Critical Care Nursing Practice Questions

Critical Care Nursing Practice Questions Related

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A hospital interviews two different candidates for a position in the ICU. Both candidates have around 10 years of experience working in the ICU. Both have excellent interpersonal skills and highly positive references. One, however, has certification in critical care nursing. Which of the following is the most compelling and accurate reason for the hospital to hire the candidate with certification?

  • A. The certified nurse will have more knowledge and expertise.
  • B. The certified nurse will behave more ethically.
  • C. The certified nurse will be more caring toward patients.
  • D. The certified nurse will work more collaboratively with other nurses.
Correct Answer: A

Rationale: The correct answer is A: The certified nurse will have more knowledge and expertise. Certification in critical care nursing indicates that the candidate has undergone specialized training and passed a standardized exam, demonstrating a higher level of knowledge and skill in critical care practices compared to a non-certified candidate. This certification ensures that the nurse has met specific competency standards in critical care, making them better equipped to handle complex situations in the ICU.

Summary:
- Choice B (ethical behavior) and Choice C (caring towards patients) are subjective qualities that can be present in both certified and non-certified nurses.
- Choice D (collaboration with other nurses) is not directly related to certification but can be influenced by the individual's interpersonal skills.
- Ultimately, the certification in critical care nursing provides concrete evidence of the candidate's advanced knowledge and expertise, making them the most compelling choice for the hospital to hire.

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An 81-year-old patient who has been in the intensive care unit (ICU) for a week is now stable, and transfer to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset confusion. The nurse will plan to:

  • A. Give PRN lorazepam (Ativan) and cancel the transfer.
  • B. Inform the receiving nurse and then transfer the patient.
  • C. Notify the health care provider and postpone the transfer.
  • D. Obtain an order for restraints as needed and transfer the patient.
Correct Answer: C

Rationale: The correct answer is C: Notify the health care provider and postpone the transfer. The new onset confusion in an elderly patient in the ICU can be a sign of delirium, which is a serious condition that requires prompt evaluation and management. By notifying the healthcare provider, they can assess the patient's condition, order appropriate tests, and adjust the treatment plan as needed. Postponing the transfer allows for further observation and intervention to address the underlying cause of the confusion.

Choice A (Give PRN lorazepam and cancel the transfer) is incorrect because administering lorazepam may worsen the confusion in an elderly patient and should not be done without proper evaluation.

Choice B (Inform the receiving nurse and then transfer the patient) is incorrect because transferring the patient without addressing the new onset confusion can lead to potential complications and delay in appropriate management.

Choice D (Obtain an order for restraints as needed and transfer the patient) is incorrect because using restraints should only be considered as a

Daily weights are being recorded for the patient with a urine output that has been less than the intravenous and oral intake. The weight yesterday was 97.5 kg. This morning it is 99 kg. The nurse understands that this corresponds to a(n)

  • A. fluid retention of 1.5 liters.
  • B. fluid loss of 1.5 liters.
  • C. equal intake and output due to insensible losses.
  • D. fluid loss of 0.5 liters.
Correct Answer: A

Rationale: The correct answer is A: fluid retention of 1.5 liters. The weight gain from 97.5 kg to 99 kg indicates an increase in fluid retention. This difference of 1.5 kg corresponds to fluid retention of 1.5 liters, as 1 liter of water weighs approximately 1 kg. This weight gain suggests that the patient is retaining more fluid than they are excreting, leading to an increase in weight.

Incorrect choices:
B: fluid loss of 1.5 liters - This is incorrect because the weight increased, indicating fluid retention.
C: equal intake and output due to insensible losses - This is incorrect as weight increased, showing an imbalance in intake and output.
D: fluid loss of 0.5 liters - This is incorrect as the weight increased, indicating fluid retention, not loss.

Family members are in the patient’s room when the patient has a cardiac arrest and the staff starts resuscitation measures. Which action should the nurse take next?

  • A. Keep the family in the room and assign a staff member to explain the care given and answer questions.
  • B. Ask the family to wait outside the patient’s room with a designated staff member to provide emotional support.
  • C. Ask the family members whether they would prefer to remain in the patient’s room or wait outside the room.
  • D. Tell the family members that patients are comforted by having family members present during resuscitation efforts.
Correct Answer: C

Rationale: The correct answer is C because it involves patient-centered care and respects the family's preferences. By asking the family members whether they would prefer to remain in the patient's room or wait outside, the nurse acknowledges their needs and allows them to make an informed decision based on their comfort level. This empowers the family members and promotes a supportive environment during a stressful situation.

Choice A is incorrect because it assumes that keeping the family in the room without their input is the best approach, which may not be the case for all families. Choice B is incorrect because asking the family to wait outside without considering their preferences may not be the most supportive action. Choice D is incorrect because it makes a blanket statement about patient comfort without considering individual family dynamics and preferences.

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.

A patient is admitted to the ICU with injuries sustained from a fall from a third-story window. The patient is conscious, his breathing is labored, and he is bleeding heavily from the abdomen. He groans constantly and complains of severe pain, but his movements are minimal. His heart rate is elevated. Which of these is a sign that he is in the second phase of the stress response? Select all that apply.

  • A. Bleeding heavily from his abdomen
  • B. Labored, slow breathing
  • C. Severe pain
  • D. Elevated heart rate
Correct Answer: C

Rationale: The correct answer is C: Severe pain. In the second phase of the stress response (resistance phase), the body is trying to cope with the stressor. Severe pain is a sign of the body's response to the injury, indicating the activation of the stress response. Labored breathing and elevated heart rate are more likely to be signs of the initial phase (alarm phase) of the stress response. Bleeding heavily from the abdomen is a medical emergency and does not specifically indicate the stress response phase.

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