Critical Care Nursing Practice Questions

Critical Care Nursing Practice Questions Related

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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  • A. Any treatment may be withdrawn and withheld, includ ing nutrition, antibiotics, and blood products.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  • C. Life-sustaining treatments may be withdrawn while a patient is receiving paralytic agents.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.

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Noise in the critical care unit can have negative effects on the patient. Which of the following interventions assists in reducing noise levels in the criticala cbiarbr.ec osme/ttetisnt g? (Select all that apply.)

  • A. Asking the family to bring in the patient’s i-Pod or other device with favorite music.
  • B. Inviting the volunteer harpist to play on the unit on a re gular basis.
  • C. Remodeling the unit to have two-patient rooms to facil itate nursing care.
  • D. Remodeling the unit to install acoustical ceiling tiles.
Correct Answer: A

Rationale: Step 1: Bringing in the patient's i-Pod with favorite music can provide personalized, soothing sounds, reducing stress and anxiety for the patient.
Step 2: Familiar music can create a calming environment, distracting the patient from external noise.
Step 3: Listening to music may improve patient comfort and overall experience in the critical care unit.
Summary: Option A is correct as it directly addresses noise reduction by providing a personalized, calming environment for the patient. Options B, C, and D do not specifically target noise reduction but focus on other aspects of care or facility improvement.

The nurse is caring for a patient with a left radial arterial lianbierb, .caonmd/t eas tp ulmonary artery catheter inserted into the right subclavian vein. Which action by th e nurse best ensures the safety of the patient being monitored with invasive hemodynamic moni toring lines?

  • A. Document all waveform values.
  • B. Limit the pressure tubing length.
  • C. Zero reference the system daily.
  • D. Ensure alarm limits are turned on.
Correct Answer: C

Rationale: The correct answer is C: Zero reference the system daily. Zero referencing ensures accuracy and calibration of pressure monitoring system by setting the baseline pressure to zero. This is crucial to prevent inaccuracies in measurements. Choice A is important but doesn't directly address the accuracy of the monitoring system. Choice B may help in preventing errors but doesn't address the accuracy of pressure measurement. Choice D is important for alerting the nurse but doesn't directly relate to the accuracy of hemodynamic monitoring.

A young adult patient with metastatic cancer, who is very close to death, appears restless. The patient keeps repeating, 'I am not ready to die.' Which action is best for the nurse to take?

  • A. Remind the patient that no one feels ready for death.
  • B. Sit at the bedside and ask if there is anything the patient needs.
  • C. Insist that family members remain at the bedside with the patient.
  • D. Tell the patient that everything possible is being done to delay death.
Correct Answer: B

Rationale: The correct answer is B because sitting at the bedside and asking if there is anything the patient needs demonstrates empathy and support. It allows the patient to express their concerns and fears, providing emotional comfort. It shows the nurse is actively listening and willing to help address any immediate needs or concerns.

Choice A is incorrect because it dismisses the patient's feelings and may come across as invalidating. Choice C is incorrect because insisting that family members remain may not be what the patient needs at that moment and could cause additional stress. Choice D is incorrect because it does not address the patient's emotional distress and may not be true in the context of terminal illness.

A nurse has achieved certification in critical care nursing. What is the most important effect that this certification will have on the nurses practice?

  • A. Recognition by peers
  • B. Increase in salary and rank
  • C. More flexibility in seeking employment
  • D. Increased confidence in critical thinking
Correct Answer: D

Rationale: The correct answer is D: Increased confidence in critical thinking. Achieving certification in critical care nursing validates the nurse's expertise and knowledge in this specialized area, leading to increased confidence in their ability to critically think through complex patient situations. This confidence translates into improved clinical decision-making and patient outcomes.

A: Recognition by peers - While recognition by peers is important for professional growth, the primary benefit of certification is enhancing clinical skills.
B: Increase in salary and rank - While certification may lead to salary increases in some cases, the most significant impact is on improving clinical skills.
C: More flexibility in seeking employment - While certification may enhance employability, the focus is on improving critical thinking skills rather than employment opportunities.

The nurse is caring for a patient with an arterial monitoring system. The nurse assesses the patient’s noninvasive cuff blood pressure to be 70/40 mm Hg. The arterial blood pressure measurement via an intraarterial catheter in the same arm is assessed by the nurse to be 108/70 mm Hg. What is the best action by the nurse?

  • A. Activate the rapid response system.
  • B. Place the patient in Trendelenburg position.
  • C. Assess the cuff for proper arm size.
  • D. Administer 0.9% normal saline bolus.
Correct Answer: C

Rationale: Rationale for Correct Answer (C - Assess the cuff for proper arm size):
1. The cuff blood pressure (70/40 mm Hg) is significantly lower than the arterial blood pressure (108/70 mm Hg).
2. Discrepancy suggests cuff size mismatch, leading to inaccurate readings.
3. Assessing cuff size ensures accurate blood pressure measurement.
4. Ensures appropriate interventions based on accurate readings.

Summary of Incorrect Choices:
A: Rapid response not warranted based solely on blood pressure discrepancy.
B: Trendelenburg position not indicated for cuff size issue.
D: Normal saline bolus not appropriate without accurate blood pressure measurement.

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