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A nurse has been working as a staff nurse in the surgical inabteirbn.scoivme/t ecsat re unit for 2 years and is interested in certification. Which credential would be most applicable for her to seek?
- A. ACNPC
- B. CCNS
- C. CCRN
- D. PCCN
Correct Answer: C
Rationale: The correct answer is C: CCRN. The nurse works in a surgical unit, making CCRN (Critical Care Registered Nurse) the most applicable credential as it focuses on critical care nursing, which is relevant to the nurse's current practice. ACNPC (Acute Care Nurse Practitioner Certification) and PCCN (Progressive Care Certified Nurse) are not suitable as they are more focused on advanced practice or progressive care respectively, not directly related to surgical units. CCNS (Clinical Nurse Specialist Certification) is not the best choice as it is more geared towards advanced practice roles in specific clinical specialties, not general staff nursing.
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The nurse is caring for a patient with severe neurological impairment following a massive stroke. The primary care provider has ordered tests to detearbmirbi.ncoem b/treasit n death. The nurse understands that criteria for brain death includes what crite ria? (Select all that apply.)
- A. Absence of cerebral blood flow.
- B. Absence of brainstem reflexes on neurological examin ation.
- C. Presents of Cheyne-Stokes respirations.
- D. Confirmation of a flat electroencephalogram.
Correct Answer: A
Rationale: The correct answer is A: Absence of cerebral blood flow. Brain death is determined by the irreversible cessation of all brain functions, including blood flow to the brain. When there is no cerebral blood flow, the brain is unable to function, leading to brain death. This criterion is essential in diagnosing brain death as it indicates a complete loss of brain function.
Explanation for why the other choices are incorrect:
- B: Absence of brainstem reflexes on neurological examination is a common sign of brain death, but it is not the primary criterion.
- C: Presence of Cheyne-Stokes respirations is not indicative of brain death. It is a pattern of breathing that can be seen in various conditions, not specifically brain death.
- D: Confirmation of a flat electroencephalogram is a supportive test for brain death but not the primary criterion. The absence of brain activity on an EEG can help confirm brain death but is not as definitive as the absence of cerebral blood flow.
While caring for a patient with a small bowel obstruction, the nurse assesses a pulmonary artery occlusion pressure (PAOP) of 1 mm Hg and hourly urine output of 5 mL. The nurse anticipates which therapeutic intervention?
- A. Diuretics
- B. Intravenous fluids
- C. Negative inotropic agents
- D. Vasopressors
Correct Answer: B
Rationale: The correct answer is B: Intravenous fluids. In the scenario of a small bowel obstruction, a PAOP of 1 mm Hg indicates hypovolemia requiring fluid resuscitation to improve cardiac output and tissue perfusion. The low urine output suggests inadequate renal perfusion, further supporting the need for fluids. Diuretics (choice A) would worsen the hypovolemia. Negative inotropic agents (choice C) decrease cardiac contractility, which is not indicated in this scenario. Vasopressors (choice D) are used for hypotension, not for hypovolemia. Therefore, the most appropriate intervention is to administer intravenous fluids to address the hypovolemia and improve tissue perfusion.
A nurse is weaning a 68-kg male patient who has chronic obstructive pulmonary disease (COPD) from mechanical ventilation. Which patient assessment finding indicates that the weaning protocol should be stopped?
- A. The patient’s heart rate is 97 beats/min.
- B. The patient’s oxygen saturation is 93%.
- C. The patient’s respiratory rate is 32 breaths/min.
- D. The patient’s spontaneous tidal volume is 450 mL.
Correct Answer: C
Rationale: The correct answer is C because a respiratory rate of 32 breaths/min indicates increased work of breathing, which could be a sign of respiratory distress. In a patient being weaned from mechanical ventilation, an elevated respiratory rate suggests that the patient may not be able to sustain adequate ventilation on their own. This warrants stopping the weaning protocol to prevent respiratory failure.
Choice A is incorrect because a heart rate of 97 beats/min is within normal range for an adult. Choice B is incorrect because an oxygen saturation of 93% is acceptable for a patient with COPD. Choice D is incorrect because a tidal volume of 450 mL is adequate for a patient weaning from mechanical ventilation.
What is the most common cause of a pulmonary embolus?
- A. An amniotic fluid embolus.
- B. A deep vein thrombosis from lower extremities.
- C. A fat embolus from a long bone fracture.
- D. Vegetation that dislodges from an infected central venous catheter.
Correct Answer: B
Rationale: The correct answer is B: A deep vein thrombosis from lower extremities. Deep vein thrombosis (DVT) is the most common cause of a pulmonary embolus as a blood clot can dislodge from the veins, travel to the lungs, and block blood flow. An amniotic fluid embolus (Choice A) occurs during childbirth and is rare as a cause of pulmonary embolism. A fat embolus (Choice C) typically occurs after a long bone fracture and is more likely to cause issues in the lungs. Vegetation from an infected central venous catheter (Choice D) can cause septic pulmonary embolism, but it is not as common as DVT.
A patient in the ICU is complaining that he is not sleeping well at night because of anxiety. Which of the following would be the most helpful intervention for the nurse to make?
- A. Provide the patient with a bath immediately following his first 90-minute REM sleep cycle.
- B. Increase the patients pain medication.
- C. Provide the patient with 5 minutes of effleurage and then minimize disruptions.
- D. Monitor the patients brain waves by polysomnography to determine his sleep pattern.
Correct Answer: C
Rationale: Rationale:
C: Providing the patient with 5 minutes of effleurage (gentle massage) and minimizing disruptions is the most helpful intervention. Effleurage can help reduce anxiety and promote relaxation, improving sleep quality. Minimizing disruptions creates a conducive environment for sleep.
A: Providing a bath after REM sleep may disrupt the patient's sleep cycle, worsening anxiety.
B: Increasing pain medication may not address the root cause of anxiety and could lead to dependency or side effects.
D: Monitoring brain waves with polysomnography is an invasive procedure not typically indicated for managing anxiety-related sleep issues.