ATI RN
Critical Care Nursing NCLEX Questions Questions
Question 1 of 5
A young man has just arrived at the ICU from out of town and received news that his girlfriend, who is admitted there, likely only has a few days left to live. Which of the following would be the best approach for the nurse to take in caring for the needs of this young man?
Correct Answer: C
Rationale: The correct answer is C: Suggesting that he meet with the hospital chaplain. This approach is best as it addresses the young man's emotional and spiritual needs during a difficult time. The chaplain can provide comfort, support, and guidance in coping with his girlfriend's situation. This option focuses on holistic care and acknowledges the importance of emotional well-being. A: Recommending that he go home and rest is not the best approach as it dismisses the young man's emotional distress. B: Giving him unrestricted visiting hours with the patient may not be appropriate as it can be overwhelming and may not address his emotional needs effectively. D: Recommending that he ask the doctor to evaluate the patient's pain control measures is important but does not directly address the young man's emotional needs in this situation.
Question 2 of 5
Which hemodynamic parameter is most appropriate for the nurse to monitor to determine the effectiveness of medications given to a patient to reduce left ventricular afterload?
Correct Answer: B
Rationale: The correct answer is B: Systemic vascular resistance (SVR). SVR reflects the resistance the heart must overcome to pump blood into the systemic circulation. By monitoring SVR, the nurse can assess the effectiveness of medications aimed at reducing left ventricular afterload, as these medications work by dilating blood vessels and reducing resistance. An effective reduction in afterload would lead to a decrease in SVR. A: Mean arterial pressure (MAP) is an indicator of perfusion pressure but may not directly reflect changes in afterload. C: Pulmonary vascular resistance (PVR) is specific to the pulmonary circulation and not directly related to left ventricular afterload. D: Pulmonary artery wedge pressure (PAWP) is a measure of left ventricular preload and filling pressures, not afterload.
Question 3 of 5
Which action is a priority for the nurse to take when the low-pressure alarm sounds for a patient who has an arterial line in the left radial artery?
Correct Answer: C
Rationale: Rationale for Correct Answer (C): When the low-pressure alarm sounds for a patient with an arterial line, the nurse should assess for cardiac dysrhythmias first. This is because a sudden drop in pressure could indicate a serious issue affecting the heart's ability to pump effectively. Identifying and addressing any cardiac dysrhythmias promptly is crucial for patient safety. Summary of Incorrect Choices: A: Fast flush of the arterial line - This would not address the underlying cause of the low-pressure alarm and may not be necessary. B: Check the left hand for pallor - While assessing perfusion is important, it is not the priority when the alarm indicates a potential cardiac issue. D: Rezero the monitoring equipment - While important for accuracy, it is not the priority when the alarm indicates a potential cardiac concern.
Question 4 of 5
The nurse is caring for a patient who has an intra-aortic balloon pump in place. Which action should be included in the plan of care?
Correct Answer: C
Rationale: The correct answer is C: Measure the patient’s urinary output every hour. This is crucial because monitoring urinary output is essential in assessing the patient’s renal function and the effectiveness of the intra-aortic balloon pump in improving cardiac output. Hourly measurement helps in early detection of any changes that may indicate complications. A: Positioning the patient supine at all times is not necessary and can lead to complications. B: Avoiding the use of anticoagulant medications is not appropriate as they are often necessary to prevent clot formation around the balloon pump. D: Providing a massive range of motion for all extremities is not recommended for a patient with an intra-aortic balloon pump as it can dislodge the device or cause harm.
Question 5 of 5
The nurse notes thick, white secretions in the endotracheal tube (ET) of a patient who is receiving mechanical ventilation. Which intervention will be most effective in addressing this problem?
Correct Answer: D
Rationale: The correct answer is D: Instill 5 mL of sterile saline into the ET before suctioning. This intervention helps to loosen and mobilize the thick secretions, making them easier to remove during suctioning. It is important to moisten the secretions to prevent mucosal damage and trauma during suctioning. A: Increasing suctioning frequency can lead to mucosal damage and increased risk of infection. B: Repositioning helps with ventilation and preventing pressure injuries, but it does not directly address the thick secretions. C: Adding water to enteral feedings will not directly address the thick secretions in the ET. In summary, instilling sterile saline into the ET before suctioning is the most effective intervention as it helps to loosen and mobilize thick secretions, making suctioning more effective and reducing the risk of mucosal damage.