ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 of 9
A critically ill patient is not expected to survive this admission. The family asks the nurse how the patient is doing. When answering this question, what should the nurse include?
Correct Answer: C
Rationale: The correct answer is C because providing specific information such as descending trends in parameters helps the family understand the patient's condition objectively. This allows them to prepare emotionally and make informed decisions. Option A is incorrect because false hope should not be given. Option B is not the best approach as the nurse should still provide some information to the family. Option D is inappropriate and insensitive as it focuses on funeral arrangements rather than addressing the family's concerns about the patient's condition.
Question 2 of 9
A nurse is caring for an elderly man recently admitted to the ICU following a stroke. She assesses his cognitive function using a new cognitive assessment test she learned about in a recent article in a nursing journal. She then brings a cup of water and a straw to the patient because she observes that his lips are dry. Later, she has the patient sit in a wheelchair and takes him to have some blood tests performed. He objects at first, saying that he can walk on his own, but the nurse explains that it is hospital policy to use the wheelchair. That evening, she recognizes signs of an imminent stroke in the patient and immediately pages the physician. Which action taken by the nurse is the best example of evidence-based practice?
Correct Answer: C
Rationale: The correct answer is C: Recognizing signs of an imminent stroke and paging the physician. This action exemplifies evidence-based practice as it involves timely identification of a critical medical condition based on clinical assessment and prompt communication with the physician for further intervention. This aligns with the principles of evidence-based practice, which emphasize the integration of best available evidence with clinical expertise and patient values. The other choices are incorrect: A: Giving the patient a cup of water - While providing hydration is important for patient care, it does not demonstrate evidence-based practice in this scenario. B: Transferring the patient in a wheelchair - Although using a wheelchair may be hospital policy, it does not directly relate to evidence-based practice in this context. D: Using the cognitive assessment test - While assessing cognitive function is essential, it does not directly address the immediate medical needs of the patient as recognizing signs of an imminent stroke does.
Question 3 of 9
In the critically ill patient, an incomplete assessment and/or management of pain or anxiety may be hampered by which of the following? (Select all that apply.)
Correct Answer: A
Rationale: Step-by-step rationale: 1. Administration of neuromuscular blocking agents can hinder pain or anxiety assessment as it paralyzes the patient, preventing them from communicating discomfort. 2. Delirium may affect the patient's ability to express pain or anxiety, but it does not directly impede assessment and management. 3. Effective nurse communication and assessment skills facilitate, rather than hamper, pain or anxiety assessment. 4. Nonverbal patients can still communicate pain or anxiety through nonverbal cues, so they do not necessarily hinder assessment.
Question 4 of 9
The charge nurse is responsible for making the patient ass ignments on the critical care unit. She assigns the experienced, certified nurse to care for thea abicrbu.cteomly/t eisltl patient diagnosed with sepsis who also requires continuous renal replacement therapy and mechanical ventilation. She assigns the nurse with less than 1 year of experience to two patients who are more stable. This assignment reflects implementation of what guiding framework?
Correct Answer: D
Rationale: The correct answer is D: Synergy model of practice. The Synergy model emphasizes matching nurse competencies with patient needs for optimal outcomes. In this scenario, the charge nurse assigned the experienced, certified nurse to a complex patient requiring specialized care (sepsis, renal replacement therapy, ventilation), aligning with the model's principle of matching nurse expertise to patient acuity. Assigning the less experienced nurse to stable patients aligns with the model's focus on optimizing patient outcomes by matching nurse competencies appropriately. A: Crew resource management model focuses on teamwork and communication to enhance safety, not specifically on nurse-patient assignments. B: National Patient Safety Goals are broad guidelines for improving patient safety, not specific to nurse-patient assignments. C: Quality and Safety Education for Nurses (QSEN) model focuses on integrating quality and safety competencies into nursing education, not specifically on nurse-patient assignments.
Question 5 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 6 of 9
Family members have a need for information. Which intervention best assists in meeting this need?
Correct Answer: B
Rationale: The correct answer is B because providing a daily update of the patient's progress and facilitating communication with the intensivist directly addresses the family members' need for information in a timely and personalized manner. This intervention ensures that the family is kept informed about the patient's condition and treatment plan, fostering transparency and trust. It also allows for any questions or concerns to be addressed promptly, aiding in the family's understanding and involvement in the patient's care. Now, let's summarize why the other choices are incorrect: A: Handing out a pamphlet may provide information, but it lacks the personalized touch and real-time updates that are crucial for meeting the family's need for information. C: Restricting information and only allowing family members to be present at specific times may create frustration and hinder communication, not effectively meeting their information needs. D: Providing a list of medications is helpful, but it does not offer a comprehensive update on the patient's progress or facilitate direct communication with the medical team, which are
Question 7 of 9
Following insertion of a central venous catheter, the nurse obtains a stat chest x-ray film to verify proper catheter placement. The radiologist reports to the nurse: “The tip of the catheter is located in the superior vena cava.” What is the best inter pretation of these results by the nurse?
Correct Answer: C
Rationale: The correct answer is C: The distal tip of the catheter is in the appropriate position. Rationale: 1. The superior vena cava is a desirable location for a central venous catheter tip placement as it is close to the heart for rapid medication delivery. 2. Catheter tip in the superior vena cava allows for proper venous return and minimizes the risk of complications. 3. The nurse does not need to remove or adjust the catheter if the tip is in the superior vena cava. 4. Advancing the catheter into the pulmonary artery (option D) would be incorrect as it can lead to serious complications. Incorrect choices: A: Incorrect because placement in the superior vena cava is acceptable. B: Incorrect as placement in the superior vena cava does not increase the risk of ventricular dysrhythmias. D: Incorrect as advancing the catheter into the pulmonary artery is unnecessary and risky.
Question 8 of 9
Which statement regarding ethical concepts is true?
Correct Answer: C
Rationale: Rationale: Choice C is correct because a surrogate is indeed a competent adult designated to make healthcare decisions for an incapacitated person. This individual is typically chosen by the person themselves through a legal document like a healthcare proxy. This ensures that someone trusted can make important decisions when the person is unable to do so. Choices A, B, and D are incorrect because a living will and healthcare proxy serve different purposes, a signed donor card does not guarantee organ donation in the event of brain death (medical criteria are also required), and a persistent vegetative state is different from brain death (brain death implies irreversible cessation of brain function while a vegetative state involves some level of brain function).
Question 9 of 9
Which interventions may be included during “terminal we aning”? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B because during terminal weaning, the artificial ventilation is discontinued while maintaining the artificial airway to ensure comfort and support. This allows the patient to breathe on their own with support as needed. Explanation: 1. Option A: Complete extubation following ventilator withdrawal may not be suitable during terminal weaning as it involves removing the breathing tube entirely. 2. Option C: Discontinuation of anxiolytic and pain medications may not always be appropriate during terminal weaning as it depends on the patient's comfort needs. 3. Option D: Titration of ventilator support based on blood gas determinations is not typically done during terminal weaning as the focus is on gradual withdrawal of ventilation support while maintaining comfort.