IMR COMPREHENSIVE EXAM REVIEWER

Credits to Annika Ilao <3

Hand washing is the most important activity that every health care professional and hospital visitor should perform before and after contact with a patient.

a. false

b. true

b. true

PPE necessary for airborne precautions

a. gloves

b. gown

c. N95 mask

d. booties

c. N95 mask

Not all pathogens have an equal probability of inducing disease in the same host population

a. false

b. true

b. true

Examples of pathogens with droplet precautions

a.S. aureus

b.MRSA

c.mumps

d.HIV

c.mumps

Signs and symptoms of infection include

a.all of the above

b.fever

c.skin rash

d.purulent discharge

a.all of the above

Occurs when disease-causing organisms are so small that they are capable of floating on air currents

a.vehicle transmission

b.contact transmission

c.airborne transmission

d.droplet transmission

c.airobone transmission

Advantages of hand rubbing include

a.requires less time

b.all of the above

c.causes less damage to the skin

d.more effective than soap and water

b.all of the above

Direct transfer of microorganism that come into physical contact either by skin-to-skin contact or mucous membrane-to-mucous membrane contact

a.droplet transmission

b.airborne transmission

c.vehicle transmission

d.contact transmission

d.contact transmission

Wear gown to protect skin and clothing during procedures or activities where contact with blood and body fluids is anticipated

a.true

b.false

a.true

In the chain of transmission infection begins with transmission of a pathogen to the host.

a.false

b.true

b.true

These are skills in patient care

a.bed making

b.positioning

c.draping

d.all of the above

d.all of the above

In bed making the middle sheet from bottom to top is the

a.none of the above

b.top sheet

c.foundation sheet

d.draw sheet

d.draw sheet

Common soft-tissue contracture for supine patients

a.shoulder flexors

b.hip internal rotators

c.hip and knee flexors

d.ankle dorsiflexors

c.hip and knee flexors

Not a component of patient care

a.patient preparation

b.management of the environment

c.body mechanics

d.none of the above

d.none of the above

Parts of the bed include

a.headrest

b.siderails

c.hand-cranks

d.all of the above

d.all of the above

Areas of greater pressure for the spine and trunk EXCEPT

a.posterior iliac crest

b.medial epicondyle of the humerus

c.spine of scapula

d.sacrum

b.medial epicondyle of the humerus

Not a purpose for draping

a.expose or free an area to be treated

b.address modesty concerns

c.maintain a comfortable body temperature

d.provides support and stability

d.provides support and stability

Type of bed that is ready to be occupied

a.all of the above

b.closed bed

c.open bed

d.anesthetic bed

c.open bed

Mobility activities can be done independently or with assist

a.false

b.true

b.true

Importance of mobility activities include

a.effective and safest way to move from place to place

b.help the patient to move one place to another

c.all of the above

d.prevent negative effect of immobility

c.all of the above

When taking blood pressure what artery should you locate and palpate?

a.Radial

b.Ulnar

c.Axillary

d.Brachial

d.Brachial

Which of the following should be assessed without the patient's knowledge?

a.Pulse rate

b.Respiratory rate

c.Blood pressure

d.Temperature

b.Respiratory rate

Which of the following route of monitoring temperature would give you the highest reading?

a.Forehead

b.Axillary

c.Oral

d.Rectal

d.Rectal

What should be done regularly when using a aneroid instrument for blood pressure monitoring?

a.Recalibration of the dial

b.Replacement of the bladder

c.Replacement of the bulb

d.Washing of the cuff

a.Recalibration of the dial

In heart rate monitoring, if the rate and rhythm is irregular, how many seconds should you continue counting?

a.60

b.10

c.15

d.30

a.60

If the two extremities have different blood pressure reading which side will be y our reference point?

a.The one with the lower reading

b.Either side, as long as you're consistent

c.Average of the two readings taken from both sides

d.The one with the higher reading

d.The one with the higher reading

In taking the pulse pressure which artery should be used for monitoring?a.Brachial

b.Ulnar

c.Axillary

d.Radial

d.Radial

Which of the following is a normal blood pressure?

a.150/100

b.115/70

c.140/90

d.90/50

b.115/70

Which of the following is a normal respiratory rate in an adult?

a.30

b.10

c.16

d.22

c.16

In taking the vital signs

which of the following should be done first?

a.Oxygen saturation

b.Respiratory rate

c.Pulse rate

d.Temperature

c.Pulse rate

The draw sheet is placed under the head to feet

a.false

b.true

a.false

Keep knees straight your back in neutral position and lock your arms to assist the lift.

a.true

b.false

b.false

The right way to position a patient in bed

a.place a small pillow under the calf

b.all of the above

c.place a small pillow under the knees

d.place the strong arm and elbow on a pillow

a.place a small pillow under the calf

When moving an unconscious person with a partner step 1 is to tell the person what you are going to do even if he is unconscious

a.true

b.false

b.false

When sitting up a patient the following should be done

a.bend the person's knees

b.roll him on his side so that he is facing you

c.all of the above

d.tell the person what you are going to do

c.all of the above

Steps in rolling technique except

a.hold the person at his hip and shoulder blade on the far side of the body

b.bend the person's knees

c.move the person to one side of the bed

d.all of the above

d.all of the above

If moving him is difficult get the person out of bed and back in the wheelchair. Then start over and put him in bed closer to the headboard.

a.true

b.false

a.true

These are some general rules to follow when lifting EXCEPT

a.never lift more than you can comfortably handle

b.create a base of support first

c.none of the above

d.consider getting back support belte.do not use your back to do heavy lifting

c.none of the above

If the person is able, place his hands on the bed or chair and assist in the movement. If the person has had a stroke or is afraid, he can hold his hands close to his chest

a.false

b.true

b.true

Ways to prevent back and neck injuries

a.all of the above

b.good body mechanics

c.high protein intake

d.high calorie diet

b.good body mechanics

In a patient with difficulty of breathing which of the following should be used to monitor oxygen saturation?

a.Pulse oximeter

b.ECG

c.Blood pressure

d.NGT

a.Pulse oximeter

Which of the following provides access for hemodialysis for patient with kidney failure?

a.AV fistula

b.Hemovac

c.Peripheral IV line

d.Urinary catheter

a.AV fistula

Central venous pressure can be monitored by placing a/an

a.PA Line

b.PEG

c.A Line

d.ICP Monitor

a.PA Line

Which of the following devices allows for the delivery of the highest concentration of supplemental oxygen?

a.Face mask

b.Nasal cannula

c.Non-rebreather mask

d.Open face tent

c.Non-rebreather mask

Which of the following should be done if increased intracranial pressure is observed in a patient?a.Elevate head of the bed to 30 degrees

b.Have the patient lie flat in bed

c.Position the patient in a right lateral decubitus

d.Position the head in left lateral neck flexion with hip in extreme flexion

a.Elevate head of the bed to 30 degrees

Patients will be transferred immediately after surgery to

a.PACU

b.PICU

c.MICU

d.SICU

a.PACU

A 10-year-old patient needs to be monitored closely due to burn injuries and multiple fracture sustained in a fire.

Where would be the patient admitted?

a.PICU

b.MICU

c.ER

d.CCU

a.PICU

BP monitoring can be done in a limb in which

a.All of the above

b.Blood sample was drawn 15 minutes ago for laboratory test

c.Lymphedema is present and persistent for two weeks

d.AV fistula is placed two months ago

b.Blood sample was drawn 15 minutes ago for laboratory test

A patient had a recent myocardial infarction and is admitted in the ICU. What would be the best device to monitor patient's cardiac activity?

a.Oximeter

b.T Tube

c.AV Fistula

d.ECG

d.ECG

Mean arterial pressure can be monitored by placing a/an

a.NGT

b.ICP Monitor

c.Arterial line

d.PA Line

c.Arterial line

What is the optimal environment for wound healing?

a.Wet

b.Moist

c.Dry

d.Wet to dry

b.Moist

In which of the following is debridement CONTRAINDICATED?

a.Presence of callus

b.Electrical burn

c.Presence of necrotic tissues

d.Wound with blisters

b.Electrical burn

What is the importance of a wound dressing?

a.Prevents microorganism from colonizing wound

b.All of the above

c.Provides nutrients to wound bed

d.Prevent gas exchange within the wound bed

a.Prevents microorganism from colonizing wound

For highly exudative wound what would be the best dressing?

a.Alginate

b.Gauze

c.Hydrogel

d.Transparent film

a.Alginate

Which of the following is a sign of wound infection?

a.All of the above

b.Beefy red wound bed

c.Drying of wound

d.Purulent discharge

d.Purulent discharge

For a uniformly granulating wound what would be the best dressing to use?

a.Dry gauze

b.Hydrogel

c.Alginate

d.Foam

b.Hydrogel

In the Philippine setting which of the following is NOT allowed to be done by paramedical health provider in the management of wound?

a.Dressing of wound

b.Patient's education

c.Sharp debridement

d.Wound assessment

c.Sharp debridement

What is the main objective of wound management if there is a presence of undermining?

a.Maintain periwound

b.Manage tissue loads

c.Maintain warm wound environment

d.Eliminate dead space

d.Eliminate dead space

Which of the following is debridement indicated?

a.Deeper wound where ligaments are exposed

b.Presence of foreign materials

c.Granulating wound bed

d.Stable heel ulcers with eschar

b.Presence of foreign materials

What is the appropriate dressing for non-infected surgical wound?a.Hydrofiber

b.Foam

c.Alginates

d.Transparent film

d.Transparent film

Which of the following statements are correct

a.DO NOT use direct pressure on an eye injury, a wound with an embedded object, or skull fracture.

b.DO NOT remove a blood-soaked dressing. Doing so can pull off clots that have already formed.

c.All of the above

d.Protect yourself with exam gloves, extra gauze pads, or clean cloths, or have the person apply the direct pressure.

c.All of the above

If seizure lasts longer than 5 minutes call for medical attention

a.True

b.False

a.True

Which statement is true regarding the management of hyperventilation

a.All of the above

b.Calm the patient down & reassure the person

c.Encourage to breathe slowly using abdominal muscles. Purse lip breathing

d.Take the victim to quiet place or ask bystanders to leave. Assist in comfortable position (sitting)

a.All of the above

Signs and symptoms of poisoning through ingestion include

a.Nausea and Vomiting

b.Diarrhea

c.Altered mental status

d.All of the above

d.All of the above

Seek medical care for patients who fainted if

a.Both statements are correct

b.Does not quickly regain consciousness

c.Neither are correct

d.Repeated episodes of unresponsiveness

a.Both statements are correct

Evidence exists that the use of pressure points eliminates distal pulses or that the elevation of a bleeding part has any role in stopping bleeding.

a.false

b.true

a.false

Signs and symptoms of a heart attack include a.Radiating pain or discomfort in other areas of upper body

b.Chest discomfort (uncomfortable pressure, squeezing fullness, or pain)

c.Dyspnea, Cold sweat, nausea/lightheadedness

d.All of the above

d.All of the above

Signs and symptoms of rib fracture include

a.Victim holds the injured area, trying to reduce the pain

b.All of the above

c.Sharp pain, especially when the victim takes a deep breath, coughs or moves

d.Victim reports being hit where the pain is

b.All of the above

Which of the following statements are correct

a.None of the above

b.Apply an ice pack for more than 20-30 minutes.

c.Apply cold if the victim has hx of circulatory disease, Raynaud's disease or hypersensitivity to cold.

d.Apply an ice pack on the popliteal area.

a.None of the above

Using the Cincinnati Stroke Scale, ask the patient to

a.All of the above

b.show his/her tongue

c.ask to follow 2 step commands

d.ask patient to close eyes and raise both arms with palms up

d.ask patient to close eyes and raise both arms with palms up

The first thing to do in high quality CPR is to make sure the environment is safe for the rescuer and victim

a.true

b.false

a.true

True regarding heart attack

a.person become unresponsive and is not breathing or is only gasping

b.all of the above

c.when the heart develops an abnormal rhythm and that leads to inability of the heart muscles to contract or pump blood

d.happens when there is an interruption of blood supply to the heart muscles due to major heart arteries

d.happens when there is an interruption of blood supply to the heart muscles due to major heart arteries

The rule of 10 seconds states that in 10 seconds you must feel the pulse already, if no pulse after 10 seconds, begin high quality CPR starting with chest compressions

a.false

b.true

a.false

The rescue breaths in a pediatric patient should be give every

a.any of the above

b.3 to 4 seconds

c.5 to 6 seconds

d.2 to 3 seconds

c.5 to 6 seconds

You should check the pulse of the patient every

a.any of the above

b.5 minutes

c.2 minutes

d.1 minute

c.2 minutes

To open the airway in a patient with suspected head or spinal cord injury, you use a.neither

b.head tilt chin lift

c.both can be done

d.modified jaw thrust maneuver

d.modified jaw thrust maneuver

Describes high quality CPR

a.allow complete chest recoil after each compression

b.depth of 5cm

c.all of the above

d.compression rate of 100 - 120/minute

c.all of the above

Critical skills needed in BLS

a.breathing

b.all of the above

c.checking the pulse

d.compression

b.all of the above

For an anterolateral placement of AED pads, the first pad should be placed

a.directly below the right collar

b.left side of the victim's back

c.side of the left nipple

d.left side of the chest

a.directly below the right collar

Important things to remember in chest compressions

a.rate of compressions should average 100 to 120 per minute

b.follow the compression depth

c.all of the above

d.minimize interruptions

c.all of the above

Wounds that are not to be debrided

a.callus

b.electrical burns

c.blisters

d.necrotic tissue

b.electrical burns

Keep knees straight your back in neutral position and lock your arms to assist the lift.

a.true

b.false

b.false

Not used on infected wounds unless changed daily

a.gauze dressing

b.hydrofiber

c.transparent film dressing

d.hydrogel

c.transparent film dressing

Local signs of infection include

a.erythema

b.edema

c.elevated WBC count

d.warmth

c.elevated WBC count

Measures percentage of hemoglobin saturated O2 in arterial blood.

a.PA line

b.pulse oximeter

c.ECG

d.arterial line

b.pulse oximeter

An accurate temperature recording using an electronic thermometer usually takes around

a.10 seconds

b.any of the above

c.1 minute

d.30 seconds

a.10 seconds

Heart level is roughly at the

a.5th interspace

b.xiphoid process

c.clavicle

d.4th interspace

d.4th interspace

If moving him is difficult get the person out of bed and back in the wheelchair. Then start over and put him in bed closer to the headboard.

a.false

b.true

b.true

Functions of wound dressing

a.protect exposed nerve endings

b.provides thermal insulation

c.All of the above

d.provides a barrier to microorganisms

c.All of the above

Not included in the steps to do before taking a patient's blood pressure

a.ask the patient to avoid smoking 30 minutes before getting the blood pressure

b.check if the exam room is quiet and warm

c.check for presence of any AV fistulas or lymphedema

d.remove the patients clothing

d.remove the patients clothing

These are some general rules to follow when lifting EXCEPT

a.do not use your back to do heavy lifting

b.never lift more than you can comfortably handle

c.consider getting back support belt

d.create a base of support first

e.none of the above

e.none of the above

Not indicated for dry or minimally draining wounds or in wounds with thick black eschar

a.foam dressing

b.hydrofiber

c.hydrocolloid

d.alginates

d.alginates

You visited your patient that has a right chest tube. One of the orders of the physiatrist is to do PROMEs on the right shoulder. What would you do?

a.call physician to check whether orders are correct

b.do isometric exercises instead

c.defer treatment

d.proceed with the treatment observing precautions

d.proceed with the treatment observing precautions

If the person is able, place his hands on the bed or chair and assist in the movement. If the person has had a stroke or is afraid, he can hold his hands close to his chest

a.true

b.false

a.true

A mask with straps under the chin, contacts the cheeks, and is open over the pt's nose. It is secured with an elastic strap around the pt's head. It connects to a humidified O2 source with large-bore tubing.

a.non-rebreather mask

b.closed face mask

c.tracheostomy mask

d.open face tent

d.open face tent

Goals of treatment if wound has granulation tissue include

a.protect wound

b.all of the above

c.protect area around the wound

d.maintain warm, moist environment

b.all of the above

The point where the sound disappears is the best estimate for

a.heart rate

b.systolic pressure

c.all of the above

d.diastolic pressure

d.diastolic pressure

Goals of wound care and management include

a.All of the above

b.provide an optimal environment for wound healing

c.reduce stain on the area of the wound

d.protect the wound and surrounding tissue from additional trauma

a.All of the above

To intensify an inaudible Korotkoff sound, a patient may

a.relax the hand and avoid making a fist

b.all of the above

c.raise the arm before and while inflating the cuff

d.lower the arm prior to inflating

c.raise the arm before and while inflating the cuff

An arterial line gets dislodged. The line is placed at the radial artery. You tried to apply pressure but the bleeding won't stop due to the high pressure present in the arteries. You also called for assistance already, what is the best thing that you should do next?

a.bring patient to the emergency room

b.place a BP cuff on the brachial artery and inflate it

c.dangle the patient's involved UE

d.maintain pressure

b.place a BP cuff on the brachial artery and inflate it