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BKAT ICU Post Test (latest 2025 - 2026 Update ) Verified Answers by
Expert.
Nitroprusside purpose - Answer - decreases preload and afterload by vasodilation (mainly afterload) Dobutamine mechanism of action - Answer - contractility Dopamine at a low-end dose "renal dose" - Answer - 0.5-4mcg/kg/min increases renal and mesentric perfusion Dopamine at a mid-range dose - Answer - 4 - 10mcg/kg/min increases contractility and heart rate Dopamine at a high-range dose - Answer - greater than 10mcg/kg/min vasoconstriction and increases BP Dopamine and Levophed infiltration - Answer - leads to tissue necrosis Dopamine antidote - Answer - regitine (phentolamine) TpA monitor for - Answer - bleeding-hemorrhagic CVA diltiazem (cardizem) works by? - Answer - (calcium channel blocker) slows ventricular rate by slowing conduction through the SA and AV node Diltazem (cardizem) biggest effect on which hemodynamic - Answer - hypotension diltazem is used for patients with - Answer - a-fib or a-flutter amiodarone (Cordarone) is a - Answer - antiarrythmic prolongs the cardiac duration You MUST use a when using amiodarone infusion - Answer - 0.22 micron filter Watch out for in patients on a amiodarone infusion - Answer - hypotension, prolongation of QT interval and bradycardia amiodarone is used for patients with - Answer - a-fib, a-flutter and VT how much amiodarone is given to a stable VT with a pulse and a unstable pulseless VT/VF? - Answer - 150mg over 10min for VT with pulse
300mg push; repeat x1 at 150mg Epinephrine has what effect on the body? - Answer - increases HR, BP, and contractility what is the first line drug for pulseless arrest? - Answer - Epinephrine What rhythms are considered fatal? - Answer - V-fib, Vtach (pulseless), and asystole Epinephrine is also given for? - Answer - anaphylaxis and as a vasopressor for hypotension Heparin is used for? Antidote is? - Answer - anticoagulant Protamine Sulfate What is the osmotic diuretic of choice to decrease intracranial pressure? - Answer - mannitol How does mannitol work? - Answer - pulls fluids into intravascular space to be excreted by the kidneys to reduce intracranial pressure what insulin is given IV? What is the peak? - Answer - Regular insulin can only be given IV 2 - 4 hr peak time Which insulin has a peak of 8 - 14 hrs? - Answer - NPH Atropine is ineffective in which heart rhythms types? - Answer - high degree AV blocks: 2nd degree type2 and 3rd degree Atropine works by? - Answer - increasing heart rate-increasing conduction through SA node Atropine is given to treat? - Answer - symptomatic bradycardia Dilantin is given to treat - Answer - seizure disorders DO NOT give with dextrose containing solutions because it will crystalize Which corticosteroid is usually given in insufficient adrenal activity or hypersensitivity/inflammation reactions? - Answer - Cortisone If chronically using cortisone be sure to to prevent. - Answer - If chronically using cortisone be sure to taper the medications to prevent acute adrenal insufficiency This medication is a cardiac glycoside that increases contractility. - Answer - Digoxin Digoxin increases contractility by - Answer - slowing the heart rate which decreases conduction through the AV node DO NOT give with dilantin because will happen. - Answer -
Third degree AV block interpretation - Answer - a strip of p-waves laid independently over a strip of QRS complexes. Note that the p wave doesn't conduct the QRS complex that follows it. A-flutter interpretation - Answer - abnormal p-waves that produce a saw-tooth appearance Failure to Capture interpreation - Answer - spike without a complex Failure to Pace interpretation - Answer - no pacemaker activity or spike at the set rate on an ECG. usually caused by battery or circuit failure, cracked or broken pacing leads, loose connections, oversensing, or the pacing output is too low--->can lead to asystole Failure to Sense - Answer - undersensing: giving help when not needed; spikes occur on the ECG where they shouldnt Pacemaker ECG rhythms - Answer - failure to capture: spike without a p wave or QRS complex following it failure to pace: no spike on ECG at the rate set failure to sense: spike when intrinsic activity already present (undersensing) no spike when patient needs it (oversensing) Which ventricular stimulus is dangerous - Answer - R on T phenomenon Indications for a pacemaker? - Answer - symptomatic bradycardia higher AV blocks (2nd degree type 2 or Complete) what is not a treatment for higher degree AV blocks - Answer - atropine because of the impaired conduction through the AV node A-flutter happens because? - Answer - an irritable spot of the atrium fires rapidly A-flutter can cause - Answer - an increase in ventricular rate A-flutter is treated by: - Answer - antiarrhythmics (cardizem, beta blockers) cardioversion What do you do if you notice a lethal rhythm on the monitor (VT/VF)? - Answer - check the patient first
- establish unresponsiveness call for help
- begin CPR if needed When defibrillating VT/VF use joules for biphasic defibrillator or joules for monophasic. - Answer - 200 360
Normal PR interval is - Answer - 0.12-0.20 seconds Patient presents with anginal pectoris. what is initial management? - Answer - allow rest, amdinister oxygen, nitroglycerin, etc. Causes of elevated cardiac enzymes - Answer - MI, pericarditis, closed chest trauma, cardiac surgery Goal of treatment for cardiogenic shock (any shock) - Answer - increase the patient's cardiac output A patient exhibits depression after their recent MI, you should - Answer - encourage the patient to verbalize their concerns and allow interaction with family How does a cardiac tamponade occur - Answer - blood or fluid accumulates in the pericardial space what does a cardiac tamponade do to the heart - Answer - prevents the heart to pump effectively (impaired ventricular filling and contraction) S/S of cardiac tamponade - Answer - pulsus paradoxus, decreased BP, JVD, tachycardia, muffled heart sounds PAP values - Answer - Systolic: 15 - 25 Diastolic: 8- 18 PAOP (wedge) - Answer - 6 - 12 PA Catheter waveforms - Answer - PAOP (wedge) reflects pressures in the - Answer - left ventricle An elevated PAOP may indicate - Answer - left ventricular failure If you notice a continual PAOP wave form is present you should - Answer - ensure the balloon is deflated, reposition the patient and try have the patient cough You should not do what to PA catheter if a continual wedge pressure is present - Answer - Flush the line What reading reflects the right atrium - Answer - CVP An elevated CVP may indicate - Answer - fluid overload, right ventricular failure, pulmonary HTN, cardiac tamponade
Your patient with an ETT is making audible sounds (or can be a trach without a passy-mauir valve) it is most likely related to.... - Answer - the cuff is deflated which allows air to pass through the vocal cords In a patient with any kind of chest trauma ALWAYS assess for symptoms of - Answer - pneumothorax impaired gas exchange, SOB S/s of tension pneumothorax - Answer - deviated trachea, acute respiratory distress trauma patients are at risk for developing embolisms, especially those with long bone fractures. - Answer - fat S/s of fat embolus - Answer - may develop after surgery SOB, tachycardia, petechiae over upper body Your patient has diminished breath sounds and you notice limited movement of their chest. This can indicate possible atelectasis due to - Answer - hypoventilation ABG Interpretation - Answer - pH: 7.35-7. PaCO2: 35- 45 HCO3: 22 - 26 (ROME) What antibiotics are given to TB patients - Answer - INH, Rifampin, Rocephin What antibiotics should be renal-dosed - Answer - Vancomycin, gentamycin, and tobramycin Before suctioning a patient be sure the vacuum pressure is set to - Answer - 120 PPE for suctioning with a open sterile system - Answer - mask, eye protection, gloves Most important intervention for a patient with cervical spinal cord injury is to - Answer - immobilize the head and neck You have just received an patient with a high level SCI what are you concerned with and why - Answer - respirations high level spinal cord injuries could lead to paralysis/dysfunction of the respiratory muscles and cause respiratory arrest What is an early sign of increased ICP - Answer - change in LOC treatment for increased ICP - Answer - keep HOB 30, keep patient calm/quiet, avoid suctioning, avoid hip flexion, medications to decrease What medications may help decrease ICP - Answer - mannitol and hypertonic saline
List interventions made the RN during the acute phase of a stroke - Answer - - minimize stimulation, provide quiet enviornment
- control secretions
- prevent injuries
- monitor for seizures
- close assessment of neurologic Is a positive babinski normal in adults? - Answer - positive babinski is a dorsiflexion (upward) of toes. it is abnormal in patients >1 yr it indicates lesion of corticospinal tract What is the most important part of a neuro assessment - Answer - LOC is a common complication of any kind of neurologic surgery. - Answer - Diabetes Insipidus S/S of diabetes insipidus - Answer - increased UOP, dehydration, thirst, relative hypernatremia S/s of DKA - Answer - fruity breath, deep/rapid breathing in effort to blow off CO2. elevated blood glucose, dehydration, polyuria, thirst, metabolic acidosis Treatment for DKA - Answer - IV insulin, fluid replacement, potassium replacement as acidosis is corrected, corrected acidosis If you suspect hypoglycemia interventions would be - Answer - check the glucose give oral glucose containing substance (if appropriate) monitor vital signs Patient with DM who are acutely ill generally require doses of insulin due to response - Answer - higher doses of insulin due to stress response peak action of regular and NPH - Answer - 2 - 4 is regular 8 - 14 is NPH glucocorticoids: - Answer - - increase ADH productiona and aldosterone leading to sodium and water retention and decreased UOP
- increase blood glucose Normal adult UOP - Answer - 30ml/hr what lab value is the best indicator of renal function - Answer - creatinine Your patient with acute renal failure is ST with JVD, and their labs show a K+ (5.9) Na+ (150), they have 3+ edema. What is up> - Answer - fluid overloaded and electrolyte imbalance
infection control intervention for a healthcare worker *most important - Answer - hand hygeine with obese patients it is important to remember the safety of the and pt - Answer - nurse and patient when rewarming a hypothermic patient you would do this to prevent and
- Answer - slowly to prevent vasodilation and hypotention Total patient care involves - Answer - spiritual and emotional needs as well as physical NEVER tell a patient - Answer - everything will be alright
