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The vision of the American Association of Critical-Care N urses is a healthcare system driven by achieving what goal?
- A. Maintaining a healthy work environment.
- B. Providing care from a multiprofessional team under th e direction of a critical care physician.
- C. Effectively meeting the needs of critically ill patients a nd families.
- D. Creating respectful, healing, and humane environments.
Correct Answer: D
Rationale: The correct answer is D because the vision of the American Association of Critical-Care Nurses focuses on creating respectful, healing, and humane environments. This aligns with the core values of nursing, emphasizing compassion, dignity, and patient-centered care. A is incorrect as the focus is not solely on the work environment. B is incorrect as it emphasizes the role of physicians over the collaborative approach advocated by the AACN. C is incorrect as it only addresses meeting patient needs, whereas the vision encompasses a broader scope of creating healing environments.
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Slow continuous ultrafiltration is also known as isolated ultrafiltration and is used to
- A. remove plasma water in cases of volume overload.
- B. remove fluids and solutes through the process of convection.
- C. remove plasma water and solutes by adding dialysate.
- D. combine ultrafiltration, convection, and dialysis.
Correct Answer: A
Rationale: The correct answer is A because slow continuous ultrafiltration removes excess plasma water in cases of volume overload by applying a pressure gradient across a semipermeable membrane. This process helps to achieve fluid balance without removing solutes.
Choice B is incorrect because convection is not the primary mechanism of slow continuous ultrafiltration.
Choice C is incorrect as dialysate is not added in slow continuous ultrafiltration.
Choice D is incorrect as slow continuous ultrafiltration does not combine all three processes of ultrafiltration, convection, and dialysis.
Which patient should the nurse notify the organ procureme nt organization (OPO) to evaluate for possible organ donation?
- A. A 36-year-old patient with a Glasgow Coma Scale score of 3 with no activity on electroencephalogram
- B. A 68-year-old male admitted with unstable atrial fibrillation who has suffered a stroke
- C. A 40-year-old brain-injured female with a history of ovabairrbi.acnom c/taenstc er and a Glasgow Coma Scale score of 7
- D. A 53-year-old diabetic male with a history of unstable angina status post resuscitation
Correct Answer: A
Rationale: The correct answer is A because the patient is a 36-year-old with a Glasgow Coma Scale score of 3 and no activity on electroencephalogram, indicating severe brain injury and likely irreversible neurological damage. This patient meets the criteria for potential organ donation as they are neurologically devastated.
Choice B is incorrect because the patient's condition is related to stroke and atrial fibrillation, not severe brain injury that would make them a candidate for organ donation.
Choice C is incorrect because although the patient has a brain injury and a lower Glasgow Coma Scale score, the history of a reversible cause (ovarian cancer metastasis) and a higher GCS score compared to choice A make this patient less suitable for organ donation evaluation.
Choice D is incorrect as the patient's diabetic and cardiovascular history does not suggest severe brain injury that would qualify for organ donation.
The nurse returns from the cardiac catheterization laboratory with a patient following insertion of a pulmonary artery catheter and assists in transferring th e patient from the stretcher to the bed. Prior to obtaining a cardiac output, which action is m ost important for the nurse to complete?
- A. Document a pulmonary artery catheter occlusion press ure.
- B. Zero reference the transducer system at the phlebostatic axis.
- C. Inflate the pulmonary artery catheter balloon with 1 m L air.
- D. Inject 10 mL of 0.9% normal saline into the proximal port.
Correct Answer: B
Rationale: The correct answer is B: Zero reference the transducer system at the phlebostatic axis. This is the most important action before obtaining a cardiac output because zero referencing ensures accurate pressure readings. The phlebostatic axis is the level of the atria when the patient is supine, and zeroing at this point minimizes errors in pressure measurements.
Choice A is incorrect because documenting a pulmonary artery catheter occlusion pressure is not the priority at this stage. Choice C is incorrect as inflating the balloon with air should be done after zero referencing. Choice D is incorrect as injecting normal saline into the port is not necessary before zero referencing.
Many critically ill patients experience anxiety. The nurse can reduce anxiety with which approach?
- A. Asking family members to limit their visitation to 2-hour periods in morning, afternoon, and evening. You know that this is the best approach to ensure uninterrupted rest time for the patient. Tell the patient, “Your family is in the waiting room. They will be permitted to come in at 2:0 0 PM after you take a short nap.”
- B. Explaining the unit routine. “Assessments are done every 4 hours; patients are bathed on the night shift around 5:00 AM; family memabbierbr.sc oamr/ete spt ermitted to visit you after the physicians make their morning rounds. They can spend the day. Lights are out every night at 10:00 PM.”
- C. Stating, “It’s time to turn you. I am going to ask another nurse to come in and help me. We will turn you to your left side. During the turn , I’m going to inspect the skin on your back and rub some lotion on your back. T his should help to make you feel better.”
- D. Suctioning the endotracheal tube immediately when thaeb iprba.ctoiemn/tte sst tarts to cough. Sharing, “Your tube needs suctioned; you should feel better after I’m done.”
Correct Answer: C
Rationale: The correct answer is C because it addresses the patient's anxiety by providing clear communication and involving the patient in the care process. By explaining the turning procedure, inspecting the skin, and providing comfort through lotion application, the nurse establishes trust and promotes a sense of control for the patient. This approach helps alleviate anxiety by keeping the patient informed and engaged in their care.
Choice A is incorrect because limiting family visitation may not directly address the patient's anxiety. Choice B is incorrect as it focuses on routine information rather than directly addressing the patient's anxiety. Choice D is incorrect because suctioning the endotracheal tube may cause discomfort and does not address the underlying anxiety issue.
When caring for a patient with pulmonary hypertension, which parameter is most appropriate for the nurse to monitor to evaluate the effectiveness of the treatment?
- A. Central venous pressure (CVP)
- B. Systemic vascular resistance (SVR)
- C. Pulmonary vascular resistance (PVR)
- D. Pulmonary artery wedge pressure (PAWP)
Correct Answer: C
Rationale: The correct answer is C: Pulmonary vascular resistance (PVR). PVR is the most appropriate parameter to monitor in a patient with pulmonary hypertension as it directly reflects the resistance in the pulmonary circulation. A decrease in PVR indicates a reduction in the constriction of blood vessels in the lungs, suggesting improvement in pulmonary hypertension. Monitoring CVP (A) is more relevant in assessing fluid status, SVR (B) is more indicative of systemic vascular tone, and PAWP (D) is useful in assessing left-sided heart function, but they are not as specific to evaluating the effectiveness of treatment for pulmonary hypertension.