CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181, Exams of Nursing

Download CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 and more Exams Nursing in PDF only on Docsity! CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM Which of the following professional organizations best supports critical care nursing practice? a. American Association of Critical-Care Nurses b. American Heart Association c. American Nurses Association d. Society of Critical Care Medicine - Correct Answers ✅a. American Association of Critical-Care Nurses A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and is interested in certification. Which credential would be most applicable for the nurse to seek? a. ACNPC-AG b. CNML c. CCRN d. PCCN - Correct Answers ✅c. CCRN The main purpose of certification is to a. assure the consumer that you will not make a mistake. b. prepare for graduate school. c. promote magnet status for your facility. d. validate knowledge of critical care nursing. - Correct Answers ✅d. validate knowledge of critical care nursing. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM The synergy model of practice focuses on a. allowing unrestricted visiting for the patient 24 hours a day. b. holistic and alternative therapies. c. the needs of patients and their families, which drive nursing competency. d. patients' needs for energy and support. - Correct Answers ✅c. the needs of patients and their families, which drive nursing competency. The family of your critically ill patient tells you that they have not spoken with the physician in over 24 hours and that they have some questions they want clarified. During morning rounds, you convey this concern to the attending intensivist and arrange a meeting with the family at 4:00 PM. Which competency of critical care nursing does this represent? a. Advocacy and moral agency in solving ethical issues b. Clinical judgment and clinical reasoning skills c. Collaboration with patients, families, and team members d. Facilitation of learning for patients, families, and team members - Correct Answers ✅c. Collaboration with patients, families, and team members The AACN Standards for Acute and Critical Care Nursing Practice use what framework to guide critical care nursing practice? a. Evidence-based practice b. Healthy work environment CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM b. Acts ethically on the behalf of the patient and family c. Considers factors related to safe patient care d. Uses clinical inquiry and integrates research findings in practice - Correct Answers ✅b. Acts ethically on the behalf of the patient and family Which of the following assists the critical care nurse in ensuring that care is appropriate and based on research? a. Clinical practice guidelines b. Computerized physician order entry c. Consulting with advanced practice nurses d. Implementing Joint Commission National Patient Safety Goals - Correct Answers ✅a. Clinical practice guidelines Comparing the patient's current (home) medications with those ordered during hospitalization and communicating a complete list of medications to the next provider when the patient is transferred within an organization or to another setting are strategies to: a. improve accuracy of patient identification. b. prevent errors related to look-alike and sound-alike medications. c. reconcile medications across the continuum of care. d. reduce harms associated with the administration of anticoagulants. - Correct Answers ✅c. reconcile medications across the continuum of care. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM As part of nursing management of a critically ill patient, orders are written to keep the head of the bed elevated at 30 degrees, awaken the patient from sedation each morning to assess readiness to wean from mechanical ventilation, and implement oral care protocols every 4 hours. These interventions are done as a group to reduce the risk of ventilator-associated pneumonia. This group of evidence-based interventions is often called a a. bundle of care. b. clinical practice guideline. c. patient safety goal. d. quality improvement initiative. - Correct Answers ✅a. bundle of care. You work in an intermediate care unit and have asked to be involved in developing new guidelines to prevent pressure ulcers in your patient population. The nurse manager tells you that you do not yet have enough experience to be on the prevention task force and that your ideas will be rejected by others. This situation is an example of a. a barrier to handoff communication. b. a work environment that is unhealthy. c. ineffective decision making. d. nursing practice that is not evidence-based. - Correct Answers ✅b. a work environment that is unhealthy. Which of the following statements describes the core concept of the synergy model of practice? CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM a. All nurses must be certified in order to have the synergy model implemented. b. Family members must be included in daily interdisciplinary rounds. c. Nurses and physicians must work collaboratively and synergistically to influence care. d. Unique needs of patients and their families influence nursing competencies. - Correct Answers ✅d. Unique needs of patients and their families influence nursing competencies. A nurse who plans care based on the patient's gender, ethnicity, spirituality, and lifestyle is said to a. be a moral advocate. b. facilitate learning. c. respond to diversity. d. use clinical judgment. - Correct Answers ✅c. respond to diversity. Which of the following is a National Patient Safety Goal? (Select all that apply.) a. Accurately identify patients. b. Eliminate the use of patient restraints. c. Reconcile medications across the continuum of care. d. Reduce risks of health care-acquired infection. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM Which scenarios contribute to effective handoff communication at change of shift? (Select all that apply.) a. The nephrology consultant physician is making rounds and asks you for an update on the patient's status and to assist in placing a central line for hemodialysis. b. The noise level is high because twice as many staff members are present and everyone is giving report in the nurses' station. c. The unit has decided to use a standardized checklist/tool for change-of- shift reports and patient transfers. d. You and the oncoming nurse conduct a standardized report at the patient's bedside and review key assessment findings. e. The off-going nurse is giving the patient medications at the same time as giving handoff report to the oncoming nurse. - Correct Answers ✅c. The unit has decided to use a standardized checklist/tool for change-of-shift reports and patient transfers. d. You and the oncoming nurse conduct a standardized report at the patient's bedside and review key assessment findings. Which strategy is important in addressing issues associated with the aging workforce? (Select all that apply.) a. Allowing nurses to work flexible shift durations b. Encouraging older nurses to transfer to an outpatient setting that is less stressful c. Hiring nurse technicians who are available to assist with patient care, such as turning the patient CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM d. Remodeling patient care rooms to include devices to assist in patient lifting e. Developing a staffing model that accurately reflects the unit's needs. - Correct Answers ✅a. Allowing nurses to work flexible shift durations c. Hiring nurse technicians who are available to assist with patient care, such as turning the patient d. Remodeling patient care rooms to include devices to assist in patient lifting Which of the following strategies will assist in creating a healthy work environment for the critical care nurse? (Select all that apply.) a. Celebrating improved outcomes from a nurse-driven protocol with a pizza party b. Implementing a medication safety program designed by pharmacists c. Modifying the staffing pattern to ensure a 1:1 nurse/patient ratio d. Offering quarterly joint nurse-physician workshops to discuss unit issues e. Using the Situation-Background-Assessment-Recommendation (SBAR) technique for handoff communication - Correct Answers ✅a. Celebrating improved outcomes from a nurse-driven protocol with a pizza party d. Offering quarterly joint nurse-physician workshops to discuss unit issues e. Using the Situation-Background-Assessment-Recommendation (SBAR) technique for handoff communication CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM Family members have a need for information. Which interventions best assist in meeting this need? a. Handing family members a pamphlet that explains all of the critical care equipment b. Providing a daily update of the patient's progress and facilitating communication with the intensivist c. Telling them that you are not permitted to give them a status report but that they can be present at 4:00 PM for family rounds with the intensivist d. Writing down a list of all new medications and doses and giving the list to family members during visitation - Correct Answers ✅b. Providing a daily update of the patient's progress and facilitating communication with the intensivist The nurse is a member of a committee to design a critical care unit in a new building. Which design trend would best facilitate family-centered care? a. Ensure that the patient's room is large enough and has adequate space for a sleeper sofa and storage for family members' personal belongings. b. Include a diagnostic suite in close proximity to the unit so that the patient does not have to travel far for testing. c. Incorporate a large waiting room on the top floor of the hospital with a scenic view and amenities such as coffee and tea. d. Provide access to a scenic garden for meditation. - Correct Answers ✅a. Ensure that the patient's room is large enough and has adequate space for a sleeper sofa and storage for family members' personal belongings. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM d. A 78-year-old female admitted with gastrointestinal bleeding. Her hemoglobin is decreasing to a critical level. She is a Jehovah's Witness and refuses the treatment of a blood transfusion. She is capable of making her own decisions and has a clearly written advance directive declining any transfusions. Her son is upset with her and tells her she is "committing suicide." - Correct Answers ✅b. A 36-year-old male admitted for a ruptured cerebral aneurysm. He has been living with his 34-year-old girlfriend for 8 years, and they have a 4-year-old daughter. He does not have a written advance directive. His parents arrive from out-of-state and are asked to make decisions about his health care. He has not seen them in over a year. Which nursing interventions would best support the family of a critically ill patient? a. Encourage family members to stay all night in case the patient needs them. b. Give a condition update each morning and whenever changes occur. c. Limit visitation from children into the critical care unit. d. Provide beverages and snacks in the waiting room. - Correct Answers ✅b. Give a condition update each morning and whenever changes occur. Which intervention is appropriate to assist the patient in coping with admission to the critical care unit? a. Allowing unrestricted visiting by several family members at one time b. Explaining all procedures in easy-to-understand terms c. Providing back massage and mouth care CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM d. Turning down the alarm volume on the cardiac monitor - Correct Answers ✅b. Explaining all procedures in easy-to-understand terms The constant noise of a ventilator, monitor alarms, and infusion pumps predisposes the patient to: a. anxiety. b. pain. c. powerlessness. d. sensory overload. - Correct Answers ✅d. sensory overload. Which of the following statements about family assessment is false? a. Assessment of structure (who comprises the family) is the last step in assessment. b. Interaction among family members is assessed. c. It is important to assess communication among family members to understand roles. d. Ongoing assessment is important, because family functioning may change during the course of illness. - Correct Answers ✅a. Assessment of structure (who comprises the family) is the last step in assessment. Which intervention about visitation in the critical care unit is true? a. The majority of critical care nurses implement restricted visiting hours to allow the patient to rest. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM b. Children should never be permitted to visit a critically ill family member. c. Visitation that is individualized to the needs of patients and family members is ideal. d. Visiting hours should always be unrestricted. - Correct Answers ✅c. Visitation that is individualized to the needs of patients and family members is ideal. Elderly patients who require critical care treatment are at risk for increased mortality, functional decline, or decreased quality of life after hospitalization. Assuming each of these patients was discharged from the hospital, which of the following patients is at greatest risk for decreased functional status and quality of life? a. A 70-year-old man who had coronary artery bypass surgery. He developed complications after surgery and had difficulty being weaned from mechanical ventilation. He required a tracheostomy and gastrostomy. He is being discharged to a long-term acute care hospital. He is a widower. b. A 79-year-old woman admitted for exacerbation of heart failure. She manages her care independently but needed diuretic medications adjusted. She states that she is compliant with her medications but sometimes forgets to take them. She lives with her 82-year-old spouse. Both consider themselves to be independent and support each other. c. A 90-year-old man admitted for a carotid endarterectomy. He lives in an assisted living facility (ALF) but is cognitively intact. He is the "social butterfly" at all of the events at the ALF. He is hospitalized for 4 days and discharged to the ALF. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM Family assessment can be challenging, and each nurse may obtain additional information regarding family structure and dynamics. What is the best way to share this information from shift to shift? a. Create an informal family information sheet that is kept on the bedside clipboard. That way, everyone can review it quickly when needed. b. Develop a standardized reporting form for family information that is incorporated into the patient's medical record and updated as needed. c. Require that the charge nurse have a detailed list of information about each patient and family member. Thus, someone on the unit is always knowledgeable about potential issues. d. Try to remember to discuss family structure and dynamics as part of the change-of-shift report. - Correct Answers ✅b. Develop a standardized reporting form for family information that is incorporated into the patient's medical record and updated as needed. The spouse of a patient who is hospitalized in the critical care unit following resuscitation for a sudden cardiac arrest at work demands to meet with the nursing manager. The spouse demands, "I want you to reassign us to another nurse. His current nurse is not in the room enough to make sure everything is okay." The nurse recognizes that this response most likely is due to the spouse's a. desire to pursue a lawsuit if the assignment is not changed. b. inability to participate in the husband's care. c. lack of prior experience in a critical care setting. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM d. sense of loss of control of the situation. - Correct Answers ✅d. sense of loss of control of the situation Open visitation policies are expected by many professional organizations. Which statement reflects adherence to current recommendations? a. Allow animals on the unit; however, these can only be "therapy" animals through the hospital's pet therapy program. b. Allow family visitation throughout the day except at change of shift and during rounds. c. Determine, in collaboration with the patient and family, who can visit and when. Facilitate open visitation policies. d. Permit open visitation by adults 18 years of age and older; limit visits of children to 1 hour. - Correct Answers ✅c. Determine, in collaboration with the patient and family, who can visit and when. Facilitate open visitation policies. The VALUE mnemonic is a helpful strategy to enhance communication with family members of critically ill patients. Which of the following statements describes a VALUE strategy? a. View the family as guests on the unit. b. Acknowledge family emotions. c. Learn as much as you can about family structure and function. d. Use a trained interpreter if the family does not speak English. - Correct Answers ✅b. Acknowledge family emotions. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM The VALUE mnemonic includes the following: V—Value what the family tells you. A—Acknowledge family emotions. L—Listen to the family members. U—Understand the patient as a person. E—Elicit (ask) questions of family members. Changing visitation policies can be challenging. The nurse manager recognizes which of the following as an effective strategy for promoting changes in practice? a. Ask the clinical nurse specialist to lead a journal club on open visitation after each nurse is tasked to read one research article about visitation. b. Discuss the pros and cons of open visitation at the next staff meeting. c. Invite the nurses with the most experience to develop a revised policy. d. Task the unit-based nurse practice council to invite volunteers to serve on the council to revise the current policy toward more liberal visitation. - Correct Answers ✅d. Task the unit-based nurse practice council to invite volunteers to serve on the council to revise the current policy toward more liberal visitation. Nursing strategies to help families cope with the stress of critical illness include: (Select all that apply.) CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM c. Provide informal conversation by discussing your plans for after work. d. Respond promptly to call bells or other communication for assistance. e. Inform the patient that you have cared for many similar patients. - Correct Answers ✅a. Allow family members to remain at the bedside. d. Respond promptly to call bells or other communication for assistance. The critical care environment is often stressful to a critically ill patient. Identify stressors that are common. (Select all that apply.) a. Alarms that sound from various devices b. Bright fluorescent lighting c. Lack of day-night cues d. Sounds from the mechanical ventilator e. Visiting hours tailored to meet individual needs - Correct Answers ✅a. Alarms that sound from various devices b. Bright fluorescent lighting c. Lack of day-night cues d. Sounds from the mechanical ventilator To reduce relocation stress in patients transferring out of the intensive care unit, the nurse can (Select all that apply.) a. ask the nurses on the intermediate care unit to give the family a tour of the new unit. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM b. contact the intensivist to see if the patient can stay one additional day in the critical care unit so that he and his family can adjust better to the idea of a transfer. c. ensure that the patient will be located near the nurses' station in the new unit. d. invite the nurse who will be assuming the patient's care to meet with the patient and family in the critical care unit prior to transfer. e. help the patient and family focus on the positive meaning of a transfer. - Correct Answers ✅a. ask the nurses on the intermediate care unit to give the family a tour of the new unit. d. invite the nurse who will be assuming the patient's care to meet with the patient and family in the critical care unit prior to transfer. e. help the patient and family focus on the positive meaning of a transfer. The critical care environment is stressful to the patient. Which interventions assist in reducing this stress? (Select all that apply.) a. Adjust lighting to promote normal sleep-wake cycles. b. Provide clocks, calendars, and personal photos in the patient's room. c. Talk to the patient about other patients you are caring for on the unit. d. Tell the patient the day and time when you are providing routine nursing interventions. e. Allow unlimited visitation tailored to the patient's individual needs. - Correct Answers ✅a. Adjust lighting to promote normal sleep-wake cycles. b. Provide clocks, calendars, and personal photos in the patient's room. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM e. Allow unlimited visitation tailored to the patient's individual needs. Ideally, an advance directive should be developed by the a. family if the patient is in critical condition. b. patient as part of the hospital admission process. c. patient before hospitalization. d. patient's health care surrogate. - Correct Answers ✅c. patient before hospitalization. A critically ill patient has a living will in the chart. The patient's condition has deteriorated, but the spouse wants "everything done," regardless of the patient's wishes. Which ethical principle is the spouse violating? a. Autonomy b. Beneficence c. Justice d. Nonmaleficence - Correct Answers ✅a. Autonomy Which statement regarding ethical concepts is true? a. A living will is the same as a health care proxy. b. A signed donor card ensures that organ donation will occur in the event of brain death. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM Which of the following organizations requires a mechanism for addressing ethical issues? a. American Association of Critical-Care Nurses b. American Hospital Association c. Society of Critical Care Medicine d. The Joint Commission - Correct Answers ✅d. The Joint Commission The nurse is caring for a patient who is not responding to medical treatment. The intensivist holds a conference with the family, and a decision is made to withdraw life support. The nurse's religious beliefs are not in agreement with the withdrawal of life support. However, the nurse assists with the process to avoid confronting the charge nurse. Afterward the nurse feels guilty for "killing the patient." This scenario is likely to cause a. abandonment. b. family stress. c. moral distress. d. negligence. - Correct Answers ✅c. moral distress. The nurse is caring for a patient who has been declared brain dead. The patient is considered a potential organ donor. To proceed with donation, the nurse understands that a. a signed donor card mandates that organs be retrieved in the event of brain death. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM b. after brain death has been determined, perfusion and oxygenation of organs is maintained until organs can be removed in the operating room. c. the health care proxy does not need to give consent for the retrieval of organs. d. once a patient has been established as brain dead, life support is withdrawn and organs are retrieved. - Correct Answers ✅b. after brain death has been determined, perfusion and oxygenation of organs is maintained until organs can be removed in the operating room. The nurse is caring for a patient who is declared brain dead and is an organ donor. The following events occur: 1300 Diagnostic tests for brain death are completed. 1330 Intensivist reviews diagnostic test results and writes in the progress note that the patient is brain dead. 1400 Patient is taken to the operating room for organ retrieval. 1800 All organs have been retrieved for donation. The ventilator is discontinued. 1810 Cardiac monitor shows flatline. What is the official time of death recorded in the medical record? a. 1300 b. 1330 c. 1400 d. 1800 e. 1810 - Correct Answers ✅b. 1330 The nurse is caring for a critically ill patient on mechanical ventilation. The physician identifies the need for a bronchoscopy, which requires informed CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM consent. For the physician to obtain consent from the patient, the patient must be able to a. be weaned from mechanical ventilation. b. have knowledge and competence to make the decision. c. nod his head that it is okay to proceed. d. read and write in English. - Correct Answers ✅b. have knowledge and competence to make the decision. The nurse is caring for a critically ill patient with terminal cancer. The monitor alarms and shows a potentially lethal rhythm. The patient has no pulse. The patient does not have a "do not resuscitate" order written on the chart. What is the appropriate nursing action? a. Contact the attending physician immediately to determine if CPR should be initiated. b. Contact the family immediately to determine if they want CPR to be started. c. Give emergency medications but withhold intubation. d. Initiate CPR and call a code. - Correct Answers ✅d. Initiate CPR and call a code. When addressing an ethical dilemma, contextual, physiological, and personal factors of the situation must be considered. Which of the following is an example of a personal factor? CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM a. Anyone who is comfortable approaching the family should discuss the option of organ donation. b. Brain death determination is required before organs can be retrieved for transplant. c. Donation of selected organs after cardiac death is ethically acceptable. d. Family members should consider the withdrawal of life support so that the patient can become an organ donor. - Correct Answers ✅c. Donation of selected organs after cardiac death is ethically acceptable. Warning signs that can assist the critical care nurse in recognizing that an ethical dilemma may exist include which of the following? (Select all that apply.) a. Family members are confused about what is happening to the patient. b. Family members are in conflict as to the best treatment options. They disagree with one another and cannot come to consensus. c. The family asks that the patient not be told of treatment plans. d. The patient's condition has changed dramatically for the worse and is not responding to conventional treatment. e. The physician is considering the use of a medication that is not approved to treat the patient's condition. - Correct Answers ✅a. Family members are confused about what is happening to the patient. b. Family members are in conflict as to the best treatment options. They disagree with one another and cannot come to consensus. c. The family asks that the patient not be told of treatment plans. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM d. The patient's condition has changed dramatically for the worse and is not responding to conventional treatment. e. The physician is considering the use of a medication that is not approved to treat the patient's condition. The nurse is caring for a patient whose condition has deteriorated and who is not responding to standard treatment. The physician calls for an ethical consultation with the family to discuss potential withdrawal of treatment versus aggressive treatment. The nurse understands that applying a model for ethical decision making involves which of the following? (Select all that apply.) a. Burden versus benefit b. Family's wishes c. Patient's wishes d. Potential outcomes of treatment options e. Cost savings of withdrawing treatment - Correct Answers ✅a. Burden versus benefit c. Patient's wishes d. Potential outcomes of treatment options The nurse utilizes which of the following strategies when encountering an ethical dilemma in practice? (Select all that apply.) a. Change-of-shift report updates b. Ethics consultation services CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM c. Formal multiprofessional ethics committees d. Pastoral care services e. Social work consultation - Correct Answers ✅b. Ethics consultation services c. Formal multiprofessional ethics committees The nurse is caring for a patient with severe neurological impairment following a massive stroke. The physician has ordered tests to determine brain death. The nurse understands that criteria for brain death include (Select all that apply.) a. absence of cerebral blood flow. b. absence of brainstem reflexes on neurological examination. c. Cheyne-Stokes respirations. d. flat electroencephalogram. e. responding only to painful stimuli. - Correct Answers ✅a. absence of cerebral blood flow. b. absence of brainstem reflexes on neurological examination. d. flat electroencephalogram The nurse is caring for an 80-year-old patient who has been treated for gastrointestinal bleeding. The family has agreed to withhold additional treatment. The patient has a written advance directive specifying requests. The directive notes that the patient wants food and fluid to be continued. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM c. Obtain a stat chest x-ray film to verify proper catheter placement. d. Zero reference and level the catheter at the phlebostatic axis. - Correct Answers ✅d. Zero reference and level the catheter at the phlebostatic axis. A patient is admitted to the hospital with multiple trauma and extensive blood loss. The nurse assesses vital signs to be BP 80/50 mm Hg, heart rate 135 beats/min, respirations 36 breaths/min, cardiac output (CO) of 2 L/min, systemic vascular resistance of 3000 dynes/sec/cm-5, and a hematocrit of 20%. The nurse anticipates administration of which the following therapies or medications? a. Blood transfusion b. Furosemide c. Dobutamine infusion d. Dopamine hydrochloride infusion - Correct Answers ✅a. Blood transfusion After pulmonary artery catheter insertion, the nurse assesses a pulmonary artery pressure of 45/25 mm Hg, a pulmonary artery occlusion pressure (PAOP) of 20 mm Hg, a cardiac output of 2.6 L/min and a cardiac index of 1.9 L/min/m2. Which provider order is of the highest priority? a. Apply 50% oxygen via Venturi mask. b. Insert an indwelling urinary catheter. c. Begin a dobutamine infusion. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM d. Obtain stat cardiac enzymes and troponin. - Correct Answers ✅c. Begin a dobutamine infusion. The nurse is caring for a patient with a left subclavian central venous catheter (CVC) and a left radial arterial line. Which assessment finding by the nurse requires immediate action? a. A dampened arterial line waveform b. Numbness and tingling in the left hand c. Slight bloody drainage at subclavian insertion site d. Slight redness at subclavian insertion site - Correct Answers ✅b. Numbness and tingling in the left hand The provider writes an order to discontinue a patient's left radial arterial line. When discontinuing the patient's invasive line, what is the priority nursing action? a. Apply an air occlusion dressing to insertion site. b. Apply pressure to the insertion site for 5 minutes. c. Elevate the affected limb on pillows for 24 hours. d. Keep the patient's wrist in a neutral position. - Correct Answers ✅b. Apply pressure to the insertion site for 5 minutes Following insertion of a central venous catheter, the nurse obtains a stat chest x-ray film to verify proper catheter placement. The radiologist reports CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM to the nurse: "The tip of the catheter is located in the superior vena cava." What is the best interpretation of these results by the nurse? a. The catheter is not positioned correctly and should be removed. b. The catheter position increases the risk of ventricular dysrhythmias. c. The distal tip of the catheter is in the appropriate position. d. The physician should be called to advance the catheter into the pulmonary artery. - Correct Answers ✅c. The distal tip of the catheter is in the appropriate position. While inflating the balloon of a pulmonary artery catheter (PAC) with 1.0 mL of air to obtain a pulmonary artery occlusion pressure (PAOP), the nurse encounters resistance. What is the best nursing action? a. Add an additional 0.5 mL of air to the balloon and repeat the procedure. b. Advance the catheter with the balloon deflated and repeat the procedure. c. Deflate the balloon and obtain a chest x-ray study to determine line placement. d. Lock the balloon in the inflated position, and flush the distal port of the PAC with normal saline. - Correct Answers ✅c. Deflate the balloon and obtain a chest x-ray study to determine line placement. The nurse is caring for a patient following insertion of a left subclavian central venous catheter (CVC). Which assessment finding 2 hours after insertion by the nurse warrants immediate action? a. Diminished breath sounds over left lung field CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM a. A patient with a central venous pressure (RAP/CVP) of 6 mm Hg and 40 mL of urine output in the past hour b. A patient with a left radial arterial line with a BP of 110/60 mm Hg and slightly dampened arterial waveform c. A patient with a pulmonary artery occlusion pressure of 25 mm Hg and an oxygen saturation of 89% on 3 L of oxygen via nasal cannula d. A patient with a pulmonary artery pressure of 25/10 mm Hg and an oxygen saturation of 94% on 2 L of oxygen via nasal cannula - Correct Answers ✅c. A patient with a pulmonary artery occlusion pressure of 25 mm Hg and an oxygen saturation of 89% on 3 L of oxygen via nasal cannula The nurse is caring for a patient following insertion of a left subclavian central venous catheter (CVC). Which action by the nurse best reduces the risk of catheter-related bloodstream infection (CRBSI)? a. Review daily the necessity of the central venous catheter. b. Cleanse the insertion site daily with isopropyl alcohol. c. Change the pressurized tubing system and flush bag daily. d. Maintain a pressure of 300 mm Hg on the flush bag. - Correct Answers ✅a. Review daily the necessity of the central venous catheter. During insertion of a pulmonary artery catheter, the provider asks the nurse to assist by inflating the balloon with 1.5 mL of air. As the provider advances the catheter, the nurse notices premature ventricular contractions on the monitor. What is the best action by the nurse? CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM a. Deflate the balloon while slowly withdrawing the catheter. b. Instruct the patient to cough and deep-breathe forcefully. c. Inflate the catheter balloon with an additional 1 mL of air. d. Ensure lidocaine hydrochloride (IV) is immediately available. - Correct Answers ✅d. Ensure lidocaine hydrochloride (IV) is immediately available. Following insertion of a pulmonary artery catheter (PAC), the provider requests the nurse obtain a blood sample for mixed venous oxygen saturation (SvO2). Which action by the nurse best ensures the obtained value is accurate? a. Zero referencing the transducer at the level of the phlebostatic axis following insertion b. Calibrating the system with a central venous blood sample and arterial blood gas value c. Ensuring patency of the catheter using a 0.9% normal saline solution pressurized at 300 mm Hg d. Using noncompliant pressure tubing that is no longer than 36 to 48 inches and has minimal stopcocks - Correct Answers ✅b. Calibrating the system with a central venous blood sample and arterial blood gas value The nurse is caring for a 70-kg patient in septic shock with a pulmonary artery catheter. Which hemodynamic value indicates an appropriate response to therapy aimed at enhancing oxygen delivery to the organs and tissues? CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM a. Arterial lactate level of 1.0 mEq/L b. Cardiac output of 2.5 L/min c. Mixed venous (SvO2) of 40% d. Cardiac index of 1.5 L/min/m2 - Correct Answers ✅a. Arterial lactate level of 1.0 mEq/L The nurse is caring for a patient with a pulmonary artery catheter. Assessment findings include a blood pressure of 85/40 mm Hg, heart rate of 125 beats/min, respiratory rate 35 breaths/min, and arterial oxygen saturation (SpO2) of 90% on a 50% Venturi mask. Hemodynamic values include a cardiac output (CO) of 1.0 L/min, central venous pressure (CVP) of 1 mm Hg, and a pulmonary artery occlusion pressure (PAOP) of 3 mm Hg. The nurse questions which of the following physician's orders? a. Titrate supplemental oxygen to achieve a SpO2 94%. b. Infuse 500 mL 0.9% normal saline over 1 hour. c. Obtain arterial blood gas and serum electrolytes. d. Administer furosemide (Lasix) 20 mg intravenously. - Correct Answers ✅d. Administer furosemide (Lasix) 20 mg intravenously. The charge nurse has a pulse contour cardiac output monitoring system available for use in the surgical intensive care unit. For which patient is use of this device most appropriate? a. A patient with a history of aortic insufficiency admitted with a postoperative myocardial infarction CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM the patient from the stretcher to the bed. Before obtaining a cardiac output, which action is most important for the nurse to complete? a. Document a pulmonary artery catheter occlusion pressure. b. Zero reference the transducer system at the phlebostatic axis. c. Inflate the pulmonary artery catheter balloon with 1 mL air. d. Inject 10 mL of 0.9% normal saline into the proximal port. - Correct Answers ✅b. Zero reference the transducer system at the phlebostatic axis. The charge nurse is supervising the care of four critical care patients being monitored using invasive hemodynamic modalities. Which patient should the charge nurse evaluate first? a. A patient in cardiogenic shock with a cardiac output (CO) of 2.0 L/min b. A patient with a pulmonary artery systolic pressure (PAP) of 20 mm Hg c. A hypovolemic patient with a central venous pressure (CVP) of 6 mm Hg d. A patient with a pulmonary artery occlusion pressure (PAOP) of 10 mm Hg - Correct Answers ✅a. A patient in cardiogenic shock with a cardiac output (CO) of 2.0 L/min The nurse is caring for a mechanically ventilated patient being monitored with a left radial arterial line. During the inspiratory phase of ventilation, the nurse assesses a 20 mm Hg decrease in arterial blood pressure. What is the best interpretation of this finding by the nurse? a. The mechanical ventilator is malfunctioning. b. The patient may require fluid resuscitation. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM c. The arterial line may need to be replaced. d. The left limb may have reduced perfusion. - Correct Answers ✅b. The patient may require fluid resuscitation. Upon entering the room of a patient with a right radial arterial line, the nurse assesses the waveform to be slightly dampened and notices blood to be backed up into the pressure tubing. What is the best action by the nurse? a. Check the inflation volume of the flush system pressure bag. b. Disconnect the flush system from the arterial line catheter. c. Zero reference the transducer system at the phlebostatic axis. d. Reduce the number of stopcocks in the flush system tubing. - Correct Answers ✅a. Check the inflation volume of the flush system pressure bag. The nurse is caring for a patient with a left radial arterial line and a pulmonary artery catheter inserted into the right subclavian vein. Which action by the nurse best ensures the safety of the patient being monitored with invasive hemodynamic monitoring lines? a. Document all waveform values. b. Limit the pressure tubing length. c. Zero reference the system daily. d. Ensure alarm limits are turned on. - Correct Answers ✅d. Ensure alarm limits are turned on. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM The nurse is preparing to measure the thermodilution cardiac output (TdCO) in a patient being monitored with a pulmonary artery catheter. Which action by the nurse best ensures the safety of the patient? a. Ensure the transducer system is zero referenced at the level of the phlebostatic axis. b. Avoid infusing vasoactive agents in the port used to obtain the TdCO measurement. c. Maintain a pressure of 300 mm Hg on the flush solution using a pressure bag. d. Limit the length of the noncompliant pressure tubing to a maximum 48 inches. - Correct Answers ✅b. Avoid infusing vasoactive agents in the port used to obtain the TdCO measurement. When performing an initial pulmonary artery occlusion pressure (PAOP), what are the best nursing actions? (Select all that apply.) a. Inflate the balloon for no more than 8 to 10 seconds while noting the waveform change. b. Inflate the balloon with air, recording the volume necessary to obtain a reading. c. Maintain the balloon in the inflated position for 8 hours following insertion. d. Zero reference and level the air-fluid interface of the transducer at the level of the phlebostatic axis. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM Which of the following situations may result in a low cardiac output and low cardiac index? (Select all that apply.) a. Exercise b. Hypovolemia c. Myocardial infarction d. Shock e. Fever - Correct Answers ✅b. Hypovolemia c. Myocardial infarction d. Shock A patient has coronary artery bypass graft surgery and is transported to the surgical intensive care unit at noon and is placed on mechanical ventilation. Interpret the initial arterial blood gas levels pH: 7.31 PaCO2: 48 mm Hg Bicarbonate: 22 mEq/L PaO2: 115 mm Hg O2 saturation: 99% a. Normal arterial blood gas levels with a high oxygen level b. Partly compensated respiratory acidosis; normal oxygen c. Uncompensated metabolic acidosis with high oxygen levels CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM d. Uncompensated respiratory acidosis; hyperoxygenated - Correct Answers ✅d. Uncompensated respiratory acidosis; hyperoxygenated The provider orders the following mechanical ventilation settings for a patient who weighs 75 kg. The patient's spontaneous respiratory rate is 22 breaths/min. Which arterial blood gas abnormality may occur if the patient continues to be tachypneic at these ventilator settings? Settings: Tidal volume: 600 mL (8 mL per kg) FiO2: 0.5 Respiratory rate: 14 breaths/min Mode assist/control Positive end-expiratory pressure: 10 cm H2O a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis - Correct Answers ✅d. Respiratory alkalosis A patient's ventilator settings are adjusted to treat hypoxemia. The fraction of inspired oxygen is increased from 0.6 to 0.7, and the positive end- expiratory pressure is increased from 10 to 15 cm H2O. Shortly after these adjustments, the nurse notes that the patient's blood pressure drops from 120/76 mm Hg to 90/60 mm Hg. What is the most likely cause of this decrease in blood pressure? CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM a. Decrease in cardiac output b. Hypovolemia c. Increase in venous return d. Oxygen toxicity - Correct Answers ✅a. Decrease in cardiac output The nurse is caring for a patient with an endotracheal tube. The nurse understands that endotracheal suctioning is needed to facilitate removal of secretions and that the procedure a. decreases intracranial pressure. b. depresses the cough reflex. c. is done as indicated by patient assessment. d. is more effective if preceded by saline instillation. - Correct Answers ✅c. is done as indicated by patient assessment A patient is admitted to the progressive care unit with a diagnosis of community-acquired pneumonia. The patient has a history of chronic obstructive pulmonary disease and diabetes. A set of arterial blood gases obtained on admission without supplemental oxygen shows pH 7.35; PaCO2 55 mm Hg; bicarbonate 30 mEq/L; PaO2 65 mm Hg. These blood gases reflect: a. hypoxemia and compensated metabolic alkalosis. b. hypoxemia and compensated respiratory acidosis. c. normal oxygenation and partly compensated metabolic alkalosis. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM a. compliance. b. resistance. c. tidal volume. d. work of breathing. - Correct Answers ✅d. work of breathing. Which of the following devices is best suited to deliver 65% oxygen to a patient who is spontaneously breathing? a. Face mask with non-rebreathing reservoir b. Low-flow nasal cannula c. Simple face mask d. Venturi mask - Correct Answers ✅a. Face mask with non-rebreathing reservoir A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min. His spontaneous respirations are 12 breaths/min. He receives a dose of morphine sulfate, and his spontaneous respirations decrease to 4 breaths/min. Which acid-base disturbance will likely occur? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis - Correct Answers ✅c. Respiratory acidosis CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min. His spontaneous respirations are 12 breaths/min. He receives a dose of morphine sulfate, and his respirations decrease to 4 breaths/min. What adjustments may need to be made to the patient's ventilator settings? a. Add positive end-expiratory pressure (PEEP). b. Add pressure support. c. Change to assist/control ventilation at a rate of 4 breaths/min. d. Increase the synchronized intermittent mandatory ventilation respiratory rate. - Correct Answers ✅d. Increase the synchronized intermittent mandatory ventilation respiratory rate. Current guidelines recommend the oral route for endotracheal intubation. The rationale for this recommendation is that nasotracheal intubation is associated with a greater risk for a. basilar skull fracture. b. cervical hyperextension. c. impaired ability to "mouth" words. d. sinusitis and infection. - Correct Answers ✅d. sinusitis and infection. Oxygen saturation (SaO2) represents a. alveolar oxygen tension. b. oxygen that is chemically combined with hemoglobin. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM c. oxygen that is physically dissolved in plasma. d. total oxygen consumption. - Correct Answers ✅b. oxygen that is chemically combined with hemoglobin. Pulse oximetry measures a. arterial blood gases. b. hemoglobin values. c. oxygen consumption. d. oxygen saturation. - Correct Answers ✅d. oxygen saturation. A PaCO2 of 48 mm Hg is associated with a. hyperventilation. b. hypoventilation. c. increased absorption of O2. d. increased excretion of HCO3. - Correct Answers ✅b. hypoventilation. The nurse notes that the patient's arterial blood gas levels indicate hypoxemia. The patient is not intubated and has a respiratory rate of 22 breaths/min. The nurse's first intervention to relieve hypoxemia is to: a. call the provider for an emergency intubation procedure. b. obtain an order for bilevel positive airway pressure (BiPAP). c. notify the provider of values and obtain a prescription for oxygen. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM Bicarbonate: 24 mEq/L PaO2: 95 mm Hg O2 saturation: 97% Respirations: 20 breaths/min a. Call the provider to request rapid intubation. b. Document the findings and continue to monitor. c. Request that another set of ABGs be drawn and run. d. Correlate the patient's O2 saturation with the ABGs. - Correct Answers ✅b. Document the findings and continue to monitor. A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery. Four hours after admission to the surgical intensive care unit at 4 PM, the patient has stable vital signs and normal arterial blood gases (ABGs), and is placed on a T-piece for ventilatory weaning. The following information pertains to the 1900 assessment. Assessments and Vital Signs Nursing Action Restless Performs complete assessment Increased to 110 beats/min Suctions patient for pink, frothy secretions Respirations 36 breaths/min Obtains prescriptions from provider for ABGs, electrolyte levels, and portable chest x-ray Blood pressure 156/98 mm Hg Sinus tachycardia CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM 10 PVCs/min Elevated pulmonary artery pressure Loud crackles throughout New ABGs: pH: 7.28 PaCO2: 46 mm Hg Bicarbonate: 22 mEq/L PaO2: 58 mm Hg O2 saturation: 88% What action by the nurse is best? a. Prepare for rapid intubation. b. Increase the patient's oxygen. c. Prepare to administer a diuretic. d. Change the ventilator settings. - Correct Answers ✅c. Prepare to administer a diuretic. A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery. Four hours after admission to the surgical intensive care unit at 4 PM, the patient has stable vital signs and normal arterial blood gases (ABGs), and is placed on a T-piece for ventilatory weaning. The following information pertains to the 1900 assessment. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM Assessments and Vital Signs Nursing Action Restless Performs complete assessment Increased to 110 beats/min Suctions patient for pink, frothy secretions Respirations 36 breaths/min Obtains prescriptions from provider for ABGs, electrolyte levels, and portable chest x-ray Blood pressure 156/98 mm Hg Sinus tachycardia 10 PVCs/min Elevated pulmonary artery pressure Loud crackles throughout New ABGs: pH: 7.28 PaCO2: 46 mm Hg Bicarbonate: 22 mEq/L PaO2: 58 mm Hg O2 saturation: 88% What interdisciplinary staff member does the nurse notify to assist in the care of this patient while preparing to give this patient diuretics? a. Respiratory therapist to adjust ventilator b. Social worker to notify family CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM a. assess for tension pneumothorax. b. assess the level of positive end-expiratory pressure. c. compare the tidal volume delivered with the tidal volume prescribed. d. determine the patient's work of breathing. - Correct Answers ✅c. compare the tidal volume delivered with the tidal volume prescribed. The nurse is caring for a mechanically ventilated patient and responds to a high inspiratory pressure alarm. Recognizing possible causes for the alarm, the nurse assesses for which of the following? (Select all that apply.) a. Coughing or attempting to talk b. Disconnection from the ventilator c. Kinks in the ventilator tubing d. Need for suctioning e. Spontaneous breathing - Correct Answers ✅a. Coughing or attempting to talk c. Kinks in the ventilator tubing d. Need for suctioning Select all of the factors that may predispose the patient to respiratory acidosis. (Select all that apply.) a. Anxiety and fear b. Central nervous system depression CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM c. Diabetic ketoacidosis d. Nasogastric suctioning e. Overdose of sedatives - Correct Answers ✅b. Central nervous system depression e. Overdose of sedatives The nurse is assisting with endotracheal intubation and understands that correct placement of the endotracheal tube in the trachea would be identified by which of the following? (Select all that apply.) a. Auscultation of air over the epigastrium b. Equal bilateral breath sounds upon auscultation c. Position above the carina verified by chest x-ray d. Positive detection of carbon dioxide (CO2) through CO2 detector devices e. Fogging of the endotracheal tube - Correct Answers ✅b. Equal bilateral breath sounds upon auscultation c. Position above the carina verified by chest x-ray d. Positive detection of carbon dioxide (CO2) through CO2 detector devices The nurse is caring for a mechanically ventilated patient and is charting outside the patient's room when the ventilator alarm sounds. What is the priority order for the nurse to complete these actions: _______________, _______________, _______________, _______________? CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM a. check quickly for possible causes of the alarm that can be fixed b. after troubleshooting, connect back to mechanical ventilator and reassess patient c. go to patient's bedside d. manually ventilate the patient while getting a respiratory therapist - Correct Answers ✅c. go to patient's bedside a. check quickly for possible causes of the alarm that can be fixed d. manually ventilate the patient while getting a respiratory therapist b. after troubleshooting, connect back to mechanical ventilator and reassess patient The nurse is assisting with endotracheal intubation of the patient and recognizes that the procedure will be done in what order: _______________, _______________, _______________, _______________, _______________? a. assess balloon on endotracheal tube for symmetry and leaks b. assess lung fields for bilateral expansion c. inflate balloon of endotracheal tube d. insert endotracheal tube with laryngoscope and blade e. suction oropharynx - Correct Answers ✅a. assess balloon on endotracheal tube for symmetry and leaks. e. suction oropharynx CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM In assessing a patient, the nurse understands that an early sign of hypoxemia is a. clubbing of nail beds. b. cyanosis. c. hypotension. d. restlessness. - Correct Answers ✅d. restlessness. The basic underlying pathophysiology of acute respiratory distress syndrome results in a. a decrease in the number of white blood cells available. b. damage to the right mainstem bronchus. c. damage to the type II pneumocytes, which produce surfactant. d. decreased capillary permeability. - Correct Answers ✅c. damage to the type II pneumocytes, which produce surfactant. The nurse is caring for a patient with acute respiratory distress syndrome who is hypoxemic despite mechanical ventilation. The provider prescribes a nontraditional ventilator mode as part of treatment. Despite sedation and analgesia, the patient remains restless and appears to be in discomfort. The nurse informs the provider of this assessment and anticipates an order for a. continuous lateral rotation therapy. b. guided imagery. c. neuromuscular blockade. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM d. prone positioning. - Correct Answers ✅c. neuromuscular blockade. A patient presents to the emergency department in acute respiratory failure secondary to community-acquired pneumonia. The patient has a history of chronic obstructive pulmonary disease. The nurse anticipates which treatment to facilitate ventilation? a. Emergency tracheostomy and mechanical ventilation b. Mechanical ventilation via an endotracheal tube c. Noninvasive positive-pressure ventilation (NPPV) d. Oxygen at 100% via bag-valve-mask device - Correct Answers ✅c. Noninvasive positive-pressure ventilation (NPPV) Which of the following acid-base disturbances commonly occurs with the hyperventilation and impaired gas exchange seen in severe exacerbation of asthma? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis - Correct Answers ✅c. Respiratory acidosis An acute exacerbation of asthma is treated with which of the following? a. Corticosteroids and theophylline by mouth b. Inhaled bronchodilators and intravenous corticosteroids CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM c. Prone positioning or continuous lateral rotation d. Sedation and inhaled bronchodilators - Correct Answers ✅b. Inhaled bronchodilators and intravenous corticosteroids The nurse is discharging a patient home following treatment for community- acquired pneumonia. As part of the discharge teaching, the nurse instructs, a. "If you get the pneumococcal vaccine, you'll never get pneumonia again." b. "It is important for you to get an annual influenza shot to reduce your risk of pneumonia." c. "Stay away from cold, drafty places because that increases your risk of pneumonia when you get home." d. "Since you have been treated for pneumonia, you now have immunity from getting it in the future." - Correct Answers ✅b. "It is important for you to get an annual influenza shot to reduce your risk of pneumonia." The nurse is discharging a patient with asthma. As part of the discharge instruction, the nurse instructs the patient to prevent exacerbation by: a. obtaining an appointment for follow-up pulmonary function studies 1 week after discharge. b. limiting activity until the patient is able to climb two flights of stairs. c. taking all asthma medications as prescribed. d. taking medications on a "prn" basis according to symptoms. - Correct Answers ✅c. taking all asthma medications as prescribed. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM A definitive diagnosis of pulmonary embolism can be made by a. arterial blood gas (ABG) analysis. b. chest x-ray examination. c. pulmonary angiogram. d. ventilation-perfusion scanning. - Correct Answers ✅c. pulmonary angiogram. A strategy for preventing pulmonary embolism in patients at risk who cannot take anticoagulants is a. administration of two aspirin tablets every 4 hours. b. infusion of thrombolytics. c. insertion of a vena cava filter. d. subcutaneous heparin administration every 12 hours. - Correct Answers ✅c. insertion of a vena cava filter. Which of the following treatments may be used to dissolve a thrombus that is lodged in the pulmonary artery? a. Aspirin b. Embolectomy c. Heparin d. Thrombolytics - Correct Answers ✅d. Thrombolytics CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM The nurse is assessing a patient. Which assessment would cue the nurse to the potential of acute respiratory distress syndrome (ARDS)? a. Increased oxygen saturation via pulse oximetry b. Increased peak inspiratory pressure on the ventilator c. Normal chest radiograph with enlarged cardiac structures d. PaO2/FiO2 ratio >300 - Correct Answers ✅b. Increased peak inspiratory pressure on the ventilator The nurse calculates the PaO2/FiO2 ratio for the following values: PaO2 is 78 mm Hg; FiO2 is 0.6 (60%). a. 46.8; meets criteria for ARDS b. 130; meets criteria for ARDS c. 468; normal lung function d. Not enough data to compute the ratio - Correct Answers ✅b. 130; meets criteria for ARDS The nurse is assessing a patient with acute respiratory distress syndrome. An expected assessment is a. cardiac output of 10 L/min and low systemic vascular resistance. b. PAOP of 10 mm Hg and PaO2 of 55. c. PAOP of 20 mm Hg and cardiac output of 3 L/min. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM d. PAOP of 5 mm Hg and high systemic vascular resistance. - Correct Answers ✅b. PAOP of 10 mm Hg and PaO2 of 55. The nurse is caring for a patient who is being turned prone as part of treatment for acute respiratory distress syndrome. The nurse understands that the priority nursing concern for this patient is which of the following? a. Management and protection of the airway b. Prevention of gastric aspiration c. Prevention of skin breakdown and nerve damage d. Psychological support to patient and family - Correct Answers ✅a. Management and protection of the airway During rounds, the provider alerts the team that proning is being considered for a patient with acute respiratory distress syndrome. The nurse understands that proning is a. an optional treatment to improve ventilation. b. less of a risk for skin breakdown because the patient is face down. c. possible with minimal help from coworkers. d. used to provide continuous lateral rotational turning. - Correct Answers ✅a. an optional treatment to improve ventilation. The etiology of noncardiogenic pulmonary edema in acute respiratory distress syndrome (ARDS) is related to damage to the CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM c. Provide deep vein thrombosis prophylaxis. d. Provide prophylaxis for peptic ulcer disease. e. Swab the mouth with foam swabs every 2 hours. - Correct Answers ✅a. Interrupt sedation each day to assess readiness to extubate. b. Maintain head of bed at least 30 degrees of elevation. c. Provide deep vein thrombosis prophylaxis. d. Provide prophylaxis for peptic ulcer disease. Select the strategies for preventing deep vein thrombosis (DVT) and pulmonary embolus (PE). (Select all that apply.) a. Graduated compression stockings b. Heparin or low-molecular weight heparin for patients at risk c. Sequential compression devices d. Strict bed rest e. Leg massage - Correct Answers ✅a. Graduated compression stockings b. Heparin or low-molecular weight heparin for patients at risk c. Sequential compression devices The nurse is caring for a mechanically ventilated patient. The nurse understands that strategies to prevent ventilator-associated pneumonia include which of the following? (Select all that apply.) a. Drain condensate from the ventilator tubing away from the patient. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM b. Elevate the head of the bed 30 to 45 degrees. c. Instill normal saline as part of the suctioning procedure. d. Perform regular oral care with chlorhexidine. e. Awaken the patient daily to determine the need for continued ventilation. - Correct Answers ✅a. Drain condensate from the ventilator tubing away from the patient. b. Elevate the head of the bed 30 to 45 degrees d. Perform regular oral care with chlorhexidine. The nurse is caring for a patient in acute respiratory failure and understands that the patient should be positioned (Select all that apply.) a. high Fowler's. b. side lying with head of bed elevated. c. sitting in a chair. d. supine with the bed flat. e. Trendelenburg. - Correct Answers ✅a. high Fowler's. b. side lying with head of bed elevated. c. sitting in a chair. The nurse is caring for a patient with cystic fibrosis (CF) and understands that treatment consists of which of the following? (Select all that apply.) a. Airway clearance therapies CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM ,,. CRITICAL CARE-EXAM 1 QUESTIONS AND ANSWERS (LATEST UPDATE 2023/2024) VERIFIED ANSWERS (181 QUESTIONS) GRADED A+ BEST NURSING EXAM b. Antibiotic therapy c. Nutritional support d. Tracheostomy e. Lung transplant - Correct Answers ✅a. Airway clearance therapies b. Antibiotic therapy c. Nutritional support e. Lung transplant