Critical Care Nursing NCLEX Questions

Critical Care Nursing NCLEX Questions Related

Review Critical Care Nursing NCLEX Questions related questions and content

The family members of a critically ill, 90-year-old patient bring in a copy of the patient’s living will to the hospital, which identifies the patient’s wiasbhireb.sc orme/gteasrt ding health care. The nurse discusses the contents of the living will with the patient’s physician. This is an example of implementation of which of the AACN Standards of Pr ofessional Performance?

  • A. Acquires and maintains current knowledge of practice
  • B. Acts ethically on the behalf of the patient and family
  • C. Considers factors related to safe patient care
  • D. Uses clinical inquiry and integrates research findings i n practice
Correct Answer: C

Rationale: The correct answer is C: Considers factors related to safe patient care. The scenario involves the nurse discussing the patient's living will with the physician, which is essential for ensuring safe patient care by following the patient's preferences. This aligns with the AACN standard of considering factors related to safe patient care, as the nurse is actively involving all relevant parties in decision-making to provide care that is in line with the patient's wishes.

Explanation of why other choices are incorrect:
A: Acquires and maintains current knowledge of practice - While important, this choice does not directly relate to the scenario where the focus is on safe patient care through communication and collaboration.
B: Acts ethically on behalf of the patient and family - While ethics are important, the scenario is more about following the patient's wishes as outlined in the living will rather than making ethical decisions.
D: Uses clinical inquiry and integrates research findings in practice - While valuable in nursing practice, this choice does not directly apply to the scenario where

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The nurse educator is evaluating the care that a new registered nurse (RN) provides to a patient receiving mechanical ventilation. Which action by the new RN indicates the need for more education?

  • A. The RN increases the FIO2 to 100% before suctioning.
  • B. The RN secures a bite block in place using adhesive tape.
  • C. The RN asks for assistance to reposition the endotracheal tube.
  • D. The RN positions the patient with the head of the bed at 10 degrees.
Correct Answer: D

Rationale: The correct answer is D because positioning the patient with the head of the bed at 10 degrees is incorrect for a patient receiving mechanical ventilation. The optimal position for such patients is to elevate the head of the bed to 30-45 degrees to prevent aspiration and improve oxygenation. Option A is incorrect as increasing FIO2 before suctioning is appropriate to ensure adequate oxygenation. Option B is incorrect as securing a bite block in place using adhesive tape is a standard practice to prevent the patient from biting on the endotracheal tube. Option C is incorrect as asking for assistance to reposition the endotracheal tube shows the RN is aware of the importance of proper placement to ensure effective ventilation.

The nurse is caring for a patient who has undergone major abdominal surgery. The nurse notices that the patient’s urine output has been less than 20 mL/hour for the past 2 hours. The patient’s blood pressure is 100/60 mm Hg, and the pulse is 110 beats/min. Previously, the pulse was 90 beats/min with a blood pressure of 120/80 mm Hg. The nurse should

  • A. contact the provider and expect a prescription for a normal saline bolus.
  • B. wait until the provider makes rounds to report the assessment findings.
  • C. continue to evaluate urine output for 2 more hours.
  • D. ignore the urine output, as this is most likely postrenal in origin.
Correct Answer: A

Rationale: The correct answer is A: contact the provider and expect a prescription for a normal saline bolus. The patient is showing signs of hypovolemia with decreased urine output, low blood pressure, and elevated heart rate. This indicates inadequate perfusion and potential hypovolemic shock. Administering a normal saline bolus will help restore intravascular volume and improve perfusion. Waiting for the provider to make rounds (option B) could delay necessary intervention. Continuing to evaluate urine output for 2 more hours (option C) is not appropriate given the patient's current condition. Ignoring the urine output (option D) is dangerous as it could lead to further complications.

The American Association of Critical-Care Nurses (AACN) sponsors certification in critical care nursing for several critical care subspecialties. What is the most important benefit of such certification for the profession of nursing?

  • A. Provides positive publicity for nursing
  • B. Validates nurses expert knowledge and practice
  • C. Mandated by government regulations
  • D. Demonstrates basic knowledge in the field
Correct Answer: B

Rationale: The correct answer is B because certification validates nurses' expert knowledge and practice. This is important as it ensures that nurses have the necessary skills and competence to provide high-quality care in critical care settings. Certification is voluntary and not mandated by government regulations (Choice C). It goes beyond demonstrating basic knowledge (Choice D) by confirming specialized expertise. While certification may garner positive publicity (Choice A), the primary benefit is the validation of advanced skills and knowledge.

The nurse is preparing to obtain a pulmonary artery occlusion pressure (PAOP) reading for a patient who is mechanically ventilated. Ensuring that the aaibri-rbf.lcuoimd/ teinstt erface is at the level of the phlebostatic axis, what is the best nursing action?

  • A. Place the patient in the supine position and record the PAOP immediately after exhalation.
  • B. Place the patient in the supine position and document the average PAOP obtained after three measurements.
  • C. Place the patient with the head of bed elevated 30 degrees and document the average PAOP pressure obtained.
  • D. Place the patient with the head of bed elevated 30 degr ees and record the PAOP just before the increase in pressures during inhalation.
Correct Answer: C

Rationale: The correct answer is C because placing the patient with the head of the bed elevated 30 degrees is the best position for obtaining an accurate PAOP reading. Elevating the head of the bed helps to align the phlebostatic axis with the atrium, ensuring an accurate measurement of PAOP. This position reduces the impact of hydrostatic pressure on the reading. Options A and D are incorrect because the supine position and recording during exhalation or just before the increase in pressures during inhalation can lead to inaccurate readings. Option B is incorrect because documenting the average PAOP after three measurements does not address the importance of positioning for accuracy.

The nurse is caring for a patient in acute respiratory failure and understands that the patient should be positioned (Select all that apply.)

  • A. high Fowler’s.
  • B. side lying with head of bed elevated.
  • C. sitting in a chair.
  • D. supine with the bed flat.
Correct Answer: A

Rationale: The correct answer is A: high Fowler's position. This position promotes optimal lung expansion by allowing the chest to expand fully, improving oxygenation. It also helps reduce the work of breathing. Side lying with the head of the bed elevated (B) may not provide the same level of lung expansion. Sitting in a chair (C) may not be suitable for a patient in acute respiratory failure as it may not provide adequate support for breathing. Supine with the bed flat (D) can worsen respiratory distress by limiting lung expansion.

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