RLE LP 3 Summative Exam

Total points

48/50

Knowledge on emergency care and immediate management is critical in providing effective

interventions. It is our hope that this RLE has equipped you with the essential tools about the
emergency department and how to handle urgent cases such as HTN crisis. To consummate this week's
learnings, answer the following questions.

This test covers the topic on Hypertensive crisis management and the Crash cart.

By affixing my name (LAST NAME, First Name, Middle Initial) below, I affirm that I shall complete this
test independently and without help. I further understand that no score shall be awarded if I am caught
cheating. Finally, I am fully aware of how my grade shall be computed. *

SUMAYAO, Fayth Mae M.

1. The crash cart is a set of trays, drawers on wheels used for transporting and dispensing medications
and equipment at the site of medical emergency. *

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A. True

B. False

2. Which one of the following consists a general content of the crash cart that health facilities should
have? *

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A. Intravenous fluid, medications, airway, surgical equipment

B. Intravenous fluid, intravenous lines, medications, surgical equipment

C. Intravenous lines, medications, intubation, procedures equipment

D. Intravenous lines, medications, airway, trauma equipment

3. The emergency department hosts clients with a wide variety of actual or potential problems, and their
condition may change constantly. With this information, the crash cart is essential in ED because it
delivers basic life support only. *

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A. True

B. False

4. It is a set of instructions that help providers respond to life-threatening medical events in a systematic
fashion that is usually found on top of the crash cart. *

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A. Emergency crash cart check sheet

B. Resuscitation algorithms

C. Basic life support algorithms

D. Emergency drug information sheet

Correct answer

B. Resuscitation algorithms

5. The crash cart is used for the following except: *

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A. Respiratory arrest

B. Hyperglycemia
C. Cardiac arrest

D. Anaphylactic reaction

6. The nurse employed at the emergency department is assigned to check the crash cart at the start of
the morning shift. What equipment should be checked and documented? *

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A. Automatic External Defibrillator

B. Glucometer

C. Cardiac monitor

D. Pulse Oximeter

7. Nurse Mike has just finished his orientation as a new ER staff in a hospital. Which statement by the
nurse signifies he understood the crash cart orientation? *

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A. “The code blue form is accomplished weekly”.

B. “The crash cart equipment checklist is only done once a year”.

C. “The crash cart checklist is done daily”.

D. “The crash cart checklist is done quarterly”.

8. Nurse Mike was also taught that access to the defibrillator, resuscitation medications, supplies, and
equipment should be fast and easy, and crash carts need to be carefully _______________. *

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A. Stocked, color-coded and checked

B. Stocked, numbered and maintained

C. Equipped, organized and maintained

D. Equipped, organized and checked

9. Additionally, Mike’s supervisor emphasized that their hospital must make sure that medical
equipment for resuscitation and medications for ________________ are _________________ for use
based on the needs of the population served. *

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A. Basic life support, checked and organized

B. Basic and advanced life support, checked and organized

C. Advanced life support, standardized and available

D. Basic and advanced life support, standardized and available

10. Which one of the following best illustrates a well-maintained medication drawer? *

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A. Expiration dates are checked every first day of every quarter

B. Expiration dates are checked every first day of the month

C. Expired medications are pulled out and used

D. Expired medications are kept in place

11. Which is used to sort patients into groups based on the severity of their health problems and the
immediacy with which these problems must be treated? *

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A. Emergency Scale

B. Triage
C. Acuity

D. None of the above

12. Why is it necessary to classify patients in the emergency department? *

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A. Patients who comes first will be served first

B. Patients in need of emergent treatment will be served first

C. Patients in need of urgent treatment are seen last

D. Healthcare providers wants to group their patients according to age

13. A 23-year-old man arrives at the emergency department and complains of breathlessness. Upon
assessment he appears dyspneic with oxygen saturation of 82% on room air, pulse rate of 125 beats per
minute and blood pressure of 123/85 mmHg. What should the nurse do next? *

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A. Inform the physician

B. Administer oxygen

C. Activate code blue

D. Do nothing and continue assessment

14. Mike is assigned to triage clients coming to the emergency department for treatment on the evening
shift. Mike should assign priority to which client? *

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A. A client complaining of muscle aches, a headache, and history of seizures

B. A client who twisted her ankle when rollerblading and is requesting medication for pain
C. A client with a minor laceration on the index finger sustained while cutting an eggplant

D. A client with chest pain who states that he just ate pizza that was made with a very spicy sauce

15. Which of the following crash cart medication is used for cardiac arrest especially caused by asystole
or pulseless electrical activity? *

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A. Atropine

B. Amiodarone

C. Calcium Chloride

D. Epinephrine

16. Which of the following crash cart medication blocks parasympathetic action, increases SA node
automaticity and AV conduction? *

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A. Atropine

B. Amiodarone

C. Adenosine

D. Dopamine

17. This crash cart medication is given to correct metabolic acidosis. *

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A. Magnesium Sulfate

B. Sodium Bicarbonate
C. Sodium Chloride

D. Vasopressin

18. Which statement best describes the drug Lidocaine? *

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A. Treats specific cardiac arrhythmias

B. Reduces electrical activity of cardiac tissue

C. Only used in ventricular arrhythmias

D. All of the above

19. Which statement best describes the drug Amiodarone? *

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A. Treats all kinds of cardiac arrhythmias

B. Speeds time for ventricular filling

C. Slows electrical conduction

D. All of the above

20. Which statement best describes the drug Magnesium Sulfate? *

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A. Given to patients with CNS depression

B. Given to patients with Torsades de pointes

C. Given to patients with hypermagnesemia

D. All of the above

21. It is an alternative to epinephrine when cardiac arrest is caused by ventricular tachycardia or

ventricular fibrillation. *

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A. Amiodarone

B. Atropine

C. Vasopressin

D. Dopamine

22. Epinephrine decreases systemic vascular resistance and blood pressure. *

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A. True

B. False

23. Which action illustrates the best nursing consideration after administration of Magnesium? *

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A. Monitor for hypotension, asystole, bradycardia and respiratory paralysis

B. Monitor for hypertension, tachycardia and respiratory paralysis

C. Monitor patient for reflexive tachycardia

D. Recognize the development of metabolic acidosis

24. Which crash cart medication is used to reverse partially or completely opioid depression including
respiratory depression? *

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A. Lanoxin

B. Naloxone

C. Naltrexone

D. Naproxen

25. Which ER nurse role has a legal and ethical obligation to safeguard the patient’s rights and interests?
*

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A. Advocate

B. Care Provider

C. Educator

D. Manager

26. You received a 34 y/o male patient in the ER with following mean BP= 170/ 80 mmHg. Based on this,
how would you classify the blood pressure of the client? *

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A. Stage II HTN

B. Stage I HTN

C. Normal

D. Prehypertension
27. You received a 44 y/o female patient in the ER with following mean BP= 118/ 90 mmHg. Based on
this, how would you classify the blood pressure of the client? *

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A. Stage II HTN

B. Stage I HTN

C. Normal

D. Prehypertension

28. You received an 81 y/o male patient in the ER with following mean BP= 130/ 90 mmHg. Based on
this, how would you classify the blood pressure of the client? *

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A. Stage II HTN

B. Stage I HTN

C. Normal

D. Prehypertension

29. The target end organs affected during hypertensive emergency include the following, EXCEPT? *

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A. Myocardium

B. Kidneys

C. Aorta

D. Liver
30. The treatment goals for normalizing BP in hypertensive urgency should be achieved within which
time frame? *

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A. First hour

B. First two hours

C. 12- 24 hours

D. 24-48 hours

31. An increased blood pressure stretches the blood vessels proximal to target end organs such as the
kidney. Which of the following is activated to maintain normal flow towards the organ? *

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A. RAAS

B. Autoregulation

C. Vasodilation reflex

D. Vaso-vagal reflex

Correct answer

B. Autoregulation

32. Which of the following is the most important nursing consideration in administering Nitroprusside? *

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A. Screen for allergic reaction to the medication

B. Administer orally to avoid toxicity

C. Defer for patients with renal insufficiency

D. None of the above

33. The following belong to a class of medications called vasodilators, EXCEPT? *

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A. Nitroglycerin

B. Diazoxide

C. Enalaprilat

D. Nitroprusside

34. ACE inhibitors prevent the conversion of which of the following? *

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A. Renin to Angiotensin I

B. Angiotensin I to Angiotensin II

C. Renin to Angiotensin II

D. Angiotensin II to Aldosterone

35. ACE inhibitors often cause a side effect as a consequence of the site of receptors. Angiotensin
converting enzymes are located in which organ? *

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A. Lungs

B. Kidneys

C. Arteries

D. Liver
36. This is the drug of choice for hypertensive patients with aortic dissection. *

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A. Clonidine

B. Diazoxide

C. Hydralazine

D. Trimethaphan

37. This is the drug of choice for hypertensive patients who are pregnant. *

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A. Phentolamine

B. Diazoxide

C. Hydralazine

D. Trimethaphan

38. This is the drug of choice for hypertensive patients due to pheochromocytoma. *

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A. Phentolamine

B. Diazoxide

C. Hydralazine

D. Trimethaphan
39. A doctor orders for CT angiography of the chest and abdomen in a hypertensive patient in crisis.
What complication is being detected by this diagnostic? *

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A. Aortic Dissection

B. Ischemic Heart disease

C. Heart failure

D. Increased pulmonary vein pressure

40. A doctor orders for CT angiography of the chest and abdomen in a hypertensive patient in crisis.
What complication is being detected by this diagnostic? *

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A. Aortic Dissection

B. Ischemic Heart disease

C. Heart failure

D. Increased pulmonary vein pressure

41. Using the case of Dinah Macujah C. Duterte in your activities, she presented with papilledema and
edema in the bilateral extremities. These are mainly consequences of which mechanism? *

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A. Vasodilation

B. Increased capillary permeability

C. Increased peripheral vascular resistance

D. Excess vascular fluid volume

42. One of the prescriptions for Mrs. Duterte was Ondansetron. The main indication for the patient is
the presence of which symptom? *

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A. Fatigue

B. Restlessness

C. Nausea and Vomiting

D. High blood pressure

43. Which electrolyte imbalance present in Mrs. Duterte could explain the irregular pulses during
assessment? *

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A. Hyperkalemia

B. Hypernatremia

C. Hypernatermia

D. None of the above

44. Nicardipine is usually titrated after the first hour. The main indication for this is? *

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A. Prevent hypotensive episodes

B. Prevent toxicity

C. Avoid dependence

D. None of the above

45. Which of the following is the net effect of the sudden cessation of Amlodipine and Losartan by Mrs.
Duterte? *

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A. Fluid volume excess

B. Vasodilation

C. Vasoconstriction

D. All of the above

46. Blurring of vision that occurs in hypertensive patients is associated with? *

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A. Increased IOP

B. Decreased arterial flow to retina

C. Nausea and Vomiting

D. All of the above

47. Acute kidney injury impairs the ability of the organ to effectively eliminate metabolic wastes. Which
of the following are expected signs and symptoms due to AKI? Select all that apply. *

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A. Increased BUN and Crea

B. Pruritis

C. JVD distension

D. Oliguria
48. Interpret the following ABG of patient Duterte: pH= 7.27 PaCO2= 38 mmHgHCO3= 12 mmol/ L
PaO2= 91 mmHg *

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A. Uncompensated Metabolic Acidosis

B. Partially compensated Metabolic Acidosis

C. Fully compensated Respiratory Acidosis

D. Fully compensated Metabolic Acidosis

49. Teaching the client how to cope with stress will help control BP. Which mechanism correctly
describes the effect of stress to BP? *

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A. Fluid volume excess

B. Vasoconstriction

C. Vasodilation

D. Pupil dilation

Feedback

Release of catecholamines due to stress will cause vasoconstriction which then leads to elevated BP.

50. Health teaching on low salt diet will help prevent which of the following? *

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A. Fluid volume excess

B. Vasoconstriction

C. Vasodilation

D. Pupil dilation

Feedback

Where salt goes, water follows. High salt diet increases vascular fluid retention.

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