ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 of 9
A 20-year-old patient arrives in the emergency department (ED) several hours after taking 25 to 30 acetaminophen (Tylenol) tablets. Which action will the nurse plan to take?
Correct Answer: A
Rationale: The correct answer is A: Give N-acetylcysteine (Mucomyst). N-acetylcysteine is the antidote for acetaminophen overdose. It helps replenish glutathione, which is depleted by acetaminophen metabolism. This prevents liver damage. Choice B, chelation therapy, is not indicated for acetaminophen overdose. Choice C, oxygen therapy, is not directly related to acetaminophen overdose treatment. Choice D, drinking water, will not address the overdose and may not be safe in high doses. Therefore, the best course of action is to administer N-acetylcysteine to prevent liver damage in acetaminophen overdose.
Question 2 of 9
The patient is admitted to the unit with the diagnosis of rhabdomyolysis. The patient is started on intravenous (IV) fluids and IV mannitol. What action by the nurse is best?
Correct Answer: B
Rationale: The correct answer is B: Assess the patient’s lungs. Rhabdomyolysis can lead to acute kidney injury due to myoglobin release from damaged muscle cells. IV fluids and mannitol are given to prevent kidney damage by promoting myoglobin excretion. Assessing the patient’s lungs is crucial to monitor for potential complications such as acute respiratory distress syndrome (ARDS) which can occur as a result of rhabdomyolysis. This assessment helps to ensure early detection and prompt intervention if respiratory issues arise. Summary of Incorrect Choices: A: Assess the patient’s hearing - This is not directly related to rhabdomyolysis or its treatment. C: Decrease IV fluids once the diuretic has been administered - Decreasing IV fluids can exacerbate kidney injury in rhabdomyolysis. D: Give extra doses before giving radiological contrast agents - Mannitol is not routinely given before radiological contrast agents in the context of rhabdomyolysis management.
Question 3 of 9
The nurse is caring for a patient who requires administration of a neuromuscular blocking (NMB) agent to facilitate ventilation with non-traditional m odes. The nurse understands that neuromuscular blocking agents provide what outcome?
Correct Answer: D
Rationale: The correct answer is D: No sedation or analgesia. Neuromuscular blocking agents do not provide sedation or pain relief; they solely act on skeletal muscles to induce paralysis for procedures like intubation. Choice A is incorrect because NMB agents do not affect anxiety levels. Choice B is incorrect because NMB agents do not provide analgesia. Choice C is incorrect because NMB agents do not induce sedation. The primary purpose of NMB agents is to induce muscle paralysis without affecting consciousness or pain perception.
Question 4 of 9
The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period of time. Which of the following nursing interventions would improve the patient’s well-being and reduce anxiety the most?
Correct Answer: B
Rationale: The correct answer is B because pet therapy has been shown to reduce anxiety and improve well-being in hospitalized patients. Interacting with therapy dogs can provide comfort, companionship, and a distraction from the hospital environment. Bringing in a therapy dog can help the trauma patient feel more relaxed and supported during their extended hospital stay. Choice A may be comforting but does not address the therapeutic benefits of pet therapy. Choice C may provide soothing music, but pet therapy has been specifically proven to reduce anxiety in patients. Choice D, observing fish in an aquarium, may be calming but does not involve the interactive benefits of pet therapy.
Question 5 of 9
A male client is angry and is leaving the hospital against medical advice (AMA). The client demands to take his chart with him and states the chart is 'his' and he doesn’t want any more contact with the hospital. How should the nurse respond?
Correct Answer: D
Rationale: The correct answer is D because the client's medical chart is the property of the hospital, but the client has the right to a copy of the information. By offering to make a copy of the chart for the client, the nurse respects the client's autonomy while also ensuring that the hospital maintains the original medical record. This response balances the client's rights with legal and ethical considerations. Choice A is incorrect because the hospital is legally obligated to maintain the client's medical record even if the client leaves against medical advice. Choice B is incorrect as it denies the client access to their medical information, which goes against the principle of patient autonomy. Choice C is also incorrect as it does not address the client's request for a copy of their chart.
Question 6 of 9
The nurse is caring for a patient who has an intra-aortic balloon pump (IABP) following a massive heart attack. When assessing the patient, the nurse notices blood backing up into the IABP catheter. In which order should the nurse take the following actions?
Correct Answer: A
Rationale: Correct Answer: A Rationale: 1. Ensuring the IABP console is turned off is crucial to prevent further complications and stop potential harm to the patient. 2. By turning off the IABP console, the nurse can halt the pumping action, allowing assessment of the situation without interference. 3. This action takes priority over other steps as it addresses the immediate issue of blood backing up into the IABP catheter. 4. Once the console is turned off, the nurse can proceed with assessing the patient's vital signs, notifying the healthcare provider, and obtaining supplies if needed. Summary of Incorrect Choices: - Option B: Assessing vital signs and orientation is important, but addressing the malfunction of the IABP takes precedence to prevent harm. - Option C: Notifying the healthcare provider is necessary, but first, the immediate issue of blood backing up into the catheter must be addressed. - Option D: Obtaining supplies for a new catheter is premature without first addressing
Question 7 of 9
A mode of pressure-targeted ventilation that provides posiatbivirbe. cporme/tsessut re to decrease the workload of spontaneous breathing through what action by the endotracheal tube?
Correct Answer: C
Rationale: The correct answer is C: Pressure support ventilation. This mode delivers a set pressure to support each spontaneous breath, decreasing the workload of breathing. Pressure support ventilation assists the patient's inspiratory efforts without providing a set tidal volume like in volume-targeted ventilation. Continuous positive airway pressure (Choice A) maintains a constant level of positive pressure throughout the respiratory cycle but does not actively support spontaneous breathing efforts. Positive end-expiratory pressure (Choice B) maintains positive pressure at the end of expiration to prevent alveolar collapse but does not directly support spontaneous breathing. T-piece adapter (Choice D) is a weaning device that allows the patient to breathe spontaneously without ventilatory support.
Question 8 of 9
The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H2O of peak end-expiratory pressure (PEEP). Which action indicates that the new RN is safe?
Correct Answer: B
Rationale: The correct answer is B: The RN uses a closed-suction technique to suction the patient. This is the safe action because closed-suction technique minimizes the risk of ventilator-associated infections by maintaining a closed system during suctioning, reducing the exposure to pathogens. Closed-suction systems also help maintain lung compliance and oxygenation levels during the suctioning process. Rationale: Option A is incorrect because suctioning every 1 to 2 hours may be too frequent and can lead to hypoxia and mucosal damage. Option C is incorrect as taping the connection between the ventilator tubing and ET can interfere with the proper functioning of the ventilator and increase the risk of disconnection. Option D is incorrect because changing ventilator circuit tubing routinely every 48 hours is not evidence-based practice and can increase the risk of contamination and unnecessary costs.
Question 9 of 9
A patient who has experienced blunt abdominal trauma during a motor vehicle collision is complaining of increasing abdominal pain. The nurse will plan to teach the patient about the purpose of:
Correct Answer: B
Rationale: The correct answer is B: Abdominal ultrasonography. This is because ultrasonography is a non-invasive imaging technique that can quickly evaluate for internal injuries such as organ damage or bleeding in patients with blunt abdominal trauma. It is a rapid and effective diagnostic tool to assess the extent of injury and guide further management. Peritoneal lavage (A) is an invasive procedure used in trauma settings to detect intra-abdominal bleeding but is not typically used for teaching purposes. Nasogastric tube placement (C) is used for decompression and drainage in certain conditions but is not relevant for assessing abdominal trauma. Magnetic resonance imaging (MRI) (D) is not typically used as the initial imaging modality for acute trauma due to time constraints and its limited availability in emergency settings.