Critical Care Nursing Exam Questions

Critical Care Nursing Exam Questions Related

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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

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Which acid-base disturbances commonly occurs with the hyperventilation and impaired gas exchange seen in severe exacerbation of asthma?

  • A. Metabolic acidosis
  • B. Metabolic alkalosis
  • C. Respiratory acidosis
  • D. Respiratory alkalosis
Correct Answer: D

Rationale: The correct answer is D: Respiratory alkalosis. Hyperventilation in severe asthma exacerbation leads to excessive removal of CO2, causing a decrease in carbonic acid levels, resulting in respiratory alkalosis. Metabolic acidosis (A) is not typically associated with hyperventilation. Metabolic alkalosis (B) is caused by excessive loss of acid or gain of bicarbonate, not by hyperventilation. Respiratory acidosis (C) is characterized by an increase in CO2 levels due to inadequate ventilation, which is the opposite of what occurs in severe asthma exacerbation.

The nurse is discussing the role of hospice care with a patient and family. Which statement by the nurse accurately describes hospice care?

  • A. Hospice care aims to cure serious illnesses through specialized treatments.
  • B. Hospice care provides support and comfort for patients at the end of life.
  • C. Hospice care is only for patients with cancer-related illnesses.
  • D. Hospice care focuses primarily on extending life expectancy.
Correct Answer: B

Rationale: The correct answer is B because hospice care indeed focuses on providing support and comfort for patients at the end of life. This is achieved through pain management, emotional support, and enhancing quality of life. Choice A is incorrect because hospice care does not aim to cure serious illnesses but rather to provide comfort and care. Choice C is incorrect as hospice care is not limited to patients with cancer but is available to individuals with various terminal illnesses. Choice D is incorrect as hospice care does not focus on extending life expectancy but rather on improving the quality of life during the end-of-life period.

The nurse notes premature ventricular contractions (PVCs) while suctioning a patient’s endotracheal tube. Which action by the nurse is a priority?

  • A. Decrease the suction pressure to 80 mm Hg.
  • B. Document the dysrhythmia in the patient’s chart.
  • C. Stop and ventilate the patient with 100% oxygen.
  • D. Give antidysrhythmic medications per protocol.
Correct Answer: C

Rationale: The correct answer is C: Stop and ventilate the patient with 100% oxygen. This is the priority action because PVCs can lead to life-threatening arrhythmias and inadequate oxygenation. By stopping suctioning and providing 100% oxygen, the nurse ensures proper oxygenation and ventilation, which takes precedence over addressing the dysrhythmia itself. Decreasing suction pressure (choice A) may not address the underlying issue and could potentially harm the patient. Documenting the dysrhythmia (choice B) is important but not as urgent as ensuring adequate oxygenation. Giving antidysrhythmic medications (choice D) should be done under the direction of a healthcare provider and is not the first-line intervention in this situation.

A hospice nurse who has become close to a terminally ill patient is present in the home when the patient dies and feels saddened and tearful as the family members begin to cry. Which action should the nurse take at this time?

  • A. Contact a grief counselor as soon as possible.
  • B. Cry along with the patient’s family members.
  • C. Leave the home as soon as possible to allow the family to grieve privately.
  • D. Consider whether working in hospice is desirable because patient losses are common.
Correct Answer: B

Rationale: The correct answer is B: Cry along with the patient’s family members. This action demonstrates empathy and support for the family's grief, showing that the nurse acknowledges and shares their feelings. It can help the family feel understood and supported during a difficult time. By crying with the family, the nurse can validate their emotions and provide comfort without intruding on their personal space. This approach fosters a sense of connection and trust between the nurse and the family, enhancing the quality of care provided.
Incorrect Choices:
A: Contact a grief counselor as soon as possible - This choice may be premature and could come across as impersonal or distancing in the immediate aftermath of the patient’s death.
C: Leave the home as soon as possible - This choice would be insensitive and could make the family feel abandoned in their time of need.
D: Consider whether working in hospice is desirable because patient losses are common - This choice is inappropriate as it suggests the nurse should reconsider their career choice based on emotional reactions,

Intrapulmonary shunting refers to what outcome?

  • A. Alveoli that are not perfused.
  • B. Blood that is shunted from the left side of the heart to t he right and causes heart failure.
  • C. Blood that is shunted from the right side of the heart to the left without oxygenation.
  • D. Shunting of blood supply to only one lung.
Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct:
1. Intrapulmonary shunting refers to blood bypassing the normal oxygenation process in the lungs.
2. Choice C describes blood being shunted from the right side of the heart (deoxygenated blood) to the left side without oxygenation, leading to systemic circulation without oxygenation.
3. Choices A, B, and D do not accurately describe intrapulmonary shunting as they focus on other concepts like alveolar perfusion, heart failure, and unilateral lung blood supply, respectively.

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