A patient is having difficulty weaning from mechanical ve ntilation. The nurse assesses the patient and notes what potential cause of this difficult weaning?

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Question 1 of 9

A patient is having difficulty weaning from mechanical ve ntilation. The nurse assesses the patient and notes what potential cause of this difficult weaning?

Correct Answer: B

Rationale: The correct answer is B: Hemoglobin of 8 g/dL. Low hemoglobin levels can lead to inadequate oxygen delivery to tissues, causing respiratory distress and difficulty weaning from mechanical ventilation. This is due to reduced oxygen-carrying capacity leading to increased work of breathing. A: Cardiac output of 6 L/min is within normal range and not directly related to difficulty weaning from mechanical ventilation. C: Negative sputum culture and sensitivity indicate absence of respiratory infection but not a direct cause of difficulty weaning. D: White blood cell count of 8000 is within normal range and not a direct cause of difficulty weaning.

Question 2 of 9

Two unlicensed assistive personnel (UAP) are arguing on the unit about who deserves to take a break first. What is the most important basic guideline that the nurse should follow in resolving the conflict?

Correct Answer: D

Rationale: The correct answer is D: Deal with issues and not personalities. This guideline is important because it focuses on resolving the conflict based on the actual problem at hand, rather than personal biases or emotions. By addressing the issues causing the argument, the nurse can help the UAPs find a fair and logical solution. A: Requiring the UAPs to reach a compromise may not address the root cause of the conflict and could lead to further disagreements. B: Weighing the consequences is important but may not be as effective in resolving the conflict as directly addressing the issues. C: Encouraging humor may temporarily diffuse the situation but may not lead to a lasting resolution.

Question 3 of 9

The nurse notes that a patient’s endotracheal tube (ET), which was at the 22 cm mark, is now at the 25 cm mark and the patient is anxious and restless. Which action should the nurse take next?

Correct Answer: C

Rationale: The correct answer is C: Listen to the patient’s breath sounds. Moving from 22 cm to 25 cm may indicate ET tube migration. Checking breath sounds can confirm proper tube placement. A may not address the underlying issue. B could worsen the situation if the tube is misplaced. D is not urgent compared to assessing airway integrity.

Question 4 of 9

The nurse has identified an increase in medication errors in the critical care unit over the past several months. What aspect of medication procedures should be evaluated first?

Correct Answer: A

Rationale: The correct answer is A: Adherence to procedures by nursing staff. This should be evaluated first because medication errors are often caused by human factors such as staff not following proper procedures. By assessing adherence, the root cause of errors can be identified and addressed. Choice B: Clarity of interdisciplinary communication may contribute to errors but doesn't directly address staff adherence to procedures. Choice C: Number of new employees could be a factor, but focusing on adherence to procedures is more crucial. Choice D: Changes in administration procedures may impact errors, but evaluating staff adherence is more immediate and directly related to errors.

Question 5 of 9

What is the treatment for an acute exacerbation of asthma?

Correct Answer: B

Rationale: The correct answer is B: Inhaled bronchodilators and intravenous corticosteroids. Bronchodilators help to quickly open up the airways during an asthma exacerbation, providing immediate relief. Intravenous corticosteroids help reduce airway inflammation and prevent further worsening of symptoms. Corticosteroids by mouth (Choice A) are not as effective as intravenous administration during an acute exacerbation. Prone positioning or continuous lateral rotation (Choice C) is not a recommended treatment for asthma exacerbation. Sedation and inhaled bronchodilators (Choice D) are not appropriate as sedation can depress respiratory function and worsen the condition.

Question 6 of 9

A patient requires neuromuscular blockade (NMB) as part of treatment of refractive increased intracranial pressure. The nursing care for this patient includes which interventions? (Select all that apply.)

Correct Answer: C

Rationale: The correct answer is C: Ensuring that deep vein thrombosis prophylaxis is initiated. When a patient requires neuromuscular blockade for increased intracranial pressure, they are likely immobile, which increases the risk of deep vein thrombosis (DVT). Initiating DVT prophylaxis, such as compression stockings or anticoagulant therapy, helps prevent blood clot formation. Choice A is incorrect because sedatives can mask signs of neurologic deterioration in this patient population. Choice B is incorrect as it promotes activities that may increase intracranial pressure and could be harmful. Choice D, while important for overall patient care, is not directly related to the specific nursing interventions required for a patient receiving neuromuscular blockade for increased intracranial pressure.

Question 7 of 9

A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining a fractured bone. The healthcare provider explains the surgery needed to immobilize the fracture. Which action should be implemented to obtain a valid informed consent?

Correct Answer: A

Rationale: The correct answer is A: Obtain the permission of the custodial parent for the surgery. In this scenario, the client is a minor (16 years old), which means they are not legally able to provide informed consent for medical procedures. The custodial parent holds legal responsibility for the minor's healthcare decisions. Thus, obtaining the permission of the custodial parent is crucial to ensure valid informed consent. Choice B is incorrect because the non-custodial parent's consent may not be legally required if the custodial parent is available to provide consent. Choice C is incorrect because obtaining consent should precede any administration of medications. Choice D is incorrect as the stepfather's consent may not hold legal weight unless designated as a legal guardian.

Question 8 of 9

Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who

Correct Answer: D

Rationale: The correct answer is D because a patient with a history of fluid overload due to heart failure is at the greatest risk of developing acute kidney injury. Heart failure can lead to decreased kidney perfusion causing acute kidney injury. In this scenario, the patient's fluid overload exacerbates the situation, further compromising kidney function. Choice A is incorrect as aminoglycosides can cause kidney injury but the duration of 6 days is less concerning compared to chronic fluid overload from heart failure in choice D. Choice B is incorrect because controlled hypertension does not directly increase the risk of acute kidney injury. Choice C is incorrect as the patient being discharged 2 weeks earlier after aminoglycoside therapy does not necessarily indicate a higher risk compared to chronic fluid overload.

Question 9 of 9

What is the primary mode of action of a neuromuscular bl ocking agent?

Correct Answer: C

Rationale: The correct answer is C: Paralysis. Neuromuscular blocking agents work by blocking the transmission of nerve impulses at the neuromuscular junction, leading to muscle paralysis. This paralysis helps facilitate intubation, surgical procedures, and mechanical ventilation. A: Analgesia - Neuromuscular blocking agents do not provide pain relief; they primarily induce muscle paralysis without affecting pain sensation. B: Anticonvulsant - Neuromuscular blocking agents do not prevent or treat seizures; their mechanism of action is not related to controlling convulsions. D: Sedation - Neuromuscular blocking agents do not induce sedation; they specifically target the neuromuscular junction to cause muscle paralysis.

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