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Which of the following is (are) official journal(s) of the A merican Association of Critical-Care Nurses? (Select all that apply.)
- A. American Journal of Critical Care
- B. Critical Care Clinics of North America
- C. Critical Care Nurse
- D. Critical Care Nursing Quarterly
Correct Answer: A
Rationale: Step-by-step rationale:
1. The American Association of Critical-Care Nurses (AACN) publishes the American Journal of Critical Care (AJCC).
2. The AJCC is a peer-reviewed journal that covers critical care nursing practice, research, and education.
3. The content in AJCC aligns with AACN's mission and standards for critical care nursing.
4. Hence, AJCC is an official journal of AACN.
Summary of other choices:
- B: Critical Care Clinics of North America - Not an official journal of AACN.
- C: Critical Care Nurse - Not an official journal of AACN.
- D: Critical Care Nursing Quarterly - Not an official journal of AACN.
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A 28-year-old patient who has deep human bite wounds on the left hand is being treated in the urgent care center. Which action will the nurse plan to take?
- A. Prepare to administer rabies immune globulin (BayRab).
- B. Assist the health care provider with suturing the bite wounds.
- C. Teach the patient the reason for the use of prophylactic antibiotics.
- D. Keep the wounds dry until the health care provider can assess them.
Correct Answer: C
Rationale: The correct answer is C: Teach the patient the reason for the use of prophylactic antibiotics. This is the most important action because human bites can introduce harmful bacteria into the wound, leading to infection. Prophylactic antibiotics help prevent infection in deep human bite wounds.
Choice A is incorrect because rabies immune globulin is not indicated for human bite wounds. Choice B is incorrect because suturing human bite wounds can trap bacteria and increase the risk of infection. Choice D is incorrect because keeping the wounds dry is not sufficient; proper wound cleaning and antibiotic treatment are essential in this case.
The nurse is caring for a postoperative patient with chroni c obstructive pulmonary disease (COPD). Which assessment would be a cue to the patient developing postoperative pneumonia?
- A. Bradycardia
- B. Change in sputum characteristics
- C. Hypoventilation and respiratory acidosis
- D. Pursed-lip breathing
Correct Answer: B
Rationale: The correct answer is B: Change in sputum characteristics. This is a cue for postoperative pneumonia in a COPD patient because it can indicate an infection in the lungs. Postoperative pneumonia is a common complication in patients with COPD due to impaired lung function and weakened immune system. Other choices are incorrect: A) Bradycardia is not a specific indicator of postoperative pneumonia. C) Hypoventilation and respiratory acidosis can be seen in patients with COPD but are not specific to postoperative pneumonia. D) Pursed-lip breathing is a coping mechanism for patients with COPD and is not directly related to postoperative pneumonia.
The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter. The nurse assesses a blood pressure of 90/60 mm Hg, hear t rate 110 beats/min, respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which hemodynamic value reqaubiirrbe.sco imm/temste diate action by the nurse?
- A. Cardiac index (CI) of 1.2 L/min/m3
- B. Cardiac output (CO) of 4 L/min
- C. Pulmonary vascular resistance (PVR) of 80 dynes/sec/cm5
- D. Systemic vascular resistance (SVR) of 1800 dynes/sec /cm5
Correct Answer: B
Rationale: The correct answer is B: Cardiac output (CO) of 4 L/min. In this scenario, the patient is presenting with signs of pulmonary congestion and hypoxemia, indicating possible cardiogenic pulmonary edema. As the cardiac output is a key indicator of how well the heart is functioning and delivering blood to the body, a low cardiac output can lead to inadequate tissue perfusion and worsen the patient's condition. Therefore, immediate action is required to address the low cardiac output to improve tissue perfusion and oxygenation.
Choices A, C, and D are incorrect as they do not directly address the primary concern of inadequate cardiac output in this patient. Cardiac index, pulmonary vascular resistance, and systemic vascular resistance are important parameters to monitor, but in this case, the priority is to address the low cardiac output to improve the patient's condition.
The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H2O of peak end-expiratory pressure (PEEP). Which action indicates that the new RN is safe?
- A. The RN plans to suction the patient every 1 to 2 hours.
- B. The RN uses a closed-suction technique to suction the patient.
- C. The RN tapes the connection between the ventilator tubing and the ET.
- D. The RN changes the ventilator circuit tubing routinely every 48 hours.
Correct Answer: B
Rationale: The correct answer is B: The RN uses a closed-suction technique to suction the patient. This is the safe action because closed-suction technique minimizes the risk of ventilator-associated infections by maintaining a closed system during suctioning, reducing the exposure to pathogens. Closed-suction systems also help maintain lung compliance and oxygenation levels during the suctioning process.
Rationale: Option A is incorrect because suctioning every 1 to 2 hours may be too frequent and can lead to hypoxia and mucosal damage. Option C is incorrect as taping the connection between the ventilator tubing and ET can interfere with the proper functioning of the ventilator and increase the risk of disconnection. Option D is incorrect because changing ventilator circuit tubing routinely every 48 hours is not evidence-based practice and can increase the risk of contamination and unnecessary costs.
Renin plays a role in blood pressure regulation by
- A. activating the renin-angiotensin-aldosterone cascade.
- B. suppressing angiotensin production.
- C. decreasing sodium reabsorption.
- D. inhibiting aldosterone release.
Correct Answer: A
Rationale: The correct answer is A because renin activates the renin-angiotensin-aldosterone cascade, which ultimately leads to vasoconstriction, increased blood pressure, and aldosterone release to increase sodium and water reabsorption. Renin does not suppress angiotensin production (B), decrease sodium reabsorption (C), or inhibit aldosterone release (D), as these actions would counteract its role in blood pressure regulation.