ThatQuiz Test Library Take this test now
NCM 118 Semi Finals BSN-C
Contributed by: Forones
  • 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) Prepare for endoscopy
B) Administer proton pump inhibitor
C) Insert a nasogastric tube
D) Start IV fluid resuscitation
  • 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 from lower GI
C) Bleeding has stopped
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) Normal finding post-endoscopy
C) Rebleeding from ulcer site
D) New onset of lower GI bleed
  • 4. 4.
    A patient with GI bleeding is scheduled for blood transfusion. Which assessment finding requires immediate attention?
A) Crackles in lungs after transfusion
B) BP 110/70 mmHg
C) Temperature 37°C
D) Pulse 88 bpm
  • 5. 5.
    During octreotide infusion for variceal bleeding, the nurse observes bradycardia. What is the best nursing action?
A) Stop infusion and notify physician
B) Give atropine
C) Continue infusion
D) Decrease IV fluids
  • 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) Provide pain relief
C) Elevate the head of the bed
D) Measure bladder pressure
  • 7. 7.
    What parameter best reflects intra-abdominal pressure?
A) Gastric residual volume
B) Mean arterial pressure
C) Central venous pressure
D) Bladder pressure
  • 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) Compression of inferior vena cava
D) Vasodilation
  • 9. 9.
    What is the initial management of mild intra-abdominal hypertension?
A) insert chest tube
B) Immediate surgical decompression
C) Optimize fluid balance and positioning
D) Start vasopressors
  • 10. 10.
    In abdominal compartment syndrome, which nursing assessment finding is most alarming?
A) Respiratory rate 18/min
B) Soft abdomen
C) Heart rate 90 bpm
D) Urine output 15 mL/hr
  • 11. 11.
    A patient with liver failure has confusion and flapping tremor (asterixis). What should the nurse suspect?
A) Hepatic encephalopathy
B) Hypocalcemia
C) Hypoglycemia
D) Hypokalemia
  • 12. 12.
    Which lab result is consistent with liver failure?
A) Decreased bilirubin
B) Elevated ALT and AST
C) Increased albumin
D) Decreased ammonia
  • 13. 13.
    A patient with liver failure has ascites. Which intervention is most appropriate?
A) Restrict fluids
B) Encourage high-sodium diet
C) Encourage deep breathing
D) Position in high Fowler’s
  • 14. 14.
    After paracentesis, what is the most important nursing action?
A) Monitor blood pressure
B) Record urine output
C) Document color of fluid
D) Check bowel sounds
  • 15. 15.
    The nurse should withhold lactulose if the patient exhibits which symptom?
A) Mild abdominal pain
B) Severe diarrhea
C) Two soft stools per day
D) Drowsiness
  • 16. 16.
    A patient with severe epigastric pain radiating to the back is diagnosed with acute pancreatitis. Which finding indicates a serious complication?
A) Nausea
B) Grey-Turner’s sign
C) Fever
D) Vomiting
  • 17. 17.
    Which lab result supports the diagnosis of acute pancreatitis?
A) Decreased lipase
B) Low WBC count
C) Elevated amylase and lipase
D) Low bilirubin
  • 18. 18.
    What is the priority nursing intervention in acute pancreatitis?
A) Maintain NPO status
B) Encourage oral fluids
C) Administer insulin
D) Provide low-fat diet
  • 19. 19.
    Which electrolyte imbalance is common in pancreatitis?
A) Hyperkalemia
B) Hypocalcemia
C) Hypernatremia
D) Hypomagnesemia
  • 20. 20.
    Which position best relieves pain in acute pancreatitis?
A) Supine
B) Prone
C) Left side-lying with knees flexed
D) Trendelenburg
  • 21. 21.
    A diabetic patient arrives with fruity odor breath and Kussmaul respirations. What is the priority action?
A) Prepare for dialysis
B) Begin IV fluids
C) Start insulin drip
D) Administer bicarbonate
  • 22. 22.
    Which lab result confirms DKA?
A) Serum ketones positive
B) HCO₃ 24 mEq/L
C) Blood glucose 180 mg/dL
D) pH 7.45
  • 23. 23.
    Which electrolyte must be monitored closely during insulin therapy in DKA?
A) Calcium
B) Potassium
C) Sodium
D) Magnesium
  • 24. 24.
    Which sign indicates effective management of DKA?
A) Increased urine output
B) Dry mucous membranes
C) Decreasing ketones and glucose
D) Fruity odor persists
  • 25. 25.
    The nurse should administer insulin infusion until:
A) B. Glucose < 200 mg/dL and patient can eat
B) D. IV fluids completed
C) A. Ketones disappear
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) B. HHNK
D) C. Hypoglycemia
  • 27. 27.
    What is the primary cause of HHNK?
A) A. Infection or dehydration
B) D. Hypokalemia
C) C. Excess carbohydrate intake
D) B. Insulin overdose
  • 28. 28.
    Which intervention is most important in initial management of HHNK?
A) C. Start antibiotics
B) B. Rehydrate with IV fluids
C) A. Administer IV insulin bolus
D) D. Provide potassium supplements
  • 29. 29.
    What differentiates HHNK from DKA?
A) A. Presence of ketones
B) B. Level of glucose
C) C. pH value
D) D. All of the above
  • 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) A. Fluid volume deficit
C) D. Acidosis
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) A. Diuretic
B) D. Initial
C) B. Oliguric
D) C. Recovery
  • 32. 32.
    Which lab finding indicates renal failure?
A) B. Increased BUN and creatinine
B) D. High GFR
C) A. Decreased creatinine
D) C. Low potassium
  • 33. 33.
    In chronic renal failure, which diet is most appropriate?
A) C. High sodium
B) B. Low potassium and phosphorus
C) D. High fluid intake
D) A. High protein
  • 34. 34.
    The nurse monitors which ECG change for hyperkalemia in renal failure?
A) A. ST depression
B) C. U waves
C) D. Flat P waves
D) B. Peaked T waves
  • 35. 35.
    Which medication helps remove potassium in renal failure?
A) A. Kayexalate
B) D. Mannitol
C) B. Lasix
D) C. Spironolactone
  • 36. 36.
    A trauma patient presents with BP 80/50 mmHg, pulse 130 bpm, cool clammy skin. What type of shock is this?
A) D. Anaphylactic
B) B. Hypovolemic
C) A. Cardiogenic
D) C. Neurogenic
  • 37. 37.
    What is the first nursing action in hypovolemic shock?
A) D. Draw labs
B) C. Give oxygen
C) B. Start IV fluids
D) A. Administer vasopressors
  • 38. 38.
    In septic shock, which finding indicates early stage?
A) D. Hypothermia
B) B. Bounding pulse
C) A. Cold clammy skin
D) C. Bradycardia
  • 39. 39.
    Which lab test confirms septic shock?
A) B. Increased sodium
B) A. Blood culture positive
C) D. Elevated calcium
D) C. Decreased BUN
  • 40. 40.
    The most reliable indicator of adequate tissue perfusion in shock is:
A) A. Skin color
B) B. Urine output
C) C. Blood pressure
D) D. Capillary refill
  • 41. 41.
    Which of the following meets SIRS criteria?
A) C. RR 14, WBC 5,000
B) B. Temp 36°C, HR 70
C) D. BP 120/80
D) A. Temp 38.5°C, HR 100, WBC 15,000
  • 42. 42.
    What is the primary trigger for SIRS?
A) B. Dehydration
B) A. Infection or tissue injury
C) C. Hypoglycemia
D) D. Hypertension
  • 43. 43.
    MODS is characterized by:
A) D. Local inflammation only
B) A. Dysfunction of two or more organ systems
C) B. Single organ failure
D) C. Mild infection
  • 44. 44.
    A patient with MODS develops jaundice, oliguria, and confusion. What does this indicate?
A) A. Improvement
B) B. Multisystem involvement
C) C. Dehydration
D) D. Stable condition
  • 45. 45.
    Nursing priority in SIRS management is:
A) C. Oxygen removal
B) D. High-protein diet
C) A. Early identification and treatment of infection
D) B. Fluid restriction
  • 46. 46.
    In MODS, which intervention prevents further organ injury?
A) B. Limit IV fluids
B) A. Maintain oxygenation and perfusion
C) D. Withhold nutrition
D) C. Stop antibiotics
  • 47. 47.
    Which assessment finding indicates progression from SIRS to MODS?
A) D. Mild fever
B) A. Stable BP and urine output
C) B. Decreasing LOC and urine output
D) C. Warm, dry skin
  • 48. 48.
    Which laboratory marker is typically elevated in SIRS/MODS?
A) B. Hematocrit
B) C. Sodium
C) D. Glucose
D) A. C-reactive protein (CRP)
  • 49. 49.
    The nurse monitors for which complication in MODS?
A) A. Disseminated intravascular coagulation (DIC)
B) B. Hyperthyroidism
C) C. Dehydration
D) D. Hypoglycemia
  • 50. 50.
    What is the ultimate goal in managing SIRS and MODS?
A) B. Restrict fluids
B) D. Lower WBC count
C) A. Prevent sepsis and maintain organ perfusion
D) C. Decrease urine output
Created with That Quiz — where a math practice test is always one click away.