ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 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 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
The nurse is preparing to measure the thermodilution cardaiabicrb o.cuomtp/tuest t (TdCO) in a patient being monitored with a pulmonary artery catheter. Which action by the nurse best ensures the safety of the patient?
Correct Answer: B
Rationale: The correct answer is B: Avoid infusing vasoactive agents in the port used to obtain the TdCO measurement. This action ensures patient safety by preventing the introduction of vasoactive agents directly into the bloodstream during the measurement process. Infusing vasoactive agents can lead to inaccurate TdCO readings and potentially harm the patient. Choice A is incorrect because zero referencing the transducer system at the level of the phlebostatic axis is important for accurate pressure monitoring but not directly related to TdCO measurement safety. Choice C is incorrect as maintaining a pressure of 300 mm Hg on the flush solution bag is not directly related to the safety of TdCO measurement. Choice D is incorrect as limiting the length of noncompliant pressure tubing is important for accurate pressure readings but not directly related to the safety of TdCO measurement.
Question 4 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 5 of 9
When assisting with the placement of a pulmonary artery (PA) catheter, the nurse notes that the catheter is correctly placed when the monitor shows a:
Correct Answer: D
Rationale: Step-by-step rationale for Answer D being correct: 1. PA catheter measures PA pressures. 2. PAWP reflects left atrial pressure. 3. Correct placement shows typical PAWP tracing. 4. PA pressure waveform (A) is not specific to PAWP. 5. Systemic arterial pressure tracing (B) is unrelated. 6. Systemic vascular resistance tracing (C) is not monitored by PA catheter.
Question 6 of 9
The nurse is caring for a patient in the critical care unit whaobi,r ba.cfotemr/ tebset ing declared brain dead, is being managed by the OPO transplant coordinator. Thir ty minutes into the shift, assessment by the nurse includes a blood pressure 75/50 mm Hg, hear t rate 85 beats/min, and respiratory rate 12 breaths/min via assist/control ventilation. The oxygen saturation (SpO ) is 99% and 2 core temperature 93.8° F. Which primary care provider ord er should the nurse implement first?
Correct Answer: C
Rationale: The correct answer is C: Begin phenylephrine (Neo-Synephrine) for systolic BP < 90 mm Hg. The nurse should implement this order first because the patient's low blood pressure (75/50 mm Hg) indicates hypotension, which can lead to inadequate perfusion to vital organs. Phenylephrine is a vasoconstrictor that can help increase the patient's blood pressure and improve perfusion. It is crucial to address hypotension promptly to prevent further complications. Choice A is incorrect because maintaining the patient's temperature above 96.8°F is not the most urgent concern in this scenario. Choice B is incorrect as obtaining a basic metabolic panel every 4 hours is not the immediate priority when the patient is experiencing hypotension. Choice D is incorrect as drawing arterial blood gas every 4 hours is not the most urgent intervention needed to address the patient's low blood pressure.
Question 7 of 9
The nurse is caring for a patient with an admitting diagnosis of congestive failure. While attempting to obtain a pulmonary artery occlusion pressure in the supine position, the patient becomes anxious and tachypneic. What is the best action by the nurse?
Correct Answer: D
Rationale: The correct answer is D: Elevate the head of the bed 45 degrees while recording pressures. Rationale: 1. Elevating the head of the bed will help improve the patient's breathing by reducing the pressure on the diaphragm. 2. This position will also help alleviate the patient's anxiety and tachypnea, promoting better oxygenation. 3. Recording pressures in this position will provide accurate data for monitoring the patient's condition. Summary: A: Limiting the supine position to 10 seconds does not address the underlying issues causing the patient's anxiety and tachypnea. B: Administering anxiety medications without addressing the positioning issue may not effectively manage the patient's symptoms. C: Encouraging the patient to take slow deep breaths is helpful, but changing the position of the patient is more crucial in this situation.
Question 8 of 9
Which is likely the most common recollection from a patie nt who required endotracheal intubation and mechanical ventilation?
Correct Answer: A
Rationale: The correct answer is A: Difficulty communicating. When a patient undergoes endotracheal intubation and mechanical ventilation, they are unable to speak normally. This leads to frustration and anxiety due to the inability to communicate effectively with healthcare providers and loved ones. The lack of communication can also impact their emotional well-being. Choices B, C, and D are less likely as the most common recollection because patients might not remember feeling uncomfortable, experiencing pain, or having sleep disruption during sedation and ventilation. Additionally, the inability to communicate is a primary concern for patients in this situation.
Question 9 of 9
A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min. Spontaneous re spirations are 12 breaths/min. The patient receives a dose of morphine sulfate, and now respi rations decrease to 4 breaths/min. What adjustments may need to be made to the patient’s ve ntilator settings?
Correct Answer: C
Rationale: The correct answer is C: Change to assist/control ventilation at a rate of 4 breaths/min. When the patient's spontaneous respirations decrease to match the ventilator rate, it indicates that the patient is not actively participating in breathing. Changing to assist/control ventilation allows the patient to trigger breaths when they desire, ensuring a more synchronized and comfortable breathing pattern. A: Adding PEEP may help improve oxygenation but is not directly related to the issue of decreased spontaneous respirations. B: Adding pressure support provides additional support during inspiration but does not address the underlying issue of decreased spontaneous respirations. D: Increasing the SIMV respiratory rate would not address the patient's decreased spontaneous respirations and could potentially lead to overventilation.