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 caring for a patient diagnosed with acute respiratory failure identifies “Risk for Ineffective Airway Clearance” as a nursing diagnosis. Wh at nursing intervention is relevant to this diagnosis?
Correct Answer: A
Rationale: The correct answer is A: Elevate head of bed to 30 degrees. Elevating the head of the bed helps promote optimal airway clearance by facilitating drainage of secretions and reducing the risk of aspiration. This position also improves lung expansion and oxygenation. Choice B is important for preventing venous thromboembolism but not directly related to airway clearance. Choice C may not be appropriate as excessive sedation can impair airway clearance. Choice D is important for preventing pressure ulcers but does not directly address airway clearance.
Question 3 of 5
What is the basic underlying pathophysiology of acute respiratory distress syndrome?
Correct Answer: C
Rationale: The correct answer is C: Damage to the type II pneumocytes, which produce surfactant. Acute respiratory distress syndrome (ARDS) is characterized by damage to the alveolar epithelium, including type II pneumocytes responsible for producing surfactant. Surfactant reduces surface tension in the alveoli, preventing collapse. Damage to type II pneumocytes impairs surfactant production, leading to alveolar collapse and impaired gas exchange. Choices A, B, and D are incorrect because ARDS is not primarily caused by a decrease in white blood cells, damage to the right mainstem bronchus, or decreased capillary permeability.
Question 4 of 5
The nurse discharging a patient diagnosed with asthma ins tructs the patient to prevent exacerbation by taking what action?
Correct Answer: C
Rationale: The correct answer is C: Taking all asthma medications as prescribed. This is the most appropriate action to prevent exacerbation of asthma symptoms. By taking medications as prescribed, the patient can effectively manage and control their asthma, reducing the risk of exacerbation. Following the prescribed medication regimen helps to keep inflammation in check and maintain airway function. Choice A is incorrect because while follow-up appointments are important, they do not directly prevent exacerbation. Choice B is incorrect as limiting activity may not address the underlying cause of exacerbation. Choice D is incorrect as taking medications on an "as needed" basis may not provide consistent control of asthma symptoms, leading to potential exacerbation.
Question 5 of 5
What diagnostic procedure is required to make a definitive diagnosis of pulmonary embolism?
Correct Answer: C
Rationale: The correct answer is C: High resolution multidetector CT angiogram. This diagnostic procedure is required for a definitive diagnosis of pulmonary embolism because it provides detailed imaging of the pulmonary vasculature, allowing visualization of blood clots in the pulmonary arteries. A: Arterial blood gas (ABG) analysis does not directly diagnose pulmonary embolism but may show signs of hypoxemia or respiratory alkalosis, which can be seen in some cases of pulmonary embolism. B: Chest x-ray examination may show nonspecific findings such as atelectasis or pleural effusion but cannot definitively diagnose pulmonary embolism. D: Ventilation-perfusion scanning is another imaging modality used in the diagnosis of pulmonary embolism, but it is less commonly used compared to CT angiogram due to lower sensitivity and specificity.