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NCM 118 Semi Finals BSN-C - Quiz
  • 1. 1.
    A 58-year-old male presents with hematemesis and melena. His blood pressure is 90/60 mmHg, and pulse is 120 bpm. What is the nurse’s priority action?
A) Administer proton pump inhibitor
B) Prepare for endoscopy
C) Start IV fluid resuscitation
D) Insert a nasogastric tube
  • 2. 2.
    The nurse is caring for a patient with an upper GI bleed. The nasogastric tube returns bright red blood. What does this finding indicate?
A) Ongoing active bleeding
B) Bleeding has stopped
C) Bleeding from lower GI
D) Normal NG output
  • 3. 3.
    After endoscopy for bleeding ulcers, the patient reports black tarry stools. What is the nurse’s interpretation?
A) Upper GI bleeding is resolving
B) New onset of lower GI bleed
C) Rebleeding from ulcer site
D) Normal finding post-endoscopy
  • 4. 4.
    A patient with GI bleeding is scheduled for blood transfusion. Which assessment finding requires immediate attention?
A) Pulse 88 bpm
B) Temperature 37°C
C) Crackles in lungs after transfusion
D) BP 110/70 mmHg
  • 5. 5.
    During octreotide infusion for variceal bleeding, the nurse observes bradycardia. What is the best nursing action?
A) Give atropine
B) Continue infusion
C) Decrease IV fluids
D) Stop infusion and notify physician
  • 6. 6.
    A trauma patient with massive fluid resuscitation has tense abdomen and decreased urine output. What is the nurse’s priority?
A) Administer diuretics
B) Measure bladder pressure
C) Elevate the head of the bed
D) Provide pain relief
  • 7. 7.
    What parameter best reflects intra-abdominal pressure?
A) Bladder pressure
B) Mean arterial pressure
C) Central venous pressure
D) Gastric residual volume
  • 8. 8.
    A patient with intra-abdominal hypertension has decreased cardiac output. What is the underlying cause?
A) Increased intrathoracic pressure
B) Increased venous return
C) Vasodilation
D) Compression of inferior vena cava
  • 9. 9.
    What is the initial management of mild intra-abdominal hypertension?
A) Optimize fluid balance and positioning
B) insert chest tube
C) Start vasopressors
D) Immediate surgical decompression
  • 10. 10.
    In abdominal compartment syndrome, which nursing assessment finding is most alarming?
A) Soft abdomen
B) Urine output 15 mL/hr
C) Heart rate 90 bpm
D) Respiratory rate 18/min
  • 11. 11.
    A patient with liver failure has confusion and flapping tremor (asterixis). What should the nurse suspect?
A) Hypoglycemia
B) Hypocalcemia
C) Hypokalemia
D) Hepatic encephalopathy
  • 12. 12.
    Which lab result is consistent with liver failure?
A) Increased albumin
B) Decreased bilirubin
C) Elevated ALT and AST
D) Decreased ammonia
  • 13. 13.
    A patient with liver failure has ascites. Which intervention is most appropriate?
A) Restrict fluids
B) Encourage deep breathing
C) Position in high Fowler’s
D) Encourage high-sodium diet
  • 14. 14.
    After paracentesis, what is the most important nursing action?
A) Record urine output
B) Check bowel sounds
C) Monitor blood pressure
D) Document color of fluid
  • 15. 15.
    The nurse should withhold lactulose if the patient exhibits which symptom?
A) Severe diarrhea
B) Mild abdominal pain
C) Drowsiness
D) Two soft stools per day
  • 16. 16.
    A patient with severe epigastric pain radiating to the back is diagnosed with acute pancreatitis. Which finding indicates a serious complication?
A) Grey-Turner’s sign
B) Fever
C) Nausea
D) Vomiting
  • 17. 17.
    Which lab result supports the diagnosis of acute pancreatitis?
A) Low bilirubin
B) Low WBC count
C) Elevated amylase and lipase
D) Decreased lipase
  • 18. 18.
    What is the priority nursing intervention in acute pancreatitis?
A) Administer insulin
B) Maintain NPO status
C) Encourage oral fluids
D) Provide low-fat diet
  • 19. 19.
    Which electrolyte imbalance is common in pancreatitis?
A) Hyperkalemia
B) Hypomagnesemia
C) Hypocalcemia
D) Hypernatremia
  • 20. 20.
    Which position best relieves pain in acute pancreatitis?
A) Prone
B) Left side-lying with knees flexed
C) Trendelenburg
D) Supine
  • 21. 21.
    A diabetic patient arrives with fruity odor breath and Kussmaul respirations. What is the priority action?
A) Start insulin drip
B) Begin IV fluids
C) Administer bicarbonate
D) Prepare for dialysis
  • 22. 22.
    Which lab result confirms DKA?
A) Blood glucose 180 mg/dL
B) Serum ketones positive
C) HCO₃ 24 mEq/L
D) pH 7.45
  • 23. 23.
    Which electrolyte must be monitored closely during insulin therapy in DKA?
A) Magnesium
B) Calcium
C) Potassium
D) Sodium
  • 24. 24.
    Which sign indicates effective management of DKA?
A) Decreasing ketones and glucose
B) Increased urine output
C) Dry mucous membranes
D) Fruity odor persists
  • 25. 25.
    The nurse should administer insulin infusion until:
A) D. IV fluids completed
B) A. Ketones disappear
C) B. Glucose < 200 mg/dL and patient can eat
D) C. pH returns to normal
  • 26. 26.
    An elderly type 2 diabetic is admitted with dehydration and glucose of 700 mg/dL, no ketones. What is the likely diagnosis?
A) A. DKA
B) D. SIADH
C) C. Hypoglycemia
D) B. HHNK
  • 27. 27.
    What is the primary cause of HHNK?
A) A. Infection or dehydration
B) D. Hypokalemia
C) B. Insulin overdose
D) C. Excess carbohydrate intake
  • 28. 28.
    Which intervention is most important in initial management of HHNK?
A) A. Administer IV insulin bolus
B) C. Start antibiotics
C) B. Rehydrate with IV fluids
D) D. Provide potassium supplements
  • 29. 29.
    What differentiates HHNK from DKA?
A) C. pH value
B) D. All of the above
C) B. Level of glucose
D) A. Presence of ketones
  • 30. 30.
    A nurse identifies decreased skin turgor and dry mucous membranes in a HHNK patient. What should the nurse expect?
A) C. Hypoglycemia
B) D. Acidosis
C) A. Fluid volume deficit
D) B. Fluid overload
  • 31. 31.
    A patient with acute renal failure has urine output of 200 mL/24 hrs. What phase is this?
A) B. Oliguric
B) C. Recovery
C) A. Diuretic
D) D. Initial
  • 32. 32.
    Which lab finding indicates renal failure?
A) C. Low potassium
B) B. Increased BUN and creatinine
C) A. Decreased creatinine
D) D. High GFR
  • 33. 33.
    In chronic renal failure, which diet is most appropriate?
A) A. High protein
B) C. High sodium
C) D. High fluid intake
D) B. Low potassium and phosphorus
  • 34. 34.
    The nurse monitors which ECG change for hyperkalemia in renal failure?
A) D. Flat P waves
B) B. Peaked T waves
C) C. U waves
D) A. ST depression
  • 35. 35.
    Which medication helps remove potassium in renal failure?
A) C. Spironolactone
B) A. Kayexalate
C) B. Lasix
D) D. Mannitol
  • 36. 36.
    A trauma patient presents with BP 80/50 mmHg, pulse 130 bpm, cool clammy skin. What type of shock is this?
A) C. Neurogenic
B) B. Hypovolemic
C) A. Cardiogenic
D) D. Anaphylactic
  • 37. 37.
    What is the first nursing action in hypovolemic shock?
A) C. Give oxygen
B) D. Draw labs
C) A. Administer vasopressors
D) B. Start IV fluids
  • 38. 38.
    In septic shock, which finding indicates early stage?
A) C. Bradycardia
B) A. Cold clammy skin
C) B. Bounding pulse
D) D. Hypothermia
  • 39. 39.
    Which lab test confirms septic shock?
A) C. Decreased BUN
B) B. Increased sodium
C) A. Blood culture positive
D) D. Elevated calcium
  • 40. 40.
    The most reliable indicator of adequate tissue perfusion in shock is:
A) B. Urine output
B) D. Capillary refill
C) A. Skin color
D) C. Blood pressure
  • 41. 41.
    Which of the following meets SIRS criteria?
A) D. BP 120/80
B) C. RR 14, WBC 5,000
C) B. Temp 36°C, HR 70
D) A. Temp 38.5°C, HR 100, WBC 15,000
  • 42. 42.
    What is the primary trigger for SIRS?
A) B. Dehydration
B) D. Hypertension
C) C. Hypoglycemia
D) A. Infection or tissue injury
  • 43. 43.
    MODS is characterized by:
A) B. Single organ failure
B) C. Mild infection
C) A. Dysfunction of two or more organ systems
D) D. Local inflammation only
  • 44. 44.
    A patient with MODS develops jaundice, oliguria, and confusion. What does this indicate?
A) D. Stable condition
B) A. Improvement
C) B. Multisystem involvement
D) C. Dehydration
  • 45. 45.
    Nursing priority in SIRS management is:
A) B. Fluid restriction
B) C. Oxygen removal
C) A. Early identification and treatment of infection
D) D. High-protein diet
  • 46. 46.
    In MODS, which intervention prevents further organ injury?
A) C. Stop antibiotics
B) A. Maintain oxygenation and perfusion
C) D. Withhold nutrition
D) B. Limit IV fluids
  • 47. 47.
    Which assessment finding indicates progression from SIRS to MODS?
A) C. Warm, dry skin
B) A. Stable BP and urine output
C) B. Decreasing LOC and urine output
D) D. Mild fever
  • 48. 48.
    Which laboratory marker is typically elevated in SIRS/MODS?
A) D. Glucose
B) A. C-reactive protein (CRP)
C) C. Sodium
D) B. Hematocrit
  • 49. 49.
    The nurse monitors for which complication in MODS?
A) B. Hyperthyroidism
B) C. Dehydration
C) A. Disseminated intravascular coagulation (DIC)
D) D. Hypoglycemia
  • 50. 50.
    What is the ultimate goal in managing SIRS and MODS?
A) C. Decrease urine output
B) B. Restrict fluids
C) A. Prevent sepsis and maintain organ perfusion
D) D. Lower WBC count
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