Download Semester 2, 2015/16 - University of Bolton

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UNIVERSITY OF BOLTON
SCHOOL OF HEALTH & HUMAN SCIENCES
SEMESTER TWO EXAMINATION 2016
MANAGING THE ACUTELY ILL PATIENT
MODULE NO: HLT 6005
Date: Wednesday 11th May 2016
INSTRUCTIONS TO CANDIDATES:
Time: 5.00pm-6.30pm
There are 50 questions.
Answer 50 questions.
All questions carry equal marks.
Page 2 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
1. What is the function of the cell membrane?
A.
B.
C.
D.
E.
Regulates the transition of proteins
Contains genes, regulates metabolism
Produces proteins
Synthesises carbohydrate molecules
It serves as the cells external boundary, separating it from other cells & from
the external environment
2. What are the Two used medications in the cardiac arrest algorithm:
A.
B.
C.
D.
E.
Amoxicillin and adrenaline
Atropine and amlodipine
Diazepam and atropine
Adrenaline and amiodarone
Amiodarone and diazepam
3. Compensation or illness can be defined best by which of the following?
A.
B.
C.
D.
E.
The body’s inability to maintain homeostasis
The body working harder to maintain homeostasis
The point at which only medical assistance can reverse a disease
The point at which blood pressure falls
All of the above
4. Which one of the following is an early sign that a compensatory mechanism has
been activated in response to blood loss?
A.
B.
C.
D.
E.
Urine output will be reduced
Systolic blood pressure will fall
The respiratory rate will be reduced
Capillary refill will be less than 2 seconds
The mean arterial pressure will be less than 60 mmHg
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Page 3 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
5. Adenosine Triphosphate (ATP) is generated in the;
A.
B.
C.
D.
E.
Mitochondria
Lysosomes
Centrosomes
Ribosomes
Vacuole
6. Shock is a term that is always characterised by which one of the following?
A.
B.
C.
D.
E.
An increase in blood volume
A decrease in effective circulating blood volume
A reduction in blood volume
A reduction in heart rate
An obstruction to blood flow
7. Which one of the following makes up the perfusion triad?
A.
B.
C.
D.
E.
Cardiac pump, blood volume, respiratory rate
Blood volume, plasma volume, interstitial volume
Intravascular fluid, interstitial fluid, intracellular fluid
Cardiac pump, blood volume, peripheral vascular resistance
Muffled heart sound, low blood pressure, jugular vein distension
8. Which one is NOT part of the sepsis six guideline?
A.
B.
C.
D.
E.
Give High- flow oxygen
Take blood cultures
Give IV Anti-biotic
Start IV Fluid resuscitation
Check Troponin
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Page 4 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
9. An elevated level of carbon dioxide in the blood will be represented by which
blood gas
A.
B.
C.
D.
E.
pH – 7.20, p02 – 7.5, pCo2 – 15, HCO3 - 23
pH – 7.35, pO2 – 8.5, pCO2 – 7.5, HCO3 -24
pH – 7.50, pO2 – 10, pCO2 – 6.5, HCO3 – 22
pH – 7.32, pO2 – 11, pCO2 – 10, HCO3 – 24
pH – 7.25, pO2 – 13, pC02 – 9,
HCO3 – 24
10. Which fluid is the safest to use for the immediate replacement of blood volume?
A.
B.
C.
D.
E.
Glucose 5%
Haemaccel
Dextran
Sodium Chloride 0.9%
Sodium Chloride 1.45%
11. Which one of the following observations will directly assess how well a person is
oxygenating?
A.
B.
C.
D.
E.
Pulse pressure
Blood pressure
Oxygen saturation
Capillary refill
Respiratory rate
12. Chemoreceptors are responsible for monitoring which of the following;
A.
B.
C.
D.
E.
Chemical concentration
Body Temperature
Osmotic pressure
Pressure
Fluid balance
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Page 5 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
13. The fluid compartments classified in the body are correctly classified as;
A.
B.
C.
D.
E.
Intracellular, intravenous, intrathecal,
First space, second space, third space
Intravascular, interstitial, intracellular
Arterial, capillary, venous
Intracellular
14. In which fluid compartment is the majority of the bodies’ water stored?
A.
B.
C.
D.
E.
Extracellular
Third space
Interstitial
Intravascular
Intracellular
15. What is the function of the pancreas in the negative feedback loop?
A.
B.
C.
D.
E.
Maintaining oxygen
Compensation
Homeostatic control
Blood glucose and insulin regulation.
Releasing Oxytocin
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Page 6 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
16. Look at the image shown. What is the name of the structure shown by the arrow
labelled “11”?
A.
B.
C.
D.
E.
Cricoid cartilage
Trachea
Thyroid cartilage
Vocal fold
Glottis
17. Ventilation refers to which one of the following?
A. Movement of air between the environment and the lungs
B. Intracellular movement of air
C. Extracellular movement of air.
D. Movement of carbon dioxide around the body
E. Movement of oxygen around the body.
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Page 7 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
18. Name the piece of equipment in the following picture:
A. Laryngeal mask
B. Airway insertion device
C. I-gel
D. Naso-pharyngeal airway
E. Oro-pharyngeal airway
19. Which of the following best describes what processes occur during the
generation of a P- wave on an ECG?
A.
B.
C.
D.
E.
The whole of the heart muscle repolarises
The heart is at complete rest
Atrial depolarisation
Ventricular depolarization
The atrioventricular node initiates a contraction
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Page 8 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
20. Homeostasis can be defined as:
A. The inability of the body to maintain its own environment
B. The condition of a system when it is able to maintain its essential
variables within limits acceptable to its own structure in the face of
unexpected disturbances
C. The balance of oxygen and fluid within the body
D. The process through which cell energy is produced
E. The process that prevents inflammation in healthy tissues
21. What does the acronym AVPU stand for?
A.
B.
C.
D.
E.
Air ventilation pulse urine output
Alert variant professionals understanding
Airway vented patient unconsciousness
Alert voice pain unresponsive
Air voice pain unresponsive
22. A pulse oximeter measures which of the following?
A. The amount of O2 in the arteries
B. The amount of O2 passing through the heart
C. The amount of O2 attached to haemoglobin passing through the tissues
D. The amount of red bold cells passing through the tissues
E. The percentage of O2 in the blood which passes through the lungs
23. Which of the following improves outcomes for the patient in the event of a
‘Ventricular Tachycardia’ (VT) cardiac arrest?
A. Early rescue breaths
B. Early chest compressions
C. Early call for help
D. Early defibrillation
E. Early oxygen delivery
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Page 9 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
24. Which one of the following observations is not part of the minimum data set that
should be obtained as a part of screening acutely ill patients?
A.
B.
C.
D.
E.
Urine Output
Respiratory Rate
Blood Pressure
Peak expiratory flow
Pulse rate
25. Systemic inflammatory response syndrome (SIRS) occurs when /is characterised
by
A. Increased organ perfusion
B. Increased blood pressure
C. reduced platelet activation
D. Localised activation of inflammation
E. Widespread activation of the inflammatory process leading to reduced
blood pressure and organ perfusion.
26. Type 2 respiratory failure is characterised by which of the following?
A. Decreased O2 and increased Co2
B. Decreased O2 and decreased Co2
C. Increased O2 and increased Co2
D. Increased O2 and decreased Co2
E. None of the above
27. A low level of oxygen in the blood is referred to as which one of the following?
A.
B.
C.
D.
E.
Hypoxia
Hypercapnia
Hypoxemia
Hypocapnia
Hyperopia
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Page 10 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
28. Mean Arterial Pressure represents;
A.
B.
C.
D.
E.
The difference between the systolic and diastolic pressure
The pulse pressure
The perfusion pressure of blood at tissue level
Both B and C
The osmotic pressure in the venous system
29. A patient whom you are caring has physiological observations of; respiratory
rate- 18 breaths per minute; pulse 82 beats per minute; BP 110/66 mmHg. Which
one of the following statements is true?
A. The patient has observations which suggest that they are
haemodynamically stable.
B. There is insufficient information provided in order to make a reasoned
assessment of this patients’ needs
C. The patient is likely to be physiological unstable
D. A doctor or outreach nurse team should be made aware of this patient
E. The patient should receive four hourly observations
30. Which one of the following is a sign of an upper airway obstruction?
A.
B.
C.
D.
E.
Chest pain
Low blood pressure
Unequal chest expansion
Vomiting
Snoring sounds
31. Read the following definition and decide which of the following terms it is
explaining;
“The ability of a system to maintain its essential variables within limits acceptable
to its own structure in the face of unexpected disturbances”
A.
B.
C.
D.
E.
The perfusion triad
Compensation
Positive feedback
Homeostasis
Negative feedback
PLEASE TURN THE PAGE
Page 11 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
32. A blood small blood loss, of
on blood pressure?
300 ml, will have which one of the following effects
A. The systolic pressure will rise
B .No effect on blood pressure will be seen due to a small blood loss
C. The Diastolic pressure will rise
D .The systolic pressure will fall
E .The mean arterial pressure will reduce
33. A widening pulse press is a sign of:
A .Vasodilation
B. Vasoconstriction
C. Hypotension
D. Hypertension
E .Hypercapnia
34.Chest expansion will be reduced in which of the following conditions?
A.
B.
C.
D.
E.
Tension pneumothorax
Pulmonary oedema
Metabolic acidosis
Pulmonary embolism
Cor pulmonale
35. ABCDE stands for:
A.
B.
C.
D.
E.
Airway, body, circulation, disability, examination
Airway, breathing, circulation, disability, exposure
Agony, breathing, circulation, death, exposure
Airway, breathing, circulation, disability, examination
Anaphylaxis, body, colour, death, examination
PLEASE TURN THE PAGE
Page 12 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
36 . What are the key components of a breathing assessment?
A.
B.
C.
D.
E.
The use of accessory muscles
The rate, rhythm and depth of respiration
The shape and expansion of the chest
The colour of a patients skin and mucous membrane
All of the above
37. In a person with anaphylactic shock which one of the following best describes
what happens to the total volume of body water?
A.
B.
C.
D.
E.
Total body water volume is reduced
Total body water volume is increased
Total body water volume remains the same, it is just wrongly distributed
The blood volume is increased
The body water volume becomes more concentrated
38. Effective capillary refill time is:
A.
B.
C.
D.
E.
Less than 2 seconds
Less than 4 seconds
Less than 6 second
Less than 8 seconds
Less than 10 seconds
39. Which of the following is not a classification of shock?
A. Hypovolemic
B. Neurogenic
C. Obstructive
D. Septic
E. Compensator
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Page 13 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
40. Look at the image shown. What is the name of the structure shown by the arrow
labelled “9”?
A.
B.
C.
D.
E.
Glottis
Epiglottis
Tongue
Larynx
Trachea
PLEASE TURN THE PAGE
Page 14 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
41. Who is responsible for defibrillating a patient?
A. The doctor
B. The senior nurse
C. The anaesthetist
D. Anyone who is trained in the use of a defibrillator
E. The cardiologist
42. What factors may need to be considered when monitoring a person’s blood
pressure reading?
A. Age
B. Pregnancy
C. Athletes
D. BP controlled
E. All of the above
43. An increase in heart rate could occur when a person is
A. Dehydrated
B. Asleep
C. Talking quickly
D. Hypothermic
E. Bradycardic
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Page 15 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
44. In the image below, the device labeled with the letter “B” should NOT be used in
patients with which one of the following?
A .Bleeding disorder or those taking anticoagulants
B. Fractured base of skull
C. Patient who have pneumothorax
D. Semi-conscious patients
E. Patients with severe chest injuries
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Page 16 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
45. If inflammation is widespread in the body which one of the following effects will it
have on the blood pressure?
A. Decrease the blood pressure
B. Increase the blood pressure
C .Be clinically undetectable
D. Decrease the pulse rate
E .Increase the SpO2%
46 . A patient who is in shock will normally have which one of the following?
A. A reduced urine output
B. A prolonged capillary refill time
C. A rapid heart rate
D. A rapid respiratory rate
E. All of the above
47. In a person with septic shock, which one of the following principally occurs and
leads to a reduction in blood flow?
A.
B.
C.
D.
E.
Vasodilation and a leak of fluid out of vasculature and into the tissue
Widespread vasoconstriction
The development of an arrhythmia
Slow pulse
Septic shock does not affect blood flow
48. What is the aim of giving Aspirin to a person with a suspected ‘Acute Coronary
Syndrome?’
A.
B.
C.
D.
E.
Relieve pain
Suppress inflammation
Dissolve blood clots blocking the coronary vessels
Prevent further platelet aggregation
All of the above
PLEASE TURN THE PAGE
Page 17 of 17
School of Health & Human Sciences
Semester Two Examination 2016
Managing the Acutely Ill Patient
Module No. HLT6005
49 . Normal cardiac rhythms originate from:
A.
B.
C.
D.
E.
The Bundle of His
Atrioventricular node
Sinoatrial node
The left Bundle Branches
The Purkinje fibers
50. Look at the image shown. What is the name of the structure shown by the
arrow labelled “10”?
A.
B.
C.
D.
E.
Hypopharynx
Oesophagus
Trachea
Glottis
Nasopharynx
END OF QUESTIONS