ATI RN
Critical Care Nursing Practice Questions Questions
Question 1 of 5
assessment, the patient is restless, heart rate has increased to 110 beats/min, respirations are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sinaubsir bt.acocmh/ytecsat rdia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretio ns. Loud crackles are audible throughout lung fields. The nurse notifies the physician, w ho orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. How d oes the nurse interpret the following blood gas levels? pH 7.28 PaCO 46 mm Hg Bicarbonate 22 mEq/L PaO 58 mm Hg O saturation 88% 2
Correct Answer: B
Rationale: The correct answer is B: Hypoxemia and uncompensated respiratory acidosis. Step-by-step rationale: 1. pH is low (7.28), indicating acidosis. 2. PaCO2 is elevated (46 mm Hg), indicating respiratory acidosis. 3. PaO2 is low (58 mm Hg), indicating hypoxemia. 4. Bicarbonate is within normal range (22 mEq/L), suggesting no compensation for the acidosis. 5. Oxygen saturation is low (88%), supporting the presence of hypoxemia. Summary: A: Incorrect - pH is low, not indicating compensated alkalosis. C: Incorrect - Various abnormalities in the blood gas levels are present. D: Incorrect - There is hypoxemia and uncompensated acidosis, not metabolic alkalosis.
Question 2 of 5
The nurse notes that the patient’s arterial blood gas levels indicate hypoxemia. The patient is not intubated and has a respiratory rate of 22 breaths/min. what is the nurse’s first intervention to relieve hypoxemia?
Correct Answer: C
Rationale: The correct answer is C: Provide for oxygen administration. The first intervention for hypoxemia is to increase oxygen levels to improve oxygen saturation in the blood. Oxygen administration can be achieved through various devices such as nasal cannula, face mask, or non-rebreather mask. This intervention helps to increase the oxygen supply to the patient's tissues and organs, addressing the underlying cause of hypoxemia. Calling for emergency intubation (choice A) is not the first step unless the patient's condition deteriorates. Obtaining an order for BiPAP (choice B) may be beneficial in some cases but is not the initial intervention for hypoxemia. Suctioning secretions (choice D) may be necessary if airway obstruction is present but is not the first step in addressing hypoxemia.
Question 3 of 5
An ICU nurse has provided excellent care for a 6-year-old girl who had been admitted to the ICU for a head injury. The nurse was attentive not only to the needs of the patient but also went out of her way to care for the needs of the girls family. According to research, which of the following forms of recognition would the nurse value the most?
Correct Answer: A
Rationale: Rationale: The correct answer is A: A card from the girl's family. The nurse would value this form of recognition the most because it directly reflects the impact of her care on the patient and her family. It is a personal, heartfelt gesture that acknowledges the nurse's compassion and dedication. A card from the family shows genuine appreciation and gratitude for the nurse's efforts, making it the most meaningful form of recognition. Summary: - Choice B: A plaque from the ICU physicians could be seen as a formal recognition but lacks the personal touch and direct impact of the nurse's care on the patient and family. - Choice C: A letter of commendation from the hospital's administration is a professional acknowledgment but may not capture the emotional connection and impact that the nurse had on the family. - Choice D: A bouquet of flowers from her supervisor is a nice gesture but does not necessarily reflect the specific impact of the nurse's care on the patient and family.
Question 4 of 5
While waiting for cardiac transplantation, a patient with severe cardiomyopathy has a ventricular assist device (VAD) implanted. When planning care for this patient, the nurse should anticipate:
Correct Answer: D
Rationale: The correct answer is D because monitoring the surgical incision for signs of infection is essential post-VAD implantation to prevent complications. This step is crucial in early identification and treatment of any potential infection, which can lead to serious outcomes. A) Giving immunosuppressive medications is not typically required for VAD implantation, as the primary goal is to support cardiac function rather than prevent rejection. B) Preparing the patient for a permanent VAD is premature, as the goal is often to bridge to transplantation or recovery, not permanent VAD placement. C) Teaching the patient the reason for complete bed rest is not necessary for VAD implantation, as patients are typically encouraged to gradually increase activity levels under guidance.
Question 5 of 5
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.
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