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Medical-Surgical Exam: Acute Interventions & Pathophysiology

Test 03: Critical Care Priorities

This exam focuses on Emergency Response, Neurological Assessment, and Pharmacological Safety based on contemporary standards.

Airway First: In patients with acute heart failure and low oxygen, always prop the patient up and give oxygen before giving medications like diuretics.
Stroke Protocol: A STAT CT scan of the head is the absolute priority for a suspected stroke. You must rule out a bleed before any clot-busting drugs are given.
Drug Safety: Ketorolac (Toradol) has a strict 5-day limit. Using it longer greatly increases the risk of kidney failure and stomach bleeding.
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Q:1A 19-year-old male presents with severe right lower quadrant (RLQ) abdominal pain, fever, nausea, and vomiting. On examination, he has RLQ tenderness and no bowel sounds. Labs show an elevated white blood cell count with a high percentage of neutrophils. Which organ is most likely affected?
Q:2A 65-year-old male with a history of heart failure presents to the emergency department with severe shortness of breath. His blood pressure is 160/90, heart rate is 105, respiratory rate is 26, and O2 saturation is 86%. He has jugular venous distention, crackles in his lungs, and pedal edema. What is the most appropriate next step in management?
Q:3A 45-year-old male is brought to the emergency department by police. He is extremely agitated, paranoid, confused, and is being physically restrained. He is dyspneic and wheezing. What is the first-line treatment for chemical restraint in this patient?
Q:4A "code blue" is called on a 66-year-old female patient. The first provider to arrive finds no radial pulse. Before starting chest compressions, what is the most appropriate location to check for a central pulse?
Q:5A 65-year-old male with rectal carcinoma undergoes a low anterior resection. He later reports erectile dysfunction. ... [Show Full Question 5]
Q:6A 71-year-old woman is post-op from a femoral neck fracture. She develops new-onset disorientation and confusion. ... [Show Full Question 6]
Q:7A 32-year-old male has a knife injury to his lower back. A CT scan shows a right hemisection of the ... [Show Full Question 7]
Q:8A 65-year-old amputee with a history of diabetes has been experiencing a constant, burning pain in his missing right ... [Show Full Question 8]
Q:9A 60-year-old female with diabetes and migraines starts atorvastatin and has a dose increase. A month later, she reports muscle weakness and decreased, ... [Show Full Question 9]
Q:10A 54-year-old man has recurrent episodes of acute gout. He is prescribed a drug that lowers uric ... [Show Full Question 10]
Q:11A 16-year-old male presents to the ED with sudden, severe scrotal pain. Physical exam shows an enlarged, tender ... [Show Full Question 11]
Q:12A 26-year-old female with a history of intranasal drug use has a positive Hepatitis C ... [Show Full Question 12]
Q:13A patient scheduled for a lower limb amputation expresses to the nurse that they feel hopeless and their ... [Show Full Question 13]
Q:14An 80-year-old female with a history of diabetes is admitted with nausea and vomiting. She is hypotensive and tachycardic. Her creatinine ... [Show Full Question 14]
Q:15A 28-year-old female with a history of hypothyroidism presents with lethargy, bradycardia, and significant edema. ... [Show Full Question 15]
Q:16A 25-year-old patient is three days post-op from an appendectomy and is receiving intravenous ... [Show Full Question 16]
Q:17A 16-year-old female presents with altered mental status and is found to have track marks. She is admitted for drug intoxication. Two ... [Show Full Question 17]
Q:18An 78-year-old patient is admitted with left-sided numbness, weakness, and ... [Show Full Question 18]
Q:19The nurse is assessing a patient experiencing motor loss from a left-sided cerebrovascular ... [Show Full Question 19]
Q:20The nurse identifies which patient as being at the highest ... [Show Full Question 20]

Test 03 Study Summary

1. Delirium Prevention The best way to help elderly patients after surgery is to reorient them often. Avoid using sedatives which can make confusion worse.
2. Spinal Cord Injury Brown-Séquard syndrome causes a unique pattern: loss of movement on the side of the injury, but loss of pain sensation on the opposite side.
3. Gout Management Allopurinol is for long-term prevention by lowering uric acid. It is not used for treating a sudden, painful attack.

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