Critical Care Nursing Practice Questions -Nurselytic

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Critical Care Nursing Practice Questions Questions

Question 1 of 5

What is the basic underlying pathophysiology of acute respiratory distress syndrome?

Correct Answer: C

Rationale: The correct answer is C: Damage to the type II pneumocytes, which produce surfactant. Acute respiratory distress syndrome (ARDS) is characterized by damage to the alveolar epithelium, including type II pneumocytes responsible for producing surfactant. Surfactant reduces surface tension in the alveoli, preventing collapse. Damage to type II pneumocytes impairs surfactant production, leading to alveolar collapse and impaired gas exchange.

Choices A, B, and D are incorrect because ARDS is not primarily caused by a decrease in white blood cells, damage to the right mainstem bronchus, or decreased capillary permeability.

Question 2 of 5

The patient has a Glasgow Coma Scale (GCS) score of 3 and discussions have been held with the family about withdrawing life support. Which statemen t by the nurse best describes requirements that must be met to sustain Centers for Medicare and Medicaid Services (CMS) Conditions of Participation?

Correct Answer: C

Rationale: The correct answer is C because notifying the organ procurement organization (OPO) once the patient has been pronounced brain dead is a requirement to sustain CMS Conditions of Participation. This step ensures that the proper protocols are followed for organ donation.


Choice A is incorrect because notifying the OPO of impending death is not a requirement for sustaining CMS Conditions of Participation.


Choice B is incorrect because obtaining informed consent for organ donation is not directly related to meeting the requirements of CMS Conditions of Participation.


Choice D is incorrect because while evaluating the patient's suitability for organ donation is important, it is not a specific requirement under CMS Conditions of Participation.

Question 3 of 5

A normal urine output is considered to be

Correct Answer: D

Rationale: The correct answer is D (1 to 2 L/day) because the average adult typically produces 1 to 2 liters of urine per day. This range is considered normal for maintaining proper hydration and eliminating waste products.
Choice A (80 to 125 mL/min) is incorrect as it represents the rate of urine production per minute, which is not commonly used to measure daily urine output.
Choice B (180 L/day) is unrealistic and far exceeds the normal range for urine output.
Choice C (80 mL/min) is too low for daily urine output and would not be sufficient for adequate waste elimination.

Question 4 of 5

A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the healthcare provider discontinued the medication because his blood pressure has been normal for the past three months. Which instruction should the nurse provide?

Correct Answer: D

Rationale: The correct answer is D: Ask the healthcare provider about tapering the drug dose over the next week. This answer is correct because propranolol is a beta-blocker, and abrupt discontinuation can lead to rebound hypertension, angina, or even myocardial infarction due to the sudden withdrawal of the medication. Tapering the drug dose over time allows the body to adjust gradually and reduces the risk of these adverse effects.


Choice A is incorrect because obtaining another antihypertensive prescription is not necessary if the client's blood pressure has been normal for the past three months.
Choice B is incorrect because abruptly stopping the medication without tapering can lead to withdrawal symptoms.
Choice C is incorrect because simply reporting uncomfortable symptoms without taking appropriate action (tapering the drug dose) is not addressing the potential risks associated with abrupt discontinuation of propranolol.

Question 5 of 5

When it is noted that a patient’s endotracheal tube is not se cured tightened, he respiratory care practitioner assists the nurse in taping the tube. After the tu be is retaped, the nurse auscultates the patient’s lungs and notes that the breath sounds over the left lung fields are absent. The nurse suspects is the cause of this finding?

Correct Answer: A

Rationale: The correct answer is A: The endotracheal tube is in the right mainstem bronchus. When the endotracheal tube is not secured properly and is retaped, there is a possibility that it may have migrated into the right mainstem bronchus, leading to absent breath sounds in the left lung fields. This condition is known as endobronchial intubation. In such cases, ventilation primarily occurs in the right lung, resulting in decreased or absent breath sounds on the contralateral side.

Choices B, C, and D are incorrect as they do not explain the absence of breath sounds over the left lung fields in this specific scenario.

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