‫تمريض كريتكال‬

1) Lecture of DR salwa

1-Introduction 2- DKA 3-MI 4- ICP 5-GIT bleeding

1-Introduction
Q1: What the Critical care nursing :-

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Q2: What the aim aims of Intensive and Critical Care:

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Q3: Definition OF Critical care :-

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Q4: Definition OF Critical Illness :-

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Q5: Definition OF Critically ill patient :-

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Q6: What is Principles of Critical Care Nursing:

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Q7: Who needs critical care?

-Sever :- 1………………….. 2-………………… -Serious :- 1………………….. 2-…………………

-Failure: 1……………………………………. 2………………………………………. 3…………..…………………………..

-3 S : 1 ………………..…………………. 2………………………………………. 3…………………………………..

Q8 : Who is Critical care nurse

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Q9 : What is Roles of critical care nurse

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Q10 : What is functions of critical care nurse

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Q1 :What is the Aim of critical care?

a) Administering medications
b) Monitoring vital signs
c) promote excellence of care of critically ill patients
d) Conducting research
Q2 : Which of the following is NOT a common reason for admission to the ICU?

a) Respiratory failure
b) Septic shock
c) Diabetic ketoacidosis
d) Uncomplicated fracture
Q3 : What is the role of the critical care nurse in end-of-life care?

a) Making decisions about life support

b) Advocating for the patient's wishes
c) Notifying the patient's family about the prognosis
d) All of the above
Q4 : What is critical care nursing?

a. The care of patients with chronic illnesses

b. The care of patients with terminal illnesses
c. The care of patients who are acutely ill or unstable
d. The care of patients with mental health disorders

Q5 : What are some common medical conditions that require critical care?

a. Hypertension and diabetes

b. Cancer and heart disease
c. Sepsis and respiratory failure
d. Depression and anxiety
Q6 : What is the importance of continuing education in critical care nursing?

a. It allows nurses to specialize in a particular area of critical care

b. It ensures that nurses are up-to-date with the latest treatments and technologies
c. It is a requirement for maintaining nursing licensure
d. It helps nurses earn higher salaries

1-C 2-D 3-B 4- C 5-C 6-B

2-DKA
Q1: Definition OF DKA :-

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Q2 : Causes OF DKA :-

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Q3 :What are the signs and symptoms of DKA?

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Q4 : Treatment of DKA includes:

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Q5 : How to prevent DKA :-

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Q6 : Nursing Diagnoses for DKA :-

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 3- MI

Q1: Definition OF MI :-

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Q2 : Causes OF MI :-

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Q3 : Who is most at risk?

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Q4 : Type of MI

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Q5 : What are LDL and HDL cholesterol?

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Q6 : Clinical manifestations OF MI

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Q7 : Diagnostic test:

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Q8 : Myocardial Infarction Treatment

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Q9 : Surgical and other procedures:

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Q10 : Complications of myocardial infarction:

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Q11 : Nursing Diagnoses for MI :-

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1) The nurse is caring for a client diagnosed with MI who is experiencing chest pain. Which interventions
should the nurse implement first? (select all that apply)

a. Administer morphine sulfate intramusculary. b. Administer an aspirin orally.

c. Apply O2 via nasal cannula. d. Place the client in a supine position.

e. Administer nitroglycerin subcutaneously.

2) The client comes into the emergency department saying, “I’m having a heart attack”. Which question
is most pertinent when assessing the client?

a. “Can you describe the chest pain?”.

b. “What were you doing when the pain started?”.

c. “Did you have a high-fat meal today?”.

d. “Does the pain get worse when you lie down?”.

3 )Which of the following is the most common symptom of MI?

a. Chest pain. b. Dyspnea c. Edema. d. Palpitations.

4) Medical treatment of coronary artery disease includes which of the following procedures?

a. Cardiac catheterization. b. Coronary artery bypass surgery.

c. Oral medication therapy. d. Percutaneous transluminal coronary angioplasty.

5) The healthcare provider prescribes Nitroglycerin ointment to be applied topically every 8 hours for a
client who was admitted for chest pain and a MI. Which statement, if made by the client, would indicate
understanding of the side effects of nitroglycerin ointment? I may experience:

a. A headache. b. Increased BP readings.

c. A slow Pulse rate. d. Confusion.

6) What is the most common complication of MI?

a. Cardiogenic shock. b. Heart failure. c. Arrhythmia. d. pericarditis

7) An ECG is prescribed for a client who reports chest pain. What early finding does the nurse expect on
the lead over the infarcted area?

a. Flattened T waves. b. Absence of P waves.

c. Elevated ST segments. d. Disappearance of Q waves.

8) Which of the following actions is the first priority of care for a client exhibiting signs & symptoms of
coronary artery disease?

a. Decrease anxiety. b. Enhance myocardial oxygenation.

c. Administer sublingual nitroglycerin. d. Educate the client about his symptoms.

9) A client arrives at the emergency room complaining of chest pain and dizziness. The client has a
history of angina. The healthcare provider prescribes an ECG & lab tests. A change in which component
of the ECG tracing should the nurse recognize as the client actively having a MI?

a. QRS complex. b. ST segment. c. P wave. d. R wave.

10) A client admitted to the hospital for chest pain is diagnosed with angina. The nurse should teach the
client that the most common characteristic of anginal pain is that it is:

a. Relieved by rest. b. Precipitated by light activity.

c. Described by sharp or knife-like. d. Unaffected by the administration of vasodilators.

11) What is the first intervention for a client experiencing MI?

a. Administer morphine. b. Administer oxygen.

c. Administer sublingual nitroglycerin. d. Obtain an ECG.

12) The nurse teaches the client that: the major difference between angina and pain associated with MI
is that:

a. Angina is relieved with nitroglycerin and rest. b. Angina can be fatal.

c. MI pain always radiates to the left arm or jaw. d. MI pain can’t be treated

13) What is the primary reason for administering morphine to a client with an MI?

a. To sedate the client. b. To decrease the client’s pain.

c. To decrease the client’s anxiety. d. To decrease oxygen demand on the client’s heart

14) What is a myocardial infarction (MI)?

a. A type of arrhythmia b. A type of chest pain caused by reduced blood flow to the heart

c. A type of stroke d. A heart attack

15)What is the most common cause of MI?

a. Coronary artery disease (CAD) b. Heart failure

c. Aortic stenosis d. Mitral valve prolapse

16) What are the different types of MI?

a. ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI) b. Acute, chronic, and refractory

c. Mild, moderate, and severe d. There is only one type of MI

17) What is the difference between STEMI and NSTEMI?

a. STEMI is caused by a complete blockage of a coronary artery, while NSTEMI is caused by a partial
blockage

b. STEMI is a chronic condition, while NSTEMI is an acute condition

c. STEMI is treated with surgery, while NSTEMI is treated with medications

d. There is no difference between the two types of MI

18) What are some risk factors for MI?

a. Age, family history, and smoking b. High blood pressure, diabetes, and obesity

c. High cholesterol, sedentary lifestyle, and poor diet d. All of the above

19) What is the goal of treatment for MI?

a. To restore blood flow to the heart and prevent further damage

b. To cure the underlying cause of the heart attack

c. To prevent the development of atherosclerosis

d. To reduce the risk of stroke

20) What are some medications used to treat MI?

a. Aspirin, nitroglycerin, and beta-blockers b. Clopidogrel, heparin, and statins

c. ACE inhibitors, diuretics, and calcium channel blockers d. All of the above

21) What is the role of the nurse in managing MI?

a. To monitor vital signs and symptoms b. To administer medications as ordered

c. To educate the patient about lifestyle changes to reduce risk factors d. All of the

22) What is the difference between stable angina and MI?

a. Stable angina is caused by a partial blockage of a coronary artery, while MI is caused by a complete
blockage
b. Stable angina is relieved by rest or medication, while MI is not

c. Stable angina is a chronic condition, while MI is an acute condition

d. There is no difference between the two conditions

23 ) What is the purpose of a cardiac catheterization in diagnosing and treating MI?

a. To visualize the coronary arteries and identify blockages

b. To measure heart rate and blood pressure during exercise

c. To measure the amount of oxygen in the blood

d. To diagnose arrhythmias

24) What is the mechanism of action of aspirin in treating MI?

a. It inhibits platelet aggregation and reduces the risk of blood clots

b. It dilates blood vessels and increases blood flow to the heart

c. It reduces heart rate and contractility, and decreases oxygen demand

d. It reduces cholesterol levels and prevents atherosclerosis

25) What is the mechanism of action of beta-blockers in treating MI?

a. They dilate blood vessels and increase blood flow to the heart

b. They reduce heart rate and contractility, and decrease oxygen demand

c. They inhibit platelet aggregation and reduce the risk of blood clots

d. They reduce cholesterol levels and prevent atherosclerosisAnswer:

26) What is the difference between a Q-wave and non-Q-wave MI?

a. A Q-wave MI is more severe than a non-Q-wave MI

b. A Q-wave MI is caused by a complete blockage of a coronary artery, while a non-Q-wave MI is caused by

a partial blockage

c. A Q-wave MI causes permanent damage, while a non-Q-wave MI causes reversible damage

d. There is no difference between the two types of MI

27) What is the purpose of an exercise stress test in diagnosing MI?

a. To measure heart rate and blood pressure during exercise

b. To visualize the coronary arteries using imaging techniques

c. To measure the amount of oxygen in the blood

d. To diagnose arrhythmias
28) What are some potential complications of MI?

a. Heart failure, arrhythmias, and cardiogenic shock

b. Stroke, pulmonary embolism, and deep vein thrombosis

c. Pneumonia, sepsis, and renal failure

d. All of the above

29) What is the role of cardiac enzymes in diagnosing MI?

a. To identify areas of ischemia in the heart

b. To measure the amount of oxygen in the blood

c. To diagnose arrhythmias

d. To identify damage to heart muscle cells

1-A,C 2-A 3-A 4-C 5-A 6-C 7-C 8-B 9-B 10-A
11-B 12- A 13-D 14-D 15-A 16-A 17-A 18-D 19-A 20-D
21-D 22-A 23-A 24-A 25-B 26-C 27-A 28-A 29-D

4- ICP
Q1 : What is increased intracranial pressure (ICP)?

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Q2 : Causes of increased intracranial pressure:

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Q3 : Symptoms of ICP:
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Q4 : How is ICP DIAGNOSEDE ?

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Q5 : How is ICP treated?
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Q6 : What are the complications of ICP?

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1) The nurse is positioning the female client with increased ICP. Which of the following positions would
the nurse avoid?

a. Head turned to the side. b. Neck in neutral position.

c. Head of bed elevated 30 to 45 degrees. d. Head midline.

2) Kate with severe head injury is being monitoring by nurse for increasing ICP , which should be most
indicative sign of increased ICP

a. polydipsia b. increase restlessness

c. tachypnea d . intermittent tachycardia

3) What is increased intracranial pressure (ICP)?

a. A condition where there is too much cerebrospinal fluid in the brain

b. A condition where there is too little blood flow to the brain

c. A condition where there is too much pressure inside the skull

d. A condition where there is too little oxygen in the brain

4)What are some common causes of increased ICP?

a. Traumatic brain injury b. Brain tumors

c. Cerebral edema d. All of the above

5)What are some signs and symptoms of increased ICP?

a. Headache and nausea b. Confusion and altered mental status

c. Seizures and coma d. All of the above

6) What is the role of the nurse in managing increased ICP?

a. To monitor neurological status and vital signs

b. To administer medications for pain and sedation

c. To position the patient to promote venous drainage from the brain

d. All of the above

7) What are some medications used to manage increased ICP?

a. Mannitol and hypertonic saline b. Anticoagulants and antiplatelets

c. Antiepileptic drugs and beta-blockers d. All of the above

8)What is the normal range for intracranial pressure?

a. 0-5 mmHg b. 5-15 mmHg

c. 15-25 mmHg d. 25-35 mmHg

9)What is the purpose of a ventriculostomy in managing increased ICP?

a. To drain cerebrospinal fluid and reduce ICP b. To deliver medications directly to the brain

c. To monitor cerebral blood flow and oxygenation d. All of the above

10) What are some potential complications of increased ICP?

a. Brain herniation and cerebral ischemia b. Seizures and intracerebral hemorrhage

c. Neurogenic shock and respiratory failure d. All of the above

11) How is increased ICP diagnosed?

a. Through a physical exam and patient history

b. Through imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI)

c. Through laboratory tests such as arterial blood gas (ABG) analysis

d. There is no definitive test for increased ICP

1-A 2-B 3-C 4-D 5-D 6-D 7-A 8-B 9-A 10-A 11-B

5-GIT bleeding
Q1: Definition Upper gastrointestinal bleeding: :-

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Q2 : Major risk factors for PUD:

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Q3 : Causes of upper GIT bleeding:

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Q4 :- Symptoms:
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Q5 : Diagnostic procedures:
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Q6 : Upper gastrointestinal bleeding management

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Q7: Definition LOWER gastrointestinal bleeding: :-

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Q8 : Causes of lower GI bleeding:

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Q9 Clinical features of GIT bleeding

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Q10 : Diagnosing lower GI bleeding:

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Q11 : Management of lower GIT:

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Q12 : Complications OF GIT bleeding

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Q13 : Common Nursing diagnosis related to GIT bleeding:

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1) Which of the following is a common sign of GI bleeding?

a. Bradycardia b. Hypertension

c. Tachycardia d. Hypotension

2)Which of the following is a common symptom of upper GI bleeding?

a. Hematochezia b. Melena

c. Abdominal pain d. Diarrhea

3) Which of the following is a common symptom of lower GI bleeding?

a. Hematochezia b. Melena

c. Abdominal pain d. Diarrhea

4) What is the most common cause of non-variceal upper GI bleeding?

a. Peptic ulcer disease b. Esophageal varices

c. Mallory-Weiss tear d. Gastric cancer

5) What is the most common cause of variceal upper GI bleeding?

a. Peptic ulcer b. Esophageal varices

c. Mallory-Weiss tear d. Gastric cancer

6 )Which of the following is a common complication of GI bleeding?

a. Hypertension b. Hypovolemic shock

c. Hypernatremia d. Hyperkalemia

7)Which of the following is a common laboratory finding in GI bleeding?

a. Hypoglycemia b. Hypernatremia

c. Hypocalcemia d. Anemia

8) Which of the following is a common method of GI bleeding diagnosis?

a. Colonoscopy b. Magnetic resonance imaging (MRI)

c. Electrocardiogram (ECG) d. Pulmonary function test (PFT)

9) Which of the following is a common method of GI bleeding treatment?

a. Fluid resuscitation b. Diuretic therapy

c. Vasodilator therapy d. Antihypertensive therapy

10 )Which of the following is a common method of endoscopic treatment for GI bleeding?

a. Band ligation b. Antibiotic therapy

c. Topical ointments d. Immobilization

11) Which of the following is a common method of surgical treatment for GI bleeding?

a. Laparoscopy b. Colonoscopy

c. Endoscopy d. Angiography

12) Which of the following is a common method of pharmacological treatment for GI bleeding?

a. H2 blockers b. Antihypertensives

c. Antidepressants d. Antihistamines

13 ) Which of the following is a common method of interventional radiology treatment for GI bleeding?

a. Endovascular embolization b. Hemodialysis

c. Continuous positive airway pressure (CPAP ) d. Lumbar puncture

14) What is the primary method of prevention for GI bleeding?

a. Vaccination b. Education and awareness

c. Antibiotic prophylaxis d. Surgery

15) Which of the following is a common complication of GI bleeding?

a. Hypertension b. Hypernatremia

c. Hypothermia d. Infection
16) Which of the following is a common long-term complication of GI bleeding?

a. Chronic pain b. Hypertension

c. Hypothermia d. Iron deficiency anemia

17) Which of the following is a common psychological complication of GI bleeding?

a. Depressi b. Hypertension

c. Hypothermiad d. Anxiety

18) Which of the following is a common cause of upper GI bleeding?

a. Diverticulitis b. Peptic ulcer disease

c. Inflammatory bowel disease d. Colon cancer

19) Which of the following is a common cause of lower GI bleeding?

a. Hemorrhoids b. Pancreatitis

c. Cirrhosis d. Gallstones

20) How ‘re ulcerative colitis & Crohn’s disease definitively diagnosed?

a. EGD. b. CBC. c. Colonoscopy. d. Stool sample.

21) Which of the following isn’t a complication of peptic ulcer disease?

a. Perforation. b. GI bleeding. c. Pyloric obstruction. d. Pain.

22) Which solution would be the most appropriate initial volume replacement for a patient with sever GI
bleeding?

a. 200 ml of Saline 0.9% (NS) per hours for 5 hours.

b. 1 liter of Ringer’s lactate (RL) over 15 minutes.

c. 2 liter of Glucose 5% (D5W) over 30 minutes.

d. 500 ml of Saline 0.15% (½NS) over 30 minutes.

23) A 50-years-old may vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To
determine possible risk factors for gastritis, the nurse will ask the patient about.

a. The amount of saturated fat in the diet.

b. Any family history of gastric or colon cancer.

c. A history of a large recent weight gain or loss.

d. Use non-steroidal anti-inflammatory drugs (NSAIDs)

24) The nurse will anticipate preparing a 71-year-old female patient who is vomiting “cofee-ground”
emesis for:

a. Endoscopy. b. Angiography. c. Barium studies. d. Gastric analysis.

25) A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the
patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action
should the nurse take?

a. Irrigate the NG tube. b. Check vital signs.

c. Give the ordered antacid. d. Elevate the foot of the bed.

1-C 2-B 3-A 4-A 5-B 6-B 7-D 8-A 9-A 10-A
12-A 13-A 14-B 15-D 16-D 17-A 18-B 19-A 02-C 21-D
22-D 23-D 24-A 25-B