Critical Care Nursing Cardiac Questions

Critical Care Nursing Cardiac Questions Related

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The nurse is caring for a patient following insertion of a left subclavian central venous catheter (CVC). Which action by the nurse best reduces th e risk of catheter-related bloodstream infection (CRBSI)?

  • A. Review daily the necessity of the central venous cathet er.
  • B. Cleanse the insertion site daily with isopropyl alcohol.
  • C. Change the pressurized tubing system and flush bag daily.
  • D. Maintain a pressure of 300 mm Hg on the flush bag.
Correct Answer: A

Rationale: The correct answer is A: Review daily the necessity of the central venous catheter. This action reduces the risk of CRBSI by promoting early removal of unnecessary catheters, which is a key strategy in preventing infections. Unnecessary catheters increase the risk of infection due to prolonged exposure to the patient's skin flora and possible contamination during insertion. Reviewing daily ensures the catheter is only kept when necessary, minimizing the duration of catheter use and reducing the chances of infection.

Summary of other choices:
B: Cleansing the insertion site daily with isopropyl alcohol is important for maintaining skin integrity but does not directly reduce the risk of CRBSI.
C: Changing the pressurized tubing system and flush bag daily is important for maintaining catheter patency but does not directly reduce the risk of CRBSI.
D: Maintaining a pressure of 300 mm Hg on the flush bag is important for proper catheter function but does not directly reduce the risk of CR

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Renin plays a role in blood pressure regulation by

  • A. activating the renin-angiotensin-aldosterone cascade.
  • B. suppressing angiotensin production.
  • C. decreasing sodium reabsorption.
  • D. inhibiting aldosterone release.
Correct Answer: A

Rationale: The correct answer is A because renin activates the renin-angiotensin-aldosterone cascade, which ultimately leads to vasoconstriction, increased blood pressure, and aldosterone release to increase sodium and water reabsorption. Renin does not suppress angiotensin production (B), decrease sodium reabsorption (C), or inhibit aldosterone release (D), as these actions would counteract its role in blood pressure regulation.

What is a strategy for preventing thromboembolism in pat ients at risk who cannot take anticoagulants?

  • A. Administration of two aspirin tablets every 4 hours.
  • B. Infusion of thrombolytics.
  • C. Insertion of a vena cava filter.
  • D. Subcutaneous heparin administration every 12 hours.
Correct Answer: C

Rationale: The correct answer is C: Insertion of a vena cava filter. This is a strategy for preventing thromboembolism in patients at risk who cannot take anticoagulants. The vena cava filter prevents blood clots from traveling to the lungs by trapping them in the inferior vena cava. It is a mechanical device that does not interfere with the body's clotting process.

Explanation of why other choices are incorrect:
A: Administration of two aspirin tablets every 4 hours is not an effective strategy for preventing thromboembolism in high-risk patients. Aspirin is an antiplatelet agent and may not be sufficient for preventing blood clots in these patients.
B: Infusion of thrombolytics is used for breaking down blood clots that have already formed, not for prevention. It is not a suitable option for preventing thromboembolism in at-risk patients.
D: Subcutaneous heparin administration every 12

A patient in the ICU has recently been diagnosed with diabetes mellitus. Before being discharged, this patient will require detailed instructions on how to manage her diet, how to self-inject insulin, and how to handle future diabetic emergencies. Which nurse competency is most needed in this situation?

  • A. Clinical judgment
  • B. Advocacy and moral agency
  • C. Caring practices
  • D. Facilitation of learning
Correct Answer: D

Rationale: The correct answer is D: Facilitation of learning. In this scenario, the nurse needs to effectively educate the patient on managing her diet, insulin injections, and handling emergencies. Facilitation of learning involves assessing the patient's learning needs, providing relevant information, demonstrating skills, and evaluating understanding. This competency is crucial for promoting patient education and empowerment in managing their condition.

A: Clinical judgment involves making decisions based on assessment data, which is important but not the primary focus in this situation.
B: Advocacy and moral agency involve standing up for patients' rights and values, which is important but not as directly relevant to the patient's education needs.
C: Caring practices involve showing empathy and compassion, which are essential but not the main competency required for educational purposes in this case.

An unresponsive 79-year-old is admitted to the emergency department (ED) during a summer heat wave. The patient’s core temperature is 105.4°F (40.8°C), blood pressure (BP) 88/50, and pulse 112. The nurse initially will plan to:

  • A. Apply wet sheets and a fan to the patient.
  • B. Provide O2 at 6 L/min with a nasal cannula.
  • C. Start lactated Ringer's solution at 1000 mL/hr.
  • D. Give acetaminophen (Tylenol) rectal suppository.
Correct Answer: A

Rationale: The correct answer is A: Apply wet sheets and a fan to the patient. This is the initial treatment for hyperthermia to aid in lowering the body temperature. Wet sheets help in evaporative cooling, while a fan enhances heat loss through convection. This approach is crucial in managing heat-related illnesses quickly. Choices B, C, and D are incorrect as they do not directly address the urgent need to reduce the patient's elevated core temperature. Providing O2, IV fluids, or acetaminophen can be considered later in the management, but the priority is to rapidly lower the body temperature in a hyperthermic patient to prevent further complications.

Which statement reflects adherence to current recommendations concerning open visitation policies?

  • A. Allowing animals on the unit; however, these can only be “therapy” animals through the hospital’s pet therapy program.
  • B. Allowing family visitation throughout the day except a t change of shift and during rounds.
  • C. Determining, in collaboration with the patient and famaiblyirb, .cwomho/te csta n visit and when.
  • D. Permitting open visitation by adults 18 years of age and older; limit visits of children to 1 hour.
Correct Answer: C

Rationale: The correct answer is C because it reflects patient-centered care by involving patients and families in decision-making. Collaborating with them on visitation preferences promotes a supportive environment. Choice A restricts animal visitation, not addressing human visitors. Choice B limits visitation during specific times, not individualized. Choice D imposes restrictions based on age, not on patient/family preferences. Therefore, Choice C is the most aligned with current recommendations for open visitation policies.

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