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NCM 118 Semi Finals BSN-C - Quiz
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) Start IV fluid resuscitation
B) Administer proton pump inhibitor
C) Prepare for endoscopy
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) Normal NG output
B) Bleeding has stopped
C) Bleeding from lower GI
D) Ongoing active bleeding
  • 3. 3.
    After endoscopy for bleeding ulcers, the patient reports black tarry stools. What is the nurse’s interpretation?
A) Normal finding post-endoscopy
B) Upper GI bleeding is resolving
C) New onset of lower GI bleed
D) Rebleeding from ulcer site
  • 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) Pulse 88 bpm
C) Temperature 37°C
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) Stop infusion and notify physician
C) Decrease IV fluids
D) Continue infusion
  • 6. 6.
    A trauma patient with massive fluid resuscitation has tense abdomen and decreased urine output. What is the nurse’s priority?
A) Provide pain relief
B) Administer diuretics
C) Measure bladder pressure
D) Elevate the head of the bed
  • 7. 7.
    What parameter best reflects intra-abdominal pressure?
A) Central venous pressure
B) Gastric residual volume
C) Mean arterial pressure
D) Bladder pressure
  • 8. 8.
    A patient with intra-abdominal hypertension has decreased cardiac output. What is the underlying cause?
A) Increased venous return
B) Compression of inferior vena cava
C) Increased intrathoracic pressure
D) Vasodilation
  • 9. 9.
    What is the initial management of mild intra-abdominal hypertension?
A) Start vasopressors
B) insert chest tube
C) Optimize fluid balance and positioning
D) Immediate surgical decompression
  • 10. 10.
    In abdominal compartment syndrome, which nursing assessment finding is most alarming?
A) Respiratory rate 18/min
B) Urine output 15 mL/hr
C) Heart rate 90 bpm
D) Soft abdomen
  • 11. 11.
    A patient with liver failure has confusion and flapping tremor (asterixis). What should the nurse suspect?
A) Hypocalcemia
B) Hepatic encephalopathy
C) Hypokalemia
D) Hypoglycemia
  • 12. 12.
    Which lab result is consistent with liver failure?
A) Elevated ALT and AST
B) Increased albumin
C) Decreased bilirubin
D) Decreased ammonia
  • 13. 13.
    A patient with liver failure has ascites. Which intervention is most appropriate?
A) Position in high Fowler’s
B) Restrict fluids
C) Encourage deep breathing
D) Encourage high-sodium diet
  • 14. 14.
    After paracentesis, what is the most important nursing action?
A) Document color of fluid
B) Monitor blood pressure
C) Check bowel sounds
D) Record urine output
  • 15. 15.
    The nurse should withhold lactulose if the patient exhibits which symptom?
A) Two soft stools per day
B) Mild abdominal pain
C) Drowsiness
D) Severe diarrhea
  • 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) Vomiting
C) Grey-Turner’s sign
D) Fever
  • 17. 17.
    Which lab result supports the diagnosis of acute pancreatitis?
A) Low bilirubin
B) Low WBC count
C) Decreased lipase
D) Elevated amylase and 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) Hypomagnesemia
B) Hypocalcemia
C) Hyperkalemia
D) Hypernatremia
  • 20. 20.
    Which position best relieves pain in acute pancreatitis?
A) Trendelenburg
B) Supine
C) Prone
D) Left side-lying with knees flexed
  • 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) Administer bicarbonate
D) Start insulin drip
  • 22. 22.
    Which lab result confirms DKA?
A) HCO₃ 24 mEq/L
B) pH 7.45
C) Serum ketones positive
D) Blood glucose 180 mg/dL
  • 23. 23.
    Which electrolyte must be monitored closely during insulin therapy in DKA?
A) Potassium
B) Sodium
C) Calcium
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) C. pH returns to normal
C) D. IV fluids completed
D) A. Ketones disappear
  • 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) C. Hypoglycemia
C) D. SIADH
D) B. HHNK
  • 27. 27.
    What is the primary cause of HHNK?
A) A. Infection or dehydration
B) B. Insulin overdose
C) C. Excess carbohydrate intake
D) D. Hypokalemia
  • 28. 28.
    Which intervention is most important in initial management of HHNK?
A) A. Administer IV insulin bolus
B) D. Provide potassium supplements
C) C. Start antibiotics
D) B. Rehydrate with IV fluids
  • 29. 29.
    What differentiates HHNK from DKA?
A) C. pH value
B) D. All of the above
C) A. Presence of ketones
D) B. Level of glucose
  • 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) B. Fluid overload
D) A. Fluid volume deficit
  • 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) A. Decreased creatinine
B) D. High GFR
C) C. Low potassium
D) B. Increased BUN and creatinine
  • 33. 33.
    In chronic renal failure, which diet is most appropriate?
A) A. High protein
B) B. Low potassium and phosphorus
C) C. High sodium
D) D. High fluid intake
  • 34. 34.
    The nurse monitors which ECG change for hyperkalemia in renal failure?
A) A. ST depression
B) C. U waves
C) B. Peaked T waves
D) D. Flat P waves
  • 35. 35.
    Which medication helps remove potassium in renal failure?
A) D. Mannitol
B) C. Spironolactone
C) A. Kayexalate
D) B. Lasix
  • 36. 36.
    A trauma patient presents with BP 80/50 mmHg, pulse 130 bpm, cool clammy skin. What type of shock is this?
A) B. Hypovolemic
B) C. Neurogenic
C) D. Anaphylactic
D) A. Cardiogenic
  • 37. 37.
    What is the first nursing action in hypovolemic shock?
A) B. Start IV fluids
B) C. Give oxygen
C) A. Administer vasopressors
D) D. Draw labs
  • 38. 38.
    In septic shock, which finding indicates early stage?
A) D. Hypothermia
B) C. Bradycardia
C) A. Cold clammy skin
D) B. Bounding pulse
  • 39. 39.
    Which lab test confirms septic shock?
A) C. Decreased BUN
B) B. Increased sodium
C) D. Elevated calcium
D) A. Blood culture positive
  • 40. 40.
    The most reliable indicator of adequate tissue perfusion in shock is:
A) C. Blood pressure
B) A. Skin color
C) B. Urine output
D) D. Capillary refill
  • 41. 41.
    Which of the following meets SIRS criteria?
A) B. Temp 36°C, HR 70
B) D. BP 120/80
C) A. Temp 38.5°C, HR 100, WBC 15,000
D) C. RR 14, WBC 5,000
  • 42. 42.
    What is the primary trigger for SIRS?
A) A. Infection or tissue injury
B) C. Hypoglycemia
C) D. Hypertension
D) B. Dehydration
  • 43. 43.
    MODS is characterized by:
A) A. Dysfunction of two or more organ systems
B) C. Mild infection
C) D. Local inflammation only
D) B. Single organ failure
  • 44. 44.
    A patient with MODS develops jaundice, oliguria, and confusion. What does this indicate?
A) B. Multisystem involvement
B) D. Stable condition
C) A. Improvement
D) C. Dehydration
  • 45. 45.
    Nursing priority in SIRS management is:
A) A. Early identification and treatment of infection
B) B. Fluid restriction
C) C. Oxygen removal
D) D. High-protein diet
  • 46. 46.
    In MODS, which intervention prevents further organ injury?
A) B. Limit IV fluids
B) D. Withhold nutrition
C) A. Maintain oxygenation and perfusion
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) C. Warm, dry skin
D) B. Decreasing LOC and urine output
  • 48. 48.
    Which laboratory marker is typically elevated in SIRS/MODS?
A) B. Hematocrit
B) C. Sodium
C) A. C-reactive protein (CRP)
D) D. Glucose
  • 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) D. Lower WBC count
B) A. Prevent sepsis and maintain organ perfusion
C) C. Decrease urine output
D) B. Restrict fluids
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