MCQs

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Practice Questions

72. A patient with acute kidney injury is receiving continuous furosemide infusion. The nurse observes urine output of 10 mL/hr despite the infusion. What clinical implication is immediate?

A. Patient is over-hydrated
B. Furosemide resistance or worsening kidney injury, requiring physician notification and alternative strategies
C. Patient is dehydrated
D. Patient needs more sodium
nmdcat.online BS Nursing
Jun 6, 2026
nmdcat.online BS Nursing
Jun 6, 2026

70. A patient on mechanical ventilation is prescribed a continuous infusion of fentanyl for pain management. The nurse observes the patient’s respiratory rate has decreased to 8 breaths/min. What medicinal concern is immediate?

A. Insufficient pain control
B. Opioid-induced respiratory depression, requiring physician notification and possible dose reduction or naloxone administration
C. Pain is well controlled
D. Patient is anxious
nmdcat.online BS Nursing
Jun 6, 2026

69. A patient is admitted to the ICU with suspected acute coronary syndrome. They are complaining of crushing chest pain radiating to the left arm. What is the urgent initial nursing intervention?

A. Administer oral pain medication
B. Administer oxygen, nitroglycerin, aspirin, and morphine (MONA) as ordered, and obtain 12-lead ECG
C. Administer a diuretic
D. Order a meal
nmdcat.online BS Nursing
Jun 6, 2026

68. A nurse is managing a patient with a Swan-Ganz catheter (pulmonary artery catheter). The nurse observes the waveform “wedges” spontaneously and stays there. What is the immediate technical action?

A. Inflate the balloon further
B. Immediately deflate the balloon and pull back slightly to prevent pulmonary artery rupture
C. Inject air into the balloon
D. Administer a diuretic
nmdcat.online BS Nursing
Jun 6, 2026

67. A patient with acute liver failure develops spontaneous bleeding from the gums and GI tract. What clinical complication is the nurse assessing for?

A. Hyperglycemia
B. Coagulopathy (impaired clotting factor synthesis)
C. Hypokalemia
D. Hypernatremia
nmdcat.online BS Nursing
Jun 6, 2026

66. A patient is receiving a continuous infusion of vasopressin for refractory septic shock. The nurse observes new onset of chest pain and ST-segment elevation on the ECG. What medicinal concern is immediate?

A. Vasopressin is not working
B. Vasopressin-induced myocardial ischemia, requiring immediate physician notification and possible discontinuation
C. Hypoglycemia
D. Allergic reaction
nmdcat.online BS Nursing
Jun 6, 2026
nmdcat.online BS Nursing
Jun 6, 2026

63. A patient in the ICU has a sudden onset of unresponsiveness and a blood glucose of 30 mg/dL. What is the immediate life-saving nursing intervention?

A. Administer oral glucose
B. Administer IV dextrose (e.g., D50W) stat
C. Administer insulin
D. Administer a diuretic
nmdcat.online BS Nursing
Jun 6, 2026

62. A nurse is managing a patient with an external ventricular drain (EVD). The ICP reading suddenly spikes from 12 mmHg to 30 mmHg. What is the immediate nursing action?

A. Clamp the EVD
B. Assess for causes (e.g., agitation, coughing, EVD obstruction), ensure proper EVD drainage, and notify physician
C. Lower the head of the bed
D. Administer more fluid
nmdcat.online BS Nursing
Jun 6, 2026

61. A patient is admitted to the ICU with acute respiratory failure requiring mechanical ventilation. What is the critical nursing intervention to prevent ventilator-associated pneumonia (VAP)?

A. Supine positioning
B. Elevate head of bed 30-45 degrees, daily sedation holidays, oral care with chlorhexidine, and DVT/stress ulcer prophylaxis
C. Frequent suctioning only
D. Allowing patient to self-extubate
nmdcat.online BS Nursing
Jun 6, 2026

60. A patient with an acute ST-elevation myocardial infarction (STEMI) receives fibrinolytic therapy. The nurse observes new onset of neurological deficits (e.g., slurred speech, facial droop). What medicinal complication is urgent?

A. Allergic reaction
B. Intracranial hemorrhage, requiring immediate discontinuation of fibrinolytic and urgent CT scan
C. Reperfusion arrhythmia
D. Hypoglycemia
nmdcat.online BS Nursing
Jun 6, 2026

59. A patient in hypovolemic shock is receiving rapid IV fluid resuscitation. The nurse notes the patient is developing signs of fluid overload (e.g., crackles, dyspnea, elevated CVP). What is the immediate nursing action?

A. Administer more fluids
B. Slow down or stop fluid administration, elevate head of bed, and notify physician
C. Administer a vasopressor
D. Administer an antibiotic
nmdcat.online BS Nursing
Jun 6, 2026

58. A patient is on mechanical ventilation and receiving continuous enteral feedings. The gastric residual volume (GRV) is consistently high (e.g., >500 mL). What is the clinical concern?

A. Patient is absorbing nutrients well
B. Delayed gastric emptying and high risk of aspiration
C. Patient is dehydrated
D. Patient is hungry
nmdcat.online BS Nursing
Jun 6, 2026

57. A patient with a severe traumatic brain injury has an ICP of 20 mmHg. The nurse observes the patient is becoming increasingly agitated. What is the critical nursing action?

A. Increase environmental stimulation
B. Assess for pain, discomfort, or other causes of agitation, and administer analgesia/sedation as ordered to prevent further ICP elevation
C. Apply physical restraints immediately
D. Administer a diuretic
nmdcat.online BS Nursing
Jun 6, 2026

56. A patient is admitted to the ICU with severe rhabdomyolysis. The nurse observes dark, tea-colored urine and a rising creatinine level. What is the most urgent medicinal intervention?

A. Administer a diuretic
B. Aggressive intravenous fluid resuscitation to prevent acute kidney injury
C. Administer antibiotics
D. Administer a vasoconstrictor
nmdcat.online BS Nursing
Jun 6, 2026

55. A nurse is monitoring a patient on an arterial line. The patient’s mean arterial pressure (MAP) suddenly drops from 70 mmHg to 45 mmHg. What is the immediate nursing action?

A. Re-zero the transducer
B. Assess the patient's clinical status, check for bleeding/disconnection, and initiate rapid fluid bolus or vasopressor as ordered
C. Administer a diuretic
D. Calibrate the monitor
nmdcat.online BS Nursing
Jun 6, 2026

53. A patient with severe respiratory failure is unresponsive to conventional ventilation and has worsening hypoxemia. What urgent intervention might be considered as ordered by the physician?

A. Increase sedation only
B. Preparation for proning or ECMO
C. Discontinuation of ventilator
D. Administration of diuretics
nmdcat.online BS Nursing
Jun 6, 2026
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