ThatQuiz Test Library Take this test now
NCM 118 Semi Finals BSN-C - Quiz
Contributed by: Forones
  • 1. 1.
    A 58-year-old male presents with hematemesis and melena. His blood pressure is 90/60 mmHg, and pulse is 120 bpm. What is the nurse’s priority action?
A) Administer proton pump inhibitor
B) Start IV fluid resuscitation
C) Insert a nasogastric tube
D) Prepare for endoscopy
  • 2. 2.
    The nurse is caring for a patient with an upper GI bleed. The nasogastric tube returns bright red blood. What does this finding indicate?
A) Bleeding has stopped
B) Normal NG output
C) Bleeding from lower GI
D) Ongoing active bleeding
  • 3. 3.
    After endoscopy for bleeding ulcers, the patient reports black tarry stools. What is the nurse’s interpretation?
A) Rebleeding from ulcer site
B) Upper GI bleeding is resolving
C) New onset of lower GI bleed
D) Normal finding post-endoscopy
  • 4. 4.
    A patient with GI bleeding is scheduled for blood transfusion. Which assessment finding requires immediate attention?
A) BP 110/70 mmHg
B) Temperature 37°C
C) Pulse 88 bpm
D) Crackles in lungs after transfusion
  • 5. 5.
    During octreotide infusion for variceal bleeding, the nurse observes bradycardia. What is the best nursing action?
A) Give atropine
B) Continue infusion
C) Stop infusion and notify physician
D) Decrease IV fluids
  • 6. 6.
    A trauma patient with massive fluid resuscitation has tense abdomen and decreased urine output. What is the nurse’s priority?
A) Administer diuretics
B) Provide pain relief
C) Measure bladder pressure
D) Elevate the head of the bed
  • 7. 7.
    What parameter best reflects intra-abdominal pressure?
A) Central venous pressure
B) Gastric residual volume
C) Bladder pressure
D) Mean arterial pressure
  • 8. 8.
    A patient with intra-abdominal hypertension has decreased cardiac output. What is the underlying cause?
A) Increased intrathoracic pressure
B) Increased venous return
C) Vasodilation
D) Compression of inferior vena cava
  • 9. 9.
    What is the initial management of mild intra-abdominal hypertension?
A) Start vasopressors
B) Optimize fluid balance and positioning
C) Immediate surgical decompression
D) insert chest tube
  • 10. 10.
    In abdominal compartment syndrome, which nursing assessment finding is most alarming?
A) Heart rate 90 bpm
B) Soft abdomen
C) Respiratory rate 18/min
D) Urine output 15 mL/hr
  • 11. 11.
    A patient with liver failure has confusion and flapping tremor (asterixis). What should the nurse suspect?
A) Hypoglycemia
B) Hypokalemia
C) Hepatic encephalopathy
D) Hypocalcemia
  • 12. 12.
    Which lab result is consistent with liver failure?
A) Decreased bilirubin
B) Elevated ALT and AST
C) Decreased ammonia
D) Increased albumin
  • 13. 13.
    A patient with liver failure has ascites. Which intervention is most appropriate?
A) Encourage high-sodium diet
B) Restrict fluids
C) Position in high Fowler’s
D) Encourage deep breathing
  • 14. 14.
    After paracentesis, what is the most important nursing action?
A) Monitor blood pressure
B) Document color of fluid
C) Check bowel sounds
D) Record urine output
  • 15. 15.
    The nurse should withhold lactulose if the patient exhibits which symptom?
A) Mild abdominal pain
B) Severe diarrhea
C) Two soft stools per day
D) Drowsiness
  • 16. 16.
    A patient with severe epigastric pain radiating to the back is diagnosed with acute pancreatitis. Which finding indicates a serious complication?
A) Nausea
B) Vomiting
C) Fever
D) Grey-Turner’s sign
  • 17. 17.
    Which lab result supports the diagnosis of acute pancreatitis?
A) Low WBC count
B) Elevated amylase and lipase
C) Decreased lipase
D) Low bilirubin
  • 18. 18.
    What is the priority nursing intervention in acute pancreatitis?
A) Provide low-fat diet
B) Maintain NPO status
C) Encourage oral fluids
D) Administer insulin
  • 19. 19.
    Which electrolyte imbalance is common in pancreatitis?
A) Hyperkalemia
B) Hypernatremia
C) Hypocalcemia
D) Hypomagnesemia
  • 20. 20.
    Which position best relieves pain in acute pancreatitis?
A) Left side-lying with knees flexed
B) Supine
C) Trendelenburg
D) Prone
  • 21. 21.
    A diabetic patient arrives with fruity odor breath and Kussmaul respirations. What is the priority action?
A) Administer bicarbonate
B) Prepare for dialysis
C) Begin IV fluids
D) Start insulin drip
  • 22. 22.
    Which lab result confirms DKA?
A) Blood glucose 180 mg/dL
B) HCO₃ 24 mEq/L
C) pH 7.45
D) Serum ketones positive
  • 23. 23.
    Which electrolyte must be monitored closely during insulin therapy in DKA?
A) Magnesium
B) Sodium
C) Calcium
D) Potassium
  • 24. 24.
    Which sign indicates effective management of DKA?
A) Fruity odor persists
B) Dry mucous membranes
C) Increased urine output
D) Decreasing ketones and glucose
  • 25. 25.
    The nurse should administer insulin infusion until:
A) C. pH returns to normal
B) A. Ketones disappear
C) B. Glucose < 200 mg/dL and patient can eat
D) D. IV fluids completed
  • 26. 26.
    An elderly type 2 diabetic is admitted with dehydration and glucose of 700 mg/dL, no ketones. What is the likely diagnosis?
A) C. Hypoglycemia
B) A. DKA
C) D. SIADH
D) B. HHNK
  • 27. 27.
    What is the primary cause of HHNK?
A) B. Insulin overdose
B) A. Infection or dehydration
C) D. Hypokalemia
D) C. Excess carbohydrate intake
  • 28. 28.
    Which intervention is most important in initial management of HHNK?
A) B. Rehydrate with IV fluids
B) C. Start antibiotics
C) D. Provide potassium supplements
D) A. Administer IV insulin bolus
  • 29. 29.
    What differentiates HHNK from DKA?
A) A. Presence of ketones
B) B. Level of glucose
C) C. pH value
D) D. All of the above
  • 30. 30.
    A nurse identifies decreased skin turgor and dry mucous membranes in a HHNK patient. What should the nurse expect?
A) D. Acidosis
B) B. Fluid overload
C) A. Fluid volume deficit
D) C. Hypoglycemia
  • 31. 31.
    A patient with acute renal failure has urine output of 200 mL/24 hrs. What phase is this?
A) D. Initial
B) C. Recovery
C) B. Oliguric
D) A. Diuretic
  • 32. 32.
    Which lab finding indicates renal failure?
A) B. Increased BUN and creatinine
B) D. High GFR
C) C. Low potassium
D) A. Decreased creatinine
  • 33. 33.
    In chronic renal failure, which diet is most appropriate?
A) C. High sodium
B) D. High fluid intake
C) B. Low potassium and phosphorus
D) A. High protein
  • 34. 34.
    The nurse monitors which ECG change for hyperkalemia in renal failure?
A) D. Flat P waves
B) B. Peaked T waves
C) A. ST depression
D) C. U waves
  • 35. 35.
    Which medication helps remove potassium in renal failure?
A) B. Lasix
B) C. Spironolactone
C) D. Mannitol
D) A. Kayexalate
  • 36. 36.
    A trauma patient presents with BP 80/50 mmHg, pulse 130 bpm, cool clammy skin. What type of shock is this?
A) C. Neurogenic
B) B. Hypovolemic
C) D. Anaphylactic
D) A. Cardiogenic
  • 37. 37.
    What is the first nursing action in hypovolemic shock?
A) B. Start IV fluids
B) D. Draw labs
C) C. Give oxygen
D) A. Administer vasopressors
  • 38. 38.
    In septic shock, which finding indicates early stage?
A) A. Cold clammy skin
B) D. Hypothermia
C) C. Bradycardia
D) B. Bounding pulse
  • 39. 39.
    Which lab test confirms septic shock?
A) A. Blood culture positive
B) D. Elevated calcium
C) C. Decreased BUN
D) B. Increased sodium
  • 40. 40.
    The most reliable indicator of adequate tissue perfusion in shock is:
A) A. Skin color
B) C. Blood pressure
C) D. Capillary refill
D) B. Urine output
  • 41. 41.
    Which of the following meets SIRS criteria?
A) B. Temp 36°C, HR 70
B) C. RR 14, WBC 5,000
C) A. Temp 38.5°C, HR 100, WBC 15,000
D) D. BP 120/80
  • 42. 42.
    What is the primary trigger for SIRS?
A) D. Hypertension
B) B. Dehydration
C) A. Infection or tissue injury
D) C. Hypoglycemia
  • 43. 43.
    MODS is characterized by:
A) C. Mild infection
B) A. Dysfunction of two or more organ systems
C) B. Single organ failure
D) D. Local inflammation only
  • 44. 44.
    A patient with MODS develops jaundice, oliguria, and confusion. What does this indicate?
A) A. Improvement
B) D. Stable condition
C) C. Dehydration
D) B. Multisystem involvement
  • 45. 45.
    Nursing priority in SIRS management is:
A) C. Oxygen removal
B) A. Early identification and treatment of infection
C) D. High-protein diet
D) B. Fluid restriction
  • 46. 46.
    In MODS, which intervention prevents further organ injury?
A) A. Maintain oxygenation and perfusion
B) D. Withhold nutrition
C) B. Limit IV fluids
D) C. Stop antibiotics
  • 47. 47.
    Which assessment finding indicates progression from SIRS to MODS?
A) A. Stable BP and urine output
B) B. Decreasing LOC and urine output
C) C. Warm, dry skin
D) D. Mild fever
  • 48. 48.
    Which laboratory marker is typically elevated in SIRS/MODS?
A) A. C-reactive protein (CRP)
B) C. Sodium
C) B. Hematocrit
D) D. Glucose
  • 49. 49.
    The nurse monitors for which complication in MODS?
A) C. Dehydration
B) A. Disseminated intravascular coagulation (DIC)
C) D. Hypoglycemia
D) B. Hyperthyroidism
  • 50. 50.
    What is the ultimate goal in managing SIRS and MODS?
A) A. Prevent sepsis and maintain organ perfusion
B) C. Decrease urine output
C) D. Lower WBC count
D) B. Restrict fluids
Created with That Quiz — where a math practice test is always one click away.