PMS III Practice Quiz 2
PMS III Clinical Knowledge Quiz
Welcome to the PMS III Clinical Knowledge Quiz! This interactive quiz is designed for healthcare professionals to test their knowledge on critical concepts related to patient care, surgical procedures, and emergency responses.
It's time to put your skills to the test! Here are some topics covered:
- Hypothermia and patient populations
- Respiratory distress syndrome in neonates
- Cytokines and inflammatory responses
- Fluid management in various clinical scenarios
Which of the following is not a patient population at risk for hypothermia?
Patients undergoing abdominal surgery
Patients undergoing short procedures
Really young patients
Really old patients
Which condition below could lead to cell lysis, if not properly monitored?
Isotonicity
Hypertonicity
Hypotonicity
None of the options are correct
A pt with respiratory distress syndrome would present with which of the following
CXR with ground glass appearance
Tripod position
Expiratory stridor
CXR with hyperinflation
How many liters of blood are in the body of an average 70kg person?
3L
4L
5L
6L
A baby from the NICU presents with tachypnea, nasal flaring and grunting. You decide to order a CXR and it shows a ground glass appearance. What is your diagnosis?
Epiglottitis
Croup
RDS
PNA
For the above patient, about how soon will these sx present?
Within 1 week
12 hours after birth
Within 4 hours of birth
At any time while in the NICU
An important cytokine to the compensatory anti-inflammatory response syndrome (CARS) is:
IL-1
IL-10
IL-6
TNF- alpha
The most common etiology of croup is:
RSV
Parainfluenza
Enterovirus
Adenovirus
A 50 yo M with a PMH of angina presents to the ED. Vitals show hypotension and tachycardia. On physical exam, you note bounding pulses and warm, flushed, dry skin. The most likely cause of his condition is:
Acute MI
Cardiogenic shock
Anaphylactic shock
Septic shock
In surgery, there is a(n) ____ in ADH level and _____ activation of the RAAS.
Increase; decreased
Increase; increased
Decrease; increased
Decrease; decreased
_____ is an independent risk factor for surgical site infection and increases the risk by 5x.
Low glucose
Older age
Immobilization
Low protein
The presence of stridor during the expiratory phase indicates an obstruction in the _________ area:
Subglottic or glottin
Laryngeal
Cervical
Tracheo-bronchial
How do you treat ophthalmia neonatorum?
Topical erythromycin
Azithromycin 1g IM
PO erythromycin
Amoxicillin 100mg/kg/day BID
This type of blood product is most useful for treating VonWillebrand disease.
FFP
Cryoprecipitate
PRBC
Crystalloid
Which of the following is true about septic shock?
The patient is usually hypotensive and bradycardic
The patient's skin is cool and pale
There is decreased SVR
The pulse is weak and thready
Using the Holiday-Segard calculation method, how much fluid should a 50 kg patient receive daily?
3000 mL
2400 mL
2100 mL
1750 mL
What type of fluid would a patient with severe hyponatremia most likely be started on
Hypotonic
Hypertonic
Isotonic
Colloid
Which of the following is NOT true regarding the primary survey in trauma assessment?
Shold take 2-5 minutes
Provider should perform complete head to toe PE in no specific order
Assess using ABCDE sequence
Assessment includes FAST US scan
_______ solutions cause cell dehydration and help increase fluid in the extracellular space.
Hypotonic
Osmosis
Isotonic
Hypertonic
3 m/o M presents with wheezing and fine crackles on auscultation. Per mother, pt had a recent URI that was treated 2 weeks ago. What should you suspect is going on?
Asthma
PNA
Epiglottitis
Bronchiolitis
Which of the following are patients NOT at risk of contracting due to transfusion?
HIV
Hepatitis B
Parovirus B19
CMV
Which of the following is true about RDS of the newborn?
Risk is directly proportional to gestational age
Stridor is a common finding
Infants born from pregnancy with gestational DM is a risk factor
Grunting is often heard during inspiration
A unique characteristic of ________ shock is the mobilization of blood from the liver as a compensation.
Anaphylactic
Hemorrhagic
Cardiogenic
Septic
A 57 y/o M presents to the ER with DKA. After patient has received NS and insulin, what else should be given to prevent further complication?
D5 1/2 NS
Metformin
Glimepiride
Dextrose 10%
A 45 y/o M is brought to the ED via EMS after a bar fight and sustained multiple abd stab wounds. On exam, pt smells of alcohol, bleeding from stab wounds, tachycardic, BP of 90/60mmHg, and is confused. The extent of the patient’s injuries are not yet life threatening. You suspect pt may have lost _____ amount of blood.
750 mL
1400 mL
1700 mL
2100 mL
Regarding the above patient, which of the following should this patient receive?
Lactated ringer
PRBC
0.45 NaCl
D10W
A patient with cerebral edema would most likely be ordered what type of solution?
3% Saline
0.9% NS
Lactated ringer's
0.22% normal saline
Which of the following is not a major complication of shock?
Acute renal failure
Gut ischemia
DIC
Increased urinary output
Isotonic fluids cause shifting of water from the extracellular space to the intracellular space.
True
False
5 y/o M presents with tachypnea, hypoxia, crackles and wheezing on exam. Pt also reports a non-productive cough. What medication would this patient most likely receive?
Amoxicillin
Vancomycin
Bactrim
Keflex
Which of the following is a crystalloid?
FFP
Cryoprecipitate
Lactated Ringers
Prothrombin complex
Which of the follow is NOT a complication of fluid administration?
Central pontine myelinolysis
Vascular infection
Phlebitis
Dry tongue
Crackles on auscultation
You are the PA-S on call (lucky you) and a nurse calls to inform you that a 5 yo F pt s/p tonsillectomy has a high fever, tachycardia, and muscle rigidity with no sign of infection at the surgery or IV sites. You are a genius, so you know what's wrong and you tell the nurse to administer:
Halothane
Succinylcholine
Dantrolene
Naloxone
This immunologic complication of blood transfusion occurs most commonly with platelets or FFP.
Delayed extravascular hemolytic reaction
Acute intravascular hemolytic reaction
Transfusion associated acute lung injury
Allergic reaction
A patient is being admitted with dehydration due to nausea and vomiting. Which fluid would you expect the patient to be started on?
5% Dextrose in 0.9% Saline
0.33% saline
0.22% saline
0.9% NS
When administering a hypertonic solution the nurse should closely watch for?
Signs of dehydration
Pulmonary edema
Fluid volume deficiency
Increased lactate level
How should you evaluate a pt with suspected epiglottitis?
Visual eam with pt saying "Aaaaa"
Visual exam using tongue depressor
Clinical diagnosis without direct visualization of throat
Child disturbing on PE
When replacing fibrinogen and vWF, which of the following should you use?
Cryoprecipitate
Protrhombin complex concentrate
Fresh frozen plasma
Platelets
Which fluid is commonly used to mix medication?
NS
D5W
Lactated ringers
D10W
RSV is the leading agent for which of the following: *
Bronchiolitis
Croup
PNA
Epiglottitis
Which of the following is NOT true about crystalloid fluids?
It consists mostly of water and electrolytes
The amount given is about equal to the amount lost
Lactated Ringers is an example of a crystalloid fluid
It is generally the first fluid used when a patient is hypovolemic
All of the following are hypertonic solutions except:
3% NaCl
D5 1/2 NaCl
D10W
Lactated ringer
Which of the following is true regarding hypothermia in surgery?
Usually only occurs in extremes of age
Occurs secondary to fluid shifts and anesthesia
More common in those undergoing cardiovascular surgery
Is not the result of inhibition of HPA axis
The doctor orders an isotonic fluid for a patient. Which of the following is not an isotonic fluid?
0.9% Normal Saline
Lactated Ringer's
0.45% Saline
D5 ¼ NaCl
________ fluids remove water from the extracellular space into the intracellular space
Hypotonic
Hypertonic
Isotonic
Colloids
A delayed extravascular hemolytic reaction s/p transfusion would present with which of the following?
Hemoglobinuria
Increased haptoglobin
Urticaria
Leukoagglutinin
T/F: When evaluating acute blood loss, H/H is a reliable parameter.
True
False
2 y/o F presents with a barking cough and stridor on exam. Which neck xray finding would you expect to see?
White out
Steeple sign
Thumb sign
Ground glass
Atelectasis
A 62 yo M patient is s/p hip replacement surgery and he has spiked a post-op fever. You have ruled out any infection, he has been up and ambulating, so you begin to wonder what drugs you gave him that could have caused his fever. A common cause of post-op fever is...
Alpha blockers
Acetaminophen
Cephalosporins
BZD
Which patient below would NOT be a candidate for a hypotonic solution?
Patient with increased intracranial pressure
Patient with Diabetic Ketoacidosis
Patient experiencing Hyperosmolar Hyperglycemia
All of the above options are correct
Which of the following is NOT an indication for platelet transfusion?
Plt. Count 8000 in asymptomatic pt
Plt. Count 16000 w/ a coagulation disorder
Plt. Count 19000 w/ major bleeding
Plt. Count 45000 w/ general surgery
When the cell presents with the same concentration on the inside and outside with no shifting of fluids this is called?
Hypotonic
Hypertonic
Isotonic
Osmosis
Which cytokine is not Pro-inflammatory?
IL-10
TNF-alpha
IL-1
IL-6
D5W solutions are sometimes considered a hypotonic solution as well as an isotonic solution because after the body metabolizes the dextrose the solution acts as a hypotonic solution.
True
False
What is the suspected pathogen causing epiglottitis in a patient who was born in the US and is UTD on their vaccinations with no significant PMH?
Hib
Group A strep
Candida
RSV
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