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A collection of critical care nursing exam questions covering a wide range of topics in the field of critical care nursing. The questions test the nurse's knowledge and decision-making skills in various scenarios, such as managing patients with respiratory issues, fluid and electrolyte imbalances, medication administration, and responding to emergency situations. The questions cover important nursing concepts and interventions, and require the nurse to apply their clinical knowledge to provide appropriate care for critically ill patients. Studying this document could help nursing students and professionals prepare for exams, improve their critical thinking skills, and enhance their understanding of best practices in critical care nursing.
Typology: Exams
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One of your patients coded but is now stabilized and you are catching up on charting. The step-down unit calls to get report on your other patient who is to be transfered. The nurses near you do not appear busy. How should you prioritize your time? - correct answerGive report and ask the nurses to prepare the patient for transfer. Your patient was intubated but still has oral medications on their list of medications. How should you ensure they receive their medications? - correct answerAsk the provider to update the route of administration. What laboratory value should you monitor closely if your patient is vomiting coffee ground emesis? - correct answerHemoglobin What ECG finding is indicative of hyperkalema? - correct answerpeaked T wave You witness a patient that is not assigned to you fall out of bed and begin crying for help but you do not see the assigned nurse to assist the patient. What should you do first? - correct answerCheck on the patient's status and call for assistance. When assessing for fever in your intubated patient, placement of the thermometer in which area would be most accurate? - correct answerPulmonary artery or bladder Your patient has just completed IV potassium replacement. When should you collect their repeat potassium level? - correct answer30-60 min Your patient is receiving an antiarrhythmic agent. Which of the following assessment parameters is the MOST important for you to evaluate? - correct answerECG Your patient is undergoing a weaning trial from the ventilator. Fifteen minutes into the trial the patient's heart rate increases to 140 bpm and they start to grab at their oxygen and IV tubing. What should you do NEXT? - correct answerC. Stop weaning and rest the patient While assessing a patient just admitted to the hospital, he admits to drinking 12 cans of beer a day, with the last drink being right before admission. What is the expected onset of delirium tremens? - correct answerWithin 48-72 hours You have administered a pain medication that has a half-life of 120 minutes, onset of action 6 min, tmax of 15 minutes, and is mostly excreted in the uring. when can the patient expect the medication to start working - correct answer6 minutes
A lethargic but oriented patient is being admitted for sepsis and their family member is in the waiting area. Their belonging include a ring, cell phone, and wallet. The patient asks if they can keep the ring on and phone at bedside. What is your BEST response? - correct answerIt is best if your family takes your belongings. What is a significant complication of imaging studies performed with iv contrast - correct answerAcute kidney injury What respiratory support would an alert patient with an acute COPD exacerbatiobn likely receive FIRST? - correct answerBipap Your intubated and unresponsive patient is scheduled for surgery in the morning. Who is the most appropriate person to make decisions for your patient? - correct answerThe healthcare POA When administering a titratable infusion what information must you check on the medication IV bag to confirm the correct dose is being administered? - correct answerConcentration Your patient has a known baseline heart rate of around 45. The ECG monitor keeps alarming when the heart rate decreases below 50. Their vital signs are stable. What would you do? - correct answerA. Adjust the alarm parameters How is dopamine usually administered in the icu when given intravenously - correct answerTitratable continous infusion Which of the following can be given through an enteral feeding tube? - correct answerImmediate release pills When donning an N-95 mask, how should you secure the nose? - correct answerFit the nose piece with both hands What type of medication is used in the critical care setting to help manage the symptoms of alcohol withdrawal? - correct answerBenzodiazepines While admitting a patient with a history of IV drug use, what precautions should you take? - correct answerCarefully inspect items for presence of sharps. Your patient is intubated and begins to cough up clear mucous inside their ETT. What should you do NEXT? - correct answerA. Instill normal saline to lavage ETTWRONG B. Sit the patient up to 30 degrees in bed wrong C. Inspect their oral cavity and suction mouth D. Provide 100% oxygenation and prepare to suction What is a complication of long term TPN? - correct answerLiver injury
Which assessment establishes baseline hand perfusion before an ABG puncture or arterial line placement? - correct answerAllen Test You find the concentration of an IV medication bag that is hanging and infusing into your patient does not match the concentration in the order. What should you do NEXT? - correct answerStop the infusion Your patient has a right chest tube that was placed after thoracotomy. They report that is very painful when they cough and request cough medicing. What should you do? - correct answerTeach them to splint their right side when coughing and give pain medicine Your patient had an unplanned self-extubation. They are now alert and sitting up. Their pulse oximetry is 98% on 4 liters face mask. What action should you prioritize? - correct answerA. Inspecting the oral cavity B. Checking blood pressure and the heart rate*WRONG C. Administering an albuterol nebulizer D. Performing an ordered STAT ABG *WRONG Your are admitting a patient who is sedated and intubated directly from the operating room after a major surgery. The anesthesia provider connects the patient to the ventilator in the ICU room and leaves before entering orders for the patient's ventilatory settings. How should you proceed? - correct answerContact the ICU intensivist or specialist assigned to the case For a patient with septic shock, What would you monitor to objectively determine the effectiveness and need to titrate a dobutamine infusion. - correct answerScVo Which of the following actions complies with ventilator acquired pneumonia (VAP) prevention protocols? - correct answerKeep head of bed 30-45 degrees What assessment tool is needed for a patient who has uncomplicated retrosternal hemorrhage? - correct answerFollow up imaging test Which condition may cause increased effects from a medication that is mostly metabolized by the liver? - correct answerHepatitis C An intubated patient with a GCS of 3 is admitted to the ICU from the ER after being found down for an unknown amount of time at home. The CT scan reveals profuse cerebral edema. When is the BEST time to notify organ donation services? - correct answerWithin 24 hours of admission to the ICU What order is included in the pre-procedural checklist for patients at risk for acute kidney injury who are to receive IV contrast? - correct answerPre-hydration with IV Fluids
Your patient is intubated with an ETT and sedated without spontaneous monements when the ventilator alarms with a high-pressure warning. The ventilator tubing is free and unkinked. What should you do NEXT? - correct answerProvide 100% oxygen and prepare to suction the patient Your postoperative patient suddenly becomes dyspneic, clutches their chest and their Sp02 drops to 89% the patient has a swollen left calf. what condition do you suspect? - correct answerPulmonary embolism What IV sedative would MOST likely be ordered for a non-intubated patient? - correct answerDexmedetkomidine (precedex) What is the normal cardiovasculat response to early sepsis? - correct answerIncreased cardiac output You have just received report on Patient A and Patient B. Patient A is intubated, sedated, and on a vasoactive infusion to keep their BP greater than 110 mmHg systolic on an arterial line. Patient B was extubated an hour ago and has a scheduled glucose check due in 1 hour. What is your PRIORITY action? - correct answerAssess Patient B's respiratory status Which of the following diets would be BEST for a patient with renal failure? - correct answerLow sodium, Low potassium and moderate protein Your patient on a furosemide infusion has a positive daily fluid balance, new bilateral crackles on auscultation and has gained weight since admission. What action should you take? - correct answerDiscuss increasing the furosemide infusion with the provider What ventilator adjustment do you expect when your patient's ABG is pH 7.40, PaCO 112, BICARB 22? - correct answerDecrease in FiO What information do you need from the provider to setup a cerebral intraventricular drainage system? - correct answerMaximum ICP After turning a patient with CVP monitoring what should you do to ensure accuracy of the CVP reading? - correct answerZero the line at phlebostatic axis In a patient with septic shock, after fluid administration which of the following findings is MOST suggestive of the need to start a vasopressor? - correct answerMean arterial pressure 40-50 mmHg Your patient's family does not want to tell the patient of their life-threatening diagnosis and pleads with you not to let the patient know. What is the MOST appropriate response? - correct answerAcknowledge the family's concerns and recommend a meeting with the family and interdisciplinary team.
What is the BEST way to determine a STEMI? - correct answer12 Lead ECG What condition does the Confusion Assessment Method for ICU (CAM-ICU) detect? - correct answerDelirium You are caring for an underweight, older adult who is intubated, sedated, and septic. You have implemented turning every 2 hours. While inspectingthe patient's back you notice bony prominences with intact but reddened skin. What should youinclude in the plan of care? - correct answerUse of specialized air bed You are to administer 1 mg of morphine IV but it only comes in a 2 mg vial. How should you proceed? - correct answerWaste 1 mg with a second nurse and then give the drug to the patient The provider has ordered 2 units of FFP to be transfused. Your patient's religious beliefs prevent them from accepting blood products. What is your BEST response? - correct answerInform the provider and discuss additional options. During cardiogenic shock what temporary intervention might be ordered to improve perfusion until definitive treatment is provided? - correct answerInotropic infusion While reviewing your patient's EHR prior to receiving report, you notice that their documented urine output for the past 24 hours is 600ml. What would be the MOST important action to take for this patient? - correct answerconfirm with the off-going nurse if this is a known situation. You are caring for a confused patient with edema who has large swollen wrist. You find that someone has taped their ID bracelet to the side of the bed. How should you secure their ID bracelet? - correct answerPlace a new ID bracelet on the patient's wrist while confirming perfusion to the hand You are caring for a patient with diabetic ketoacidosis with suspected sepsis. You have the following tasks to complete: Draw blood cultures, checkblood glucose, administer antibiotic, insert urinary catheter, and check urine for glucose. Which task should you complete FIRST? - correct answerDraw blood culture A code is initiated and the second nurse is observed not following ACLS protocol. What is the BEST actionsto take? - correct answerStop the nurse immediately and institute ACLS protocol During the first hour of tPA infusion, how frequently should you monitor blood pressure?
What MUST you confirm before removing a cervical spine collar? - correct answerPresence of active order to remove Which of the following signs or symptoms indicates a patient might not be tolerating the extubation? - correct answerThe patient is coughing and has tachycardia Which age group is MORE likely to experence a "Blown" vein - correct answerolder adults What acid/base imbalance is MOST likely to be found in a patient with COPD - correct answerRespiratroy acidosis Which of the following should you do if your patient suddenly becomes diaphoretic, anxious, tachycardic, and has clammy skin? - correct answerCheck their glucose What information is MOST important for you to confirm in smart IV pump settings? - correct answerWeight Besides the white blood cells, what laboratroy value is used in the diagnosis of sepsis? - correct answerLactic acid Which medication is associated with increased delirium in critical care patients? - correct answerLorazepam ( ativan) What is an effective way to evaluate for cyanosis in a person of color - correct answerCheck inner eyelids What cardiac condition shows cardiomegaly on chest x-ray - correct answerSystolic heart failure Your patient begins to choke and a code blue is called. The provider is unsuccessful at removing the object and is unable to place the ETT. You would expect to prepare for what type of procedure - correct answerSurgical airway One of your patients coded but is now stabilized and you are catching up on charting. The step-down unit calls to get report on your other patient who is to be transferred. The nurses near you do not appear busy. How should you prioritize your time? - correct answerGive report and ask the nurses to prepare the patient for transfer. Your patient was intubated but still has oral medications on their list of medications. How should you ensure they receive their medications? - correct answerAsk the provider to update the route of administration. What laboratory value should you monitor closely if your patient is vomiting coffee ground emesis? - correct answerHemoglobin
What ECG finding is indicative of hyperkalemia? - correct answerPeaked T waves You witness a patient that is not assigned to you fall out of bed and begin crying for help but you do not see the assigned nurse to assist the patient. What should you do first? - correct answerCheck on the patient's status and call for assistance. When assessing for fever in your intubated patient, placement of the thermometer in which area would be most accurate? - correct answerPulmonary artery or bladder Your patient has just completed IV potassium replacement. When should you collect their repeat potassium level? - correct answer30-60 min Your patient is receiving an anti-arrhythmic agent. Which of the following assessment parameters is the MOST important for you to evaluate? - correct answerECG Your patient is undergoing a weaning trial from the ventilator. Fifteen minutes into the trial the patient's heart rate increases to 140 bpm and they start to grab at their oxygen and IV tubing. What should you do NEXT? - correct answerStop weaning and rest the patient While assessing a patient just admitted to the hospital, he admits to drinking 12 cans of beer a day, with the last drink being right before admission. What is the expected onset of delirium tremens? - correct answerWithin 48-72 hours You have administered a pain medication that has a half-life of 120 minutes, onset of action 6 min, Tmax of 15 minutes, and is mostly excreted in the urine. When can the patient expect the medication to start working? - correct answer6 minutes A lethargic but oriented patient is being admitted for sepsis and their family member is in the waiting area. Their belonging include a ring, cell phone, and wallet. The patient asks if they can keep the ring on and phone at bedside. What is your BEST response? - correct answerIt is best if your family takes your belongings. What is a significant complication of imaging studies performed with IV contrast? - correct answerAcute kidney injury What respiratory support would an alert patient with an acute COPD exacerbation likely receive FIRST? - correct answerBiPAP Your intubated and unresponsive patient is scheduled for surgery in the morning. Who is the most appropriate person to make decisions for your patient? - correct answerThe healthcare POA When administering a titratable infusion what information must you check on the medication IV bag to confirm the correct dose is being administered? - correct answerConcentration
Your patient has a known baseline heart rate of around 45. The ECG monitor keeps alarming when the heart rate decreases below 50. Their vital signs are stable. What would you do? - correct answerAdjust the alarm parameters How is dopamine usually administered in the ICU when given intravenously? - correct answerTitratable continuous infusion Which of the following can be given through an enteral feeding tube? - correct answerImmediate release pills When donning an N-95 mask, how should you secure the nose? - correct answerFit the nose piece with both hands What type of medication is used in the critical care setting to help manage the symptoms of alcohol withdrawal? - correct answerBenzodiazepines While admitting a patient with a history of IV drug use, what precautions should you take? - correct answerCarefully inspect items for presence of sharps. Your patient is intubated and begins to cough up clear mucous inside their ETT. What should you do NEXT? - correct answerProvide 100% oxygenation and prepare to suction What is a complication of long term TPN? - correct answerLiver injury Which assessment establishes baseline hand perfusion before an ABG puncture or arterial line placement? - correct answerAllen Test You find the concentration of an IV medication bag that is hanging and infusing into your patient does not match the concentration in the order. What should you do NEXT? - correct answerStop the infusion Your patient has a right chest tube that was placed after thoracotomy. They report that is very painful when they cough and request cough medicine. What should you do? - correct answerTeach them to splint their right side when coughing and give pain medicine Your patient had an unplanned self-extubation. They are now alert and sitting up. Their pulse oximetry is 98% on 4 liters face mask. What action should you prioritize? - correct answerInspecting the oral cavity Your are admitting a patient who is sedated and intubated directly from the operating room after a major surgery. The anesthesia provider connects the patient to the ventilator in the ICU room and leaves before entering orders for the patient's ventilatory
settings. How should you proceed? - correct answerContact the ICU intensivist or specialist assigned to the case For a patient with septic shock, What would you monitor to objectively determine the effectiveness and need to titrate a dobutamine infusion. - correct answerScVo Which of the following actions complies with ventilator acquired pneumonia (VAP) prevention protocols? - correct answerKeep head of bed 30-45 degrees What assessment tool is needed for a patient who has uncomplicated retrosternal hemorrhage? - correct answerFollow up imaging test Which condition may cause increased effects from a medication that is mostly metabolized by the liver? - correct answerHepatitis C An intubated patient with a GCS of 3 is admitted to the ICU from the ER after being found down for an unknown amount of time at home. The CT scan reveals profuse cerebral edema. When is the BEST time to notify organ donation services? - correct answerWithin 24 hours of admission to the ICU What order is included in the pre-procedural checklist for patients at risk for acute kidney injury who are to receive IV contrast? - correct answerPre-hydration with IV Fluids Your patient is intubated with an ETT and sedated without spontaneous movements when the ventilator alarms with a high-pressure warning. The ventilator tubing is free and unkinked. What should you do NEXT? - correct answerProvide 100% oxygen and prepare to suction the patient Your postoperative patient suddenly becomes dyspneic, clutches their chest and their Sp02 drops to 89% the patient has a swollen left calf. what condition do you suspect? - correct answerPulmonary embolism What IV sedative would MOST likely be ordered for a non-intubated patient? - correct answerDexmedetomidine (Precedex) What is the normal cardiovascular response to early sepsis? - correct answerIncreased cardiac output You have just received report on Patient A and Patient B. Patient A is intubated, sedated, and on a vasoactive infusion to keep their BP greater than 110 mm Hg systolic on an arterial line. Patient B was extubated an hour ago and has a scheduled glucose check due in 1 hour. What is your PRIORITY action? - correct answerAssess Patient B's respiratory status
Which of the following diets would be BEST for a patient with renal failure? - correct answerLow sodium, Low potassium and moderate protein Your patient on a furosemide infusion has a positive daily fluid balance, new bilateral crackles on auscultation and has gained weight since admission. What action should you take? - correct answerDiscuss increasing the furosemide infusion with the provider What ventilator adjustment do you expect when your patient's ABG is pH 7.40, PaCO 112, BICARB 22? - correct answerDecrease in FiO What information do you need from the provider to setup a cerebral intraventricular drainage system? - correct answerMaximum ICP After turning a patient with CVP monitoring what should you do to ensure accuracy of the CVP reading? - correct answerZero the line at phlebostatic axis In a patient with septic shock, after fluid administration which of the following findings is MOST suggestive of the need to start a vasopressor? - correct answerMean arterial pressure 40-50 mmHg Your patient's family does not want to tell the patient of their life-threatening diagnosis and pleads with you not to let the patient know. What is the MOST appropriate response? - correct answerAcknowledge the family's concerns and recommend a meeting with the family and interdisciplinary team. What is the BEST way to determine a STEMI? - correct answer12 Lead ECG What condition does the Confusion Assessment Method for ICU (CAM-ICU) detect? - correct answerDelirium You are caring for an underweight, older adult who is intubated, sedated, and septic. You have implemented turning every 2 hours. While inspecting the patient's back you notice bony prominences with intact but reddened skin. What should you include in the plan of care? - correct answerUse of specialized air bed You are to administer 1 mg of morphine IV but it only comes in a 2 mg vial. How should you proceed? - correct answerWaste 1 mg with a second nurse and then give the drug to the patient The provider has ordered 2 units of FFP to be transfused. Your patient's religious beliefs prevent them from accepting blood products. What is your BEST response? - correct answerInform the provider and discuss additional options. During cardiogenic shock what temporary intervention might be ordered to improve perfusion until definitive treatment is provided? - correct answerInotropic infusion
While reviewing your patient's EHR prior to receiving report, you notice that their documented urine output for the past 24 hours is 600ml. What would be the MOST important action to take for this patient? - correct answerConfirm with the off-going nurse if this is a known situation. You are caring for a confused patient with edema who has large swollen wrist. You find that someone has taped their ID bracelet to the side of the bed. How should you secure their ID bracelet? - correct answerPlace a new ID bracelet on the patient's wrist while confirming perfusion to the hand You are caring for a patient with diabetic ketoacidosis with suspected sepsis. You have the following tasks to complete: Draw blood cultures, check blood glucose, administer antibiotic, insert urinary catheter, and check urine for glucose. Which task should you complete FIRST? - correct answerDraw blood culture A code is initiated and the second nurse is observed not following ACLS protocol. What is the BEST action to take? - correct answerStop the nurse immediately and institute ACLS protocol During the first hour of tPA infusion, how frequently should you monitor blood pressure?
Which medication is associated with increased delirium in critical care patients? - correct answerLorazepam (Ativan) What is an effective way to evaluate for cyanosis in a person of color? - correct answerCheck inner eyelids What cardiac condition shows cardiomegaly on chest x-ray? - correct answerSystolic heart failure Your patient begins to choke and a code blue is called. The provider is unsuccessful at removing the object and is unable to place the ETT. You would expect to prepare for what type of procedure? - correct answerSurgical airway