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Both the electroencephalogram (EEG) monitor and the Bis pectral Index Score (BIS) or Patient State Index (PSI) analyzer monitors are used to ass ess patient sedation levels in critically ill patients. Why are the BIS and PSI monitors simpler to use?
- A. They are only be used on heavily sedated patients.
- B. They can only be used on pediatric patients.
- C. They provide raw EEG data and a numeric value.
- D. They require only five leads.
Correct Answer: C
Rationale: The correct answer is C because BIS and PSI monitors provide both raw EEG data and a numeric value, simplifying the interpretation of patient sedation levels. Raw EEG data offers detailed information on brain activity, while the numeric value allows for quick assessment. This simplifies the monitoring process compared to interpreting raw EEG data alone.
Choice A is incorrect as BIS and PSI monitors are not restricted to heavily sedated patients. Choice B is incorrect as they are not limited to pediatric patients. Choice D is incorrect as the number of leads required does not determine the simplicity of use; it is the data interpretation that matters.
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The patient’s serum creatinine level is 0.7 mg/dL. The expected BUN level should be
- A. 1 to 2 mg/dL.
- B. 7 to 14 mg/dL.
- C. 10 to 20 mg/dL.
- D. 20 to 30 mg/dL.
Correct Answer: C
Rationale: The correct answer is C (10 to 20 mg/dL). The normal BUN-to-creatinine ratio is approximately 10:1. With a serum creatinine level of 0.7 mg/dL, the expected BUN level should be around 7 to 14 mg/dL. Therefore, choice C (10 to 20 mg/dL) falls within this expected range. Choices A, B, and D are incorrect as they do not align with the typical BUN-to-creatinine ratio and would indicate abnormal kidney function.
On their first visit to a critically ill patient, family members stand in the doorway of the room, making no effort to approach the patient. What is the most appropriate nursing action?
- A. Instruct the family where the patient can be touched and what to say.
- B. Engage the family in social conversation to ease them into the milieu.
- C. Use visiting hours to explain to the family the general status of the patient.
- D. Leave the family to adjust to the situation when they are ready.
Correct Answer: A
Rationale: The correct answer is A because instructing the family on where the patient can be touched and what to say helps empower them to interact appropriately with the patient. This action promotes the family's involvement in the patient's care, encourages communication, and fosters a supportive environment. Choice B is incorrect as engaging in social conversation may not address the family's hesitance to approach the patient directly. Choice C is incorrect because waiting for visiting hours to provide information may delay necessary support for the family. Choice D is incorrect as leaving the family without guidance may perpetuate their discomfort and hinder their ability to provide emotional support to the patient.
assessment, the patient is restless, heart rate has increased to 110 beats/min, respirations are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sinaubsir bt.acocmh/ytecsat rdia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretio ns. Loud crackles are audible throughout lung fields. The nurse notifies the physician, w ho orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. How d oes the nurse interpret the following blood gas levels? pH 7.28 PaCO 46 mm Hg Bicarbonate 22 mEq/L PaO 58 mm Hg O saturation 88% 2
- A. Hypoxemia and compensated respiratory alkalosis
- B. Hypoxemia and uncompensated respiratory acidosis
- C. Normal arterial blood gas levels
- D. Normal oxygen level and partially compensated metabaobliribc.c aomci/dteosts is
Correct Answer: B
Rationale: The correct answer is B: Hypoxemia and uncompensated respiratory acidosis.
Step-by-step rationale:
1. pH is low (7.28), indicating acidosis.
2. PaCO2 is elevated (46 mm Hg), indicating respiratory acidosis.
3. PaO2 is low (58 mm Hg), indicating hypoxemia.
4. Bicarbonate is within normal range (22 mEq/L), suggesting no compensation for the acidosis.
5. Oxygen saturation is low (88%), supporting the presence of hypoxemia.
Summary:
A: Incorrect - pH is low, not indicating compensated alkalosis.
C: Incorrect - Various abnormalities in the blood gas levels are present.
D: Incorrect - There is hypoxemia and uncompensated acidosis, not metabolic alkalosis.
Which action will the nurse need to do when preparing to assist with the insertion of a pulmonary artery catheter?
- A. Determine if the cardiac troponin level is elevated.
- B. Auscultate heart and breath sounds during insertion.
- C. Place the patient on NPO status before the procedure.
- D. Attach cardiac monitoring leads before the procedure.
Correct Answer: D
Rationale: The correct answer is D: Attach cardiac monitoring leads before the procedure. This is essential to monitor the patient's cardiac rhythm and detect any abnormalities during catheter insertion. Cardiac monitoring leads provide real-time information on the patient's heart rate and rhythm, allowing the nurse to promptly address any complications.
A: Determining if the cardiac troponin level is elevated is not directly related to assisting with pulmonary artery catheter insertion.
B: Auscultating heart and breath sounds during insertion is important but does not take precedence over attaching cardiac monitoring leads.
C: Placing the patient on NPO status before the procedure may be necessary for other procedures, but it is not specifically required for assisting with pulmonary artery catheter insertion.
The nurse caring for a patient diagnosed with acute respiratory failure identifies “Risk for Ineffective Airway Clearance” as a nursing diagnosis. Wh at nursing intervention is relevant to this diagnosis?
- A. Elevate head of bed to 30 degrees.
- B. Obtain order for venous thromboembolism prophylaxi s.
- C. Provide adequate sedation.
- D. Reposition patient every 2 hours.
Correct Answer: A
Rationale: The correct answer is A: Elevate head of bed to 30 degrees. Elevating the head of the bed helps promote optimal airway clearance by facilitating drainage of secretions and reducing the risk of aspiration. This position also improves lung expansion and oxygenation. Choice B is important for preventing venous thromboembolism but not directly related to airway clearance. Choice C may not be appropriate as excessive sedation can impair airway clearance. Choice D is important for preventing pressure ulcers but does not directly address airway clearance.