Critical Care Nursing Practice Questions

Critical Care Nursing Practice Questions Related

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An ICU nurse has provided excellent care for a 6-year-old girl who had been admitted to the ICU for a head injury. The nurse was attentive not only to the needs of the patient but also went out of her way to care for the needs of the girls family. According to research, which of the following forms of recognition would the nurse value the most?

  • A. A card from the girls family
  • B. A plaque from the ICU physicians naming her as Nurse of the Year
  • C. A letter of commendation from the hospitals administration
  • D. A bouquet of flowers from her supervisor
Correct Answer: A

Rationale: Rationale: The correct answer is A: A card from the girl's family. The nurse would value this form of recognition the most because it directly reflects the impact of her care on the patient and her family. It is a personal, heartfelt gesture that acknowledges the nurse's compassion and dedication. A card from the family shows genuine appreciation and gratitude for the nurse's efforts, making it the most meaningful form of recognition.

Summary:
- Choice B: A plaque from the ICU physicians could be seen as a formal recognition but lacks the personal touch and direct impact of the nurse's care on the patient and family.
- Choice C: A letter of commendation from the hospital's administration is a professional acknowledgment but may not capture the emotional connection and impact that the nurse had on the family.
- Choice D: A bouquet of flowers from her supervisor is a nice gesture but does not necessarily reflect the specific impact of the nurse's care on the patient and family.

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Which of the following assists the critical care nurse in ensuring that care is appropriate and based on research?

  • A. Clinical practice guidelines
  • B. Computerized physician order entry
  • C. Consulting with advanced practice nurses
  • D. Implementing Joint Commission National Patient Safe ty Goals
Correct Answer: A

Rationale: The correct answer is A: Clinical practice guidelines. Clinical practice guidelines are evidence-based recommendations that assist nurses in providing appropriate care based on research. They outline best practices for specific patient populations or conditions, helping nurses make informed decisions.

Summary:
- B: Computerized physician order entry: While it may improve accuracy and efficiency, it does not specifically ensure care based on research.
- C: Consulting with advanced practice nurses: While collaboration is valuable, it does not guarantee care based on research.
- D: Implementing Joint Commission National Patient Safety Goals: Important for patient safety, but not directly related to ensuring care based on research.

A family member approaches the nurse caring for their gra vely ill son and states, “We want to donate our son’s organs.” What is the best action by the nu rse?

  • A. Arrange a multidisciplinary meeting with physicians.
  • B. Consult the hospital’s ethics committee for a ruling.
  • C. Notify the organ procurement organization (OPO).
  • D. Obtain family consent to withdraw life support.
Correct Answer: C

Rationale: The correct answer is C: Notify the organ procurement organization (OPO). This is the best action because the OPO is responsible for coordinating organ donation and transplantation. By involving the OPO, the nurse ensures that the donation process is handled appropriately and ethically.

Choice A: Arranging a multidisciplinary meeting with physicians may be necessary but should not be the first step in this situation.

Choice B: Consulting the hospital’s ethics committee may be helpful, but the immediate priority is to involve the OPO to facilitate organ donation.

Choice D: Obtaining family consent to withdraw life support is not the nurse’s role in this situation. The focus should be on organ donation to honor the family's wishes.

The family is considering withdrawing life-sustaining measures from the patient. The nurse knows that ethical principles for withholding or withdrawi ng life-sustaining treatments include which of the following?

  • A. Any treatment may be withdrawn and withheld, includ ing nutrition, antibiotics, and blood products.
  • B. Doses of analgesic and anxiolytic medications must be adjusted carefully and should not exceed usual recommended limits.
  • C. Life-sustaining treatments may be withdrawn while a patient is receiving paralytic agents.
  • D. The goal of withdrawal and withholding of treatments is to hasten death and thus relieve suffering.
Correct Answer: A

Rationale: The correct answer is A because it aligns with the ethical principle of patient autonomy, which emphasizes the patient's right to make decisions about their own care. Withholding or withdrawing life-sustaining treatments, including nutrition, antibiotics, and blood products, respects the patient's autonomy. This choice also reflects the principle of beneficence, as it aims to prevent unnecessary suffering and respects the patient's wishes.

Option B is incorrect because it focuses on pain and anxiety management rather than the broader ethical considerations of withholding life-sustaining treatments.

Option C is incorrect because withdrawing life-sustaining treatments while a patient is receiving paralytic agents can pose additional risks and complications, potentially conflicting with the principles of nonmaleficence and beneficence.

Option D is incorrect because the primary goal of withdrawing or withholding treatments is not to hasten death but to respect the patient's autonomy and quality of life. This choice does not align with the ethical principles of patient-centered care.

The critical care unit environment is very stressful for patients, families, and staff. What nursing action is directed at reducing environmental stress?

  • A. Constant expert evaluation of patient status
  • B. Limiting visits to immediate family
  • C. Bathing all patients during hours of sleep
  • D. Maintaining a quiet environment during hours of sleep
Correct Answer: D

Rationale: The correct answer is D: Maintaining a quiet environment during hours of sleep. This action is directed at reducing environmental stress in the critical care unit because noise and disturbances during sleep can negatively impact patients' rest and recovery. By ensuring a quiet environment, patients can have uninterrupted sleep, which is crucial for healing.

Rationale:
1. Constant expert evaluation of patient status (A) may be important but does not directly address environmental stress.
2. Limiting visits to immediate family (B) may hinder patients' emotional support and can be stressful for families.
3. Bathing all patients during hours of sleep (C) may disrupt patients' rest and increase stress levels rather than reduce it.

A 54-year-old patient arrives in the emergency department (ED) after exposure to powdered lime at work. Which action should the nurse take first?

  • A. Obtain the patient’s vital signs.
  • B. Obtain a baseline complete blood count.
  • C. Decontaminate the patient by showering with water.
  • D. Brush off any visible powder on the skin and clothing.
Correct Answer: D

Rationale: The correct answer is D because brushing off any visible powder on the skin and clothing is the first step in managing exposure to powdered lime. This action helps to remove the source of exposure and prevent further absorption through the skin. It is crucial to prevent additional contact and reduce the risk of further harm. Obtaining vital signs (choice A) and a complete blood count (choice B) can be important but should come after the initial decontamination. Decontaminating the patient by showering with water (choice C) is not recommended for lime exposure as it can react with water and cause further injury.

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