Saudi Prometric Nursing Critical Care Nursing 2

Question 1

A patient develops hypotension, tachycardia, warm flushed skin, and a widened pulse pressure following a severe anaphylactic reaction. This presentation is most characteristic of:

Accepted Answer

Distributive shock

Answer

Hypovolemic shock

Answer

Cardiogenic shock

Answer

Obstructive shock

Question 2

According to current Surviving Sepsis Campaign guidelines, which fluid is recommended as first-line resuscitation for a patient in septic shock?

Accepted Answer

Crystalloid solution at 30 mL/kg

Answer

5% dextrose in water (D5W)

Answer

5% albumin solution

Answer

3% hypertonic saline

Question 3

A patient remains hypotensive despite receiving 30 mL/kg of IV fluid resuscitation for septic shock. Which vasopressor is the recommended first-line agent?

Accepted Answer

Norepinephrine

Answer

Epinephrine

Answer

Dopamine

Answer

Vasopressin

Question 4

A patient post-cardiac surgery develops hypotension, tachycardia, cool extremities, decreased urine output, and an elevated pulmonary capillary wedge pressure (PCWP) of 22 mmHg. These findings are consistent with:

Accepted Answer

Cardiogenic shock

Answer

Distributive shock

Answer

Obstructive shock

Answer

Hypovolemic shock

Question 5

A critically ill patient's serum lactate measures 6 mmol/L. The nurse interprets this finding as indicating:

Accepted Answer

Tissue hypoperfusion with anaerobic metabolism

Answer

Adequate tissue perfusion

Answer

Compensated respiratory alkalosis

Answer

Metabolic alkalosis

Question 6

A patient develops urticaria, stridor, hypotension, and angioedema minutes after receiving IV contrast dye. What is the FIRST treatment the nurse should administer?

Accepted Answer

Epinephrine 0.5 mg IM (1:1000 solution)

Answer

Diphenhydramine 50 mg IV

Answer

Methylprednisolone 125 mg IV

Answer

Normal saline 1 L bolus

Question 7

The nurse is monitoring fluid resuscitation in a patient with 40% total body surface area (TBSA) burns. Which parameter BEST indicates adequate resuscitation?

Accepted Answer

Urine output of 0.5–1 mL/kg/hour

Answer

Heart rate below 60 bpm

Answer

Mean arterial pressure above 120 mmHg

Answer

Central venous pressure above 15 mmHg