigation

54
Q

Disaster management phase that includes planning, training and educational ativities

A

Prepardness

55
Q

Use of succinycholine in Guillain-Barre patients is contraindicated because it may cause what electrolyte abnormality?

A

Hyperkalemia

56
Q

Severe aching of the back assoc with tetanus

A

Opisthotonos

57
Q

What is hypoxia in COPD patients due to?

A

ventilation/perfusion mismatch

58
Q

What should be performed to r/o urethral injury?

A

retrograde urethrogram

59
Q

What kind of medications might cause urinary retention?

A

Antihypertensives

60
Q

How do you describe critical incident stress?

A

A normal response to an abnormal event

61
Q

Why do we use a LOW tidal volume in ARDS patients on a vent?

A

To prevent volutrauma

62
Q

What ETCO2 reading during CPR demonstrates adequate compressions/good quality CPR?

A

> 10 (normal ETCO2 is 35-45)

63
Q

During neonatal resus, what provides the most accurate eval of infants resp effectiveness?

A

cont cardiac monitoring

64
Q

What kind of spider bite is necrotoxic - this may lead to DIC?

Which is neurotoxic - this may also cause abdominal rigidity/cramping?

A

Brown recluse

Black widow

65
Q

Common symptom of diphtheria?

Findings of diphtheria indicating severe complication of the disease?

A

thick gray membrane covering throat and tonsils

ST-T wave changes, dysrhythmias may indicate myocarditis and other possible cardiac involvement

66
Q

What can lead to an accelerated juntional rhythm?

A

Dig toxicity

67
Q

2 assessment findings assoc with compensated shock

A

Narrowing pulse pressure
Bounding pulse

68
Q

Diagnostic test for PE

A

Spiral CT

69
Q

What is considered one of the most teratogenic drugs?

A

Valproic acid / depakote

70
Q

What should we do to a frostbitten area

A

Protect and immobolize with loose dressing after thawing

do not massage/rub
rewarm with water b/t 99-102 degrees

71
Q

V-fib amiodarone dose

A

300mg rapid IV bolus initially followed by 150mg rapid IV bolus

72
Q

How is culture defined?

A

patterns of behaviors and beliefs shared by persons living in a social group

73
Q

Particular spasm of the neck muscles that causes uncontrollable twisting of neck muscles assoc with dystonic reaction.

A

torticollis

74
Q

what is used to treat a dystonic reaction related to the admin of haldol?

A

benztropine (cogentin)

75
Q

What lactate level is considered abnormal for exam?

A

> or = 4

76
Q

2 foods high in K that should be avoided with potassium sparing diuretics (spironolactone)?

A

bananas
avocados

77
Q

Leukemia most commonly diagnosed in peds

A

ALL

78
Q

hot potato voice

A

PTA

79
Q

inflammatory response of the inner ear that can result from recent viral or bacterial infection. Inflammation affects the cochlea, resulting in tinnitus, nystagmus and dizziness.

A

Labyrinthitis

80
Q

flunitrazepam (Rohypnol) anecdote

A

flumazenil (Romazicon)

81
Q

What is the goal of wound are?

A

To maintain function

82
Q

Recommended time to start antibiotics for septic shock? Sepsis without shock?

A

1 hour if shock, 3 hours if not

83
Q

How do we confirm organophospate poisoning?

A

plasma pseudocholinesterase level

84
Q

What does cyanide poisoning affect?

A

Lactate levels

85
Q

Gastritis assoc with n/v expected abnormal lab?

A

Electrolytes - potassium b/c this is lost in vomit

86
Q

When is pain experienced with a gastric ulcer? Duodenal ulcer?

A

Gastric = after eating

Duodenal = worse with empty stomach, relieved with eating

87
Q

med class for vaginitis

A

antimicrobials (most commonly antibiotics for trich/BV and antifungals for yeast)

88
Q

Untreated penile fracture from the rupture of the tunica albuginea may develop what complication?

A

Erecticle difficulities

Fracture = immediate pain, hematoma, swelling, audible popping sound. Requires surgery.

89
Q

What needs to be used with clindamycin vag cream?

A

Back up birth control - weakens condoms for 72 hours

90
Q

1st intervention for clear ruptured ectopic?

A

Emergency surgery

91
Q

Blood glucose levels at 1 minute after birth in neonates below what require treatment with D10?

A

Below 40

92
Q

Why do we give pitocin after delivery of a full term baby?

A

To reduce PP bleeding

93
Q

Where should rabies vaccine be administered?

A

In the deltoid furthest from IG administration bc IG may suppress antibody production from the vaccine

94
Q

Sick following camping trip.

Symptoms = single necrotic looking lesion

No rash. Symmetrical, ascending paralysis

A

Tularemia

Colorado tick fever

95
Q

Firefigher with seizures, hypotension, hypoxia after fighting a house fire - symptoms likely due to what?

What med should we treat with?

A

Cyanide, hydroxocobalamin (vitamin B12)

96
Q

Clinical manifestation of bronchitis

A

dry cough that develops into productive cough

97
Q

While transferring a patient with a chest tube, the drainage system falls and breaks. What do you do?

A

Insert end of chest tube into sterile water

98
Q

What can INH cause?

A

hepatotoxiity

99
Q

Normal positive reading for PPD? Positive reading for immunocompromised patients?

A

10mm

5mm

100
Q

Epiglottitis priority intervention

A

intubation

101
Q

History if cliff diving 90 feet + pink, frothy sputum with cough

A

pulmonary edema

102
Q

Patient becomes unconscious during scuba diving. What position do we put them in?

A

left lateral decub, head down

103
Q

What are 3 categories of secondary traumatic stress?

A

-Intrusion (repeated reliving of disturbing events)
-Avoidance
-Arousal

104
Q

What med for procedural sedation has the shortest duration of action?

A

Propofol (3-8 minutes)

105
Q

What might someone cleaning out a cat litter box be at risk for?

What is a bacterial infection from animal bites, particularly cats?

A

Toxoplasmosis

Pasteurellosis

106
Q

Multiple blood transfusion electrolyte abnormality

A

Hypocalcemia (anticoagulant citrate used in blood products binds to calcium)

107
Q

What med should be avoided in patients with elevated T3 and T4?

A

aspirin

108
Q

What age patient can experience PTSD?

A

Any age

109
Q

What is the purpose of the GCS?

A

To assess level of consciousness in head-injured patients

110
Q

What is true regarding intranasal administration of meds?

A

Onset of the drug action may be delayed

111
Q

Hypoxia associated with near drowning will cause cerebral edema, leading to what?

A

An increase in ICP

112
Q

This med is a vasodilator that decreases BP by relaxing vascular smooth muscle and dilating coronary arteries. It must be protected from light during administration.

A

Nitroprusside

113
Q

Why do we give morphine to patients with an MI?

A

it decreases catecholamine release, which results in a decrease in HR and afterload

114
Q

Bright red stools associated with lower GI bleeding/hemorrhoids

A

Hematochezia

115
Q

What is the gold standard for diagnosing a kidney stone?

A

Noncontrast helical CT scan

116
Q

What is the most common cause of cirrhosis?

A

Alcohol

117
Q

What chemistry tests are elevated in patients with pancreatitis? (3)

A

-BUN
-creatinine
-glucose

118
Q

What do we do for a prolapsed cord during an emergency delivery?

A

Place hand under the head of the fetus, with a gentle lift

119
Q

Med most likely administered to a patient with a dermal burn from hydrofluoric acid

A

Calcium gluconate

120
Q

What 3 meds are used to treat cyanide poisioning?

A

-HYDROXOCOALAMIN
-Sodium nitrate
-Sodium thiosulfate

121
Q

What are 2 reasons for failure to capture while externally pacing a patient?

A

Metabolic Acidosis
Hypoxemia

122
Q

This can occur from blunt trauma, direct blow, strangulation, or clothesline-type injury. Assessment findings include dyspnea, tachypnea, hoarseness, SQ emphysema, hemoptysis, airway obstrution. Tx = HOB 30 degrees, NPO, vocal rest, humidified oxygen.

A

Tracheobronchial Injury

123
Q

The amount of blood in the left ventricle at the end of diastole

A

Preload

124
Q

Urine output less than what is an indication of impaired renal function?

A

30ml/hr

125
Q

Large FB impaled in eye. After visual acuity, what should you do?

A

Place a rigid eye shield over the affected eye

Should also patch other eye to minimize consensual movement

126
Q

Eye pain, photophobia, purulent d/c and decreased vision that may occur after conjunctivitis; can l/t corneal ulceration and blindness if left untreated

A

Keratitis

127
Q

Symptoms such as swelling in fat pad at the base of the neck (buffalo hump), moon face, abd swelling that is due to prolonged exposure to cortisone

A

Cushing’s syndrome

128
Q

Complication of hypothyroidism. Rare and serious.

A

Myxedema Coma

129
Q

What can decreasing a glucose level too quickly in DKA cause?

A

Cerebral edema (concerning symptom is HA)

130
Q

This is associated with the use of antipsychotic meds. Symptoms include fever, muscle rigidity, altered level of consciousness. Treatment is to remove the offending agent.

A

Neuroleptic malignant syndrome

131
Q

What are 2 common findings in chronic lymphocytic leukemia?

A

hepatomegaly, splenomegaly

132
Q

Crutch training for stairs

A

-Going up: uninjured leg goes first, followed by injured leg and crutches

-Going down: place crutches down a step and step down the the injured leg, followed by the uninjured leg

CEN2 (12 decks)

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