Critical Care Nursing Practice Questions

Critical Care Nursing Practice Questions Related

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When addressing an ethical dilemma, contextual, physiolo gical, and personal factors of the situation must be considered. Which of the following is an example of a personal factor?

  • A. The hospital has a policy that everyone must have an aadbvirba.ncocme/dte sdt irective on the chart.
  • B. The patient has lost 20 pounds in the past month and is fatigued all of time.
  • C. The patient has expressed their beliefs concerning wha t quality of life means and their wishes.
  • D. The primary care provider considers care to be futile in a given situation.
Correct Answer: C

Rationale: The correct answer is C because the patient's expressed beliefs and wishes regarding quality of life are personal factors that directly influence the ethical dilemma. This factor reflects the individual's values, beliefs, and preferences, which are essential in making ethical decisions that respect the patient's autonomy. Considering the patient's beliefs helps healthcare professionals navigate complex ethical situations by aligning the care provided with the patient's values. Choices A, B, and D do not directly relate to personal factors but rather focus on hospital policies, physiological symptoms, and the provider's perspective, respectively. Personal factors are crucial in ethical decision-making as they center on the patient's autonomy and preferences.

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Which of the following situations may result in a low cardiac output and low cardiac index? (Select all that apply.)

  • A. Exercise
  • B. Hypovolemia
  • C. Myocardial infarction
  • D. Shock
Correct Answer: B

Rationale: Certainly. Hypovolemia, or low blood volume, can lead to low cardiac output and cardiac index because the heart has less blood to pump, resulting in reduced circulation. Exercise typically increases cardiac output to meet increased demand. Myocardial infarction may reduce cardiac output temporarily, but not consistently. Shock, a condition where the body's tissues do not receive enough oxygen and nutrients, can lead to low cardiac output, making it a possible cause.

The nurse is caring for a patient diagnosed with hyperactivaebi rdb.ecloimri/tuemst . The nurse focuses interventions toward which priority need?

  • A. Comfort
  • B. Nourishment
  • C. Safety
  • D. Sedation
Correct Answer: C

Rationale: The correct answer is C: Safety. In hyperactive delirium, the patient may be agitated, disoriented, and at risk of harm. Safety is the priority to prevent falls or injury. Comfort (A) is important but secondary to safety in this case. Nourishment (B) can wait until safety is ensured. Sedation (D) may be considered but only after safety measures are in place.

The patient is getting hemodialysis for the second time when he complains of a headache and nausea and, a little later, of becoming confused. The nurse realizes these are symptoms of

  • A. dialyzer membrane incompatibility.
  • B. a shift in potassium levels.
  • C. dialysis disequilibrium syndrome.
  • D. hypothermia.
Correct Answer: C

Rationale: The correct answer is C: dialysis disequilibrium syndrome. This occurs when there is a rapid decrease in urea concentration in the blood during hemodialysis, causing fluid shifts and cerebral edema leading to symptoms like headache, nausea, and confusion. Dialyzer membrane incompatibility (A) would present with allergic reactions, not neurological symptoms. A shift in potassium levels (B) may cause muscle weakness or cardiac arrhythmias, but not the described symptoms. Hypothermia (D) would present with low body temperature and shivering, not the neurological symptoms mentioned.

What is the best way to monitor agitation and effectivenes s of treating it in the critically ill patient?

  • A. Confusion Assessment Method (CAM-ICU)
  • B. FACES assessment tool
  • C. Glasgow Coma Scale
  • D. Richmond Agitation Sedation Scale
Correct Answer: D

Rationale: The correct answer is D: Richmond Agitation Sedation Scale (RASS). RASS is specifically designed to monitor agitation and sedation levels in critically ill patients, providing a standardized and objective assessment. It includes clear descriptors for different levels of agitation and sedation, allowing for consistent monitoring and treatment adjustments. CAM-ICU is mainly used for delirium assessment, not agitation. FACES assessment tool is more appropriate for pain assessment. Glasgow Coma Scale is focused on assessing level of consciousness, not agitation specifically. By using RASS, healthcare providers can accurately track agitation levels and evaluate the effectiveness of interventions in managing agitation in critically ill patients.

Which organization requires a mechanism for addressing ethical issues?

  • A. American Association of Critical-Care Nurses
  • B. American Hospital Association
  • C. Society of Critical Care Medicine
  • D. The Joint Commission
Correct Answer: D

Rationale: The correct answer is D, The Joint Commission, because it is a regulatory body that accredits healthcare organizations and requires them to have mechanisms for addressing ethical issues to ensure patient safety and quality of care. The other choices (A, B, C) are professional organizations that focus on specific areas of healthcare practice and do not have the authority to set regulatory standards for addressing ethical issues in healthcare organizations.

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