TEST BANK INTRODUCTION TO CRITICAL CARE NURSING 7TH EDITION QUESTIONS WITH ANSWERS, Exams of Nursing

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TEST BANK INTRODUCTION TO

CRITICAL CARE NURSING 7TH EDITION

QUESTIONS WITH ANSWERS

Chapter06:NutritionalTherapy - Correct answer 1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Becauseenteral tubefeedingsarenotpossible,thedecisionistoinitiateparenteralfeedings.Whatarethemajorc omplicationsforthistherapy - Correct answer b. Fluidandelectrolyteimbalancesandsepsis 1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Becauseenteral tubefeedingsarenotpossible,thedecisionistoinitiateparenteralfeedings.Whatarethemajorc omplicationsforthistherapy - Correct answer b. Fluidandelectrolyteimbalancesandsepsis .Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastricsmall- borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement ? - Correct answer d. Topreventaspirationofthefeedings .Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastricsmall- borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement ? - Correct answer d. Topreventaspirationofthefeedings 3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcatheterins ertion? - Correct answer d. Subclavianvein 3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcatheterins ertion? - Correct answer d. Subclavianvein 4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallowstudy,th epatientisplacedonenteralfeedings.Followingplacementofanasogastrictubefortubefeedin g,whatisthenextcriticalstep? - Correct answer c. Obtainachestradiograph. 4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallowstudy,th epatientisplacedonenteralfeedings.Followingplacementofanasogastrictubefortubefeedin g,whatisthenextcriticalstep? - Correct answer c. Obtainachestradiograph.

5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinuousflo wtubefeeding.Thenurseknowsthatthisapproachwaschosenbecause: - Correct answer c. theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves 5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinuousflo wtubefeeding.Thenurseknowsthatthisapproachwaschosenbecause: - Correct answer c. theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves 6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewouldcarryo utwhichinterventiontominimizeaspirationrisk? - Correct answer Elevatetheheadofthebed30degrees. 6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewouldcarryo utwhichinterventiontominimizeaspirationrisk? - Correct answer Elevatetheheadofthebed30degrees. 7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilkygreenfl uid.Thisisaconcernbecausethismostlikelydemonstratesthatthepatienthas: - Correct answer d. tube feeding intolerance. 7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilkygreenfl uid.Thisisaconcernbecausethismostlikelydemonstratesthatthepatienthas: - Correct answer d. tube feeding intolerance. 8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.Thenur seholdsthetubefeeding,whichhadbeeninfusingat100mL/ hr.Thenurseknowsthatthenextactionshouldbe: - Correct answer d. recheck the residual in 2hours 8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.Thenur seholdsthetubefeeding,whichhadbeeninfusingat100mL/ hr.Thenurseknowsthatthenextactionshouldbe: - Correct answer d. recheck the residual in 2hours 9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolerance? - Correct answer a. Abdominal distention 9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolerance? - Correct answer a. Abdominal distention 10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrhea.Asto olspecimeniscollectedtocheckforwhichpossiblecause? - Correct answer a. Clostridium difficile

10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrhea.Asto olspecimeniscollectedtocheckforwhichpossiblecause? - Correct answer a. Clostridium difficile 11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurselistedpo ssibleinterventionsforthispatient.Whichinterventionneedscorrectionbeforefinalizingthepla nofcare? - Correct answer b. Infuseantibioticsthroughtheintravenousline. 11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurselistedpo ssibleinterventionsforthispatient.Whichinterventionneedscorrectionbeforefinalizingthepla nofcare? - Correct answer b. Infuseantibioticsthroughtheintravenousline. 12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemostsensiti veindicatorofproteinsynthesisandcatabolism? - Correct answer c. Prealbumin 12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemostsensiti veindicatorofproteinsynthesisandcatabolism? - Correct answer c. Prealbumin 13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug- nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug- nutrientreactions? - Correct answer d. Phenytoin 13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug- nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug- nutrientreactions? - Correct answer d. Phenytoin 14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract? - Correct answer d. Without nutritional stimulation, mucosal villi atrophy. 14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract? - Correct answer d. Without nutritional stimulation, mucosal villi atrophy. 15.An important nutritional consideration in the elderly population is: - Correct answer c. potential for drug-nutrient interaction related to polypharmacy. 15.An important nutritional consideration in the elderly population is: - Correct answer c. potential for drug-nutrient interaction related to polypharmacy. 16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude: - Correct answer d. weight loss, elevated glucose, and dehydration 16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude: - Correct answer d. weight loss, elevated glucose, and dehydration

17.In trauma patients ,enteral nutrition via nasogastric tube feedings into the small bowel is best initiated within what time frame following the injury? - Correct answer a. 24hours 17.In trauma patients ,enteral nutrition via nasogastric tube feedings into the small bowel is best initiated within what time frame following the injury? - Correct answer a. 24hours 18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalcareunito naventilator.Thenutritionassessmentnotesthatthepatienthasaproteinandvitamindeficienc yandisunderweight.Whichformulafornutritionalassessmentismostappropriate? - Correct answer b. Fiber-added formula 18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalcareunito naventilator.Thenutritionassessmentnotesthatthepatienthasaproteinandvitamindeficienc yandisunderweight.Whichformulafornutritionalassessmentismostappropriate? - Correct answer b. Fiber-added formula 19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceofnutrition altherapy - Correct answer d. Gut mucosa is preserved. 19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceofnutrition altherapy - Correct answer d. Gut mucosa is preserved. 20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein? - Correct answer b. The patient with ileitis 20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein? - Correct answer b. The patient with ileitis 21.Thebestnursingapproachtopreventfeedingtubeobstructionis: - Correct answer b. flushthetubeevery4hourswith20to30mLoftapwater. 21.Thebestnursingapproachtopreventfeedingtubeobstructionis: - Correct answer b. flushthetubeevery4hourswith20to30mLoftapwater. 22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequirementsto : - Correct answer c. 35kcal/kg/day 22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequirementsto : - Correct answer c. 35kcal/kg/day 23.Malnutritioncontributestoinfectionriskby - Correct answer b. impairing immune function

23.Malnutritioncontributestoinfectionriskby - Correct answer b. impairing immune function 24.Apatient,whohasatubefeeding,requiresachestx- raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse: - Correct answer d. stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph. 24.Apatient,whohasatubefeeding,requiresachestx- raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse: - Correct answer d. stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph. 1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?(Selectallthatapply.) - Correct answer a. Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsiderations.b. Fingerstickglucoselevelsareassessedevery6hoursandprn. d. Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydrates, andfats. 1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?(Selectallthatapply.) - Correct answer a. Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsiderations.b. Fingerstickglucoselevelsareassessedevery6hoursandprn. d. Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydrates, andfats. 2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration? (Selectallthatapply). - Correct answer b. Changethetubingevery24hours. d. Monitortriglyceridelevels. 2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration? (Selectallthatapply). - Correct answer b. Changethetubingevery24hours. d. Monitortriglyceridelevels. 3.Calorie-densefeedings:(Selectallthatapply.) - Correct answer a. are most useful in heart failure and liver disease. 3.Calorie-densefeedings:(Selectallthatapply.) - Correct answer a. are most useful in heart failure and liver disease. 4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.) - Correct answer b. elevatedbloodsugar. c. infectionatthecathetersite. d. volumeoverload.

4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.) - Correct answer b. elevatedbloodsugar. c. infectionatthecathetersite. d. volumeoverload. 5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition? (Selectallthatapply.) - Correct answer a. Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues. b. Insulinmaybeaddedtoaparenteralnutritionsolution. c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition. 5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition? (Selectallthatapply.) - Correct answer a. Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues. b. Insulinmaybeaddedtoaparenteralnutritionsolution. c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition. Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__ - Correct answer A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency. D.Obtainchestradiograph. E.Assessresiduals. ANS: B,D,C,A,E Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__ - Correct answer A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency. D.Obtainchestradiograph. E.Assessresiduals. ANS: B,D,C,A,E 1.Apatienthascoronaryarterybypassgraftsurgeryandistransportedtothesurgicalintensivec areunitatnoon.Heisplacedonmechanicalventilation.Interprethisinitialarterialbloodgaslevel s: pH7. PaCO248mmHg Bicarbonate22mEq/L PaO2115mmHg O2saturation99% - Correct answer d. Uncompensated respiratory acidosis; hyper oxygenated 1.Apatienthascoronaryarterybypassgraftsurgeryandistransportedtothesurgicalintensivec areunitatnoon.Heisplacedonmechanicalventilation.Interprethisinitialarterialbloodgaslevel s: pH7. PaCO248mmHg Bicarbonate22mEq/L PaO2115mmHg O2saturation99% - Correct answer d. Uncompensated respiratory

acidosis; hyper oxygenated 2.Thephysicianordersthefollowingmechanicalventilationsettingsforapatientwhoweighs kg.Thepatientsspontaneousrespiratoryrateis22breaths/ min.Whatarterialbloodgasabnormalitymayoccurifthepatientcontinuestobetachypneicatthe seventilatorsettings? Settings: Tidalvolume:600mL(8mLperkg) FiO2:0. Respiratoryrate:14breaths/min Mode assist/ control - Correct answer d. Respiratory alkalosis 2.Thephysicianordersthefollowingmechanicalventilationsettingsforapatientwhoweighs kg.Thepatientsspontaneousrespiratoryrateis22breaths/ min.Whatarterialbloodgasabnormalitymayoccurifthepatientcontinuestobetachypneicatthe seventilatorsettings? Settings: Tidalvolume:600mL(8mLperkg) FiO2:0. Respiratoryrate:14breaths/min Mode assist/ control - Correct answer d. Respiratory alkalosis 3.Apatientsventilatorsettingsareadjustedtotreathypoxemia.Thefractionofinspiredoxygenis increasedfrom.60to.70,andthepositiveend- expiratorypressureisincreasedfrom10to15cmH2O.Shortlyaftertheseadjustments,thenurs enotesthatthepatientsbloodpressuredropsfrom120/76mmHgto90/60mmHg.Whatisthemo stlikelycauseofthisdecreaseinbloodpressure? - Correct answer a. Decrease in cardiac output 3.Apatientsventilatorsettingsareadjustedtotreathypoxemia.Thefractionofinspiredoxygenis increasedfrom.60to.70,andthepositiveend- expiratorypressureisincreasedfrom10to15cmH2O.Shortlyaftertheseadjustments,thenurs enotesthatthepatientsbloodpressuredropsfrom120/76mmHgto90/60mmHg.Whatisthemo stlikelycauseofthisdecreaseinbloodpressure? - Correct answer a. Decrease in cardiac output 4.Thenurseiscaringforapatientwithanendotrachealtube.Thenurseunderstandsthatendotra chealsuctioningisneededtofacilitateremovalofsecretionsandthattheprocedure: - Correct answer c. is done as indicated by patient assessment. 4.Thenurseiscaringforapatientwithanendotrachealtube.Thenurseunderstandsthatendotra chealsuctioningisneededtofacilitateremovalofsecretionsandthattheprocedure: - Correct answer c. is done as indicated by patient assessment.

5.A65-year-oldpatientisadmittedtotheprogressivecareunitwithadiagnosisofcommunity- acquiredpneumonia.Thepatienthasahistoryofchronicobstructivepulmonarydiseaseanddia betes.Asetofarterialbloodgasesobtainedonadmissionwithoutsupplementaloxygenshowsp H7.35;PaCO255mmHg;bicarbonate30mEq/L;PaO265mmHg.Thesebloodgasesreflect: - Correct answer hypoxemia and compensated respiratory acidosis 5.A65-year-oldpatientisadmittedtotheprogressivecareunitwithadiagnosisofcommunity- acquiredpneumonia.Thepatienthasahistoryofchronicobstructivepulmonarydiseaseanddia betes.Asetofarterialbloodgasesobtainedonadmissionwithoutsupplementaloxygenshowsp H7.35;PaCO255mmHg;bicarbonate30mEq/L;PaO265mmHg.Thesebloodgasesreflect: - Correct answer hypoxemia and compensated respiratory acidosis 6.Apatientsstatusworsensandneedsmechanicalventilation.Thepulmonologistwantsthepat ienttoreceive10breaths/ minfromtheventilatorbutwantstoencouragethepatienttobreathespontaneouslyinbetweent hemechanicalbreathsathisowntidalvolume.Thismodeofventilationiscalled: - Correct answer c. intermittent mandatory ventilation 6.Apatientsstatusworsensandneedsmechanicalventilation.Thepulmonologistwantsthepat ienttoreceive10breaths/ minfromtheventilatorbutwantstoencouragethepatienttobreathespontaneouslyinbetweent hemechanicalbreathsathisowntidalvolume.Thismodeofventilationiscalled: - Correct answer c. intermittent mandatory ventilation 7.Apatientsendotrachealtubeisnotsecuredtightly.Therespiratorycarepractitionerassiststh enurseintapingthetube.Afterthetubeisretaped,thenurseauscultatesthepatientslungsandn otesthatthebreathsoundsovertheleftlungfieldsareabsent.Thenursesuspectsthat: - Correct answer a. the endotracheal tube is in the right main stem bronchus. 7.Apatientsendotrachealtubeisnotsecuredtightly.Therespiratorycarepractitionerassiststh enurseintapingthetube.Afterthetubeisretaped,thenurseauscultatesthepatientslungsandn otesthatthebreathsoundsovertheleftlungfieldsareabsent.Thenursesuspectsthat: - Correct answer a. the endotracheal tube is in the right main stem bronchus. 8.Amodeofpressure- targetedventilationthatprovidespositivepressuretodecreasetheworkloadofspontaneousbr eathingthroughtheendotrachealtubeis: - Correct answer c. pressure support ventilation. 8.Amodeofpressure- targetedventilationthatprovidespositivepressuretodecreasetheworkloadofspontaneousbr eathingthroughtheendotrachealtubeis: - Correct answer c. pressure support ventilation. 9.Neuromuscularblockingagentsareusedinthemanagementofsomeventilatedpatients.The irprimarymodeofactionis: - Correct answer c. paralysis

9.Neuromuscularblockingagentsareusedinthemanagementofsomeventilatedpatients.The irprimarymodeofactionis: - Correct answer c. paralysis 10.Oneoftheearlysignsoftheeffectofhypoxemiaonthenervoussystemis: - Correct answer restlessness. 10.Oneoftheearlysignsoftheeffectofhypoxemiaonthenervoussystemis: - Correct answer restlessness. 11.Theamountofeffortneededtomaintainagivenlevelofventilationistermed: - Correct answer work of breathing. 11.Theamountofeffortneededtomaintainagivenlevelofventilationistermed: - Correct answer work of breathing. 12.Whichofthefollowingdevicesisbestsuitedtodeliver65%oxygentoapatientwhoisspontan eouslybreathing? - Correct answer a. Face mask with non-rebreathing reservoir 12.Whichofthefollowingdevicesisbestsuitedtodeliver65%oxygentoapatientwhoisspontan eouslybreathing? - Correct answer a. Face mask with non-rebreathing reservoir 13.Apatientisbeingmechanicallyventilatedinthesynchronizedintermittentmandatoryventila tionmodeatarateof4breaths/min.Hisspontaneousrespirationsare12breaths/ min.Hereceivesadoseofmorphinesulfate,andhisrespirationsdecreaseto4breaths/ min.Whichacid-basedisturbancewilllikelyoccur? - Correct answer Respiratory acidosis 13.Apatientisbeingmechanicallyventilatedinthesynchronizedintermittentmandatoryventila tionmodeatarateof4breaths/min.Hisspontaneousrespirationsare12breaths/ min.Hereceivesadoseofmorphinesulfate,andhisrespirationsdecreaseto4breaths/ min.Whichacid-basedisturbancewilllikelyoccur? - Correct answer Respiratory acidosis 14.Apatientisbeingmechanicallyventilatedinthesynchronizedintermittentmandatoryventila tionmodeatarateof4breaths/min.Hisspontaneousrespirationsare12breaths/ min.Hereceivesadoseofmorphinesulfate,andhisrespirationsdecreaseto4breaths/ min.Whatadjustmentsmayneedtobemadetothepatientsventilatorsettings? - Correct answer Increasethesynchronizedintermittentmandatoryventilationrespiratoryrate 14.Apatientisbeingmechanicallyventilatedinthesynchronizedintermittentmandatoryventila tionmodeatarateof4breaths/min.Hisspontaneousrespirationsare12breaths/ min.Hereceivesadoseofmorphinesulfate,andhisrespirationsdecreaseto4breaths/ min.Whatadjustmentsmayneedtobemadetothepatientsventilatorsettings? - Correct answer Increasethesynchronizedintermittentmandatoryventilationrespiratoryrate 15.Currentguidelinesrecommendtheoralrouteforendotrachealintubation.Therationaleforth isrecommendationisthatnasotrachealintubationisassociatedwithagreaterriskfor: - Correct answer d. sinusitisandinfection.

15.Currentguidelinesrecommendtheoralrouteforendotrachealintubation.Therationaleforth isrecommendationisthatnasotrachealintubationisassociatedwithagreaterriskfor: - Correct answer d. sinusitisandinfection. 16.Oxygensaturation(SaO2)represents: - Correct answer b. oxygen that is chemically combined with hemoglobin. 16.Oxygensaturation(SaO2)represents: - Correct answer b. oxygen that is chemically combined with hemoglobin. 17.Pulseoximetrymeasures: - Correct answer d. oxygen saturation. 17.Pulseoximetrymeasures: - Correct answer d. oxygen saturation. 18.APaCO2of48mmHgisassociatedwith: - Correct answer .b. hypoventilation. 18.APaCO2of48mmHgisassociatedwith: - Correct answer .b. hypoventilation. 19.Thenursenotesthatthepatientsarterialbloodgaslevelsindicatehypoxemia.Thepatientisn otintubatedandhasarespiratoryrateof22breaths/ min.Thenursesfirstinterventiontorelievehypoxemiaisto: - Correct answer c. notify the provider of values and obtain order for oxygen. 19.Thenursenotesthatthepatientsarterialbloodgaslevelsindicatehypoxemia.Thepatientisn otintubatedandhasarespiratoryrateof22breaths/ min.Thenursesfirstinterventiontorelievehypoxemiaisto: - Correct answer c. notify the provider of values and obtain order for oxygen. 20.Apatientpresentstotheemergencydepartmentdemonstratingagitationandcomplainingo fnumbnessandtinglinginhisfingers.Hisarterialbloodgaslevelsrevealthefollowing:pH7.51,P aCO225,HCO325.Thenurseinterpretsthesebloodgasvaluesas: - Correct answer d. uncompensated respiratory alkalosis. 20.Apatientpresentstotheemergencydepartmentdemonstratingagitationandcomplainingo fnumbnessandtinglinginhisfingers.Hisarterialbloodgaslevelsrevealthefollowing:pH7.51,P aCO225,HCO325.Thenurseinterpretsthesebloodgasvaluesas: - Correct answer d. uncompensated respiratory alkalosis. 21.Positiveend- expiratorypressure(PEEP)isamodeofventilatoryassistancethatproducesthefollowingcondi tion: - Correct answer d. There is pressure remaining in the lungs at the end of expiration that is measured in cm H2O. 21.Positiveend- expiratorypressure(PEEP)isamodeofventilatoryassistancethatproducesthefollowingcondi

tion: - Correct answer d. There is pressure remaining in the lungs at the end of expiration that is measured in cm H2O. 22.Thenurseiscaringforapatientwhoismechanicallyventilated.Aspartofthenursingcare,the nurseunderstandsthat: - Correct answer a. communication with intubated patients is often difficult. 22.Thenurseiscaringforapatientwhoismechanicallyventilated.Aspartofthenursingcare,the nurseunderstandsthat: - Correct answer a. communication with intubated patients is often difficult. 23.Apatientishavingdifficultyweaningfrommechanicalventilation.Thenurseassessesthepa tientforapotentialcauseofthisdifficultweaning,whichincludes: - Correct answer b. hemoglobinof8g/dL 23.Apatientishavingdifficultyweaningfrommechanicalventilation.Thenurseassessesthepa tientforapotentialcauseofthisdifficultweaning,whichincludes: - Correct answer b. hemoglobinof8g/dL 24.A53-year-old,80- kgpatientisadmittedtothecardiacsurgicalintensivecareunitaftercardiacsurgerywith thefollowingarterialbloodgas(ABG)levels.Whatisthenursesinterpretationofthesevalues? - Correct answer c. Normal ABG val 24.A53-year-old,80- kgpatientisadmittedtothecardiacsurgicalintensivecareunitaftercardiacsurgerywith thefollowingarterialbloodgas(ABG)levels.Whatisthenursesinterpretationofthesevalues? - Correct answer c. Normal ABG val 25.A53-year-old,80- kgpatientisadmittedtothecardiacsurgicalintensivecareunitaftercardiacsurgery. Fourhoursafteradmissiontothesurgicalintensivecareunitat4PM,thepatienthasstablevitalsi gnsand normalarterialbloodgases(ABGs),andisplacedonaT- pieceforventilatoryweaning.Duringthenurses PM(1900)assessment,thepatientisrestless,heartratehasincreasedto110beats/ min,respirationsare breaths/min,andbloodpressureis156/98mmHg.Thecardiacmonitorshowssinustachycardi awith prematureventricularcontractions(PVCs)perminute.Pulmonaryarterypressuresareelevate d.Thenurse suctionsthepatientandobtainspink,frothysecretions.Loudcracklesareaudiblethroughoutlu ngfields. Thenursenotifiesthephysician,whoordersanABGanalysis,electrolytelevels,andaportablec hestx-ray study.Howdoesthenurseinterpretthefollowingbloodgaslevels - Correct answer Hypoxemia and uncompensated respiratory acidosis

25.A53-year-old,80- kgpatientisadmittedtothecardiacsurgicalintensivecareunitaftercardiacsurgery. Fourhoursafteradmissiontothesurgicalintensivecareunitat4PM,thepatienthasstablevitalsi gnsand normalarterialbloodgases(ABGs),andisplacedonaT- pieceforventilatoryweaning.Duringthenurses PM(1900)assessment,thepatientisrestless,heartratehasincreasedto110beats/ min,respirationsare breaths/min,andbloodpressureis156/98mmHg.Thecardiacmonitorshowssinustachycardi awith prematureventricularcontractions(PVCs)perminute.Pulmonaryarterypressuresareelevate d.Thenurse suctionsthepatientandobtainspink,frothysecretions.Loudcracklesareaudiblethroughoutlu ngfields. Thenursenotifiesthephysician,whoordersanABGanalysis,electrolytelevels,andaportablec hestx-ray study.Howdoesthenurseinterpretthefollowingbloodgaslevels - Correct answer Hypoxemia and uncompensated respiratory acidosis 26.A53-year-old,80- kgpatientisadmittedtothecardiacsurgicalintensivecareunitaftercardiacsurgery. Fourhoursafteradmissiontothesurgicalintensivecareunitat4PM,thepatienthasstablevitalsi gnsand normalarterialbloodgases(ABGs)andisplacedonaT- pieceforventilatoryweaning.Duringthenurses7PM (1900)assessment,thepatientisrestless,heartratehasincreasedto110beats/ min,respirationsare breaths/min,andbloodpressureis156/98mmHg.Thecardiacmonitorshowssinustachycardi awith prematureventricularcontractions(PVCs)perminute.Pulmonaryarterypressuresareelevate d.Thenurse suctionsthepatientandobtainspink,frothysecretions.Loudcracklesareaudiblethroughoutlu ngfields.The nursenotifiesthephysician,whoordersanABGanalysis,electrolytelevels,andaportablechest x-raystudy. Incommunicatingwiththephysician,whichstatementindicatesthenurseunderstandswhatisli kelyoccurring withthepatient? - Correct answer My assessment indicates potential fluid overload 26.A53-year-old,80- kgpatientisadmittedtothecardiacsurgicalintensivecareunitaftercardiacsurgery. Fourhoursafteradmissiontothesurgicalintensivecareunitat4PM,thepatienthasstablevitalsi gnsand normalarterialbloodgases(ABGs)andisplacedonaT- pieceforventilatoryweaning.Duringthenurses7PM (1900)assessment,thepatientisrestless,heartratehasincreasedto110beats/ min,respirationsare breaths/min,andbloodpressureis156/98mmHg.Thecardiacmonitorshowssinustachycardi awith prematureventricularcontractions(PVCs)perminute.Pulmonaryarterypressuresareelevate

d.Thenurse suctionsthepatientandobtainspink,frothysecretions.Loudcracklesareaudiblethroughoutlu ngfields.The nursenotifiesthephysician,whoordersanABGanalysis,electrolytelevels,andaportablechest x-raystudy. Incommunicatingwiththephysician,whichstatementindicatesthenurseunderstandswhatisli kelyoccurring withthepatient? - Correct answer My assessment indicates potential fluid overload 27.Thenurseiscaringforamechanicallyventilatedpatientandnotesthehighpressurealarmso unding.The nursecannotquicklyidentifythecauseofthealarmandnotesthepatientsoxygensaturationisde creasing andheartrateandrespiratoryrateareincreasing.Thenursespriorityactionisto - Correct answer d. manually ventilate the patient while calling for a respiratory therapist 27.Thenurseiscaringforamechanicallyventilatedpatientandnotesthehighpressurealarmso unding.The nursecannotquicklyidentifythecauseofthealarmandnotesthepatientsoxygensaturationisde creasing andheartrateandrespiratoryrateareincreasing.Thenursespriorityactionisto - Correct answer d. manually ventilate the patient while calling for a respiratory therapist 28.Thenurseiscaringforapatientwhoseventilatorsettingsinclude15cmH2Oofpositiveend- expiratory pressure(PEEP).Thenurseunderstandsthatalthoughbeneficial,PEEPmayresultin: - Correct answer d. low cardiac output secondary to increased intrathoracic pressure 28.Thenurseiscaringforapatientwhoseventilatorsettingsinclude15cmH2Oofpositiveend- expiratory pressure(PEEP).Thenurseunderstandsthatalthoughbeneficial,PEEPmayresultin: - Correct answer d. low cardiac output secondary to increased intrathoracic pressure 29.Whenassessingthepatientforhypoxemia,thenurserecognizesthatanearlysignoftheeffe ct ofhypoxemiaonthecardiovascularsystemis - Correct answer tachycardia 29.Whenassessingthepatientforhypoxemia,thenurserecognizesthatanearlysignoftheeffe ct ofhypoxemiaonthecardiovascularsystemis - Correct answer tachycardia 30.Thenurseiscaringforamechanicallyventilatedpatient.Thephysiciansareconsideringperf orminga tracheostomybecausethepatientishavingdifficultyweaningfrommechanicalventilation.Rel atedto tracheostomy,thenurseunderstandswhichofthefollowing - Correct answer The greatest risk after a percutaneous tracheostomy is accidental Dec annulation 30.Thenurseiscaringforamechanicallyventilatedpatient.Thephysiciansareconsideringperf orminga tracheostomybecausethepatientishavingdifficultyweaningfrommechanicalventilation.Rel

atedto tracheostomy,thenurseunderstandswhichofthefollowing - Correct answer The greatest risk after a percutaneous tracheostomy is accidental Dec annulation 31.Thenurseisassessingtheexhaledtidalvolume(EVT)inamechanicallyventilatedpatient.T he rationaleforthisassessmentisto: - Correct answer compare the tidal volume delivered with the tidal volume prescribed 31.Thenurseisassessingtheexhaledtidalvolume(EVT)inamechanicallyventilatedpatient.T he rationaleforthisassessmentisto: - Correct answer compare the tidal volume delivered with the tidal volume prescribed 1.Thenurseiscaringforamechanicallyventilatedpatientandrespondstoahighinspiratorypres surealarm. Recognizingpossiblecausesforthealarm,thenurseassessesforwhichofthefollowing - Correct answer Coughing or attempting to talk/ c. Kinks in the ventilator Need for suctioning 1.Thenurseiscaringforamechanicallyventilatedpatientandrespondstoahighinspiratorypres surealarm. Recognizingpossiblecausesforthealarm,thenurseassessesforwhichofthefollowing - Correct answer Coughing or attempting to talk/ c. Kinks in the ventilator Need for suctioning Selectallofthefactorsthatmaypredisposethepatienttorespiratoryacidosi - Correct answer Central nervous system depression Overdose of sedative Selectallofthefactorsthatmaypredisposethepatienttorespiratoryacidosi - Correct answer Central nervous system depression Overdose of sedative 3.Thenurseisassistingwithendotrachealintubationandunderstandscorrectplacementofthe endotrachealtubeinthetracheawouldbeidentifiedbywhichofthefollowing? (Selectallthatapply. - Correct answer Equal bilateral breath sounds upon auscultation Position above the carina verified by chest x-ray Positive detection of carbon dioxide(CO2) through CO2 detector devices 3.Thenurseisassistingwithendotrachealintubationandunderstandscorrectplacementofthe endotrachealtubeinthetracheawouldbeidentifiedbywhichofthefollowing? (Selectallthatapply. - Correct answer Equal bilateral breath sounds upon auscultation Position above the carina verified by chest x-ray Positive detection of carbon dioxide(CO2) through CO2 detector devices

1.Thenurseiscaringforamechanicallyventilatedpatientandischartingoutsidethepatientsroo mwhenthe ventilatoralarmsounds.Whatisthepriorityorderforthenursetocompletetheseactions:_____ __________, _______________,_______________,_______________? (Putacommaandspacebetweeneachanswerchoice - Correct answer Go to patient’s bedside. After troubleshooting, connect back to mechanical ventilator and reassess patient. Manually ventilate the patient while getting respiratory therapist Barter troubleshooting, connect back to mechanical ventilator and reassess patient 1.Thenurseiscaringforamechanicallyventilatedpatientandischartingoutsidethepatientsroo mwhenthe ventilatoralarmsounds.Whatisthepriorityorderforthenursetocompletetheseactions:_____ __________, _______________,_______________,_______________? (Putacommaandspacebetweeneachanswerchoice - Correct answer Go to patient’s bedside. After troubleshooting, connect back to mechanical ventilator and reassess patient. Manually ventilate the patient while getting respiratory therapist Barter troubleshooting, connect back to mechanical ventilator and reassess patient 2.Thenurseisassistingwithendotrachealintubationofthepatientandrecognizesthattheproce durewill bed one in what order - Correct answer Assess balloon on endotracheal tube for symmetry and leaks Suction oropharynx. Insert endotracheal tube with laryngoscope and blade .Inflate balloon of endotracheal tube. Assess lung fields for bilateral expansion 2.Thenurseisassistingwithendotrachealintubationofthepatientandrecognizesthattheproce durewill bed one in what order - Correct answer Assess balloon on endotracheal tube for symmetry and leaks Suction oropharynx. Insert endotracheal tube with laryngoscope and blade .Inflate balloon of endotracheal tube. Assess lung fields for bilateral expansion 1.Thenurseisworkingforahospitalthatholdsanagreementwithalocalorganprocurementorga nization (OPO).ThepatienthasaGlasgowComaScale(GCS)scoreof3anddiscussionshavebeenheld withthe familyaboutwithdrawinglifesupport.Whichstatementbythenursebestdescribesrequirement sthatmust bemettosustainCentersforMedicareandMedicaidServices(CMS)ConditionsofParticipatio n? - Correct answer a. I need to notify Trans Life (OPO) of my patients impending death

1.Thenurseisworkingforahospitalthatholdsanagreementwithalocalorganprocurementorga nization (OPO).ThepatienthasaGlasgowComaScale(GCS)scoreof3anddiscussionshavebeenheld withthe familyaboutwithdrawinglifesupport.Whichstatementbythenursebestdescribesrequirement sthatmust bemettosustainCentersforMedicareandMedicaidServices(CMS)ConditionsofParticipatio n? - Correct answer a. I need to notify Trans Life (OPO) of my patients impending death 2.Thenurseismanagingadonorpatientsixhourspriortothescheduledharvestingofthepatient s organs.Whichassessmentfindingrequiresimmediateactionbythenurse - Correct answer b. pH 7.30; PaCO2 38mm Hg; HCO316mEq/ 2.Thenurseismanagingadonorpatientsixhourspriortothescheduledharvestingofthepatient s organs.Whichassessmentfindingrequiresimmediateactionbythenurse - Correct answer b. pH 7.30; PaCO2 38mm Hg; HCO316mEq/ 3.Thechargenurseisreviewingthestatusofpatientsinthecriticalcareunit.Whichpatientshoul dthe nursenotifytheorganprocurementorganizationtoevaluateforpossibleorgandonation?

- Correct answer a. A36-year-old patient with a Glasgow Coma Scale score of 3 with no activity on electroencephalogram 3.Thechargenurseisreviewingthestatusofpatientsinthecriticalcareunit.Whichpatientshoul dthe nursenotifytheorganprocurementorganizationtoevaluateforpossibleorgandonation? - Correct answer a. A36-year-old patient with a Glasgow Coma Scale score of 3 with no activity on electroencephalogram 4.Thetransplantcliniccoordinatorisevaluatingrelativesofapatientwithend- stagerenaldisease,whose bloodtypeisApositive,forsuitabilityasalivingdonorforkidneytransplantation.Whichfamilyme mberbest qualifiesforevaluation? - Correct answer b. A35-year-old female with a history of food allergies; blood type O negative 4.Thetransplantcliniccoordinatorisevaluatingrelativesofapatientwithend- stagerenaldisease,whose bloodtypeisApositive,forsuitabilityasalivingdonorforkidneytransplantation.Whichfamilyme mberbest qualifiesforevaluation? - Correct answer b. A35-year-old female with a history of food allergies; blood type O negative 5.Thenurseiscaringforapatientwhoisbeingevaluatedclinicallyforbraindeathbyaphysician. Which assessmentfindingsbythenursesupportbraindeath - Correct answer Absence of a corneal reflex

5.Thenurseiscaringforapatientwhoisbeingevaluatedclinicallyforbraindeathbyaphysician. Which assessmentfindingsbythenursesupportbraindeath - Correct answer Absence of a corneal reflex 6.Thenurseisprovidingpreoperativecaretoapatientwhowillreceiveatransplant.Thepatienth ashigh panelreactiveantibodies(PRA).Aspartofinductiontherapyforthispatient,thenurseunderstan dswhich medicationtobeofpriorityforadministrationintheoperatingroom? - Correct answer Alemtuzumab(Campmate) 6.Thenurseisprovidingpreoperativecaretoapatientwhowillreceiveatransplant.Thepatienth ashigh panelreactiveantibodies(PRA).Aspartofinductiontherapyforthispatient,thenurseunderstan dswhich medicationtobeofpriorityforadministrationintheoperatingroom? - Correct answer Alemtuzumab(Campmate) .Thenurseiscaringforamechanicallyventilatedpatientfollowingbilaterallungtransplantation. When planningthecareofthispatient,whatistheprioritynursingintervention? - Correct answer Endotracheal suctioning as needed .Thenurseiscaringforamechanicallyventilatedpatientfollowingbilaterallungtransplantation. When planningthecareofthispatient,whatistheprioritynursingintervention? - Correct answer Endotracheal suctioning as needed 8.Afamilymemberapproachesthenursecaringfortheirgravelyillsonandstates,Wewanttodon ateour sonsorgans.Whatisthebestactionbythenurse? - Correct answer Notify the organ procurement organization (OPO) 8.Afamilymemberapproachesthenursecaringfortheirgravelyillsonandstates,Wewanttodon ateour sonsorgans.Whatisthebestactionbythenurse? - Correct answer Notify the organ procurement organization (OPO) 9.Thenurseiscaringforapatientinthecriticalcareunitwho,afterbeingdeclaredbraindead,isbei ng managedbytheOPOtransplantcoordinator.Thirtyminutesintotheshift,assessmentbythenur seincludes abloodpressure75/50mmHg,heartrate85beats/min,andrespiratoryrate12breaths/minvia assist/controlventilation.Theoxygensaturation(SpO2)is99%andcoretemperature93.8F.W hich physicianordershouldthenurseimplementfirst? - Correct answer Begin phenylephrine(Neo-Synephrine)forsystolicBP<90mmH 9.Thenurseiscaringforapatientinthecriticalcareunitwho,afterbeingdeclaredbraindead,isbei ng managedbytheOPOtransplantcoordinator.Thirtyminutesintotheshift,assessmentbythenur seincludes abloodpressure75/50mmHg,heartrate85beats/min,andrespiratoryrate12breaths/minvia

assist/controlventilation.Theoxygensaturation(SpO2)is99%andcoretemperature93.8F.W hich physicianordershouldthenurseimplementfirst? - Correct answer Begin phenylephrine(Neo-Synephrine)forsystolicBP<90mmH 10.Thechargenurseofatransplantunitisreviewingtheclinicalcourseofseveraltransplantpati ents beingcaredforintheunit.Whichpatientassessedbythechargenurserequiresimmediateactio n? - Correct answer d. Liver transplant recipient,12 hours post op with a serum glucose of 58mg/dL 10.Thechargenurseofatransplantunitisreviewingtheclinicalcourseofseveraltransplantpati ents beingcaredforintheunit.Whichpatientassessedbythechargenurserequiresimmediateactio n? - Correct answer d. Liver transplant recipient,12 hours post op with a serum glucose of 58mg/dL 11.Thenurseiscaringforarenaltransplantrecipientinthepost- anesthesiacareunit.Bloodpressureis125/ mmHg;heartrateis115beats/min;respiratoryrateis24breaths/min;oxygensaturation(SpO2) is95%on L/minofoxygenvianasalcannula,temperatureis97.8F,andthecentralvenouspressure(CVP/ RAP)is2mm Hg.Whatisthebestactionbythenurse? - Correct answer a. Administer fluid replacement therapy; monitor intake and output closely. 11.Thenurseiscaringforarenaltransplantrecipientinthepost- anesthesiacareunit.Bloodpressureis125/ mmHg;heartrateis115beats/min;respiratoryrateis24breaths/min;oxygensaturation(SpO2) is95%on L/minofoxygenvianasalcannula,temperatureis97.8F,andthecentralvenouspressure(CVP/ RAP)is2mm Hg.Whatisthebestactionbythenurse? - Correct answer a. Administer fluid replacement therapy; monitor intake and output closely. 12.Thenurseiscaringforapostoperativerenaltransplantrecipientinthecriticalcareunit.Afters eeing minimalurineoutputinthecatheterformostoftheday,thepatientexpressesconcerntothenurse .Whatis thebestresponsebythenurse? - Correct answer It can take a few days for your kidney to start working 12.Thenurseiscaringforapostoperativerenaltransplantrecipientinthecriticalcareunit.Afters eeing minimalurineoutputinthecatheterformostoftheday,thepatientexpressesconcerntothenurse .Whatis thebestresponsebythenurse? - Correct answer It can take a few days for your kidney to start working 13.Thenurseisprovidingdischargeinstructionstoarenaltransplantrecipient.Thepatienthasa follow-up appointmentthenextdayforroutinepost-

transplantlaboratorybloodwork,includingtroughlevelsofantirejectionmedications.Whichins tructiondescribeswhatthepatientshoulddoregardingtheanti-rejection medicationsthenextday - Correct answer b. Take your morning dose of medications after labs have been drawn 13.Thenurseisprovidingdischargeinstructionstoarenaltransplantrecipient.Thepatienthasa follow-up appointmentthenextdayforroutinepost- transplantlaboratorybloodwork,includingtroughlevelsofantirejectionmedications.Whichins tructiondescribeswhatthepatientshoulddoregardingtheanti-rejection medicationsthenextday - Correct answer b. Take your morning dose of medications after labs have been drawn 14.Thenurseiscaringforapatientfollowingabilaterallungtransplant.Whenplanningpostoper ativecareof thepatient,priorityisplacedonpulmonaryhygiene.Whichstatementprovidesthebestexplanat ionforthis priority? - Correct answer d. Loss of cough reflex results in decreased ability to remove secretions effectively 14.Thenurseiscaringforapatientfollowingabilaterallungtransplant.Whenplanningpostoper ativecareof thepatient,priorityisplacedonpulmonaryhygiene.Whichstatementprovidesthebestexplanat ionforthis priority? - Correct answer d. Loss of cough reflex results in decreased ability to remove secretions effectively 15.Whilefollowinguponapostoperativerenaltransplantrecipient,thenursediscoversthatthed onor testedpositiveforcytomegalovirus(CMV).Whatisthepriorityactionbythenurse - Correct answer a. Notify the OPO transplant coordinator 15.Whilefollowinguponapostoperativerenaltransplantrecipient,thenursediscoversthatthed onor testedpositiveforcytomegalovirus(CMV).Whatisthepriorityactionbythenurse - Correct answer a. Notify the OPO transplant coordinator 16.Thetransplantclinicnurseisconductingpatienteducationontheimportanceoffollow- uphealth screeningactivitiesimportantindetectingcomplicationsassociatedwithlong- termimmunosuppressant therapy.Whichstatementismostimportantforthenursetoincludeinthediscussion - Correct answer Avoid sun exposure during peak hours of the day 16.Thetransplantclinicnurseisconductingpatienteducationontheimportanceoffollow- uphealth screeningactivitiesimportantindetectingcomplicationsassociatedwithlong- termimmunosuppressant therapy.Whichstatementismostimportantforthenursetoincludeinthediscussion - Correct answer Avoid sun exposure during peak hours of the day 17.Thenurseobtainsinitialvitalsignsonapatient2weeksposttransplantwhopresentsforfollow -up

monitoringtotheoutpatienttransplantclinic.Whichassessmentfindingbythenurserequires immediate action? - Correct answer d. Tenderness over graft site 17.Thenurseobtainsinitialvitalsignsonapatient2weeksposttransplantwhopresentsforfollow -up monitoringtotheoutpatienttransplantclinic.Whichassessmentfindingbythenurserequires immediate action? - Correct answer d. Tenderness over graft site 18.Thetransplantclinicsocialworkeriscompletingasocialhistoryonapatientwithend- stagerenal diseasewhoisbeingevaluatedfortransplant.Whichstatementbythepatientwarrantsfurthera ction - Correct answer a. I only smoke marijuana on an occasional basis 18.Thetransplantclinicsocialworkeriscompletingasocialhistoryonapatientwithend- stagerenal diseasewhoisbeingevaluatedfortransplant.Whichstatementbythepatientwarrantsfurthera ction - Correct answer a. I only smoke marijuana on an occasional basis 19.Thetransplantclinicnurseiseducatingapatientabouttherenalcriteriathatmustbemetinord ertobe placedonthetransplantwaitinglist.Whichstatementbythepatientbestindicatesanunderstan dingof the criteria - Correct answer I qualify if my glomerular filtration rate is less than 20 mL per minute 19.Thetransplantclinicnurseiseducatingapatientabouttherenalcriteriathatmustbemetinord ertobe placedonthetransplantwaitinglist.Whichstatementbythepatientbestindicatesanunderstan dingof the criteria - Correct answer I qualify if my glomerular filtration rate is less than 20 mL per minute 20.Thenurseiseducatingarenaltransplantpatientabouthisimmunosuppressantmedicationt herapy. Whichstatementbythepatientbestindicatesanappropriateunderstanding - Correct answer c. My doctors may try to stop my steroids soon after my transplant 20.Thenurseiseducatingarenaltransplantpatientabouthisimmunosuppressantmedicationt herapy. Whichstatementbythepatientbestindicatesanappropriateunderstanding - Correct answer c. My doctors may try to stop my steroids soon after my transplant 21.ThenurseispreparingtoadmitapatientwithheartfailurewhohasbeenlistedontheUNOStra nsplantlis - Correct answer b. Hospitalization is required with mechanical support and vasoactive infusions

21.ThenurseispreparingtoadmitapatientwithheartfailurewhohasbeenlistedontheUNOStra nsplantlis - Correct answer b. Hospitalization is required with mechanical support and vasoactive infusions 22.Thenurseisprovidingpostoperativeeducationtoatransplantpatientsfamily.Whenaskeda bout detectingrejection,whichanswerbythenurseismostappropriate - Correct answer a. End myocardial biopsies will be performed weekly for the first six weeks after surgery 22.Thenurseisprovidingpostoperativeeducationtoatransplantpatientsfamily.Whenaskeda bout detectingrejection,whichanswerbythenurseismostappropriate - Correct answer a. End myocardial biopsies will be performed weekly for the first six weeks after surgery 23.Thetransplantclinicnurseisconductingapretransplanteducationsessionforpatientsbein gevaluatedfor livertransplantation.Whichstatementbythenurseprovidesthebestexplanationofthenumeric systemusedto classifytheseverityofapatientsliverdisease - Correct answer A score is calculated based upon kidney function, clotting time, and bilirubin level 23.Thetransplantclinicnurseisconductingapretransplanteducationsessionforpatientsbein gevaluatedfor livertransplantation.Whichstatementbythenurseprovidesthebestexplanationofthenumeric systemusedto classifytheseverityofapatientsliverdisease - Correct answer A score is calculated based upon kidney function, clotting time, and bilirubin level 24.Whichstatementbestrepresentsappropriatedonor-to- recipientcriteriaforlivertransplantation? - Correct answer Body type and body size 24.Whichstatementbestrepresentsappropriatedonor-to- recipientcriteriaforlivertransplantation? - Correct answer Body type and body size 25.Thenurseassessesmorninglabresultsforapostoperativeday1livertransplantrecipient.La bresults notedbythenurseincludeaspartatetransaminase(AST)365U/L;alanineaminotransferase(A LT)400U/L; andserumglucoseof85mg/dL.Whatisthebestactionbythenurse? - Correct answer Notify the physician of liver enzyme results 25.Thenurseassessesmorninglabresultsforapostoperativeday1livertransplantrecipient.La bresults notedbythenurseincludeaspartatetransaminase(AST)365U/L;alanineaminotransferase(A LT)400U/L; andserumglucoseof85mg/dL.Whatisthebestactionbythenurse? - Correct answer Notify the physician of liver enzyme results 26.Thetransplantclinicnurseiseducatingagroupoftransplantrecipientsonhealthpromotion andmaintenance.Whatistheprioritystatementbythenurse - Correct answer Obtain annual vaccinations for pneumonia from your physician.

26.Thetransplantclinicnurseiseducatingagroupoftransplantrecipientsonhealthpromotion andmaintenance.Whatistheprioritystatementbythenurse - Correct answer Obtain annual vaccinations for pneumonia from your physician. .Arenaltransplantrecipientpresentstotheoutpatienttransplantclinicwithbloodglucosevalues forthepast3daysexceeding250mg/ dL.Thepatienttakesprednisone5mgdailyandtacrolimus(Prograf)2 mgtwicedaily.HemoglobinA1Cleveldrawnthedayoftheclinicappointmentwas8.5%.Whatist hebest interpretationofthisfindingbythenurse? - Correct answer Thepatienthasdevelopedposttransplantdiabetes .Arenaltransplantrecipientpresentstotheoutpatienttransplantclinicwithbloodglucosevalues forthepast3daysexceeding250mg/ dL.Thepatienttakesprednisone5mgdailyandtacrolimus(Prograf)2 mgtwicedaily.HemoglobinA1Cleveldrawnthedayoftheclinicappointmentwas8.5%.Whatist hebest interpretationofthisfindingbythenurse? - Correct answer Thepatienthasdevelopedposttransplantdiabetes 28.ThepostanesthesiacareunitreceiveshandoffcommunicationfromtheCRNAindicatingth attherenal transplantrecipientreceivedinductiontherapyintheoperatingroomwithantithymocyteglobuli n(ATG). Whatisthebestunderstandingoftheadministrationofthisdrugbythenurse? - Correct answer Administration of the drug decreases initial post-operative rejection rates 28.ThepostanesthesiacareunitreceiveshandoffcommunicationfromtheCRNAindicatingth attherenal transplantrecipientreceivedinductiontherapyintheoperatingroomwithantithymocyteglobuli n(ATG). Whatisthebestunderstandingoftheadministrationofthisdrugbythenurse? - Correct answer Administration of the drug decreases initial post-operative rejection rates 29.Thenurseispreparingtoadministerarenaltransplantrecipientsfirstdoseofmycophenolate mofetil (CellCept).Priortoadministeringthemedication,thenurseappropriatelyreviewsdrugformular yinformation. Whatisthebestunderstandingofthismedicationbythenurse? - Correct answer It is a polyclonal antibody used for maintenance therapy 29.Thenurseispreparingtoadministerarenaltransplantrecipientsfirstdoseofmycophenolate mofetil (CellCept).Priortoadministeringthemedication,thenurseappropriatelyreviewsdrugformular yinformation. Whatisthebestunderstandingofthismedicationbythenurse? - Correct answer It is a polyclonal antibody used for maintenance therapy

30.Apatientpresentstotheoutpatienttransplantclinicstating,Iwouldliketodonateoneofmykid neys. Whatisthebestresponsebythenurse - Correct answer Let us orient you to the process required to become a donor 30.Apatientpresentstotheoutpatienttransplantclinicstating,Iwouldliketodonateoneofmykid neys. Whatisthebestresponsebythenurse - Correct answer Let us orient you to the process required to become a donor Whichclinicalscenariobestrepresentshyperacuterejection? - Correct answer An implanted renal transplant that, upon reperfusion, becomes cyanotic Whichclinicalscenariobestrepresentshyperacuterejection? - Correct answer An implanted renal transplant that, upon reperfusion, becomes cyanotic 32.Whichstatementbestdescribesthelungallocationscore(LAS)usedtoprioritizelung transplant recipients - Correct answer The LAS is based on lab values, diagnostic tests, and medical diagnosis 32.Whichstatementbestdescribesthelungallocationscore(LAS)usedtoprioritizelung transplant recipients - Correct answer The LAS is based on lab values, diagnostic tests, and medical diagnosis 33.Thenurseiscaringforarenaltransplantrecipientinthepostanesthesiacareunit.Handoff communicationfromtheORincludedareportedoutputof500mLfollowinganastomosisofthere nalvessels andreperfusion.OnehourafterthetransplantrecipientwasadmittedtothePACU,theRNnotes nourine output.Whichphysicianordershouldthenurseimplementfirst? - Correct answer Irrigate the indwelling urinary catheter gently with 30 mL0.9% normal saline 33.Thenurseiscaringforarenaltransplantrecipientinthepostanesthesiacareunit.Handoff communicationfromtheORincludedareportedoutputof500mLfollowinganastomosisofthere nalvessels andreperfusion.OnehourafterthetransplantrecipientwasadmittedtothePACU,theRNnotes nourine output.Whichphysicianordershouldthenurseimplementfirst? - Correct answer Irrigate the indwelling urinary catheter gently with 30 mL0.9% normal saline 34.Thenurseiscaringforarenaltransplantpatientadmittedwithanacuterejectionepisode.The patientasks thenursehowthedoctorswillknowifthekidneyhasbeenrejected.Whatisthebestresponsebyth enurse? - Correct answer b. A procedure called a renal biopsy will be the best way to confirm rejection 34.Thenurseiscaringforarenaltransplantpatientadmittedwithanacuterejectionepisode.The patientasks thenursehowthedoctorswillknowifthekidneyhasbeenrejected.Whatisthebestresponsebyth

enurse? - Correct answer b. A procedure called a renal biopsy will be the best way to confirm rejection 1.Thefamilyofacriticallyillpatienthasaskedtodiscussorgandonationwiththepatientsnurse. When preparingtoanswerthefamilysquestions,thenurseunderstandswhichconcern(s)afamilysde cisiontodonate? - Correct answer a. Donordisfigurementinfluencesonfuneralcare, b. Fearofinferiormedicalcareprovidedtodonor e. Fearthatthepotentialdonormaynotbedeceased f. Concernoverfinancialcostsassociatedwithdonatio 1.Thefamilyofacriticallyillpatienthasaskedtodiscussorgandonationwiththepatientsnurse. When preparingtoanswerthefamilysquestions,thenurseunderstandswhichconcern(s)afamilysde cisiontodonate? - Correct answer a. Donordisfigurementinfluencesonfuneralcare, b. Fearofinferiormedicalcareprovidedtodonor e. Fearthatthepotentialdonormaynotbedeceased f. Concernoverfinancialcostsassociatedwithdonatio 1.Thenurseadmitsapatienttothecriticalcareunitfollowingamotorcyclecrash.Assessmentfin dingsby thenurseincludebloodpressure100/50mmHg,heartrate58beats/min,respiratoryrate30brea ths/min,and temperatureof100.5.Thepatientislethargic,respondstovoicebutfallsasleepreadilywhennot stimulated. Whichnursingactionismostimportanttoincludeinthispatientsplanofcare? - Correct answer Frequent neurological assessment 1.Thenurseadmitsapatienttothecriticalcareunitfollowingamotorcyclecrash.Assessmentfin dingsby thenurseincludebloodpressure100/50mmHg,heartrate58beats/min,respiratoryrate30brea ths/min,and temperatureof100.5.Thepatientislethargic,respondstovoicebutfallsasleepreadilywhennot stimulated. Whichnursingactionismostimportanttoincludeinthispatientsplanofcare? - Correct answer Frequent neurological assessment 2.Apatientwithaheadinjuryhasanintracranialpressure(ICP)of18mmHg.Herbloodpressurei s144/90mm Hg,andhermeanarterialpressure(MAP)is108mmHg.Whatisthecerebralperfusionpressure( CPP) - Correct answer c. 90mmH 2.Apatientwithaheadinjuryhasanintracranialpressure(ICP)of18mmHg.Herbloodpressurei s144/90mm Hg,andhermeanarterialpressure(MAP)is108mmHg.Whatisthecerebralperfusionpressure( CPP) - Correct answer c. 90mmH

3.Whilecaringforapatientwithatraumaticbraininjury,thenurseassessesanICPof20mmHgan daCPP of85mmHg.Whatisthebestinterpretationbythenurse? - Correct answer c. ICP is high; CPP is normal. 3.Whilecaringforapatientwithatraumaticbraininjury,thenurseassessesanICPof20mmHgan daCPP of85mmHg.Whatisthebestinterpretationbythenurse? - Correct answer c. ICP is high; CPP is normal. 4.ThenurseiscaringforamechanicallyventilatedpatientwithasustainedICPof18mmHg.The nurse needstoperformanhourlyneurologicalassessment,suctiontheendotrachealtube,performor alhygienecare, andrepositionthepatienttotheleftside.Whatisthebestactionbythenurse? - Correct answer Provide rest periods between nursing interventions 4.ThenurseiscaringforamechanicallyventilatedpatientwithasustainedICPof18mmHg.The nurse needstoperformanhourlyneurologicalassessment,suctiontheendotrachealtube,performor alhygienecare, andrepositionthepatienttotheleftside.Whatisthebestactionbythenurse? - Correct answer Provide rest periods between nursing interventions 5.Whilecaringforapatientwithabasilarskullfracture,thenurseassessescleardrainagefromth e patientsleftnaris.Whatisthebestnursingaction - Correct answer c. Place a nasal drip pad under the nose 5.Whilecaringforapatientwithabasilarskullfracture,thenurseassessescleardrainagefromth e patientsleftnaris.Whatisthebestnursingaction - Correct answer c. Place a nasal drip pad under the nose 6.Thenurseiscaringforapatientwhowashitontheheadwithahammer.Thepatientwasuncons ciousat thescenebrieflybutisnowconsciousuponarrivalattheemergencydepartment(ED)withaGCS scoreof15. Onehourlater,thenurseassessesaGCSscoreof3.Whatistheprioritynursingaction - Correct answer d. Notify the physician immediate 6.Thenurseiscaringforapatientwhowashitontheheadwithahammer.Thepatientwasuncons ciousat thescenebrieflybutisnowconsciousuponarrivalattheemergencydepartment(ED)withaGCS scoreof15. Onehourlater,thenurseassessesaGCSscoreof3.Whatistheprioritynursingaction - Correct answer d. Notify the physician immediate 7.ThenurseiscaringforapatientwithanICPof18mmHgandaGCSscoreof3.Followingthe administrationofmannitol(Osmitrol),whichassessmentfindingbythenurserequiresfurtherac tion? - Correct answer d. CVP of 2mm Hg