Critical Care Nursing Exam Questions

Critical Care Nursing Exam Questions Related

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A critically ill patient experiences stress and anxiety from many factors. Treatment of the patient focuses on reducing stressors and providing supportive care such as nutrition, oxygenation, pain management, control of anxiety, and specific care of the illness or injury. What is the best rationale for these interventions?

  • A. Helps to support the patients immune system
  • B. Part of good nursing care
  • C. Mandated by hospital policy
  • D. Reassures the patient and family
Correct Answer: A

Rationale: The correct answer is A: Helps to support the patient's immune system. Providing supportive care such as nutrition, oxygenation, pain management, and anxiety control can help reduce stress, which in turn supports the immune system. Stress weakens the immune system, making the patient more vulnerable to infections and complications. By addressing stress and anxiety through supportive care, the patient's immune system is better able to function optimally, aiding in the recovery process.

Choices B, C, and D are incorrect because:
B: Part of good nursing care - While supportive care is indeed part of good nursing care, the key rationale for these interventions in a critically ill patient is to support the immune system, not just to provide good nursing care.
C: Mandated by hospital policy - Hospital policies may dictate certain aspects of care, but the primary goal of these interventions is to support the patient's immune system, not just to comply with hospital policies.
D: Reassures the patient and family - While providing reass

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A nurse walks into a patients room and begins preparing a syringe to perform a blood draw on the patient. The nurse observes that the patient is firmly gripping the side of the bed, averting her eyes, and sweating from her forehead when she sees the needle. What would be the best intervention for the nurse to make?

  • A. Proceed with blood draw as quickly as possible, to get it over with.
  • B. Offer to come back later to perform the blood draw.
  • C. Encourage the patient to deep breathe.
  • D. Describe briefly the blood draw procedure and explain why it is necessary.
Correct Answer: D

Rationale: The correct answer is D because it shows empathy and promotes patient education. By describing the procedure and its necessity, the nurse can alleviate the patient's anxiety and build trust. This approach allows the patient to feel informed and in control, reducing fear and increasing cooperation. It also demonstrates respect for the patient's feelings and promotes a therapeutic relationship.

Choice A is incorrect as it disregards the patient's fear and can lead to increased distress. Choice B might be an option, but it doesn't address the patient's anxiety in the moment. Choice C, while helpful in some cases, doesn't directly address the patient's specific fear of the blood draw procedure.

The nurse is caring for a postoperative patient in the critica l care unit. The physician has ordered patient-controlled analgesia (PCA) for the patient. The nurse understands what facts about the PCA? (Select all that apply.)

  • A. It is a safe and effective method for administering anal gesia.
  • B. It has potentially fewer side effects than other routes of analgesic administration.
  • C. It is an ideal method to provide critically ill patients so me control over their treatment.
  • D. It does not work well without family assistance
Correct Answer: A

Rationale: Step-by-step rationale for why Answer A is correct:
1. Patient-controlled analgesia (PCA) allows patients to self-administer pain medication within preset limits, promoting pain management.
2. PCA is considered safe and effective as it provides better pain control, reduces the risk of overdose, and allows for individualized dosing.
3. Healthcare providers can monitor and adjust the PCA settings as needed to ensure optimal pain relief.
4. Studies have shown that PCA is a preferred method for postoperative pain management due to its efficacy and safety profile.
5. Overall, PCA is a reliable and beneficial approach to analgesia administration in postoperative patients.

Summary of why other choices are incorrect:
B: While PCA may have fewer side effects compared to some routes, this is not a defining characteristic of PCA.
C: While patients do have some control over their treatment with PCA, the primary focus is on pain management rather than giving control to critically ill patients.
D: PCA can be used effectively without family

The nurse wishes to assess the quality of a patient’s pain. Which questions is appropriate to obtain this assessment if the patient is able to give a verbal response?

  • A. “Is the pain constant or intermittent?”
  • B. “Is the pain sharp, dull, or crushing?”
  • C. “What makes the pain better? Worse?”
  • D. “When did the pain start?”
Correct Answer: B

Rationale: The correct answer is B because asking if the pain is sharp, dull, or crushing helps assess the quality of pain, providing specific information on the type of sensation felt. This is crucial for understanding the underlying cause and guiding appropriate treatment.

A: Asking about pain being constant or intermittent addresses duration, not quality.
C: Inquiring about what makes pain better or worse focuses on triggers, not quality.
D: Asking when the pain started addresses onset time, not quality.

To prevent any unwanted resuscitation after life-sustaininga btirrbe.acotmm/teenstt s have been withdrawn, the nurse should ensure that what intervention has been im plemented?

  • A. Do-not-resuscitate (DNR) orders are written before dis continuation of the treatments.
  • B. The family is not allowed to visit until the death occur s.
  • C. DNR orders are written as soon as possible after the di scontinuation of the treatments.
  • D. The change-of-shift report includes the information thaatb irtbh.ceo pma/tetiset nt is not to be resuscitated.
Correct Answer: A

Rationale: The correct answer is A because writing DNR orders before discontinuation of life-sustaining treatments ensures clear communication and legal documentation of the patient's wishes. Choice B is incorrect as family support is essential in end-of-life care. Choice C is incorrect as DNR orders should be established before withdrawing treatment. Choice D is incorrect as the DNR order should be in place before shift change for immediate implementation if needed.

The critical care nurse knows that in critically ill patients, renal dysfunction

  • A. is a very rare problem.
  • B. affects nearly two thirds of patients.
  • C. has a low mortality rate once renal replacement therapy has been initiated.
  • D. has little effect on morbidity, mortality, or quality of life.
Correct Answer: B

Rationale: The correct answer is B. Renal dysfunction is common in critically ill patients due to various factors like sepsis, hypotension, and nephrotoxic medications. This affects nearly two thirds of patients, making it a significant issue in critical care. Choices A, C, and D are incorrect. A is wrong because renal dysfunction is not rare in critically ill patients. C is incorrect as renal replacement therapy does not guarantee low mortality rates. D is inaccurate as renal dysfunction can have a significant impact on morbidity, mortality, and quality of life in critically ill patients.

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