Critical Care Nursing Practice Questions

Critical Care Nursing Practice Questions Related

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assessment, the patient is restless, heart rate has increased to 110 beats/min, respirations are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sinaubsir bt.acocmh/ytecsat rdia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretio ns. Loud crackles are audible throughout lung fields. The nurse notifies the physician, w ho orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. How d oes the nurse interpret the following blood gas levels? pH 7.28 PaCO 46 mm Hg Bicarbonate 22 mEq/L PaO 58 mm Hg O saturation 88% 2

  • A. Hypoxemia and compensated respiratory alkalosis
  • B. Hypoxemia and uncompensated respiratory acidosis
  • C. Normal arterial blood gas levels
  • D. Normal oxygen level and partially compensated metabaobliribc.c aomci/dteosts is
Correct Answer: B

Rationale: The correct answer is B: Hypoxemia and uncompensated respiratory acidosis.

Step-by-step rationale:
1. pH is low (7.28), indicating acidosis.
2. PaCO2 is elevated (46 mm Hg), indicating respiratory acidosis.
3. PaO2 is low (58 mm Hg), indicating hypoxemia.
4. Bicarbonate is within normal range (22 mEq/L), suggesting no compensation for the acidosis.
5. Oxygen saturation is low (88%), supporting the presence of hypoxemia.

Summary:
A: Incorrect - pH is low, not indicating compensated alkalosis.
C: Incorrect - Various abnormalities in the blood gas levels are present.
D: Incorrect - There is hypoxemia and uncompensated acidosis, not metabolic alkalosis.

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The nurse is caring for a terminally ill patient who has 20-second periods of apnea followed by periods of deep and rapid breathing. Which action by the nurse would be most appropriate?

  • A. Suction the patient.
  • B. Administer oxygen via face mask.
  • C. Place the patient in a high Fowler’s position.
  • D. Document the respirations as Cheyne-Stokes.
Correct Answer: D

Rationale: The correct answer is D because the patient is exhibiting Cheyne-Stokes breathing pattern characterized by periods of apnea followed by deep and rapid breathing. The nurse should document this pattern accurately. Option A is incorrect as suctioning is not indicated. Option B may worsen the respiratory pattern. Option C is not specifically related to addressing the breathing pattern.

The wife of a patient who is hospitalized in the critical car e unit following resuscitation for a sudden cardiac arrest at work demands to meet with the nu rsing manager. She states, “I want you to reassign my husband to another nurse. His current n urse is not in the room enough to make sure he is okay.” The nurse recognizes that this respo nse most likely is due to what unspoken need?

  • A. Desire to pursue a lawsuit if the assignment is not chanagbierbd.c.o m/test
  • B. Inability to participate in the husband’s care.
  • C. Lack of prior experience in a critical care setting.
  • D. Sense of loss of control of the situation.
Correct Answer: D

Rationale: The correct answer is D: Sense of loss of control of the situation. The wife's demand to reassign the nurse indicates her need for control over her husband's care, as she may feel overwhelmed by the sudden cardiac arrest and hospitalization. By requesting a different nurse, she seeks to regain a sense of control and assurance. The other choices are incorrect because: A does not align with the wife's immediate concern, B does not explain her request for a nurse reassignment, and C does not address her emotional response to the situation.

The AACN Standards for Acute and Critical Care Nursing Practice uses what framework to guide critical care nursing practice?

  • A. Evidence-based practice
  • B. Healthy work environment
  • C. National Patient Safety Goals
  • D. Nursing process
Correct Answer: A

Rationale: The correct answer is A: Evidence-based practice. The AACN Standards for Acute and Critical Care Nursing Practice emphasize the use of evidence-based practice to guide critical care nursing. This framework ensures that nursing interventions are based on the best available evidence, leading to improved patient outcomes. Healthy work environment (B) and National Patient Safety Goals (C) are important but not specific frameworks for critical care nursing. The nursing process (D) is a systematic approach to delivering patient care but is not the primary guiding framework in critical care nursing practice.

The patient’s serum creatinine level is 0.7 mg/dL. The expected BUN level should be

  • A. 1 to 2 mg/dL.
  • B. 7 to 14 mg/dL.
  • C. 10 to 20 mg/dL.
  • D. 20 to 30 mg/dL.
Correct Answer: C

Rationale: The correct answer is C (10 to 20 mg/dL). The normal BUN-to-creatinine ratio is approximately 10:1. With a serum creatinine level of 0.7 mg/dL, the expected BUN level should be around 7 to 14 mg/dL. Therefore, choice C (10 to 20 mg/dL) falls within this expected range. Choices A, B, and D are incorrect as they do not align with the typical BUN-to-creatinine ratio and would indicate abnormal kidney function.

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.

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