Critical Care Nursing Questions

Critical Care Nursing Questions Related

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A nurse observes that a 38-year-old single father whose 11-year-old daughter is in the ICU is struggling to explain to his 6-year-old son the likelihood that the daughter will die. The young boy asks what will happen to his sister when she dies, but the father breaks down in tears and seems unable to respond. Which of the following would be the most appropriate intervention for the nurse to make?

  • A. Suggest that the father contact his pastor, rabbi, or other spiritual leader for counself or him and his son
  • B. Sit down with the father and son and share her own religious beliefs
  • C. Ask the patients doctor to explain to the father the odds of the daughter surviving
  • D. Leave the father and son to grieve alone
Correct Answer: A

Rationale: The correct answer is A. The nurse should suggest that the father contact his spiritual leader for counseling. This option is appropriate as it recognizes the importance of spirituality in coping with difficult situations. It offers emotional support and guidance to the father and his son during a time of crisis.

Option B is incorrect as the nurse sharing her own religious beliefs may not align with the father's beliefs, potentially causing confusion or discomfort.

Option C is not the best intervention, as the doctor's role is primarily medical, and explaining the odds of survival may not address the emotional and spiritual needs of the family.

Option D is also incorrect as leaving the father and son to grieve alone does not provide them with the necessary support and guidance during such a challenging time.

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Which therapeutic interventions may be withdrawn or withabhirebl.dco mfr/otemst the terminally ill client? (Select all that apply.)

  • A. Antibiotics
  • B. Dialysis
  • C. Nutrition
  • D. Pain medications
Correct Answer: B

Rationale: The correct answer is B: Dialysis. In the context of terminally ill clients, withdrawing dialysis is appropriate as it can be burdensome without providing significant benefit towards the end of life. Dialysis does not cure terminal conditions and can prolong suffering unnecessarily.
Antibiotics (A) may be necessary for managing infections in terminally ill clients. Nutrition (C) is important for comfort and quality of life. Pain medications (D) are essential for managing pain and should not be withdrawn unless no longer beneficial or requested by the patient.

The nurse returns from the cardiac catheterization laboratory with a patient following insertion of a pulmonary artery catheter and assists in transferring th e patient from the stretcher to the bed. Prior to obtaining a cardiac output, which action is m ost important for the nurse to complete?

  • A. Document a pulmonary artery catheter occlusion press ure.
  • B. Zero reference the transducer system at the phlebostatic axis.
  • C. Inflate the pulmonary artery catheter balloon with 1 m L air.
  • D. Inject 10 mL of 0.9% normal saline into the proximal port.
Correct Answer: B

Rationale: The correct answer is B: Zero reference the transducer system at the phlebostatic axis. This is the most important action before obtaining a cardiac output because zero referencing ensures accurate pressure readings. The phlebostatic axis is the level of the atria when the patient is supine, and zeroing at this point minimizes errors in pressure measurements.

Choice A is incorrect because documenting a pulmonary artery catheter occlusion pressure is not the priority at this stage. Choice C is incorrect as inflating the balloon with air should be done after zero referencing. Choice D is incorrect as injecting normal saline into the port is not necessary before zero referencing.

The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)

  • A. Acidosis
  • B. Hypokalemia
  • C. Volume overload
  • D. Hyperkalemia
Correct Answer: C

Rationale: The correct answer is C: Volume overload. In acute kidney injury, impaired kidney function leads to fluid retention, causing volume overload. Dialysis helps remove excess fluid to restore fluid balance. Acidosis and hyperkalemia are potential complications of acute kidney injury but not the primary reasons for initiating dialysis. Hypokalemia is unlikely in acute kidney injury due to impaired excretion of potassium by the kidneys. Therefore, the most common reason for initiating dialysis in acute kidney injury is to manage volume overload.

The nurse manager is assisting a nurse with improving organizational skills and time management. Which nursing activity is the priority in pre-planning a schedule for selected nursing activities in the daily assignment?

  • A. Tracheostomy tube suctioning.
  • B. Medication administration.
  • C. Colostomy care instruction.
  • D. Client personal hygiene.
Correct Answer: B

Rationale: The correct answer is B: Medication administration. This is the priority because medication administration is time-sensitive and crucial for patient safety. It requires precise timing and cannot be delayed. Tracheostomy tube suctioning (A), colostomy care instruction (C), and client personal hygiene (D) are important nursing activities but can be adjusted within the schedule based on patient needs and acuity levels. Prioritizing medication administration ensures that patients receive their medications on time, preventing adverse events and promoting optimal health outcomes.

Which assessment finding obtained by the nurse when caring for a patient with a right radial arterial line indicates a need for the nurse to take immediate action?

  • A. The right hand is cooler than the left.
  • B. The mean arterial pressure (MAP) is 77 mm Hg.
  • C. The system is delivering 3 mL of flush solution per hour.
  • D. The flush bag and tubing were last changed 3 days previously.
Correct Answer: A

Rationale: The correct answer is A because a cooler right hand may indicate compromised circulation, potentially due to arterial occlusion or clot formation. This could lead to inadequate perfusion and tissue damage. Immediate action is needed to assess and address the cause.

Choice B is incorrect because a MAP of 77 mm Hg is within the normal range for most patients and does not require immediate action.

Choice C is incorrect as delivering 3 mL of flush solution per hour is an appropriate rate and does not indicate a need for immediate action.

Choice D is incorrect as the flush bag and tubing being changed 3 days ago does not necessarily indicate an immediate issue with the arterial line function.

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