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Acute Complex Nursing Care Course exam hints

The following are general hints. Check that you understand the following concepts:
  • Blood gas analysis
  • Lung sounds
  • Glasgow coma scale and neurological assessment

Grey Turners and Cullen’s sign
Pa02 and Sp02 concepts

Intercostal catheter nursing management
Chest pain differences - difference between stable and unstable angina and myocardial infarction
  • Can you recognise the basics of interpretation of chest x-rays such as costophrenic angle, CT ratio, silhouette sign etc.
  • Is density on the chest x-ray – white or black?
  • If a patient has a pneumothorax, what changes would be seen on the chest x-ray and if you were to auscultate his chest, what lung sounds would you hear (or not hear)?
  • If a patient has heart failure, what changes would be seen on the chest x-ray and if you were to auscultate his chest, what lung   sounds would you hear (or not hear)?

If you want to practice your skills at answering multichoice questions, try the following:

If you hear crackles when you auscultate, they are usually caused by:
a)      narrowing of the small airways during inspiration
b)      narrowing of the large airways during expiration
c)       consolidation of the lung tissue
d)      fluid filled alveoli and late opening phase during inspiration      
                              
Bronchial breath sounds heard over the periphery of the lungs may be due to:
a)      normal sounds
b)      emphysema
c)       pneumothorax
d)      consolidation

The client’s arterial blood gas analysis results were as follows:
       pH 7.24,                PCO2  58              HCO3 24  The analysis would be:
a)      respiratory acidosis with complete compensation
b)      metabolic acidosis with complete compensation
c)       respiratory acidosis with no compensation
d)      respiratory alkalosis with partial compensation

The normal range of PaC02 is:
a)      2 to 5 mm Hg
b)      35 to 45 mm Hg.
c)       22 - 26 mEq/L
d)      100 to 150 mEq/L           
                                                                  
A pneumothorax on the chest x-ray is diagnosed by the presence of:
a)      kerley B lines 
b)      white ( opacity) density with lung markings
c)       black density with no lung markings
d)      silhouette sign

A pneumothorax is best defined as:
a)      collection of air in the pleural cavity
b)      collection of blood in the lungs                
c)       collection of blood in the pleural cavity
d)      collection of blood and air in the pleural cavity

During abdominal assessment you note the patient is complaining of generalised abdominal pain, and lying extremely still. Complaining the pain increases when they move. This may lead you to think the patient may have:
a)      acute bowel obstruction
b)      peritonitis
c)       acute pancreatitis
d)      abdominal aortic aneurysm

Troponin is a cardiac enzyme, use to differentiate between:
a)     STEMI and NSTEMI
b)     stable angina and unstable angina
c)      NSTEMI and unstable angina

Other concepts you might like to read about:
Kehrs sign
3 assessment components of the Glasgow coma scale
Explain Unstable angina
Normal range of  Pa02,
Cushings Triad


UNDERGRADUATES
Short Answer questions  
Compulsory question
Principles of Oxygenation and Respiratory Distress

Choose TWO from the following five:
  1. Non invasive positive pressure ventilation
  2. Arterial Blood Gas Analysis
  3. Angina Pectoris
  4. Abdominal Assessment
  5. Pneumothorax and Underwater Seal Drainage System.

Long Answer Questions
Choose ONE from the following two:
  1. Respiratory Case Study
  2. Neurological Case Study

Respiratory case study: Combination of ABG, chest xray, and lung sounds.

Advanced Life Support question for UNDERGRADUATES
You will be asked a long answer question relating to ALS, for example what would the management be and give the reasons (rationale) for your management of a patient who has arrested.

From the course you have learnt that cardiac arrests can be divided into a Fast or (shockable) and Slow (unshockable) arrhythmia. You need to study both arrests and have knowledge of the Australian Resuscitation Council guidelines. Would you also be able to give the rationale for the treatment of arrhythmias. For example what is the rationale for administering Adrenaline 1 mg for asystole or a slow cardiac arrest.
Can you recognise asystole or ventricular tachycardia or PEA on a rhythm strip, are you able to answer questions relating to the treatment of either a fast cardiac arrest or a slow cardiac arrest. 

MASTERS STUDENTS ONLY
Multichoice hints above

Short Answers
Arterial Blood Gas Question compulsory

CHOOSE THREE (3) QUESTIONS FROM THE FOLLOWING FIVE (5) QUESTIONS.   
  1. Principles of Oxygenation: 
  2. Angina Pectoris:
  3. Non-invasive positive pressure ventilation (NIPPV):
  4. Tension Pneumothorax:
  5. Abdominal Assessment:

Compulsory Question:
Cardiac Emergency

Choose and answer only 1 (one) other question from the remaining two (2) questions.
  1. Respiratory Case Study
  2. Neurological

Details of exam:
Date:   18th December Monday
Time:   Commencing at 10.00 am
Venue:  TAFE College Southport - check email for room number 

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