Critical Care Nursing NCLEX Questions

Critical Care Nursing NCLEX Questions Related

Review Critical Care Nursing NCLEX Questions related questions and content

A patient is admitted to the hospital with multiple trauma aabnirdb .ceoxmte/tensst ive blood loss. The nurse assesses vital signs to be BP 80/50 mm Hg, heart rate 135 beats/min, respirations 36 breaths/min, cardiac output (CO) of 2 L/min, systemic vas cular resistance of 3000 dynes/sec/cm5, and a hematocrit of 20%. The nurse anticip ates administration of which the following therapies or medications?

  • A. Blood transfusion
  • B. Furosemide
  • C. Dobutamine infusion
  • D. Dopamine hydrochloride infusion
Correct Answer: C

Rationale: The correct answer is C: Dobutamine infusion. In this scenario, the patient is experiencing hypovolemic shock due to significant blood loss, resulting in low blood pressure, tachycardia, and low cardiac output. Dobutamine is a positive inotropic agent that increases cardiac contractility and output, helping to improve tissue perfusion.

Blood transfusion (A) is a common intervention for hypovolemic shock, but in this case, the patient's hematocrit is low, indicating dilutional anemia rather than acute blood loss, so addressing the cardiac output is more urgent. Furosemide (B) is a diuretic that would exacerbate the hypovolemia and worsen the patient's condition. Dopamine (D) is a vasopressor that primarily increases blood pressure, but in this case, the patient's low cardiac output is the main concern, making dobutamine a more appropriate choice.

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A critical care unit has decided to implement several measures designed to improve intradisciplinary and interdisciplinary collaboration. In addition to an expected improvement in patient outcomes, what is the most important effect that should resultf rom these measures?

  • A. Identification of incompetent practitioners
  • B. Improvement in manners on the unit
  • C. Increased staff retention
  • D. Less discussion in front of patients and families
Correct Answer: C

Rationale: Rationale:
- Improved collaboration enhances job satisfaction and reduces burnout, leading to increased staff retention.
- Higher staff retention promotes continuity of care, improves team dynamics, and enhances patient outcomes.

Summary:
- A: Not directly related to collaboration, more about performance evaluation.
- B: Manners may improve, but not the most important effect of collaboration.
- D: Collaboration involves open communication, so less discussion in front of patients is not a positive outcome.

Which of the following devices is best suited to deliver 65 % oxygen to a patient who is spontaneously breathing?

  • A. Face mask with non-rebreathing reservoir
  • B. Low-flow nasal cannula
  • C. Simple face mask
  • D. Venturi mask
Correct Answer: D

Rationale: The Venturi mask is the best choice for delivering 65% oxygen because it allows precise oxygen concentration delivery through adjustable venturi valves. This device ensures consistent oxygen levels even during variations in patient breathing patterns. Face mask with non-rebreathing reservoir (A) delivers higher oxygen concentrations, low-flow nasal cannula (B) is not suitable for precise oxygen delivery, and simple face mask (C) may not provide the desired oxygen concentration.

The family members of a critically ill, 90-year-old patient bring in a copy of the patient’s living will to the hospital, which identifies the patient’s wiasbhireb.sc orme/gteasrt ding health care. The nurse discusses the contents of the living will with the patient’s physician. This is an example of implementation of which of the AACN Standards of Pr ofessional Performance?

  • A. Acquires and maintains current knowledge of practice
  • B. Acts ethically on the behalf of the patient and family
  • C. Considers factors related to safe patient care
  • D. Uses clinical inquiry and integrates research findings i n practice
Correct Answer: C

Rationale: The correct answer is C: Considers factors related to safe patient care. The scenario involves the nurse discussing the patient's living will with the physician, which is essential for ensuring safe patient care by following the patient's preferences. This aligns with the AACN standard of considering factors related to safe patient care, as the nurse is actively involving all relevant parties in decision-making to provide care that is in line with the patient's wishes.

Explanation of why other choices are incorrect:
A: Acquires and maintains current knowledge of practice - While important, this choice does not directly relate to the scenario where the focus is on safe patient care through communication and collaboration.
B: Acts ethically on behalf of the patient and family - While ethics are important, the scenario is more about following the patient's wishes as outlined in the living will rather than making ethical decisions.
D: Uses clinical inquiry and integrates research findings in practice - While valuable in nursing practice, this choice does not directly apply to the scenario where

Which intervention about visitation in the critical care unit is true?

  • A. The majority of critical care nurses implement restricte d visiting hours to allow the patient to rest.
  • B. Children should never be permitted to visit a critically ill family member.
  • C. Visitation that is individualized to the needs of patients and family members is ideal.
  • D. Visiting hours should always be unrestricted.
Correct Answer: C

Rationale: The correct answer is C because individualized visitation meets the unique needs of patients and family members, promoting holistic care and emotional support. Choice A is incorrect as strictly restricted visiting hours may hinder family involvement in care. Choice B is incorrect as children can provide comfort and support. Choice D is incorrect as unrestricted visiting may disrupt patient rest and care routines.

The nurse is discharging a patient home following treatment for community-acquired pneumonia. As part of the discharge teaching, the nurse sh ould provide instruction?

  • A. “If you get the pneumococcal vaccine, you’ll never get pneumonia again.”
  • B. “It is important for you to get an annual influenza shot to reduce your risk of pneumonia.”
  • C. “Stay away from cold, drafty places because that incre ases your risk of pneumonia when you get home.”
  • D. “Since you have been treated for pneumonia, you now have immunity from getting it in the future.”
Correct Answer: B

Rationale: Step 1: Influenza can lead to pneumonia as a complication, so getting an annual flu shot can reduce the risk of pneumonia.
Step 2: Providing education on the importance of prevention aligns with discharge teaching goals.
Step 3: Option A is incorrect as the pneumococcal vaccine doesn't guarantee immunity from all causes of pneumonia.
Step 4: Option C is incorrect as cold or drafty places do not directly cause pneumonia.
Step 5: Option D is incorrect as having pneumonia once does not confer permanent immunity.

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