DOH Nursing Adult Health Nursing

Question 1

A patient with suspected myocardial infarction presents with chest pain. Which ECG finding is most indicative of STEMI?

Accepted Answer

ST-segment elevation in two or more contiguous leads

Answer

STEMI (ST-elevation MI) is diagnosed when ST elevation ≥1 mm is present in two or more contiguous leads (or ≥2 mm in V1–V3). This indicates complete coronary occlusion requiring immediate reperfusion therapy.

Question 2

Which medication should be withheld if a patient's apical pulse is below 60 beats per minute?

Accepted Answer

Digoxin

Answer

Digoxin slows AV conduction and is held if the apical pulse is <60 bpm (in adults) because the drug could cause dangerous bradycardia. Always take a full apical pulse for one full minute before administering digoxin.

Question 3

A patient with COPD has a PaO2 of 55 mmHg and PaCO2 of 58 mmHg. What oxygen delivery device should the nurse use?

Accepted Answer

Venturi mask at 24–28% FiO2

Answer

COPD patients may rely on hypoxic drive for respiration. Controlled low-flow oxygen via Venturi mask (24–28%) raises PaO2 to a safe level (55–65 mmHg) without eliminating the hypoxic drive. High-flow oxygen can cause CO2 retention.

Question 4

Which assessment finding is an early sign of hypovolemic shock?

Accepted Answer

Anxiety and restlessness with tachycardia

Answer

In early (compensated) hypovolemic shock, the body maintains blood pressure through sympathetic compensation, but early signs include anxiety, restlessness, and tachycardia. Hypotension is a late, decompensated sign indicating severe blood loss.

Question 5

A patient is admitted with diabetic ketoacidosis (DKA). Which laboratory finding is most consistent with this diagnosis?

Accepted Answer

Blood glucose >250 mg/dL, pH <7.3, bicarbonate <15 mEq/L, positive ketones

Answer

DKA is characterized by hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.3), low bicarbonate (<15 mEq/L), and elevated ketones. This triad results from insulin deficiency causing fat breakdown and ketone production.

DOH Nursing Practice Test

DOH Nursing Practice Test

DOH Nursing Adult Health Nursing