Study with the several resources on Docsity
Earn points by helping other students or get them with a premium plan
Prepare for your exams
Study with the several resources on Docsity
Earn points to download
Earn points by helping other students or get them with a premium plan
Community
Ask the community for help and clear up your study doubts
Discover the best universities in your country according to Docsity users
Free resources
Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors
A collection of multiple-choice questions and answers related to critical care nursing. It covers various topics, including cardiovascular, respiratory, and neurological conditions, as well as medication administration and patient management. The questions are designed to test the knowledge and understanding of critical care nurses, making it a valuable resource for exam preparation and professional development.
Typology: Exams
1 / 55
A nurse is caring for a patient with an acute inferior wall MI, post coronary artery stent deployment. For optimal care of this patient, the nurse should: A administer an analgesic for acute back pain. B apply a pressure dressing to the groin. C continuously monitor the patient in lead II.
monitor the patient in lead II Which of the following ventilator settings is most likely to decrease the work of breathing? A. assist control B pressure support C tidal volume
A patient with aortic regurgitation will have which of the following upon auscultation? A a diastolic murmur, loudest at the fifth intercostal space, midclavicular B a systolic murmur, loudest at the apex of the heart C a diastolic murmur, loudest at the second intercostal space, right sternal border
diastolic murmur, loudest at the second intercostal space, right sternal border.
A patient has acute kidney injury with fluid overload, and continuous renal replacement therapy (CRRT) has been ordered. Which of the following would indicate the need for CRRT rather than intermittent hemodialysis? A hyperkalemia
B a MAP of 45 mmHg C acidosis
Which of the following patients, who are all receiving mechanical ventilation, is most likely a candidate for a spontaneous awakening trial? A. a patient who is receiving PRN morphine. B a patient who is receiving a propofol infusion C a patient who is receiving 100% oxygen and 20 cm H2O pressure of PEEP
While the code team is performing resuscitative efforts, many of the patient's family members start to cry and pray, while other family members lie down on the floor in the corner of the room. Which of the following demonstrates the best action for the nurse to take at this time? A. Ensure that a member of the code team serves as a family presence facilitator and clearly communicates the treatment strategies to the family. B Call security to escort the family members to the waiting room due to their disruptive behavior. C Encourage the family members to leave the patient care area because they are extremely distressed. D Ask the family members to leave the patient care area because they may suffer anxiety from
team serves as a family presence facilitator and clearly communicates the treatment strategies to the family Cardiogenic shock secondary to left ventricular failure will generally result in: A decreased afterload. B a narrow pulse pressure. C decreased preload.
Massive atelectasis occurs in the presence of acute respiratory distress syndrome (ARDS). What are the 2 causes of the atelectasis that is typical of ARDS? A a surfactant deficiency and pulmonary edema B increased pulmonary vascular resistance and increased pulmonary compliance C. increased pulmonary compliance and pulmonary edema
pulmonary edema A patient was admitted with an acute inferior wall STEMI. The physician advises the nurse to monitor the patient for signs of right ventricular (RV) infarction. Which of the following are signs of RV infarction? A S4 heart sound, lung crackles B hypotension, flat neck veins C hypertension, a systolic murmur
clear lungs i Which of the following is an effect of hypothermia? A a decrease in the SaO B a decrease in the blood pressure C an increase in the heart rate
shift of the oxyhemoglobin dissociation curve to the left. It is important for a nurse to identify the signs of respiratory depression during procedural sedation. Which of the following is a LATE sign of respiratory depression? A a cough B SpO2 88% C. ETCO2 of 50 mmHg per waveform capnography
The most common cause of acute hepatic failure is: A alcohol abuse. B a salicylate overdose. C biliary obstruction.
Which of the following is most likely to lead to cardiopulmonary arrest for a patient with status asthmaticus? A bronchospasm B thick, tenacious secretions C hypoxemia
The ECG demonstrates ST elevation in leads II, III, and aVF. The nurse needs to monitor the patient closely for which of the following? A tachycardia, lung crackles B sinus bradycardia, an acute systolic murmur in the fifth intercostal space, midclavicular C second-degree AV block (Type II), hypotension D hypoxemia, an acute systolic murmur in the fifth intercostal space, left sternal border - CORRECT ANSWER>>>B. sinus bradycardia, an acute systolic murmur in the fifth intercostal space, midclavicular Which of the following statements about delirium is accurate? A Hypoactive delirium is easier to identify than hyperactive delirium or mixed delirium. B Haloperidol is an effective treatment for delirium.
C The severity of a patient's illness upon admission puts the patient at a greater risk for delirium.
patient illness upon admission puts the patient at a greater risk for delirium. Which of the following is an early indication of adequate fluid resuscitation? A a decreased heart rate A a narrowing pulse pressure C an S3 heart sound
Which of the following hemodynamic profiles would benefit from aggressive fluid administration, pressors, and antibiotic therapy? A right atrial pressure (RAP) 1 mmHg; pulmonary artery occlusion pressure (PAOP) 4 mmHg; systemic vascular resistance (SVR) 1,800 dynes/sec/cm-5; cardiac output (CO) 2 L/min B right atrial pressure (RAP) 5 mmHg; pulmonary artery occlusion pressure (PAOP) 7 mmHg; systemic vascular resistance (SVR) 400 dynes/sec/cm-5; cardiac output (CO) 8 L/min C right atrial pressure (RAP) 5 mmHg; pulmonary artery occlusion pressure (PAOP) 17 mmHg; systemic vascular resistance (SVR) 1,900 dynes/sec/cm-5; cardiac output (CO) 2 L/min D right atrial pressure (RAP) 12 mmHg; pulmonary artery occlusion pressure (PAOP) 7 mmHg; systemic
(PAOP) 7 mmHg; systemic vascular resistance (SVR) 400 dynes/sec/cm-5; cardiac output (CO) 8 L/min Pulmonary hypertension may result in which of the following? A left-sided heart failure B right-sided heart failure C increased lung compliance
A patient received a transfusion for upper GI bleeding 4 hours ago. The patient developed acute tachypnea, and the pulse oximeter read 0.88 on room air. After examining the patient and getting a chest radiograph, the physician diagnosed the patient with transfusion-related acute lung injury (TRALI). The nurse anticipates an order for which of the following? A furosemide (Lasix) B diphenhydramine (Benadryl) C subcutaneous epinephrine
support A patient with a history of chronic alcohol abuse was admitted in a stuporous state with an extremely elevated serum alcohol level. Which of the following will most likely be a part of the treatment plan for this patient? A naloxone, activated charcoal, sodium bicarbonate B flumazenil (Romazicon), lactulose, calcium gluconate C dialysis, cooling, potassium
Which of the following is indicative of a mixed acid-base disorder? A pH 7.18; PaCO2 25; PaO2 64; HCO3 11 B pH 7.33; PaCO2 29; PaO2 72; HCO3 15 C pH 7.35; PaCO2 61; PaO2 62; HCO3 4
PaO2 72; HCO 15 A patient has an 18 - gauge intravenous catheter in his right wrist. The nurse assessed the insertion site prior to administering an IV medication, and the nurse noticed that there was a red line up the arm above the insertion site, there was no swelling, the catheter blood return was brisk, and the site up the
arm with the red line was tender to touch. Which assessment and intervention is appropriate at this time? A The patient has an extravasation; apply warm compresses over the insertion site. B The patient has a grade 2 infiltration; restart the IV, and apply cool compresses over the insertion site. C The patient has phlebitis; restart the IV with a 20 - gauge catheter in the left arm. D The IV catheter is functional; give the IV medication, and reassess the catheter for blood return in an
gauge catheter in the left arm. Which of the following treatments is appropriate for the corresponding overdose? A dialysis for a salicylate overdose B Romazicon for an opiate overdose C a beta blocker for a cocaine overdose
salicylate overdose Which of the following would be LEAST likely to cause hypoglycemia for a patient with Type 1 diabetes? A late sepsis B discontinuation of enteral feeding after a morning insulin dose C a strenuous exercise session
A patient with diastolic heart failure develops supraventricular tachycardia, with a heart rate of 220 beats/minute. The most dangerous hemodynamic effect is a decrease in: A myocardial contractility. B coronary artery perfusion. C ejection fraction.
A 75 - year-old patient develops frequent 6 - to 10 - second episodes of asystole, interspersed with normal sinus rhythm that is associated with hypotension. The priority intervention is: A transcutaneous pacing. B a fluid bolus. C transvenous pacing.
A patient is receiving a heparin infusion for the treatment of a pulmonary embolism. There has been a 60% decrease in the platelet count and no clinical changes. Which of the following is indicated? A Administer vitamin K, and begin a direct thrombin inhibitor. B Discontinue heparin, and begin argatroban. C Order an enzyme-linked immunosorbent assay (ELISA), and infuse platelets.
Discontinue heparin, and begin argatroban Lab tests show urine sodium less than 20, urine osmolality greater than the serum osmolality, BUN 70, and creatinine 3.1. This is a sign of what type of renal failure? A renal hypoperfusion without tubular basement membrane involvement B nephrotoxic acute tubular necrosis, intrarenal failure C ischemic acute tubular necrosis, intrarenal failure
Which of the following statements about the provision of enteral nutrition for a critically ill patient is accurate? A It is preferred over the parenteral nutrition route. B It should be initiated 48 to 72 hours after the first day of mechanical ventilation. C It should be initiated after the patient has bowel sounds and passing flatus. D Enteral nutrition should be withheld if the gastric residual volume is greater than 100 mL. -
A patient with Type 1 diabetes has been started on metoprolol for heart disease. The nurse needs to inform the patient that the first sign of hypoglycemia might be which of the following? A mental status change B palpitations C diaphoresis
Which of the following are appropriate interventions for the treatment of anaphylaxis? A vasopressors, inotropes, fluids B epinephrine SQ, antihistamines, beta- 1 blockers C vasopressors, fluids, antibiotics
epinephrine IM, antihistamines, corticosteroids
Which of the following is most likely to be the etiology of diabetic ketoacidosis (DKA) and to require further investigation? A an infection B Type 2 diabetes C pancreatitis
One hemodynamic benefit of intra-aortic balloon pump therapy is that: A balloon inflation prevents right-to-left shunt. B balloon deflation increases coronary artery perfusion. C balloon inflation optimizes aortic valve performance.
balloon deflation decreases left ventricular afterload Which of the following patient diagnoses has the greatest degree of predictability? A an acute inferior wall MI B septic shock C heart failure
A patient presents with hypotension refractory to initial treatment, and a pulmonary artery catheter is placed. The hemodynamic profile demonstrates right atrial (RA) pressure 1 mmHg, pulmonary artery pressure (PAP) 19/6 mmHg, pulmonary artery occlusion pressure (PAOP) 4 mmHg, systemic vascular resistance (SVR) 1,500 dynes/sec/cm-5, and SvO2 55%. What is most likely the cause of this patient's hypotension, and what is the appropriate treatment? A hypovolemic shock; fluids B septic shock; vasopressors C cardiogenic shock; IABP
fluids A patient has right middle and lower lobe pneumonia. Which of the following is an appropriate intervention for this patient? A Provide fluids and expectorants. B Maintain the patient in a supine position. C Withhold enteral nutrition.
patient to the right side A patient was admitted post motor vehicle accident with hypotension and an INR of 8. Which of the following needs to be administered to this patient? A protamine sulfate B vitamin K C heparin
A patient with a history of thyroid disease was admitted with elevated TSH and decreased T3 and T4. Based on these lab results and the patient history, which of the following assessments would be expected for this patient? A tremor, fever, respiratory alkalosis B enlarged neck circumference, anemia, paranoia C hyperreflexia, tachycardia, flushed skin
delayed tendon reflexes, shallow respirations, bradycardia. Which of the following is a complication of acute pancreatitis? A septic shock B pneumonia C hypocalcemia
The hospital wants to implement strategies to conserve blood. Of the following, which is most likely to decrease blood utilization? A Continue administering platelet inhibitors pre-op.
B Monitor provider transfusion practices, and provide regular feedback. C Discontinue erythropoietin (EPO) and iron pre-op for patients with known anemia.
A patient with oat cell carcinoma has the following clinical findings: low urine output, low serum osmolality, hyponatremia, and elevated urine sodium. The nurse anticipates which of the following as part of the treatment plan? A vasopressin, free water B vasopressin, hypertonic saline C phenytoin (Dilantin), 3% saline
(Dilantin), 3 % normal saline What is an indication for which a patient, who is receiving mechanical ventilation, is placed in the prone position? A tachypnea B hypoventilation C pulmonary hypertension
Which of the following is NOT needed to calculate the creatinine clearance? A serum BUN B the patient's age C the patient's sex
A 70 kg patient required intubation for status asthmaticus. A propofol infusion was started at 40 mcg/kg/min, and the patient appears calm. The ventilator settings are: FiO2 0.30, assist-control mode 12 breaths/minute, tidal volume 400 mL, and an increased peak flow rate. The patient's respiratory rate is 28 breaths/minute, and the SpO2 is 0.98. Which of the following interventions should the nurse anticipate? A Administer vecuronium (Norcuron) PRN. B Decrease the tidal volume. C Increase the assist-control rate.
A patient has a flattened diaphragm, as confirmed on a chest X-ray, and a decreased expiratory flow rate. This patient most likely has which of the following? A pulmonary embolism
C pneumonia
disease What would be expected for a patient with intrarenal failure who requires hemodialysis? A low urine osmolality, low urine sodium A B high urine osmolality, low urine sodium C low urine osmolality, high urine sodium
osmolality, high urine sodium CORRECT ANSWER CORRECT A 24 - year-old female was admitted status post skull fracture, reportedly due to tripping down the basement stairs. Radiographic studies, that were done in the Emergency Department (ED), demonstrate healed rib and arm fractures. The patient has had frequent ED visits, and there is suspicion of domestic abuse. The patient's husband has constantly been at the patient's bedside since her admission. Which of the following nursing interventions would be most effective in this situation? A Explain to the patient and her husband that the health care provider suspects abuse. B Restrict the husband from visiting the patient. C Inform the patient and her husband that law enforcement have been notified.
PEEP therapy and mechanical ventilation are ordered for a patient with acute respiratory failure. Which of the following is a possible complication? A barotrauma B atelectasis C increased venous return
A patient's chest X-ray demonstrates a right upper lobe infiltrate. The mean arterial pressure (MAP) is 55 mmHg after fluid resuscitation, and the serum lactate is elevated. At this time, which of the following medications is a priority? A dopamine (Intropin) B norepinephrine (Levophed) C hydrocortisone (Solu-Cortef)
Which of the following clinical findings is typical of compensatory shock? A hypotension
B metabolic acidosis C blood pressure is maintained
A patient who is status post thoracic surgery has bubbling in the water seal drainage chamber of his chest tube. Which of the following interventions is indicated? A Avoid turning the patient onto his side. B Clamp the chest tube. C Avoid a high airway pressure.
airway pressure Which clinical sign might BOTH patients (one with systolic heart failure and one with diastolic heart failure) have in common? A peripheral edema B an enlarged heart size on a chest radiograph C lung crackles
A patient presents with elevated serum glucose. Which of the following parameters will best differentiate DKA from HHS in this situation?
A serum potassium B serum sodium C serum glucose
A patient presented with status asthmaticus and required mechanical ventilation. Which of the following findings would be expected shortly after intubation? A peak inspiratory pressure 68 cm H2O pressure; plateau pressure 25 cm H2O pressure B peak inspiratory pressure 68 cm H2O pressure; plateau pressure 40 cm H2O pressure C peak inspiratory pressure 28 cm H2O pressure; plateau pressure 22 cm H2O pressure D peak inspiratory pressure 28 cm H2O pressure; plateau pressure 42 cm H2O pressure -
pressure 25 cm H2O pressure A man is admitted with a gunshot wound to the head. The nurse is told by the trauma surgeon that the patient has cranial nerve III involvement. Which of the following is evidence of cranial nerve III involvement? A loss of gag reflex B right pupil is dilated and nonreactive C decerebrate posturing
dilated and no reactive. Which of the following is a contraindication to noninvasive ventilation? A a need for FiO2 of 0. B hypoventilation C obtunded mental status
A patient presents with hypotension refractory to initial treatment, and a pulmonary artery catheter was placed. The hemodynamic profile revealed the following: right atrial (RA) pressure 10 mmHg, pulmonary artery pressure (PAP) 49/25 mmHg, pulmonary artery occlusion pressure (PAOP) 24 mmHg, systemic vascular resistance (SVR) 1,900 dynes/sec/cm-5, and SvO2 48%. What is most likely the cause of this patient's hypotension and the appropriate treatment for it? A hypovolemic shock; fluids B septic shock; vasopressors C cardiogenic shock; IABP
Which of the following is most likely to result in a low SvO2? A hypothermia
B sepsis C a fever
A patient's arterial line waveform on the bedside monitor appears overdamped. The nurse understands that this: A may be due to pinpoint air bubbles in the tubing/transducer system. B leads to a false high pressure reading. C may be due to add-on pressure tubing.
pressure reading A patient is being treated for status epilepticus, and he requires intubation and mechanical ventilation. Which of the following possible pathophysiological changes might the nurse anticipate? A hypokalemia B decreased PaCO2 C bradycardia
A 19 - year-old male was admitted with traumatic injuries secondary to a motor vehicle accident. The ECG demonstrates a sinus rhythm with a short PR interval and the presence of a slow rise of the initial upstroke of the QRS. This patient is at risk for developing which of the following? A pre-excited atrial fibrillation B second-degree AV block, Type II C third-degree AV block
A patient has a blood pressure of 78/40, a right atrial (RA) pressure of 1 mmHg, a pulmonary artery occlusion pressure (PAOP) of 4 mmHg, a systemic vascular resistance (SVR) of 1,800 dynes/s/cm-5, and a cardiac output (CO) of 3 L/min. Which of the following statements about this patient is correct? A The patient has septic shock; provide vasopressors. B The patient has cardiogenic shock; provide positive inotropes. C The patient has hypovolemic shock; provide fluid resuscitation.
patient has hypovolemic shock; provide fluid resuscitation Which of the following nurse characteristics best reflects the nurse's ability to provide professional caring and ethical practice? A The nurse adheres to the rules without any exceptions. B The nurse focuses solely on the patient's physiological needs.
C The nurse targets individuals, rather than system processes, when errors occur.
Which of the following is an effective strategy for the assessment of and management of pain for a critically ill adult? A If the patient cannot accurately self-report pain, consider asking a family member, who knows the patient, whether the patient's behavior may indicate the presence of pain. B If the patient is agitated, provide sedation first, and then treat the pain with an analgesic. C Avoid the use of the Numerical Rating Scale for a patient who is receiving mechanical ventilation. D Titrate propofol for a patient with severe pain who is receiving mechanical ventilation. - CORRECT ANSWER>>>A. If the patient cannot accurately self-report pain, consider asking a family member, who knows the patient, whether the patient's behavior may indicate the presence of pain. A patient was admitted 24 hours ago with ST elevation in leads II, III, and aVF and cardiogenic shock. The patient was stabilized, but she now complains of acute dyspnea. Her PAOP is 22 mmHg with giant V- waves. The nurse anticipates: A papillary muscle rupture. B mitral stenosis. C a pulmonary embolism.
A patient with right ventricular infarction would most likely have which of the following hemodynamic pressure findings? A right atrial (RA) 4 mmHg, pulmonary artery occlusion pressure (PAOP) 18 mmHg B right atrial (RA) pressure 14 mmHg, pulmonary artery occlusion pressure (PAOP) 5 mmHg C right atrial (RA) 14 mmHg, pulmonary artery occlusion pressure (PAOP) 18 mmHg D right atrial (RA) 0 mmHg, pulmonary artery occlusion pressure (PAOP) 5 mmHg - CORRECT ANSWER>>>B. right atrial (RA) pressure 14 mmHg, pulmonary artery occlusion pressure (PAOP) 5 mmHg A patient requires fluid resuscitation and 8 units of PRBCs status post traumatic injury. Which of the following interventions is most appropriate? A Warm both blood products and crystalloids. B Monitor for hypercalcemia. C Start norepinephrine for a systolic pressure less than 90 mmHg.
products and crystalloids. Which of the following patients is a candidate for an internal fecal management system (FMS)? A a patient with excoriated skin and frequent, incontinent liquid stool B a patient with reddened skin and frequent, incontinent soft stools
C a patient who is status post large bowel resection
a patient with excoriated skin and frequent, incontinent liquid stool A patient has been diagnosed with a fat embolism. Which of the following clinical findings is most likely present for this patient? A deep vein thrombosis, hypoxemia B a long bone fracture, petechiae C pulmonary edema, hypotension
A Jehovah's Witness was admitted with a bleeding, perforated gastric ulcer. The patient's hemoglobin and hematocrit have decreased. Which of the following interventions is most appropriate for this patient? A Explain the consequences of refusing blood transfusions. B Administer washed PRBCs. C Ask the patient to sign a "No CPR" order.
blood transfusions. A patient is 5 days status post subarachnoid hemorrhage, and she develops a change in level of consciousness and hyponatremia. Which of the following orders should the nurse anticipate?