Medical Tests Medical Tests Certifications CEN Questions & Answers

• Question 51:

  You are caring for a patient in hypovalemic shock who will require plasma expansion. What do you suspect the physician will order?

  A. Cryoprecipitate

  B. Packed red blood cells

  C. Albumin

  D. Platelets

  Correct Answer: C

  Albumin would be given as a plasma expander. Cryoprecipitate is used with hemophilia patients who are bleeding because it is rich in clotting factors. Platelets are used on patients who have a low platelet count and packed red blood cells are given to replace erythrocytes.

• Question 52:

  You are preparing to give a patient a transfusion. The patient states that in previous transfusions he has always developed a rash. What medication do you suspect the physician will order prior to the transfusion?

  A. Diphenhydramine (Benadryl)

  B. Acetylsalicylic acid (ASA, aspirin)

  C. Acetaminophen (Tylenol)

  D. Ibuprofen (Motrin)

  Correct Answer: A

  The patient should receive a dose of diphenhydramine (Benadryl) prior to the transfusion to decrease the

  chances of an allergic reaction. Acetylsalicylic acid and acetaminophen are analgesics.

  Ibuprofen is a nonsteroidal anti-inflammatory medication.

• Question 53:

  You are caring for a patient who is receiving a platelet transfusion. Which of the following would indicate a therapeutic effect of the transfusion?

  A. A decrease in temperature

  B. A decrease of blood oozing from puncture sites and gums

  C. An increase hemoglobin

  D. An increase hematocrit

  Correct Answer: B

  The patient receiving a platelet transfusion should begin to have a decrease in blood oozing from puncture sites and gums. Platelets are necessary for proper clotting. Granulocytes would be given to decrease fever, and red blood cells would be given to raise hemoglobin and hematocrit.

• Question 54:

  You began administering blood to a patient 45 minutes ago. You enter the room to assess the patient and find the patient flushed and dyspneic. On auscultation the patient has crackles in the bases of both lungs. What complication of blood transfusion therapy is the patient most likely experiencing?

  A. Hypovolemia

  B. Transfusion reaction

  C. Fluid overload

  D. Bacteremia

  Correct Answer: C

  The patient is displaying all the symptoms of fluid overload. If the patient were experiencing a transfusion reaction, there would also be itching and a rash. Bacteremia would lead to the patient having a fever. Fluid overload is the best answer due to the crackles in the lungs indicating fluid has become a problem.

• Question 55:

  You are caring for a patient who has been in a multiple trauma that has lead to severe blood loss. What type of device will you need to acquire to transfuse several units of blood quickly?

  A. Cardiac monitor

  B. Pulse oximetry

  C. Blood warming device

  D. Infusion controller

  Correct Answer: C

  In order to transfuse several units quickly without causing cardiac dysrhythmia, the nurse would need a blood warming device. Blood products must be warmed if they are going to be administered quickly. In this situation, the patient would not benefit from administering the blood slow.

• Question 56:

  What is a distinctive sign that a patient has flail chest?

  A. Cyanosis

  B. Hypotension

  C. Dyspnea, especially on exhalation

  D. Paradoxical chest movement

  Correct Answer: D

  A patient with flail chest would have paradoxical chest movement. The flail chest comes from several sections of rib being broken, resulting in a floating section of ribs. This small section moves the opposite direction of the rest of the chest during inspiration and expiration.

• Question 57:

  Which clinical manifestation would a patient with a pulmonary embolus display?

  A. Decreased respirations

  B. Bradypnea

  C. Dyspnea

  D. Bradycardia

  Correct Answer: C

  The clinical manifestation that the nurse would most likely see with a pulmonary embolus is dyspnea. Other clinical manifestations that the nurse might see include tachypnea, tachycardia and chest pain. This is a medical emergency, and the physician should be notified immediately if pulmonary embolus is suspected.

• Question 58:

  Which of the following would you expect to find in a patient with acute respiratory distress syndrome?

  A. Decreased respiratory rate

  B. Pallor

  C. Low arterial PAO2

  D. An elevated arterial PAO2

  Correct Answer: C

  The patient would exhibit a low arterial PAO2. Increased respiratory rate would be the earliest sign that the

  nurse would see. Then the patient will begin to display air hunger, labored breathing, retractions and

  cyanosis.

  Hypoxia is evidenced by the arterial blood gas.

• Question 59:

  Which of the laboratory results would indicate that a patient's theophylline level is therapeutic?

  A. 5 mcg/ml

  B. 15 mcg/ml

  C. 25 mcg/ml

  D. 30 mcg/ml

  Correct Answer: B

  A therapeutic theophylline level is 15 mcg/ml. The normal range is 10 to 20 mcg/ml. Anything greater than 20 is considered toxic, meaning that the patient will start having side effects. Anything less than 10 indicates that the patient needs additional medication.

• Question 60:

  You are reviewing an arterial blood gas for a patient. Which result would lead you to believe this patient has respiratory acidosis?

  A. pH of 7.48

  B. PCO2 of 32 mm Hg

  C. pH of 7.30

  D. HCO3 of 20 mEq/L

  Correct Answer: C

  A pH level of 7.30 would indicate an acid base imbalance. The normal pH is 7.35 and 7.45. Anything less than 7.35 would indicate acidosis, and anything greater than 7.45 would indicate an alkaline state. The normal PCO2 is 35 to 45 mm Hg. Bicarbonate is usually associated with a metabolic state.