DOH Nursing Critical Care and Emergency Nursing 3

Question 1

According to KDIGO criteria, which urine output threshold defines oliguria in acute kidney injury (AKI)?

Accepted Answer

< 0.5 mL/kg/hr for 6 hours

Answer

< 1 mL/kg/hr for 2 hours

Answer

< 400 mL in 24 hours

Answer

< 30 mL/hr for 1 hour regardless of weight

Question 2

Which nursing intervention is MOST effective in preventing ventilator-associated pneumonia (VAP)?

Accepted Answer

Daily sedation vacation combined with oral care using chlorhexidine

Answer

Routine prophylactic systemic antibiotics

Answer

Maintaining the patient in a flat supine position

Answer

Changing ventilator circuits every 24 hours

Question 3

Norepinephrine is the first-line vasopressor for septic shock. What is its primary mechanism of action?

Accepted Answer

Alpha-1 agonism causing vasoconstriction and increased SVR

Answer

Beta-1 agonism that increases heart rate and contractility

Answer

Phosphodiesterase inhibition improving cardiac output

Answer

Dopaminergic receptor stimulation increasing renal perfusion

Question 4

A patient with diabetic ketoacidosis (DKA) initially has serum K+ of 5.8 mmol/L. As insulin infusion begins, what electrolyte change should the nurse anticipate?

Accepted Answer

Potassium will fall rapidly as insulin drives K+ into cells

Answer

Sodium will drop significantly requiring hypertonic saline

Answer

Calcium will rise causing hypercalcaemia

Answer

Magnesium will increase due to renal retention

Question 5

A patient post-anterior MI develops hypotension, tachycardia, raised JVP, and cool clammy skin. Which type of shock is most consistent with these findings?

Accepted Answer

Cardiogenic shock

Answer

Hypovolaemic shock

Answer

Distributive (septic) shock

Answer

Neurogenic shock

Question 6

A mechanically ventilated patient with COPD exacerbation has the following ABG: pH 7.28, PaCO2 68 mmHg, HCO3 28 mEq/L. What acid-base disturbance is present?

Accepted Answer

Respiratory acidosis with partial metabolic compensation

Answer

Metabolic acidosis with respiratory compensation

Answer

Respiratory alkalosis with metabolic compensation

Answer

Mixed metabolic and respiratory alkalosis

Question 7

When monitoring a patient with a pulmonary artery catheter (Swan-Ganz), which measurement BEST reflects left ventricular preload?

Accepted Answer

Pulmonary artery occlusion pressure (PAOP/PCWP)

Answer

Central venous pressure (CVP)

Answer

Cardiac output measured by thermodilution

Answer

Systemic vascular resistance (SVR)