Critical Care Nursing Exam Questions

Critical Care Nursing Exam Questions Related

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A patient declared brain dead is an organ donor. The following events occur: 1300 Diagnostic tests for brain death are completed. 1330 primary care provider reviews diagnostic test results and writes in the progress note that the patient is brain deaadb.i r1b.4co0m0/ tePsat tient is taken to the operating room for organ retrieval. 1800 All organs have b een retrieved for donation. The ventilator is discontinued. 1810 Cardiac monitor shows fla tline. What is the official time of death recorded in the medical record?

  • A. 1300
  • B. 1330
  • C. 1400
  • D. 1800
Correct Answer: E

Rationale: The correct answer is not provided, but based on the events described, the official time of death recorded in the medical record should be 1810 (Choice D). At this time, the cardiac monitor shows flatline, indicating the cessation of cardiac activity, which is the universally accepted point of declaring death.

Choice A (1300) is incorrect because that is when diagnostic tests for brain death were completed, but the patient was not officially declared dead at that time.

Choice B (1330) is incorrect as this is when the primary care provider reviewed the test results and documented brain death in the progress note, but the patient was not officially declared dead at this time either.

Choice C (1400) is incorrect as there is no significant event occurring at this time that signifies the patient's death.

Therefore, the most appropriate and official time of death recorded in the medical record would be 1810 when the cardiac monitor shows flatline.

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The patient’s potassium level is 7.0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?

  • A. Sodium polystyrene sulfonate
  • B. Sodium polystyrene sulfonate with sorbitol
  • C. Regular insulin
  • D. Calcium gluconate
Correct Answer: C

Rationale: Correct Answer: C - Regular insulin

Rationale:
1. Insulin promotes cellular uptake of potassium.
2. When insulin is administered, it moves potassium from extracellular to intracellular space.
3. This decreases plasma potassium levels safely.
4. Other options do not directly lower potassium levels in the same manner.

Summary of Other Choices:
A: Sodium polystyrene sulfonate - exchanges sodium for potassium in the intestines, not reducing total body potassium.
B: Sodium polystyrene sulfonate with sorbitol - similar to A, does not reduce total body potassium.
D: Calcium gluconate - does not directly lower potassium levels, used for treating hyperkalemia-induced cardiac toxicity.

The nurse is caring for a mechanically ventilated patient w ith a pulmonary artery catheter who is receiving continuous enteral tube feedings. When obtaining continuous hemodynamic monitoring measurements, what is the best nursing action?a birb.com/test

  • A. Do not document hemodynamic values until the patient can be placed in the supine position.
  • B. Level and zero reference the air-fluid interface of the t ransducer with the patient in the supine position and record hemodynamic values.
  • C. Level and zero reference the air-fluid interface of the t ransducer with the patient’s head of bed elevated to 30 degrees and record hemodynamic values.
  • D. Level and zero reference the air-fluid interface of the tarbainrbs.cdoumc/teers t with the patient supine in the side-lying position and record hemodynamic values.
Correct Answer: C

Rationale: Rationale: Option C is the correct answer because when caring for a patient with a pulmonary artery catheter receiving continuous enteral feedings, it is crucial to level and zero reference the transducer with the patient's head of bed elevated to 30 degrees. This position helps to ensure accurate hemodynamic measurements, as the head of bed elevation minimizes the impact of intra-abdominal pressure on the catheter readings. By referencing the transducer in this position, the nurse can obtain reliable and precise hemodynamic values.

Summary of Incorrect Choices:
A: This option is incorrect because delaying documentation until the patient is in the supine position can lead to inaccuracies in the hemodynamic readings due to changes in patient positioning.
B: Leveling and zero referencing the transducer with the patient in the supine position is not ideal as it does not account for the impact of intra-abdominal pressure on the catheter readings in patients receiving enteral feedings.
D: Leveling and zero referencing

The nurse is caring for 80-year-old patient who has been tr eated for gastrointestinal bleeding. The family has agreed to withhold or withdraw additional treatment. The patient has a written advance directive specifying requests. The directive notes that the patient wants food and fluid to be continued and to be made physically comfortable. Th e nurse anticipates that several orders may be written to comply with this request, including which of the following? (Select all that apply.)

  • A. “Do not resuscitate.”
  • B. Change antibiotic to a less expensive medication.
  • C. Discontinue tube feeding.
  • D. Stop any further blood transfusions.
Correct Answer: A

Rationale: The correct answer is A: "Do not resuscitate." In this scenario, the patient's advance directive specifies a desire for comfort measures and continuation of food and fluids. A DNR order aligns with this directive by respecting the patient's wish to avoid aggressive life-saving measures. This choice prioritizes the patient's autonomy and quality of life. Other options (B, C, D) are not aligned with the patient's wishes. Changing antibiotics or stopping blood transfusions may be unrelated to the patient's comfort or food/fluid preferences. Discontinuing tube feeding goes against the directive's request for food and fluid continuation.

What is the main purpose of certification for critical care n ursing?

  • A. To assure the consumer that critical nurses will not make a mistake.
  • B. To help prepare the critical care nurse for graduate sch ool.
  • C. To assist in promoting magnet status for a facility.
  • D. To validate a nurse’s knowledge of critical care nursing
Correct Answer: D

Rationale: The correct answer is D: To validate a nurse’s knowledge of critical care nursing. Certification in critical care nursing validates a nurse's expertise and knowledge in this specialized area of nursing. It demonstrates that the nurse has met certain standards and competencies in critical care practice. This certification ensures that the nurse is well-equipped to provide high-quality care to critically ill patients.

A: To assure the consumer that critical nurses will not make a mistake - This choice is incorrect because certification does not guarantee that nurses will not make mistakes. It focuses on validating knowledge and skills rather than infallibility.
B: To help prepare the critical care nurse for graduate school - This choice is incorrect as certification is more focused on practice readiness rather than academic preparation.
C: To assist in promoting magnet status for a facility - This choice is incorrect as magnet status relates more to the overall excellence and quality of nursing care in a facility, not individual certification.

The nurse is caring for a patient receiving benzodiazepine intermittently. What is the best way to administer such drugs?

  • A. Medicate around the clock, rather than as needed, to en sure constant sedation.
  • B. Administer the medications through the feeding tube to prevent complications.
  • C. Give the highest allowable dose for the greatest effect.
  • D. Titrate to a predefined endpoint using a standard sedat ion scale.
Correct Answer: D

Rationale: The correct answer is D: Titrate to a predefined endpoint using a standard sedation scale. This approach ensures individualized dosing based on the patient's response, minimizing the risk of over-sedation or under-treatment. It allows for careful monitoring and adjustment of dosage to achieve the desired level of sedation while avoiding adverse effects.

A: Administering medication around the clock may lead to unnecessary sedation and increased risk of side effects.
B: Administering medications through a feeding tube is not recommended for benzodiazepines as it may affect absorption and increase the risk of complications.
C: Giving the highest allowable dose without considering individual response can result in excessive sedation and adverse effects.

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