Critical Care Nursing Exam Questions

Critical Care Nursing Exam Questions Related

Review Critical Care Nursing Exam Questions related questions and content

The nurse is caring for a mechanically ventilated patient w ith a pulmonary artery catheter who is receiving continuous enteral tube feedings. When obtaining continuous hemodynamic monitoring measurements, what is the best nursing action?a birb.com/test

  • A. Do not document hemodynamic values until the patient can be placed in the supine position.
  • B. Level and zero reference the air-fluid interface of the t ransducer with the patient in the supine position and record hemodynamic values.
  • C. Level and zero reference the air-fluid interface of the t ransducer with the patient’s head of bed elevated to 30 degrees and record hemodynamic values.
  • D. Level and zero reference the air-fluid interface of the tarbainrbs.cdoumc/teers t with the patient supine in the side-lying position and record hemodynamic values.
Correct Answer: C

Rationale: Rationale: Option C is the correct answer because when caring for a patient with a pulmonary artery catheter receiving continuous enteral feedings, it is crucial to level and zero reference the transducer with the patient's head of bed elevated to 30 degrees. This position helps to ensure accurate hemodynamic measurements, as the head of bed elevation minimizes the impact of intra-abdominal pressure on the catheter readings. By referencing the transducer in this position, the nurse can obtain reliable and precise hemodynamic values.

Summary of Incorrect Choices:
A: This option is incorrect because delaying documentation until the patient is in the supine position can lead to inaccuracies in the hemodynamic readings due to changes in patient positioning.
B: Leveling and zero referencing the transducer with the patient in the supine position is not ideal as it does not account for the impact of intra-abdominal pressure on the catheter readings in patients receiving enteral feedings.
D: Leveling and zero referencing

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Which nursing intervention would need to be corrected on a care plan for a patient in order to be consistent with the principles of effective end-of-life ca re?

  • A. Control of distressing symptoms such as dyspnea, naus ea, and pain through use of pharmacological and nonpharmacological interventions
  • B. Limitation of visitation to reduce the emotional distresasb ierbx.cpoemr/iteesnt ced by family members
  • C. Patient and family education on anticipated patient res ponses to withdrawal of therapy
  • D. Provision of spiritual care resources as desired by the p atient and family
Correct Answer: B

Rationale: Correct Answer: B

Rationale:
1. Limiting visitation to reduce emotional distress contradicts the principles of effective end-of-life care, which emphasize holistic support for the patient and family.
2. Effective end-of-life care encourages open communication and emotional support from loved ones.
3. Limiting visitation may hinder emotional closure and support for both the patient and family.
4. Options A, C, and D align with effective end-of-life care by focusing on symptom management, education, and spiritual support for the patient and family.

The nurse is caring for an older adult patient who is in card iogenic shock and has failed to respond to medical treatment. The primary care provider conducts a conference to explain that they have exhausted treatment options and suggest that the patient be made a “do not resuscitate” status. This scenario illustrates what medical concept?

  • A. Brain death
  • B. Futility
  • C. Incompetence
  • D. Life-prolonging procedures
Correct Answer: B

Rationale: The correct answer is B: Futility. In this scenario, the primary care provider suggests making the patient a "do not resuscitate" status because further medical treatment is deemed futile. Futility refers to situations where medical interventions are unlikely to achieve the desired outcome. This decision is made when the benefits of continuing treatment do not outweigh the burdens on the patient.

Summary:
A: Brain death does not apply here as the patient is not brain dead.
C: Incompetence refers to the patient's ability to make decisions, not the medical concept being illustrated.
D: Life-prolonging procedures are not being discussed; the focus is on the futility of further treatment.

The central venous oxygen saturation (ScvO2) is decreasing in a patient who has severe pancreatitis. To determine the possible cause of the decreased ScvO2, the nurse assesses the patient’s:

  • A. Lipase.
  • B. Temperature.
  • C. Urinary output.
  • D. Body mass index.
Correct Answer: B

Rationale: The correct answer is B: Temperature. Decreased ScvO2 in severe pancreatitis can be due to systemic inflammatory response leading to increased metabolic demand and decreased tissue oxygen delivery. Monitoring temperature helps assess for presence of infection or sepsis, which can further decrease tissue oxygenation. Lipase (A) is specific for pancreatitis diagnosis, not directly related to ScvO2. Urinary output (C) is important for assessing renal function, not directly related to ScvO2. Body mass index (D) does not provide information on tissue oxygenation status in this context.

A patient is experiencing severe pain, despite receiving pain medication for the past 24 hours. The patients wife expresses concern about this to the nurse. Which response by the nurse would be most empowering to the patients family?

  • A. Explain that the doctor is an expert on pain medication and that the current level ofm edication is the best.
  • B. Recommend that the family members take turns massaging the patients feet todistract from the pain.
  • C. Encourage the family to request that the physician evaluate the patients pain control.
  • D. Ask the family to wait another 24 hours to see whether the patients pain level will go down.
Correct Answer: C

Rationale: The correct answer is C because it empowers the family to take action by requesting a physician evaluation of the patient's pain control. This step is crucial in ensuring that the patient's pain is adequately managed. By involving the physician, the family can advocate for the patient's needs and potentially explore alternative pain management strategies.

Choice A is incorrect because it dismisses the family's concerns and fails to address the need for further evaluation. Choice B may provide temporary relief but does not address the underlying issue of inadequate pain control. Choice D is incorrect as it suggests delaying action, which could lead to prolonged suffering for the patient.

What is an early signs of the effect of hypoxemia on the nervous system?

  • A. Cyanosis
  • B. Restlessness
  • C. Tachycardia
  • D. Tachypnea
Correct Answer: B

Rationale: The correct answer is B: Restlessness. When the body experiences hypoxemia (low oxygen levels), the brain is deprived of oxygen, leading to early signs such as restlessness. This is due to the brain's attempt to increase oxygen intake by increasing activity. Cyanosis (A) is a late sign of hypoxemia when oxygen levels are critically low. Tachycardia (C) and tachypnea (D) are compensatory mechanisms in response to hypoxemia, but they are not early signs affecting the nervous system directly.

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