Ms 3 Practice Test- Diabetes, Shock, Mods, ACLS, Burns And Cancer

50 Questions  I  By Krispen
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  • 1. 
    Which signs and symptoms are typical of Hyperglycemic hypermolar non-ketonic coma
    • A. 

      BS level of 400

    • B. 

      65 year old

    • C. 

      Keytones in Urine

    • D. 

      BS level of 700

    • E. 

      25 year old

    • F. 

      No keytones in urine


  • 2. 
    What is the purpose of Kussmal Respirations in a patient with DKA?
    • A. 

      To blow off CO2 which compensates for the bodies acidic state

    • B. 

      To cool off the body reducing glucose metabolism

    • C. 

      To hypoventilate which compensates for the bodies acidic state


  • 3. 
    A patient recently diagnosed with DM I asks why she can't just take oral anti-diabetic medications instead of insulin injections. You tell her:
    • A. 

      Oral medications are not effective agains DM 1 because they do not stimulate enough insulin production from the pancreas

    • B. 

      DM 1 patients can take oral anti-diabetic meds, but would have to take so many it would be too expensive

    • C. 

      Oral medications are not effective against DM 1 because the pancrease isn't producing any endogenous insulin to be supplemented


  • 4. 
    What set of ABG's would be reflective of DKA?
    • A. 

      PH- 7.30, CO2- 47, HCO3- 22, O2- 80

    • B. 

      PH- 7.32, CO2- 32, HCO3- 20, O2- 82

    • C. 

      PH- 7.38, CO2- 47, HCO3- 28, O2- 85


  • 5. 
    Pick 2 insulins that should be given together to offer 24hour coverage (in one dose) AND coverage for meals (multiple doses) - Choose all options that could apply:
    • A. 

      NPH

    • B. 

      Regular

    • C. 

      Humalog

    • D. 

      Lantus


  • 6. 
    What would you advise your DM patient in respect to exercise? (Choose all that apply)
    • A. 

      Exercising while positive for Keytones is not recommended

    • B. 

      Pt should administer insulin just prior to exercise

    • C. 

      Pt should eat a 15 gram carb snack prior to exercise

    • D. 

      It is ok to exercise if the patient's BS is less than 300


  • 7. 
    Metformin (Glucophage) works by:
    • A. 

      Inhibiting the production of glucose by the liver

    • B. 

      Delaying the absorption of glucose in the intestine

    • C. 

      Stimulating insulin release from the pancreas

    • D. 

      Enhancing insulin action at the receptor sites


  • 8. 
    When teaching about oral anti-diabetics, you should tell the patient to: (choose all that apply)
    • A. 

      Take their medication at the same time every day

    • B. 

      Take medication immediately before meals to increase effectiveness

    • C. 

      Do not skip meals

    • D. 

      This medication may affect the effectiveness of birth control pills


  • 9. 
    One serving of Carbs equals _____grams (enter just the number, not the grams!)

  • 10. 
    Your patient is on a daily dose of NPH insulin BID and Humalog SQ before meals. When would you expect to see your patient suffer from symptoms of hypoglycemia? Choose all that apply
    • A. 

      Breakfast

    • B. 

      Lunch

    • C. 

      Dinner

    • D. 

      Bedtime


  • 11. 
    When teaching your diabetic patient about preventing diabetic retinopathy, you advise them to: (choose all that apply)
    • A. 

      Maintain a normal BS

    • B. 

      Schedule annual optometrist visits

    • C. 

      Control hypertension

    • D. 

      Report loss of vision to physician


  • 12. 
    What drug is always associated with Diabetic Nephropathy?
    • A. 

      ACE inhibitors- prils

    • B. 

      Beta-Blockers- lols

    • C. 

      CCB


  • 13. 
    The most common and effective treatment options for patients with Diabetic Neuropathies are:
    • A. 

      Physical Therapy

    • B. 

      Bio-feedback

    • C. 

      Medications

    • D. 

      Hydrotherapy


  • 14. 
    What diabetic complication accounts for 50% of diabetic deaths?
    • A. 

      Diabetic Nephropathy

    • B. 

      CAD

    • C. 

      PVD

    • D. 

      Infections


  • 15. 
    Which of the following complications can contribute to Foot and leg problems/amputations? (check all that apply)
    • A. 

      Neuropathy

    • B. 

      PVD

    • C. 

      Immunocompromise

    • D. 

      HTN


  • 16. 
    You have just admitted a burn patient who drove through McDonald's and spilled scalding hot coffee on his lap. His left hand, groin and the tops of both of his thighs have 2nd degree burns. What would his TBSA be?
    • A. 

      6%

    • B. 

      11%

    • C. 

      17%


  • 17. 
    A burn victim with 32% TBSA and a weight of 200lbs is admitted to the burn unit. Using the Parkland Formla, how many mL of fluids should this patient receive in the first 8 hours of fluid resuscitation?
    • A. 

      11636 mL

    • B. 

      5818 mL

    • C. 

      364 mL


  • 18. 
    The gut should be used within the first 6 hours after a burn patient arrives at the hospital- "use it or lose it" In what circumstances would this be contraindicated?
    • A. 

      ETT and mechanical ventilation

    • B. 

      Crackels in the lungs r/t fluid resuscitation

    • C. 

      Paralytic ileus

    • D. 

      Curlings Ulcer


  • 19. 
    What type of shock is a burn patient prone to?
    • A. 

      Cardiogenic

    • B. 

      Anapylactic

    • C. 

      Hypovolemic


  • 20. 
    A burn patient has singed nasal hairs and sooty sputum. They are put on 02 via NC 6 liters but their sats continue to fall. They are intubated and put on what % of oxygen?
    • A. 

      25%

    • B. 

      50%

    • C. 

      100%


  • 21. 
    An escharotomy would be used to treat:
    • A. 

      Hypovolemia

    • B. 

      Paralytic ileus

    • C. 

      Compartment syndrome


  • 22. 
    Which of the following would be used to prevent Hypertrophic scarring?
    • A. 

      Surgery

    • B. 

      Pressure garments

    • C. 

      Massage

    • D. 

      Oral steriods


  • 23. 
    What indicators let the burn team know that skin has a better chance of re-growth? (choose all that apply)
    • A. 

      Ability to blanch

    • B. 

      Presence of hair follicles

    • C. 

      Dry appearance

    • D. 

      Absence of pain


  • 24. 
    What would indicate a risk of Restrictive Pulmonary system alterations?
    • A. 

      Singed nasal hairs

    • B. 

      Hoarse voice

    • C. 

      Circumferencial burn on thorax

    • D. 

      Full thickness burn on face


  • 25. 
    The destruction of RBC's and muscle from heat injuries can cause free hemoglobin and myoglobin to build up in the blood. What organ system would this affect most?
    • A. 

      Liver

    • B. 

      Kidneys

    • C. 

      Spleen


  • 26. 
    What are the s/s of hypovolemic shock? (Choose all that apply)
    • A. 

      Flushed, warm skin

    • B. 

      Tachypnea

    • C. 

      Bradycardia

    • D. 

      Anuria

    • E. 

      Bounding peripheral pulses


  • 27. 
    A patient with a known infection begins to experience persistent hypotension. This patient is suffering from:
    • A. 

      Sepsis

    • B. 

      Severe Sepsis

    • C. 

      Septic Shock


  • 28. 
    A patient with pneumonia is on the vent. Their PaO2 is 90 and their FiO2 is set at 35%. This patient is experiencing pulmonary shunting
    • A. 

      True

    • B. 

      False


  • 29. 
    The following lab values are indicative for Septic Shock (Choose all that apply)
    • A. 

      Lactate 3.7 mmole/L

    • B. 

      WBC 3500

    • C. 

      Temp 101.0 F

    • D. 

      RR of 24


  • 30. 
    What is the first step in the Septic Bundle?
    • A. 

      Fluid resuscitation

    • B. 

      Vasopressors

    • C. 

      ATB therapy

    • D. 

      Blood, urine, sputum and wound cultures


  • 31. 
    What is the cause of hypotension in Septic Shock?
    • A. 

      Slowing of the heart r/t electrolyte imbalances

    • B. 

      Damage to endothelial cells that affect constriction of blood vessels

    • C. 

      Hypovolemia


  • 32. 
    Why would lactate levels be monitored in a patient with Septic Shock?
    • A. 

      To monitor kidney function

    • B. 

      To determine if aerobic metabolism is replacing anaerobic metabolism

    • C. 

      To monitor muscle wasting


  • 33. 
    Xigris is an antibiotic used as a last resort to treat septic shock d/t it's toxic side effects
    • A. 

      True

    • B. 

      False


  • 34. 
    MODS or MSOF is defined by the failure of 1 or more organs
    • A. 

      True

    • B. 

      False


  • 35. 
    Unexplained fevers with negative cultures could indicate the failure of this organ
    • A. 

      Liver

    • B. 

      Kidney

    • C. 

      Gallbladder


  • 36. 
    How can DIC lead to MODS?
    • A. 

      DIC causes severe bleeding robbing the organs of oxygen

    • B. 

      DIC causes cellular toxins to be released in the blood stream,poisoning the organs

    • C. 

      DIC causes microvascular clots which block organ perfusion robbing the organs of oxygen


  • 37. 
    When the lungs suffer from an extreme inflammatory response, the pulmonary vascular and alveolar endothelium are damaged; the causes a decrease in surfactant, increased capillary permeability and refractory hypoxemia. What is another name for this pathology?

  • 38. 
    What can cause kidney failure in sepsis patients? (Choose all that apply)
    • A. 

      The use of nephrotoxic medications

    • B. 

      Hypotension

    • C. 

      DIC

    • D. 

      ARDS


  • 39. 
    Your patient arrives at the ER complaining he doesn't "feel well"- His Vitals are: T- 99.0, P-51, R-18, BP- 110/65 and 02 98%. He is alert x3 and denies any pain. You should:
    • A. 

      Administer oxygen

    • B. 

      Continue to monitor

    • C. 

      Administer atropine

    • D. 

      Administer fluids


  • 40. 
    Your ER patient is being monitored by EKG- you notice her HR has gone from 85 to 120. Her QRS measures .16. When you assess her she says she isn't having any pain but feels like her heart is beating out of her chest. Your first intervention is:
    • A. 

      Have her perform vagal manuvers such as bearing down and coughing

    • B. 

      Administer adenosine IV (chemical cardioversion)

    • C. 

      Administer amiodarone IV


  • 41. 
    Your patient who has a hx of CAD complains of chest pain. You put him on the EKG and his HR is 160 BPM. The treatment for this patient would be:
    • A. 

      Amiodarone IV

    • B. 

      Adnosine IV (Chemical Cardiovesion)

    • C. 

      Synchronized Electric Cardioversion


  • 42. 
    You go in to check on your patient and they do not have a pulse. This first thing you do is:
    • A. 

      Crap your pants

    • B. 

      Review their EKG to determine if they have a shockable rhythm

    • C. 

      Begin CPR

    • D. 

      Administer epinepherine


  • 43. 
    Your patient has 2nd degree heart block and his body has compensated for it keeping him perfused with a good blood pressure. Today after your initial assessment, you notice your patient is not themself- they seem confused, are pale and clammy. Your first intervention would be:
    • A. 

      Fluid resucitation

    • B. 

      Epinepherine

    • C. 

      Atropine


  • 44. 
    Shock, CPR,epi; shock, CPR, epi; shock, CPR, epi- what type of patient would receive this treatment?
    • A. 

      PEA

    • B. 

      Pulseless VF/VT

    • C. 

      Asystole


  • 45. 
    For a patient with an adequate BP and anaphylactic shock, you would administer between _____mg and ____mg of epinepherine at ______________ concentration (enter answers without mg and following each other with a comma and a space: x, y, x

  • 46. 
    Which type of skin cancer has the best prognosis?
    • A. 

      Basal Cell Carcinoma

    • B. 

      Squamous Cell Carcinoma

    • C. 

      Malignant Melanoma


  • 47. 
    What populations would you find Kaposi's Sarcoma in? (choose all that apply)
    • A. 

      Pacific Island

    • B. 

      AIDS patients

    • C. 

      Mediterranean

    • D. 

      European

    • E. 

      Eastern African


  • 48. 
    Your patient has a skin lesion that is rough, scaly ad thickened in appearance. It is most likely a:
    • A. 

      Basal Cell Carcinoma

    • B. 

      Squamous Cell Carcinoma

    • C. 

      Malignant Melanoma


  • 49. 
    What stage of hypovolemic shock involves the begining of anaeobic metabolism and subsequent respiatory and metabolic acidosis?
    • A. 

      Stage 1

    • B. 

      Stage 2

    • C. 

      Stage 3

    • D. 

      Stage 4


  • 50. 
    What stage of hypovolemic shock involves the onset of reduced urine output?
    • A. 

      Stage 1

    • B. 

      Stage 2

    • C. 

      Stage 3

    • D. 

      Stage 4


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