{"id":95328,"date":"2025-12-02T21:28:27","date_gmt":"2025-12-02T21:28:27","guid":{"rendered":"https:\/\/studyingnurse.com\/docs\/?p=95328"},"modified":"2025-12-02T21:28:29","modified_gmt":"2025-12-02T21:28:29","slug":"general-icu-rn-a-v2","status":"publish","type":"post","link":"https:\/\/studyingnurse.com\/docs\/general-icu-rn-a-v2\/","title":{"rendered":"Prophecy General ICU RN A v2 Assessment"},"content":{"rendered":"\n

Prophecy General ICU RN A v2 Assessment<\/h2>\n\n\n\n
#<\/strong><\/td>Question<\/strong><\/td>Answer<\/strong><\/td>Rationale (Added for Context)<\/strong><\/td><\/tr><\/thead>
1<\/td>Common complications of massive transfusions are… 1<\/sup><\/td>Dilutional Coagulopathy, DIC, hypothermia, and fibrinolysis 2<\/sup><\/td>Massive transfusion replaces volume but dilutes clotting factors. Stored blood is cold (hypothermia) and citrate in blood binds calcium, affecting clotting.<\/td><\/tr>
2<\/td>ABG pH 7.25, pCO2 40, pO2 90, HCO3 20mEq\/L 3<\/sup><\/td>Metabolic Acidosis 4<\/sup><\/td>Low pH (acidosis) + Normal PaCO2 + Low HCO3 (metabolic) indicates primary metabolic acidosis.<\/td><\/tr>
3<\/td>Long term use of TPN may lead to: 5<\/sup><\/td>Liver Failure 6<\/sup><\/td>TPN bypasses the GI tract, leading to bile stasis, steatosis, and eventual hepatic dysfunction.<\/td><\/tr>
4<\/td>Which of the following is a potential complication of high PEEP 7<\/sup><\/td>Pneumothorax 8<\/sup><\/td>High Positive End-Expiratory Pressure increases intrathoracic pressure, risking alveolar rupture (barotrauma).<\/td><\/tr>
5<\/td>What is a common assessment finding for a patient returning from a small bowel resection? 9<\/sup><\/td>Hypoactive bowel sounds 10<\/sup><\/td>Anesthesia and bowel manipulation during surgery typically cause temporary paralytic ileus.<\/td><\/tr>
6<\/td>Your patient suddenly becomes diaphoretic, anxious, tachycardic, and has clammy skin. Which of the following would you suspect? 11<\/sup><\/td>Hypoglycemia 12<\/sup><\/td>These are classic signs of sympathetic nervous system activation triggered by low blood sugar.<\/td><\/tr>
7<\/td>The staff nurse asks the nursing assistant to check on a patient… The patient is experiencing chest pain… Which of the following can the staff nurse delegate to the assistant? 13<\/sup><\/td>Gathering vitals and assessing the cause for the change in status <\/td>Note:<\/strong> While the text selects this option, technically a CNA cannot<\/em> “assess cause.” They can only gather vitals. However, compared to other options (calling MD, giving meds), this is the “best” distractor available in this specific test bank.<\/td><\/tr>
8<\/td>Your patient returned from PACU<\/a>… attempts to eat a candy bar and begins to choke. The physician is unable to clear the airway. You would expect to prepare for which emergency procedure? 15<\/sup><\/td>Bronchoscopy <\/td>If manual clearance fails, a bronchoscope is required to visualize and retrieve the foreign object from the airway.<\/td><\/tr>
9<\/td>The initial insulin therapy for a patient with acute DKA is usually administered by which route <\/td>Intravenous bolus followed by a continuous infusion <\/td>IV delivery ensures immediate onset to reverse ketosis, while continuous infusion prevents rapid drops in glucose.<\/td><\/tr>
10<\/td>Screening tests for DIC include: 19<\/sup><\/td>D-Dimer and FDPs 20<\/sup><\/td>Elevated Fibrin Degradation Products and D-Dimer indicate the simultaneous clotting and bleeding characteristic of DIC.<\/td><\/tr>
11<\/td>Which of the following hormones is secreted by the hypothalamus in an effort to regulate water balance? 21<\/sup><\/td>ADH 22<\/sup><\/td>Antidiuretic Hormone (Vasopressin) regulates water retention in the kidneys.<\/td><\/tr>
12<\/td>Which of the following IV sedatives would most likely be ordered for a non-intubated patient? 23<\/sup><\/td>Precedex 24<\/sup><\/td>Dexmedetomidine (Precedex) sedates without significant respiratory depression, making it safe for non-intubated patients.<\/td><\/tr>
13<\/td>Your patient is in bed and eating lunch when they begin to cough and gag. Suddenly they become dyspneic and bradycardic… What do you suspect happened? 25<\/sup><\/td>Aspiration 26<\/sup><\/td>Food entering the airway triggers a vagal response (bradycardia) and airway obstruction (dyspnea).<\/td><\/tr>
14<\/td>Which of the following is a response of the cardiovascular system to early sepsis? 27<\/sup>27<\/sup><\/td>Increased cardiac output and reduced systemic vascular resistance 28<\/sup>28<\/sup>28<\/sup>28<\/sup><\/td>Early “warm” sepsis is characterized by vasodilation (low SVR) and compensatory tachycardia (high CO).<\/td><\/tr>
15<\/td>Which patient would you expect to be extubated? 29<\/sup><\/td>Patient is awake, follows commands with RR of 14, FiO2 40%, and PEEP 5 30<\/sup><\/td>This patient meets the criteria: neurological stability and minimal respiratory support requirements.<\/td><\/tr>
16<\/td>Hypertensive crisis 31<\/sup><\/td>Nicardipine 32<\/sup><\/td>Nicardipine (Cardene) is a calcium channel blocker used for rapid, titratable blood pressure reduction.<\/td><\/tr>
17<\/td>Your patient sustained a crushed pelvis… You notice a pinkish sediment in the urinary catheter tubing and decreased urinary output. Which condition would you suspect? 33<\/sup><\/td>Rhabdomyolysis 34<\/sup><\/td>Muscle trauma releases myoglobin (causing pink\/tea urine), which obstructs renal tubules leading to kidney failure.<\/td><\/tr>
18<\/td>Which class of drugs should be avoided in patients with asthma? 35<\/sup><\/td>Beta Blockers 36<\/sup><\/td>Non-selective beta-blockers can cause bronchoconstriction.<\/td><\/tr>
19<\/td>CAM-ICU is a measure for which condition? 37<\/sup><\/td>Delirium 38<\/sup><\/td>Confusion Assessment Method for the ICU is the gold standard for monitoring delirium.<\/td><\/tr>
20<\/td>Which of the following drugs would you expect to administer in a patient diagnosed with myasthenia gravis? 39<\/sup><\/td>Mestinon 40<\/sup><\/td>Pyridostigmine (Mestinon) improves muscle strength by preventing the breakdown of acetylcholine.<\/td><\/tr>
21<\/td>ABG pH 7.56, paCO2 24 mmHG, HCO3 23 mEq\/L 41<\/sup><\/td>Respiratory Alkalosis 42<\/sup><\/td>High pH (alkalosis) + Low PaCO2 (respiratory) indicates respiratory alkalosis.<\/td><\/tr>
22<\/td>When assessing a chest tube, which of the following indicates a possible air leak 43<\/sup><\/td>Excessive bubbling in the water chamber 44<\/sup><\/td>Continuous bubbling in the water seal chamber suggests air is leaking from the lung or the tubing system.<\/td><\/tr>
23<\/td>Which of the following medications improves contractility, increases stroke volume, and increases cardiac output? 45<\/sup><\/td>Dobutamine 46<\/sup><\/td>Dobutamine is a beta-1 agonist\/positive inotrope used to treat heart failure.<\/td><\/tr>
24<\/td>Muffled heart sounds would indicate what condition? 47<\/sup><\/td>Cardiac tamponade 48<\/sup><\/td>Fluid in the pericardial sac acts as an insulator, muffling the sound of the heartbeat (part of Beck’s Triad).<\/td><\/tr>
25<\/td>Pain assessment in an unconscious patient 49<\/sup><\/td>Requires astute assessment skills using multiple approaches 50<\/sup><\/td>Nurses must rely on physiological indicators (HR, BP) and behavioral scales (like CPOT) rather than self-report.<\/td><\/tr>
26<\/td>Which of the following tests should be performed prior to administering tPA 51<\/sup><\/td>CT Scan 52<\/sup><\/td>A CT scan is mandatory to rule out hemorrhagic stroke before giving clot-busting drugs.<\/td><\/tr>
27<\/td>Which of the following classes of drugs are used in an effort to therapeutically decrease venous return and reduce peripheral vascular resistance? 53<\/sup><\/td>Vasodilators 54<\/sup><\/td>Dilating vessels increases the “tank” size, dropping preload (venous return) and afterload (resistance).<\/td><\/tr>
28<\/td>Identify the type of renal failure that results from bilateral obstruction of urine outflow 55<\/sup><\/td>Post-renal failure 56<\/sup><\/td>“Post-renal” refers to causes downstream from the kidney (ureters, bladder, urethra).<\/td><\/tr>
29<\/td>A patient exhibits hypotension without an increase in HR is indicative of 57<\/sup><\/td>Neurogenic Shock 58<\/sup><\/td>Disruption of the sympathetic pathways prevents the compensatory tachycardia normally seen in hypotension.<\/td><\/tr>
30<\/td>Your patient is taking… Zoloft, Lanoxin, Protonix, lasix, and coumadin. Which medication would you hold for a blood pressure of 80\/50? 59<\/sup><\/td>Lasix 60<\/sup><\/td>Diuretics decrease intravascular volume, which would further exacerbate hypotension.<\/td><\/tr>
31<\/td>A patient was admitted with a hemoglobin of 6, hematocrit of 25, has clammy skin, confusion, and agitation, BP 80\/40, HR 145. What type of shock is this? 61<\/sup><\/td>Hypovolemic 62<\/sup><\/td>Low blood counts combined with shock signs indicate hemorrhagic (hypovolemic) shock.<\/td><\/tr>
32<\/td>The patient is admitted with suspected Guillain-Barre syndrome. The nurse would expect CSF analysis to reveal which of the following to confirm the diagnosis? 63<\/sup><\/td>CSF protein of 60 mg\/dL and WBC 0 cells\/mm3 64<\/sup><\/td>“Albuminocytologic dissociation” (high protein with normal WBC count) is the hallmark finding in GBS.<\/td><\/tr>
33<\/td>Your patient is receiving IV medications of Nitroglycerin and Verapamil. Which of the following should the nurse observe for during the assessment? 65<\/sup><\/td>Hypotension 66<\/sup><\/td>Combining a nitrate (vasodilator) with a calcium channel blocker can cause severe, compounding hypotension.<\/td><\/tr>
34<\/td>CVP measures the pressure in the 67<\/sup><\/td>right atrium 68<\/sup><\/td>Central Venous Pressure is a direct measure of right atrial pressure\/preload.<\/td><\/tr>
35<\/td>Which lab value is used to determine the severity of sepsis 69<\/sup><\/td>lactic acid 70<\/sup><\/td>Elevated lactate indicates tissue hypoxia and anaerobic metabolism due to poor perfusion.<\/td><\/tr>
36<\/td>Which of the following hormones is secreted by the thyroid gland? 71<\/sup><\/td>calcitonin 72<\/sup><\/td>The thyroid secretes T3, T4, and Calcitonin (which lowers blood calcium).<\/td><\/tr>
37<\/td>An adrenocorticotropic hormone (ACTH) stimulation test would be ordered for which diagnosis? 73<\/sup><\/td>Adrenal crisis 74<\/sup><\/td>This test measures the adrenal glands’ ability to respond to stress hormones, diagnosing Addison’s\/Adrenal insufficiency.<\/td><\/tr>
38<\/td>The most common cause for the patient to file a nursing negligence claim is 75<\/sup><\/td>Ineffective communication 76<\/sup><\/td>Breakdowns in communication (with patients or other providers) are the root cause of most malpractice suits.<\/td><\/tr>
39<\/td>Which medication is a paralytic 77<\/sup><\/td>Vecuronium 78<\/sup><\/td>Vecuronium is a nondepolarizing neuromuscular blocking agent.<\/td><\/tr>
40<\/td>90% of thrombi develop in which area of the body? 79<\/sup><\/td>Legs 80<\/sup><\/td>Deep Vein Thrombosis (DVT) in the lower extremities is the primary source of venous clots.<\/td><\/tr>
41<\/td>Which of the following medications is usually the first to be administered during status epilepticus 81<\/sup><\/td>Ativan 82<\/sup><\/td>Lorazepam (Ativan) is the benzodiazepine of choice for rapid seizure termination.<\/td><\/tr>
42<\/td>Pt’s BP on admission was 110\/40, and Hgb was 10.5. The BP is now 80\/50 and pt is vomiting coffee ground emesis. You expect Hgb to be: 83<\/sup><\/td>8 84<\/sup><\/td>Active GI bleed (coffee grounds) + hemodynamic instability implies significant blood loss, lowering Hgb.<\/td><\/tr>
43<\/td>You note the appearance of a U wave on the ECG tracing… check laboratory values for the presence of 85<\/sup><\/td>Hypokalemia 86<\/sup><\/td>U waves are a specific EKG change associated with low potassium levels.<\/td><\/tr>
44<\/td>Allen test 87<\/sup><\/td>Must be performed prior to A-line insertion 88<\/sup><\/td>Ensures the ulnar artery can supply blood to the hand if the radial artery is occluded by the catheter.<\/td><\/tr>
45<\/td>low sodium, low potassium, and moderate protein 89<\/sup><\/td>Diet best for patient with renal failure? 90<\/sup><\/td>Renal failure patients cannot filter electrolytes well and require protein restriction to limit nitrogenous waste buildup.<\/td><\/tr>
46<\/td>You’re caring for a 49 yo head trauma pt with an ICP line. What is the formula for calculating the CPP? 91<\/sup><\/td>MAP-ICP 92<\/sup><\/td>Cerebral Perfusion Pressure = Mean Arterial Pressure minus Intracranial Pressure.<\/td><\/tr>
47<\/td>Pneumonia Pt presents with fever, chills, cough, SOB and chest pain. Which diagnosis would you anticipate? 93<\/sup><\/td>Pneumonia 94<\/sup><\/td>(Note: The source text lists “Pneumonia” in the question column, but these are the classic signs of pneumonia).<\/td><\/tr>
48<\/td>CVP normal range 95<\/sup><\/td>2-8 mmHg 96<\/sup><\/td>This is the standard physiological range for central venous pressure.<\/td><\/tr>
49<\/td>Pt presents with stiff neck, headache and fever for the last 24 hr. What condition would you suspect? 97<\/sup><\/td>Bacterial meningitis 98<\/sup><\/td>This triad of symptoms (nuchal rigidity, headache, fever) strongly suggests meningitis.<\/td><\/tr>
50<\/td>Hypotensive crisis, which med would you anticipate giving? 99<\/sup><\/td>Levophed 100<\/sup><\/td>Norepinephrine (Levophed) is a potent vasoconstrictor used to restore BP in shock states.<\/td><\/tr>
51<\/td>Hypotonic solution 101<\/sup><\/td>0.45% NS 102<\/sup><\/td>Half-normal saline is hypotonic (lower osmolarity than blood plasma), pushing fluid into cells.<\/td><\/tr>
52<\/td>What pathological condition might you suspect in a patient with a serum sodium of 165 and serum osmolality of 330? 103<\/sup><\/td>Diabetes Insipidus 104<\/sup><\/td>Hypernatremia and high serum osmolality result from massive free water loss, characteristic of DI.<\/td><\/tr>
53<\/td>Med commonly used to decrease ICP 105<\/sup><\/td>Mannitol 106<\/sup><\/td>Mannitol is an osmotic diuretic that pulls fluid from brain tissue into the vasculature to reduce intracranial pressure.<\/td><\/tr>
54<\/td>ABG 7.35, paCO2 60mmHg, HCO3 38 mEq 107<\/sup><\/td>Compensated respiratory acidosis 108<\/sup><\/td>Normal pH (compensated) + Acidic CO2 + Alkaline HCO3 (compensatory) = Compensated Respiratory Acidosis.<\/td><\/tr>
55<\/td>Contraindicated for Lorazepam 109<\/sup><\/td>Pt with acute angle-closure glaucoma 110<\/sup><\/td>Benzodiazepines can have mild anticholinergic effects, potentially increasing intraocular pressure in narrow-angle glaucoma.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
\"Prophecy
Prophecy General ICU RN A v2<\/figcaption><\/figure>\n\n\n\n


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