ATI RN
Critical Care Nursing Questions Questions
Question 1 of 9
As part of nursing management of a critically ill patient, o rders are written to keep the head of the bed elevated at 30 degrees, awaken the patient from se dation each morning to assess readiness to wean from mechanical ventilation, and implement oral care protocols every 4 hours. These interventions are done as a group to reduce thabei rrbi.csokm o/tef svt entilator-associated pneumonia. This group of evidence-based interventions is often referred to using what term?
Correct Answer: A
Rationale: The correct answer is A: Bundle of care. A bundle of care refers to a set of evidence-based interventions that, when implemented together, have been shown to improve patient outcomes. In this scenario, keeping the head of the bed elevated, daily awakening from sedation, and oral care protocols are bundled together to reduce the risk of ventilator-associated pneumonia. This approach is based on the idea that implementing multiple interventions simultaneously is more effective than individual interventions alone. Choices B, C, and D are incorrect because: B: Clinical practice guidelines provide recommendations for healthcare providers based on evidence but do not necessarily involve a group of interventions bundled together. C: Patient safety goals are specific objectives aimed at improving patient safety outcomes, but they do not specifically refer to a group of interventions bundled together. D: Quality improvement initiatives focus on improving processes and outcomes in healthcare settings but do not necessarily involve a group of interventions bundled together for a specific purpose like in this case.
Question 2 of 9
What is the most common cause of a pulmonary embolus?
Correct Answer: B
Rationale: The correct answer is B: A deep vein thrombosis from lower extremities. Deep vein thrombosis (DVT) is the most common cause of a pulmonary embolus as a blood clot can dislodge from the veins, travel to the lungs, and block blood flow. An amniotic fluid embolus (Choice A) occurs during childbirth and is rare as a cause of pulmonary embolism. A fat embolus (Choice C) typically occurs after a long bone fracture and is more likely to cause issues in the lungs. Vegetation from an infected central venous catheter (Choice D) can cause septic pulmonary embolism, but it is not as common as DVT.
Question 3 of 9
A Muslim patient has been admitted to the critical care unit with complications after childbirth. Based on the Synergy Model, which nurse would be the most inappropriate to assign to care for this patient?
Correct Answer: C
Rationale: Step-by-step rationale: 1. The Synergy Model emphasizes matching nurse competencies with patient needs. 2. A male nurse may not be culturally appropriate for a Muslim female patient due to religious beliefs. 3. Gender segregation is important in Islamic culture, especially concerning intimate care. 4. Therefore, assigning a new graduate male nurse to care for a Muslim female patient in critical condition is the most inappropriate choice. Summary: - Choice A is incorrect because being a new graduate does not impact cultural competence. - Choice B is incorrect as experience does not necessarily make a nurse the best fit for a specific patient. - Choice D is incorrect as postpartum experience is relevant, but cultural considerations are more critical in this scenario.
Question 4 of 9
A patient who has been declared brain dead is considered a potential organ donor. In order to proceed with donation, the nurse must understand that applicable concept?
Correct Answer: B
Rationale: The correct answer is B because after brain death is confirmed, maintaining perfusion and oxygenation of organs is crucial to ensure their viability for donation. This process allows organs to be retrieved in optimal condition during the operation. Choice A is incorrect because a signed donor card is not a legal mandate for organ retrieval. Choice C is incorrect as the healthcare proxy's consent is typically required for organ donation. Choice D is incorrect because life support is not immediately withdrawn upon brain death confirmation; instead, organ preservation measures are initiated.
Question 5 of 9
A hospice patient is manifesting a decrease in all body system functions except for a heart rate of 124 and a respiratory rate of 28. Which statement, if made by the nurse to the patient’s family member, is most appropriate?
Correct Answer: B
Rationale: The correct answer is B because an increase in heart rate and respiratory rate can be a normal response before body system functions decrease in a hospice patient. This is known as a compensatory mechanism as the body tries to maintain oxygenation. Choice A is incorrect because symptoms may not always continue to increase until death. Choice C is incorrect as it implies a reflex response, which may not be the case. Choice D is incorrect as an improvement in the patient's condition is unlikely in a hospice setting.
Question 6 of 9
The nurse is assessing pain levels in a critically ill patient . The nurse recognizes that which patient action as indicatin g the greatest level of pain?
Correct Answer: C
Rationale: Correct Answer: C (Grimacing) Rationale: 1. Grimacing is a universal nonverbal sign of pain. 2. It involves facial muscles, indicating a high level of discomfort. 3. Brow lowering and eyelid closing are subtle signs, less indicative of severe pain. 4. Staring may signify concentration, not necessarily pain. Summary: Grimacing is the correct choice as it directly correlates with pain intensity, unlike the other options which are less specific or relevant indicators of severe pain.
Question 7 of 9
A 65-year-old patient with a history of metastatic lung car cinoma has been unresponsive to chemotherapy. The medical team has determined that ther e are no additional treatments available that will prolong life or improve the quality of lifaebi ribn.c oamn/yte smt eaningful way. Despite the poor prognosis, the patient continues to receive chemotherapy and full nutrition support. This is an example of what end-of-life concept?
Correct Answer: A
Rationale: The correct answer is A: Medical futility. In this scenario, the patient's condition is terminal with no treatment options left. Continuing chemotherapy offers no benefit and may even harm the patient. Medical futility refers to interventions that are unlikely to achieve the desired outcome. B: Palliative care focuses on improving quality of life for patients with serious illnesses, which is not being addressed in this case. C: Terminal weaning involves gradually removing life-support measures, which is not happening here. D: Withdrawal of treatment would be appropriate if the treatments were no longer beneficial, but the issue here is the continued provision of futile treatment.
Question 8 of 9
The nurse is a member of a committee to design a critical care unit in a new building. Which design trend would best be implemented to facilitate famil y-centered care?
Correct Answer: A
Rationale: Correct Answer: A Rationale: 1. Family-centered care promotes involvement of family members in patient care. 2. A sleeper sofa in the patient's room allows family members to stay overnight, enhancing support for the patient. 3. Storage for personal belongings ensures families can have essentials close by, increasing comfort and convenience. 4. These design elements facilitate family presence, communication, and participation in care, aligning with family-centered care principles. Summary of Incorrect Choices: B. Having a diagnostic suite nearby is convenient but not directly related to family-centered care principles. C. A waiting room with amenities is beneficial but does not directly involve families in patient care. D. Access to a garden for meditation is helpful for relaxation but does not emphasize family involvement in care.
Question 9 of 9
The nurse is preparing to administer atropine, an anticholinergic, to a client scheduled for a cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What response is best for the nurse to provide?
Correct Answer: C
Rationale: The correct answer is C: Decrease the risk of bradycardia during surgery. Rationale: 1. Atropine is an anticholinergic medication that works by blocking the parasympathetic nervous system. 2. During surgery, the parasympathetic stimulation can lead to bradycardia (slow heart rate). 3. By administering atropine, the nurse can counteract the bradycardic effects and maintain a normal heart rate during the procedure. 4. Options A, B, and D are incorrect as atropine is not used for inducing anesthesia, relaxation, or minimizing postoperative analgesia.