ATI RN
Critical Care Nursing Practice Questions Questions
Question 1 of 9
A patient’s vital signs are pulse 87, respirations 24, BP of 128/64 mm Hg, and cardiac output is 4.7 L/min. The patient’s stroke volume is ______ mL. (Round to the nearest whole number.)
Correct Answer: A
Rationale: The stroke volume is calculated by dividing the cardiac output by the heart rate. Given the cardiac output of 4.7 L/min and a heart rate of 87 bpm, the stroke volume is 54 mL (4700 mL/87 bpm ≈ 54 mL). Therefore, choice A (54) is the correct answer. Choices B, C, and D are incorrect as they do not match the calculated stroke volume based on the provided cardiac output and heart rate.
Question 2 of 9
The nurse is caring for a patient diagnosed with hyperactivaebi rdb.ecloimri/tuemst . The nurse focuses interventions toward which priority need?
Correct Answer: C
Rationale: The correct answer is C: Safety. In hyperactive delirium, the patient may be agitated, disoriented, and at risk of harm. Safety is the priority to prevent falls or injury. Comfort (A) is important but secondary to safety in this case. Nourishment (B) can wait until safety is ensured. Sedation (D) may be considered but only after safety measures are in place.
Question 3 of 9
Which of the following assists the critical care nurse in ensuring that care is appropriate and based on research?
Correct Answer: A
Rationale: The correct answer is A: Clinical practice guidelines. Clinical practice guidelines are evidence-based recommendations that assist nurses in providing appropriate care based on research. They outline best practices for specific patient populations or conditions, helping nurses make informed decisions. Summary: - B: Computerized physician order entry: While it may improve accuracy and efficiency, it does not specifically ensure care based on research. - C: Consulting with advanced practice nurses: While collaboration is valuable, it does not guarantee care based on research. - D: Implementing Joint Commission National Patient Safety Goals: Important for patient safety, but not directly related to ensuring care based on research.
Question 4 of 9
After coronary artery bypass graft surgery a patient is transported to the surgical intensive care unit at noon and placed on mechanical ventilation. How sh ould the nurse interpret the patient’s initial arterial blood gas levels? pH 7.31 PaCO 48 mm Hg Bicarbonate 22 mEq/L PaO 115 mm Hg O saturation 99%
Correct Answer: B
Rationale: The correct answer is B: Partly compensated respiratory acidosis, normal oxygen. The pH of 7.31 indicates acidosis, the PaCO2 of 48 mm Hg shows respiratory acidosis, and the bicarbonate level of 22 mEq/L is slightly elevated, indicating the kidneys are compensating. The PaO2 of 115 mm Hg and oxygen saturation of 99% are normal, ruling out hypoxemia. Therefore, the patient is experiencing partly compensated respiratory acidosis. A: Normal arterial blood gas levels with a high oxygen level - Incorrect. The pH is low, indicating acidosis, which is not normal. C: Uncompensated metabolic acidosis with high oxygen level - Incorrect. Metabolic acidosis would have a primary issue with bicarbonate levels, which is not the case here. D: Uncompensated respiratory acidosis; hyperoxygenated - Incorrect. The oxygen levels are normal, ruling out hyperoxygenation.
Question 5 of 9
The nurse is assessing the exhaled tidal volume (EV ) in a mechanically ventilated patient. T What is the rationale for this assessment?
Correct Answer: D
Rationale: The correct answer is D: Determine the patient’s work of breathing. Assessing the exhaled tidal volume (EV) in a mechanically ventilated patient helps determine how much effort the patient is exerting to breathe. By monitoring the EV, the nurse can evaluate the patient's respiratory status and adjust ventilator settings if needed. It is crucial to ensure that the patient is not working too hard to breathe, as this can lead to respiratory distress. Incorrect answers: A: Assess for tension pneumothorax - Tension pneumothorax is typically assessed through other means such as physical examination and chest X-ray. B: Assess the level of positive end-expiratory pressure - The level of positive end-expiratory pressure is usually set based on the patient's condition and not solely based on the exhaled tidal volume. C: Compare the tidal volume delivered with the tidal volume prescribed - This comparison is important but does not directly relate to assessing the patient's work of breathing.
Question 6 of 9
The patient is in need of immediate hemodialysis, but has no vascular access. The nurse prepares the patient for insertion of
Correct Answer: A
Rationale: The correct answer is A: a percutaneous catheter at the bedside. This is the most appropriate option for immediate hemodialysis when the patient has no vascular access. A percutaneous catheter can be quickly inserted at the bedside, allowing for immediate initiation of hemodialysis. Choice B, a percutaneous tunneled catheter, involves a more complex insertion process and is not typically done at the bedside. Choices C and D, arteriovenous fistula and arteriovenous graft, require advanced planning and surgical procedures, making them unsuitable for immediate hemodialysis in this scenario.
Question 7 of 9
A patient on mechanical ventilation is experiencing severe agitation due to being on the ventilator. Which nursing intervention would be best?
Correct Answer: B
Rationale: The correct answer is B: Offering the patient a patient-controlled analgesic device. This intervention allows the patient to self-administer pain relief, which can help alleviate discomfort associated with mechanical ventilation and reduce agitation. Breathing exercises (choice A) may not address the root cause of agitation. Asking for antianxiety medication (choice C) may not be immediate or ideal due to potential side effects. Offering an MP3 player (choice D) may provide distraction but may not effectively address the agitation caused by the ventilator.
Question 8 of 9
Assuming each of these patients was discharged from the hospital, which older adult patient is at greatest risk for decreased functional status and quality of life?
Correct Answer: A
Rationale: The correct answer is A because this patient had a complex surgery with complications, requiring long-term care and loss of a significant other, which can impact their emotional well-being and support system. This can lead to decreased functional status and quality of life. Choice B is incorrect as the patient has support from a spouse and manages health care independently, indicating a good support system. Choice C is incorrect as the patient is cognitively intact and social, which suggests a good quality of life. Choice D is incorrect as the patient had a less complex procedure, well-managed diabetes, and was living independently, which indicates a lower risk for decreased functional status and quality of life compared to choice A.
Question 9 of 9
A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the healthcare provider discontinued the medication because his blood pressure has been normal for the past three months. Which instruction should the nurse provide?
Correct Answer: D
Rationale: The correct answer is D: Ask the healthcare provider about tapering the drug dose over the next week. This answer is correct because propranolol is a beta-blocker, and abrupt discontinuation can lead to rebound hypertension, angina, or even myocardial infarction due to the sudden withdrawal of the medication. Tapering the drug dose over time allows the body to adjust gradually and reduces the risk of these adverse effects. Choice A is incorrect because obtaining another antihypertensive prescription is not necessary if the client's blood pressure has been normal for the past three months. Choice B is incorrect because abruptly stopping the medication without tapering can lead to withdrawal symptoms. Choice C is incorrect because simply reporting uncomfortable symptoms without taking appropriate action (tapering the drug dose) is not addressing the potential risks associated with abrupt discontinuation of propranolol.