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
The nurse obtains the pulse rate of 89 beats/minute for an infant before administering digoxin (Lanoxin). Which action should the nurse take?
Correct Answer: A
Rationale: The correct answer is A. Infants typically have higher resting heart rates than adults, so a pulse rate of 89 beats/minute for an infant may indicate bradycardia. Digoxin can further lower the heart rate, leading to potential adverse effects like arrhythmias. Therefore, withholding the medication and contacting the healthcare provider is crucial to ensure the safety of the infant. Choice B is incorrect because administering digoxin without addressing the elevated pulse rate can be dangerous. Choice C is incorrect as assessing respiratory rate does not address the immediate concern of the elevated pulse rate. Choice D is also incorrect as waiting and giving half of the dosage may further exacerbate the situation.
Question 3 of 9
An Ethiopian man with AIDS has recently been admitted to the ICU with a case of pneumonia. The man is new to the U.S. and has no health insurance. He would likely be eligible for the states Medicaid coverage, but does not understand how to access this coverage. Which competency or competencies are most needed in this situation? Select all that apply.
Correct Answer: B
Rationale: The correct answer is B: Advocacy and moral agency. In this scenario, the Ethiopian man with AIDS is in a vulnerable position due to lack of health insurance and understanding of Medicaid coverage. Advocacy skills are crucial to help him navigate the complex healthcare system and access the necessary resources. Moral agency involves advocating for the patient's rights and well-being, ensuring that he receives appropriate care despite his socioeconomic status. Clinical judgment, collaboration, and systems thinking are important competencies but not as directly relevant in this specific situation of advocating for the patient's access to Medicaid coverage.
Question 4 of 9
What strategies are appropriate for preventing deep vein tharboirbm.cbomo/steisst (DVT) and pulmonary embolus (PE) in an at-risk patient? (Select all that apply.) WWW .THENURSINGMASTERY.COM
Correct Answer: A
Rationale: The correct answer is A: Graduated compression stockings. These stockings help prevent blood from pooling in the legs, reducing the risk of DVT and PE. They improve circulation and reduce venous stasis. Option B, heparin, is used for treatment, not prevention. Option C, sequential compression devices, help prevent DVT but are not as effective as compression stockings. Option D, strict bed rest, can actually increase the risk of DVT by reducing blood flow.
Question 5 of 9
Intrapulmonary shunting refers to what outcome?
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct: 1. Intrapulmonary shunting refers to blood bypassing the normal oxygenation process in the lungs. 2. Choice C describes blood being shunted from the right side of the heart (deoxygenated blood) to the left side without oxygenation, leading to systemic circulation without oxygenation. 3. Choices A, B, and D do not accurately describe intrapulmonary shunting as they focus on other concepts like alveolar perfusion, heart failure, and unilateral lung blood supply, respectively.
Question 6 of 9
Nociceptors differ from other nerve receptors in the body in what way?
Correct Answer: A
Rationale: The correct answer is A because nociceptors are specialized nerve receptors that do not adapt much to continual pain response. This lack of adaptation allows nociceptors to continuously signal the presence of tissue-damaging stimuli, which is crucial for the perception of pain. Choices B, C, and D are incorrect because nociceptors do not inhibit the infiltration of neutrophils and eosinophils (B), they do play a role in the inflammatory response (C), and they transmit various types of stimuli including thermal, mechanical, and chemical, not just thermal stimuli (D).
Question 7 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 8 of 9
The nurse notes premature ventricular contractions (PVCs) while suctioning a patient’s endotracheal tube. Which action by the nurse is a priority?
Correct Answer: C
Rationale: The correct answer is C: Stop and ventilate the patient with 100% oxygen. This is the priority action because PVCs can lead to life-threatening arrhythmias and inadequate oxygenation. By stopping suctioning and providing 100% oxygen, the nurse ensures proper oxygenation and ventilation, which takes precedence over addressing the dysrhythmia itself. Decreasing suction pressure (choice A) may not address the underlying issue and could potentially harm the patient. Documenting the dysrhythmia (choice B) is important but not as urgent as ensuring adequate oxygenation. Giving antidysrhythmic medications (choice D) should be done under the direction of a healthcare provider and is not the first-line intervention in this situation.
Question 9 of 9
The nurse is concerned that a patient is at increased risk of developing a pulmonary embolus and develops a plan of care for prevention to include whic h intervention?
Correct Answer: D
Rationale: The correct answer is D: Mobility. Maintaining mobility helps prevent blood stasis, a leading factor in the development of pulmonary embolism. Movement promotes circulation, reducing the risk of blood clots. A: Antiseptic oral care is important for oral hygiene but not directly related to preventing pulmonary embolism. B: Bed rest with head of bed elevated can actually increase the risk of clots due to immobility. C: Coughing and deep breathing are beneficial for preventing respiratory complications but do not address the underlying cause of pulmonary embolism.