ATI RN
Critical Care Nursing Exam Questions Questions
Question 1 of 9
Continuous venovenous hemofiltration is used to
Correct Answer: A
Rationale: The correct answer is A because continuous venovenous hemofiltration (CVVH) primarily removes fluids and solutes through the process of convection. In CVVH, blood flows through a filter where hydrostatic pressure drives plasma water and solutes across a semipermeable membrane. This process mimics the natural filtration that occurs in the kidneys. Choice B is incorrect because CVVH does not specifically target plasma water only but also removes solutes. Choice C is incorrect because CVVH does not involve adding dialysate to remove plasma water and solutes. Choice D is incorrect because while CVVH may involve ultrafiltration and convection, it does not typically include dialysis as a primary mechanism for solute removal.
Question 2 of 9
Continuous venovenous hemofiltration is used to
Correct Answer: A
Rationale: The correct answer is A because continuous venovenous hemofiltration (CVVH) primarily removes fluids and solutes through the process of convection. In CVVH, blood flows through a filter where hydrostatic pressure drives plasma water and solutes across a semipermeable membrane. This process mimics the natural filtration that occurs in the kidneys. Choice B is incorrect because CVVH does not specifically target plasma water only but also removes solutes. Choice C is incorrect because CVVH does not involve adding dialysate to remove plasma water and solutes. Choice D is incorrect because while CVVH may involve ultrafiltration and convection, it does not typically include dialysis as a primary mechanism for solute removal.
Question 3 of 9
Which nursing intervention would need to be corrected on a care plan for a patient in order to be consistent with the principles of effective end-of-life ca re?
Correct Answer: B
Rationale: Correct Answer: B Rationale: 1. Limiting visitation to reduce emotional distress contradicts the principles of effective end-of-life care, which emphasize holistic support for the patient and family. 2. Effective end-of-life care encourages open communication and emotional support from loved ones. 3. Limiting visitation may hinder emotional closure and support for both the patient and family. 4. Options A, C, and D align with effective end-of-life care by focusing on symptom management, education, and spiritual support for the patient and family.
Question 4 of 9
The nurse is caring for a 70-kg patient in septic shock with a pulmonary artery catheter. Which hemodynamic value indicates an appropriate response to therapy aimed at enhancing oxygen delivery to the organs and tissues?
Correct Answer: C
Rationale: The correct answer is C: Mixed venous (SvO2) of 40%. In septic shock, improving oxygen delivery to tissues is vital. SvO2 reflects the balance between oxygen delivery and consumption. A value of 40% indicates adequate oxygen delivery to tissues. A: Arterial lactate level of 1.0 mEq/L - Although a low lactate level is good, it does not directly indicate improved oxygen delivery. B: Cardiac output of 2.5 L/min - Cardiac output should ideally increase to improve oxygen delivery, so 2.5 L/min is low for a 70-kg patient. D: Cardiac index of 1.5 L/min/m2 - Cardiac index is cardiac output adjusted for body surface area. 1.5 L/min/m2 is low and indicates inadequate cardiac function for a patient in septic shock.
Question 5 of 9
The nurse is caring for 80-year-old patient who has been tr eated for gastrointestinal bleeding. The family has agreed to withhold or withdraw additional treatment. The patient has a written advance directive specifying requests. The directive notes that the patient wants food and fluid to be continued and to be made physically comfortable. Th e nurse anticipates that several orders may be written to comply with this request, including which of the following? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: "Do not resuscitate." In this scenario, the patient's advance directive specifies a desire for comfort measures and continuation of food and fluids. A DNR order aligns with this directive by respecting the patient's wish to avoid aggressive life-saving measures. This choice prioritizes the patient's autonomy and quality of life. Other options (B, C, D) are not aligned with the patient's wishes. Changing antibiotics or stopping blood transfusions may be unrelated to the patient's comfort or food/fluid preferences. Discontinuing tube feeding goes against the directive's request for food and fluid continuation.
Question 6 of 9
The nurse is caring for a patient whose ventilator settings i nclude 15 cm H O of positive end-expiratory pressure (PEEP). The nurse understands that although beneficial, PEEP may result in what possible problem?
Correct Answer: D
Rationale: Rationale for Correct Answer (D - Low cardiac output secondary to increased intrathoracic pressure): 1. PEEP increases intrathoracic pressure, which can impede venous return to the heart. 2. Impaired venous return reduces preload, leading to decreased cardiac output. 3. Decreased cardiac output can result in inadequate tissue perfusion and oxygenation. 4. Therefore, PEEP may cause low cardiac output due to increased intrathoracic pressure. Summary of Incorrect Choices: A. Fluid overload is not directly related to PEEP but more to fluid administration or kidney function. B. High cardiac index is unlikely as PEEP can decrease cardiac output. C. Hypoxemia is not a direct result of PEEP but may occur due to other factors like inadequate ventilation or oxygenation settings.
Question 7 of 9
A patient receiving palliative care for advanced cancer reports fatigue and loss of appetite. Which intervention should the nurse prioritize?
Correct Answer: C
Rationale: The correct answer is C: Provide rest periods to reduce fatigue. Prioritizing rest periods can help alleviate fatigue, a common symptom in patients with advanced cancer. Encouraging small, frequent meals (choice A) may not be effective if the patient has no appetite. Administering appetite stimulants (choice B) may not address the root cause of fatigue. Discussing parenteral nutrition (choice D) is not the priority as it does not directly address the fatigue and loss of appetite reported by the patient. Rest is essential for symptom management and overall well-being in palliative care.
Question 8 of 9
The nurse caring for a patient with an endotracheal tube un derstands that endotracheal suctioning is needed to facilitate removal of secretions. What additional information is the nurse aware of concerning this intervention?
Correct Answer: C
Rationale: Rationale for Correct Answer C: Endotracheal suctioning should be done as indicated by patient assessment because not all patients require routine suctioning. Performing unnecessary suctioning can lead to potential complications such as mucosal damage and increased risk of infection. Therefore, the nurse must assess the patient's respiratory status, auscultate lung sounds, monitor oxygen saturation levels, and observe for signs of increased secretions before deciding to perform suctioning. Summary of Incorrect Choices: A: Endotracheal suctioning does not directly impact intracranial pressure. It is primarily focused on maintaining airway patency and removing respiratory secretions. B: While endotracheal suctioning may temporarily suppress the cough reflex during the procedure, its primary purpose is to clear airway secretions to prevent complications such as atelectasis and respiratory distress. D: Saline instillation before suctioning is not recommended as it can lead to negative outcomes such as dehydration, mucosal damage, and increased risk of infection
Question 9 of 9
The transplant clinic coordinator is evaluating relatives of a patient with end-stage renal disease, whose blood type is A positive, for suitability as aa bliirvb.icnogm /dteostn or for kidney transplantation. Which family member best qualifies for evaluation?
Correct Answer: D
Rationale: The correct answer is D, the 70-year-old mother with blood type A positive. This choice is the best candidate for evaluation due to her blood type matching the patient's (A positive) for kidney transplantation. Age and medical history are also crucial factors in determining suitability. The 65-year-old brother (choice A) has hypertension, a significant risk factor. The 35-year-old female (choice B) with food allergies may have potential complications. The 14-year-old son (choice C) is underage and might not be a suitable donor due to age and the potential impact on his growth and development. In summary, choice D aligns with the matching blood type and age, making the mother the most suitable candidate for evaluation.