ATI RN
Critical Care Nursing Questions Questions
Question 1 of 9
A hospice patient is manifesting a decrease in all body system functions except for a heart rate of 124 and a respiratory rate of 28. Which statement, if made by the nurse to the patient’s family member, is most appropriate?
Correct Answer: B
Rationale: The correct answer is B because an increase in heart rate and respiratory rate can be a normal response before body system functions decrease in a hospice patient. This is known as a compensatory mechanism as the body tries to maintain oxygenation. Choice A is incorrect because symptoms may not always continue to increase until death. Choice C is incorrect as it implies a reflex response, which may not be the case. Choice D is incorrect as an improvement in the patient's condition is unlikely in a hospice setting.
Question 2 of 9
A critically ill patient tells the nurse that he is not afraid to die because he believes in reincarnation. What is the most appropriate nursing response?
Correct Answer: B
Rationale: The correct answer is B because it acknowledges and validates the patient's belief, showing empathy and support. By stating that the belief gives strength, the nurse facilitates a therapeutic relationship and promotes the patient's emotional well-being. Choice A is incorrect as it challenges the patient's belief system, potentially creating conflict. Choice C is inappropriate as it dismisses the patient's belief and could damage the nurse-patient relationship. Choice D is also incorrect as it invalidates the patient's belief and could harm trust and rapport.
Question 3 of 9
Which patient should the nurse notify the organ procureme nt organization (OPO) to evaluate for possible organ donation?
Correct Answer: A
Rationale: The correct answer is A because the patient is a 36-year-old with a Glasgow Coma Scale score of 3 and no activity on electroencephalogram, indicating severe brain injury and likely irreversible neurological damage. This patient meets the criteria for potential organ donation as they are neurologically devastated. Choice B is incorrect because the patient's condition is related to stroke and atrial fibrillation, not severe brain injury that would make them a candidate for organ donation. Choice C is incorrect because although the patient has a brain injury and a lower Glasgow Coma Scale score, the history of a reversible cause (ovarian cancer metastasis) and a higher GCS score compared to choice A make this patient less suitable for organ donation evaluation. Choice D is incorrect as the patient's diabetic and cardiovascular history does not suggest severe brain injury that would qualify for organ donation.
Question 4 of 9
Which statement is consistent with societal views of dying in the United States?
Correct Answer: D
Rationale: Rationale: The correct answer is D because the purpose of the healthcare system in the United States is primarily focused on disease prevention and symptom management. This aligns with societal views as healthcare is geared towards improving health outcomes and quality of life. Incorrect choices: A: Dying is not viewed as a failure of the system or providers, rather as a natural part of life. B: Most Americans prefer to die at home or in hospice care rather than in a hospital. C: Illnesses are not always curable, and death can result from various complex conditions beyond treatment.
Question 5 of 9
The nurse cares for a patient with lung cancer in a home hospice program. Which action by the nurse is most appropriate?
Correct Answer: B
Rationale: The correct answer is B because in a home hospice program, it is essential for the nurse to provide holistic care that includes addressing the patient's emotional and psychological needs. Encouraging the patient to discuss past life events and their meaning can help them process emotions, find closure, and improve their quality of life. This approach aligns with the principles of palliative care, which focus on enhancing comfort and well-being. Choice A is incorrect because discussing cancer risk factors and lifestyle modifications may not be relevant or beneficial for a patient in a hospice program. Choice C is incorrect because chemotherapy and radiation are typically not part of hospice care, which focuses on comfort rather than curative treatments. Choice D is incorrect because a thorough head-to-toe assessment multiple times a week may not be necessary or appropriate for a patient in a hospice program.
Question 6 of 9
A 100-kg patient gets hemodialysis 3 days a week. In planning the care for this patient, the nurse recommends
Correct Answer: A
Rationale: The correct answer is A: a diet of 2500 to 3500 kcal per day. During hemodialysis, the patient loses nutrients and energy, so a high-calorie diet is necessary to maintain proper nutrition and energy levels. 2500-3500 kcal/day is a suitable range for a 100-kg patient. Choice B is incorrect because protein intake should be adequate to prevent malnutrition in hemodialysis patients, typically 1.2g/kg body weight/day. Choice C is incorrect as potassium intake should be restricted in hemodialysis patients due to impaired kidney function. Choice D is incorrect because fluid intake should be individualized based on the patient's fluid status and should not be limited to less than 500 mL per day.
Question 7 of 9
A nurse is weaning a 68-kg male patient who has chronic obstructive pulmonary disease (COPD) from mechanical ventilation. Which patient assessment finding indicates that the weaning protocol should be stopped?
Correct Answer: C
Rationale: The correct answer is C because a respiratory rate of 32 breaths/min indicates increased work of breathing, which could be a sign of respiratory distress. In a patient being weaned from mechanical ventilation, an elevated respiratory rate suggests that the patient may not be able to sustain adequate ventilation on their own. This warrants stopping the weaning protocol to prevent respiratory failure. Choice A is incorrect because a heart rate of 97 beats/min is within normal range for an adult. Choice B is incorrect because an oxygen saturation of 93% is acceptable for a patient with COPD. Choice D is incorrect because a tidal volume of 450 mL is adequate for a patient weaning from mechanical ventilation.
Question 8 of 9
A patient presents to the emergency department in acute re spiratory failure secondary to community-acquired pneumonia. The patient has a history of chronic obstructive pulmonary disease. The nurse anticipates which treatment to facilitate ventilation?
Correct Answer: B
Rationale: The correct answer is B: Mechanical ventilation via an endotracheal tube. In acute respiratory failure, especially in the setting of pneumonia and COPD, mechanical ventilation is often necessary to support breathing. Endotracheal intubation allows for precise control of airway patency, oxygenation, and ventilation. Emergency tracheostomy (choice A) is typically reserved for long-term ventilatory support. Noninvasive positive-pressure ventilation (choice C) may not provide sufficient support in severe cases. Oxygen via bag-valve-mask (choice D) may not be adequate for ventilatory support in acute respiratory failure.
Question 9 of 9
The nurse is caring for a critically ill patient with a very concerned family. Given that the family is under high stress, what nursing intervention will best ameliorate their stress while preserving independence?
Correct Answer: A
Rationale: The correct answer is A: Encourage the family to participate in patient care tasks. This intervention helps to alleviate stress by involving the family in care, promoting a sense of control and empowerment. It also fosters a collaborative relationship between the family and healthcare team. The other choices are incorrect because B only focuses on asking questions but doesn't actively involve the family in care. C may add pressure on the selected representative and exclude others. D limits family involvement and may increase stress by restricting visitation.