Critical Care Nursing Cardiac Questions

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A 10-year-old female patient in ICU receiving chemotherapy has requested that her dog be allowed to visit her. She is currently sharing a room with another patient. The nurse knows that the hospital does allow for pet visits with owners, but has strict guidelines. Which of the following scenarios is most likely to be permitted?

  • A. The girls father may bring the dog in on a leash for a 20-minute visit.
  • B. The girls sister may bring the dog in with a shirt on (to prevent shedding) for an overnight stay.
  • C. The girls mother may bring the dog in on a leash for a visit as long as he has had all his vaccinations.
  • D. The dog may be brought in for a brief visit once the girl is moved to a private room.
Correct Answer: A

Rationale: The correct answer is A because it follows the hospital's guidelines for pet visits. It allows the dog to be brought in on a leash, which ensures control and safety during the visit. The 20-minute duration is appropriate to limit potential stress on the patient and other individuals in the room. Additionally, having the father bring the dog in maintains consistency with the hospital's policy of pet visits with owners.

Choices B, C, and D are incorrect because they do not adhere to the hospital's guidelines. Choice B allows for an overnight stay, which is typically not permitted due to potential disruptions and hygiene concerns. Choice C mentions vaccinations but overlooks other important factors like leash control and visit duration. Choice D suggests waiting until the girl is moved to a private room, which may not align with the hospital's policy of allowing pet visits with owners.

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Noninvasive diagnostic procedures used to determine kidney function include which of the following? (Select all that apply.)

  • A. Kidney, ureter, bladder (KUB) x-ray
  • B. Renal ultrasound
  • C. Magnetic resonance imaging (MRI)
  • D. Intravenous pyelography (IVP)
Correct Answer: A

Rationale: The correct answer is A: Kidney, ureter, bladder (KUB) x-ray. This procedure is noninvasive and commonly used to assess kidney function by visualizing the size, shape, and position of the kidneys. Renal ultrasound is also noninvasive and can provide detailed images of the kidneys. However, MRI and IVP are more invasive procedures that involve the use of contrast agents and are not typically used solely for diagnostic purposes to assess kidney function. Overall, KUB x-ray and renal ultrasound are the preferred noninvasive options for evaluating kidney function.

A patient with end-stage heart failure is experiencing consaibdirebr.caobmle/te dsty spnea. What is the appropriate pharmacological management of this symptom ?

  • A. Administration of 6 mg of midazolam and initiation of a continuous midazolam infusion.
  • B. Administration of morphine, 5 mg IV bolus, and initia tion of a continuous morphine infusion.
  • C. Hourly increases of the midazolam (Versed) infusion b y 100% dose increments.
  • D. Hourly increases of the morphine infusion by 100% dose increments.
Correct Answer: B

Rationale: The correct answer is B: Administration of morphine, 5 mg IV bolus, and initiation of a continuous morphine infusion. Morphine is the preferred pharmacological management for severe dyspnea in end-stage heart failure due to its potent analgesic and anxiolytic properties.

Step-by-step rationale:
1. Morphine is a potent opioid that helps relieve dyspnea by reducing anxiety, decreasing respiratory drive, and improving overall comfort.
2. The initial IV bolus of 5 mg provides rapid relief of dyspnea.
3. Initiating a continuous morphine infusion ensures sustained relief of dyspnea.
4. Midazolam (choice A) is a benzodiazepine used for sedation and anxiety, but it is not the first-line treatment for dyspnea in this scenario.
5. Increasing the midazolam (choice C) or morphine (choice D) infusions by 100% dose increments hourly is not appropriate as

A 28-year-old patient who has deep human bite wounds on the left hand is being treated in the urgent care center. Which action will the nurse plan to take?

  • A. Prepare to administer rabies immune globulin (BayRab).
  • B. Assist the health care provider with suturing the bite wounds.
  • C. Teach the patient the reason for the use of prophylactic antibiotics.
  • D. Keep the wounds dry until the health care provider can assess them.
Correct Answer: C

Rationale: The correct answer is C: Teach the patient the reason for the use of prophylactic antibiotics. This is the most important action because human bites can introduce harmful bacteria into the wound, leading to infection. Prophylactic antibiotics help prevent infection in deep human bite wounds.

Choice A is incorrect because rabies immune globulin is not indicated for human bite wounds. Choice B is incorrect because suturing human bite wounds can trap bacteria and increase the risk of infection. Choice D is incorrect because keeping the wounds dry is not sufficient; proper wound cleaning and antibiotic treatment are essential in this case.

The nurse is caring for a patient who has an intra-aortic balloon pump (IABP) following a massive heart attack. When assessing the patient, the nurse notices blood backing up into the IABP catheter. In which order should the nurse take the following actions?

  • A. Ensure that the IABP console has been turned off.
  • B. Assess the patient's vital signs and orientation.
  • C. Notify the healthcare provider of the IABP malfunction.
  • D. Obtain supplies for insertion of a new IABP catheter.
Correct Answer: A

Rationale: Correct Answer: A

Rationale:
1. Ensuring the IABP console is turned off is crucial to prevent further complications and stop potential harm to the patient.
2. By turning off the IABP console, the nurse can halt the pumping action, allowing assessment of the situation without interference.
3. This action takes priority over other steps as it addresses the immediate issue of blood backing up into the IABP catheter.
4. Once the console is turned off, the nurse can proceed with assessing the patient's vital signs, notifying the healthcare provider, and obtaining supplies if needed.

Summary of Incorrect Choices:
- Option B: Assessing vital signs and orientation is important, but addressing the malfunction of the IABP takes precedence to prevent harm.
- Option C: Notifying the healthcare provider is necessary, but first, the immediate issue of blood backing up into the catheter must be addressed.
- Option D: Obtaining supplies for a new catheter is premature without first addressing

An advantage of peritoneal dialysis is that

  • A. peritoneal dialysis is time intensive.
  • B. a decreased risk of peritonitis exists.
  • C. biochemical disturbances are corrected rapidly.
  • D. the danger of hemorrhage is minimal.
Correct Answer: B

Rationale: The correct answer is B: a decreased risk of peritonitis exists. Peritoneal dialysis involves the insertion of a catheter into the peritoneal cavity, which can introduce bacteria and increase the risk of peritonitis. However, compared to hemodialysis, peritoneal dialysis has a lower risk of bloodstream infections and vascular access-related complications, leading to a decreased risk of peritonitis. This advantage makes peritoneal dialysis a favorable option for some patients.
Incorrect choices:
A: peritoneal dialysis is actually less time-intensive compared to hemodialysis.
C: biochemical disturbances are corrected more gradually in peritoneal dialysis.
D: the danger of hemorrhage is not specific to peritoneal dialysis.

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