Critical Care Nursing Practice Questions

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The nurse is caring for a patient whose condition has deter iorated and is now not responding to standard treatment. The primary health care provider ca lls for an ethical consultation with the family to discuss potential withdrawal versus aggressivabei rtbr.ceoamtm/teestn t. The nurse understands that applying a model for ethical decision making involves which of the following? (Select all that apply.)

  • A. Burden versus benefit
  • B. Family’s wishes
  • C. Patient’s wishes
  • D. Potential outcomes of treatment options
Correct Answer: A

Rationale: The correct answer is A: Burden versus benefit. In ethical decision-making, considering the burden of treatment on the patient versus the potential benefits is crucial. This involves weighing the risks, benefits, and potential harm of treatment options. Family's wishes (B) and patient's wishes (C) are important factors but may not always align with what is ethically best for the patient. Potential outcomes of treatment options (D) are relevant but do not directly address the ethical dilemma of balancing burden and benefit. Therefore, A is the correct choice as it directly relates to the ethical principles guiding decision-making in this scenario.

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The nurse is assessing an older client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding?

  • A. A nystagmus on the left.
  • B. Exophthalmos on the right.
  • C. Ptosis on the left eyelid.
  • D. Astigmatism on the right.
Correct Answer: C

Rationale: The correct answer is C: Ptosis on the left eyelid. Ptosis refers to drooping of the eyelid, which is a common condition in older adults. In this scenario, the nurse should document the finding as ptosis on the left eyelid because the client's left upper eyelid is drooping, covering more of the iris than the right eyelid.

Explanation: Nystagmus (A) is an involuntary eye movement, not related to eyelid drooping. Exophthalmos (B) is the protrusion of the eyeball and not relevant to this scenario. Astigmatism (D) refers to a refractive error of the eye and does not cause eyelid drooping. Therefore, the correct choice is C as it accurately describes the client's condition.

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.

A patient’s vital signs are pulse 87, respirations 24, BP of 128/64 mm Hg, and cardiac output is 4.7 L/min. The patient’s stroke volume is ______ mL. (Round to the nearest whole number.)

  • A. 54
  • B. 64
  • C. 74
  • D. 84
Correct Answer: A

Rationale: The stroke volume is calculated by dividing the cardiac output by the heart rate. Given the cardiac output of 4.7 L/min and a heart rate of 87 bpm, the stroke volume is 54 mL (4700 mL/87 bpm ≈ 54 mL). Therefore, choice A (54) is the correct answer. Choices B, C, and D are incorrect as they do not match the calculated stroke volume based on the provided cardiac output and heart rate.

A 54-year-old patient arrives in the emergency department (ED) after exposure to powdered lime at work. Which action should the nurse take first?

  • A. Obtain the patient’s vital signs.
  • B. Obtain a baseline complete blood count.
  • C. Decontaminate the patient by showering with water.
  • D. Brush off any visible powder on the skin and clothing.
Correct Answer: D

Rationale: The correct answer is D because brushing off any visible powder on the skin and clothing is the first step in managing exposure to powdered lime. This action helps to remove the source of exposure and prevent further absorption through the skin. It is crucial to prevent additional contact and reduce the risk of further harm. Obtaining vital signs (choice A) and a complete blood count (choice B) can be important but should come after the initial decontamination. Decontaminating the patient by showering with water (choice C) is not recommended for lime exposure as it can react with water and cause further injury.

The primary health care provider writes an order to discon tinue a patient’s left radial arterial line. When discontinuing the patient’s invasive line, what is the priority nursing action?

  • A. Apply an air occlusion dressing to insertion site.
  • B. Apply pressure to the insertion site for 5 minutes.
  • C. Elevate the affected limb on pillows for 24 hours.
  • D. Keep the patient’s wrist in a neutral position.
Correct Answer: B

Rationale: The correct answer is B: Apply pressure to the insertion site for 5 minutes. This is the priority nursing action because it helps prevent bleeding and hematoma formation after removing the arterial line. Applying pressure for 5 minutes allows for adequate hemostasis.

A: Applying an air occlusion dressing to the insertion site is not the priority action. It does not address the immediate need to control bleeding.

C: Elevating the affected limb on pillows for 24 hours is not necessary and does not address the immediate need for hemostasis.

D: Keeping the patient's wrist in a neutral position is not the priority action when discontinuing an arterial line. It does not address the need for hemostasis and preventing bleeding.

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