Critical Care Nursing Questions

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A nurse is on a committee that is trying to reduce the occurrence of hospital-acquired infections in the ICU. Her role is to conduct research to find which interventions have been shown to be most effective in reducing these infections. She consults many different sources and finds conflicting information. Which of the following sources should she consider the most authoritative?

  • A. AACN expert panel report
  • B. A meta-analysis of randomized controlled trials in the American Journal of Nursing
  • C. A systematic review of qualitative studies in the Journal of Advanced Nursing
  • D. A single randomized controlled trial in the American Journal of Critical Care
Correct Answer: B

Rationale: The correct answer is B: A meta-analysis of randomized controlled trials in the American Journal of Nursing.

1. Meta-analyses provide a comprehensive overview of multiple studies, increasing the reliability of the findings.
2. Randomized controlled trials are considered the gold standard in research design for assessing intervention effectiveness.
3. The American Journal of Nursing is a reputable source in the field of nursing, ensuring the credibility of the study.
4. By synthesizing data from various trials, the meta-analysis can offer a more robust and generalizable conclusion compared to a single trial or qualitative studies.

Incorrect choices:
A: AACN expert panel report - Expert opinions may vary and lack the empirical evidence provided by research studies.
C: A systematic review of qualitative studies in the Journal of Advanced Nursing - Qualitative studies may provide valuable insights but may not offer concrete evidence on intervention effectiveness like quantitative studies.
D: A single randomized controlled trial in the American Journal of Critical Care - Single trials may not capture the full picture and

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When caring for a patient who has an arterial catheter in the left radial artery for arterial pressure-based cardiac output (APCO) monitoring, which information obtained by the nurse is most important to report to the health care provider?

  • A. The patient has a positive Allen test.
  • B. There is redness at the catheter insertion site.
  • C. The mean arterial pressure (MAP) is 86 mm Hg.
  • D. The dicrotic notch is visible in the arterial waveform.
Correct Answer: B

Rationale: The correct answer is B: There is redness at the catheter insertion site. Redness at the catheter insertion site could indicate infection, which is a serious complication that requires immediate attention to prevent sepsis. Reporting this to the healthcare provider promptly is crucial for timely intervention. Choices A, C, and D are not as urgent. A positive Allen test (choice A) assesses collateral circulation and is important for assessing perfusion before arterial cannulation but does not require immediate intervention. Choice C (MAP is 86 mm Hg) falls within the normal range, so it does not indicate an urgent issue. The visibility of the dicrotic notch in the arterial waveform (choice D) is a normal finding and does not require immediate action.

While caring for a patient with a small bowel obstruction, the nurse assesses a pulmonary artery occlusion pressure (PAOP) of 1 mm Hg and hourly urine output of 5 mL. The nurse anticipates which therapeutic intervention?

  • A. Diuretics
  • B. Intravenous fluids
  • C. Negative inotropic agents
  • D. Vasopressors
Correct Answer: B

Rationale: The correct answer is B: Intravenous fluids. In the scenario of a small bowel obstruction, a PAOP of 1 mm Hg indicates hypovolemia requiring fluid resuscitation to improve cardiac output and tissue perfusion. The low urine output suggests inadequate renal perfusion, further supporting the need for fluids. Diuretics (choice A) would worsen the hypovolemia. Negative inotropic agents (choice C) decrease cardiac contractility, which is not indicated in this scenario. Vasopressors (choice D) are used for hypotension, not for hypovolemia. Therefore, the most appropriate intervention is to administer intravenous fluids to address the hypovolemia and improve tissue perfusion.

The nurse is caring for a patient with a subarachnoid hemorrhage who is intubated and placed on a mechanical ventilator with 10 cm H2O of peak end-expiratory pressure (PEEP). When monitoring the patient, the nurse will need to notify the healthcare provider immediately if the patient develops:

  • A. Oxygen saturation of 93%.
  • B. Respirations of 20 breaths/minute.
  • C. Green nasogastric tube drainage.
  • D. Increased jugular venous distention.
Correct Answer: D

Rationale: The correct answer is D: Increased jugular venous distention. In a patient with a subarachnoid hemorrhage and on mechanical ventilation, increased jugular venous distention can indicate increased intracranial pressure, which can be life-threatening. The nurse should notify the healthcare provider immediately as it may require urgent intervention to prevent further neurological deterioration.

A: Oxygen saturation of 93% is within the acceptable range for a patient on mechanical ventilation and may not require immediate notification.
B: Respirations of 20 breaths/minute are within normal limits for a ventilated patient and do not necessarily indicate a critical condition.
C: Green nasogastric tube drainage may indicate the presence of bile and could be related to gastrointestinal issues, but it does not pose an immediate threat to the patient's neurological status.

What factors may predispose a patient to respiratory acido as bi is rb? . com/test

  • A. Anxiety and fear
  • B. Central nervous system depression
  • C. Diabetic ketoacidosis
  • D. Nasogastric suctioning
Correct Answer: B

Rationale: The correct answer is B: Central nervous system depression. This factor can lead to respiratory acidosis by depressing the respiratory drive, causing hypoventilation and retention of carbon dioxide. Anxiety and fear (A) may lead to hyperventilation, reducing carbon dioxide levels. Diabetic ketoacidosis (C) results in metabolic acidosis, not respiratory acidosis. Nasogastric suctioning (D) may cause respiratory alkalosis from excessive removal of carbon dioxide. Thus, central nervous system depression is the most likely factor predisposing a patient to respiratory acidosis.

A nurse has been working as a staff nurse in the surgical inabteirbn.scoivme/t ecsat re unit for 2 years and is interested in certification. Which credential would be most applicable for her to seek?

  • A. ACNPC
  • B. CCNS
  • C. CCRN
  • D. PCCN
Correct Answer: C

Rationale: The correct answer is C: CCRN. The nurse works in a surgical unit, making CCRN (Critical Care Registered Nurse) the most applicable credential as it focuses on critical care nursing, which is relevant to the nurse's current practice. ACNPC (Acute Care Nurse Practitioner Certification) and PCCN (Progressive Care Certified Nurse) are not suitable as they are more focused on advanced practice or progressive care respectively, not directly related to surgical units. CCNS (Clinical Nurse Specialist Certification) is not the best choice as it is more geared towards advanced practice roles in specific clinical specialties, not general staff nursing.

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