ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 of 5
A patient with respiratory failure has arterial pressure-based cardiac output (APCO) monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 12 cm H2O. Which information indicates that a change in the ventilator settings may be required?
Correct Answer: A
Rationale: The correct answer is A. A decrease in the arterial pressure (hypotension) with a low diastolic pressure (46 mmHg) may indicate inadequate perfusion, possibly due to inadequate cardiac output from the mechanical ventilation. This suggests that a change in ventilator settings may be required to improve oxygenation and perfusion. Option B is incorrect because a heart rate of 58 beats/minute alone does not provide direct information on the patient's hemodynamic status. Option C is incorrect as an increased stroke volume would usually be a positive indicator; it does not necessarily indicate a need for changing the ventilator settings. Option D is incorrect as a stroke volume variation of 12% is within normal limits and does not necessarily require a change in ventilator settings.
Question 2 of 5
The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H2O of peak end-expiratory pressure (PEEP). Which action indicates that the new RN is safe?
Correct Answer: B
Rationale: The correct answer is B: The RN uses a closed-suction technique to suction the patient. This is the safe action because closed-suction technique minimizes the risk of ventilator-associated infections by maintaining a closed system during suctioning, reducing the exposure to pathogens. Closed-suction systems also help maintain lung compliance and oxygenation levels during the suctioning process. Rationale: Option A is incorrect because suctioning every 1 to 2 hours may be too frequent and can lead to hypoxia and mucosal damage. Option C is incorrect as taping the connection between the ventilator tubing and ET can interfere with the proper functioning of the ventilator and increase the risk of disconnection. Option D is incorrect because changing ventilator circuit tubing routinely every 48 hours is not evidence-based practice and can increase the risk of contamination and unnecessary costs.
Question 3 of 5
The nurse is caring for a patient who has an intra-aortic balloon pump (IABP) following a massive heart attack. When assessing the patient, the nurse notices blood backing up into the IABP catheter. In which order should the nurse take the following actions?
Correct Answer: A
Rationale: Correct Answer: A Rationale: 1. Ensuring the IABP console is turned off is crucial to prevent further complications and stop potential harm to the patient. 2. By turning off the IABP console, the nurse can halt the pumping action, allowing assessment of the situation without interference. 3. This action takes priority over other steps as it addresses the immediate issue of blood backing up into the IABP catheter. 4. Once the console is turned off, the nurse can proceed with assessing the patient's vital signs, notifying the healthcare provider, and obtaining supplies if needed. Summary of Incorrect Choices: - Option B: Assessing vital signs and orientation is important, but addressing the malfunction of the IABP takes precedence to prevent harm. - Option C: Notifying the healthcare provider is necessary, but first, the immediate issue of blood backing up into the catheter must be addressed. - Option D: Obtaining supplies for a new catheter is premature without first addressing
Question 4 of 5
A patient who has experienced blunt abdominal trauma during a motor vehicle collision is complaining of increasing abdominal pain. The nurse will plan to teach the patient about the purpose of:
Correct Answer: B
Rationale: The correct answer is B: Abdominal ultrasonography. This is because ultrasonography is a non-invasive imaging technique that can quickly evaluate for internal injuries such as organ damage or bleeding in patients with blunt abdominal trauma. It is a rapid and effective diagnostic tool to assess the extent of injury and guide further management. Peritoneal lavage (A) is an invasive procedure used in trauma settings to detect intra-abdominal bleeding but is not typically used for teaching purposes. Nasogastric tube placement (C) is used for decompression and drainage in certain conditions but is not relevant for assessing abdominal trauma. Magnetic resonance imaging (MRI) (D) is not typically used as the initial imaging modality for acute trauma due to time constraints and its limited availability in emergency settings.
Question 5 of 5
A 20-year-old patient arrives in the emergency department (ED) several hours after taking 25 to 30 acetaminophen (Tylenol) tablets. Which action will the nurse plan to take?
Correct Answer: A
Rationale: The correct answer is A: Give N-acetylcysteine (Mucomyst). N-acetylcysteine is the antidote for acetaminophen overdose. It helps replenish glutathione, which is depleted by acetaminophen metabolism. This prevents liver damage. Choice B, chelation therapy, is not indicated for acetaminophen overdose. Choice C, oxygen therapy, is not directly related to acetaminophen overdose treatment. Choice D, drinking water, will not address the overdose and may not be safe in high doses. Therefore, the best course of action is to administer N-acetylcysteine to prevent liver damage in acetaminophen overdose.