ATI RN
Critical Care Nursing Exam Questions Questions
Question 1 of 9
During the primary survey of a patient with severe leg trauma, the nurse observes that the patient’s left pedal pulse is absent and the leg is swollen. Which action will the nurse take next?
Correct Answer: B
Rationale: The correct answer is B: Assess further for a cause of the decreased circulation. The nurse should prioritize assessing the cause of the absent left pedal pulse and leg swelling to address the severe leg trauma effectively. This step involves identifying potential vascular compromise or compartment syndrome, which are critical conditions requiring immediate intervention. Sending blood for a complete blood count (A) is not the priority in this situation. Finishing the primary survey (C) may delay addressing the circulation issue. Starting normal saline infusion (D) without addressing the circulation problem first could potentially worsen the condition. Therefore, assessing further for the cause of decreased circulation is the most appropriate next step to ensure timely and appropriate management of the patient's condition.
Question 2 of 9
What is an early signs of the effect of hypoxemia on the nervous system?
Correct Answer: B
Rationale: The correct answer is B: Restlessness. When the body experiences hypoxemia (low oxygen levels), the brain is deprived of oxygen, leading to early signs such as restlessness. This is due to the brain's attempt to increase oxygen intake by increasing activity. Cyanosis (A) is a late sign of hypoxemia when oxygen levels are critically low. Tachycardia (C) and tachypnea (D) are compensatory mechanisms in response to hypoxemia, but they are not early signs affecting the nervous system directly.
Question 3 of 9
Complications common to patients receiving hemodialysis for acute kidney injury include which of the following? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A, hypotension. During hemodialysis for acute kidney injury, fluid removal can lead to hypotension due to rapid changes in blood volume. This can cause dizziness, weakness, and even loss of consciousness. Dysrhythmias (choice B) are less common but can occur due to electrolyte imbalances. Muscle cramps (choice C) may occur during or after dialysis due to electrolyte imbalances or fluid shifts, but they are not as common as hypotension. Hemolysis (choice D) is not a common complication of hemodialysis for acute kidney injury, as it is more commonly associated with issues related to the dialysis machine or blood tubing.
Question 4 of 9
The family members are excited about being transferring t heir loved one from the critical care unit to the intermediate care unit. However, they are also fearful of the change in environment and nursing staff. To reduce relocation stress, the nurse ca n implement what intervention? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A (Arranging for the nurses on the intermediate care unit to give the family a tour of the new unit) because it helps familiarize the family with the new environment, alleviating their fears. The tour allows them to see where their loved one will be cared for, meet the nursing staff, and ask any questions they may have. This intervention promotes a smooth transition, reduces anxiety, and builds trust. Choice B is incorrect because delaying the transfer doesn't address the fear of change and can prolong stress. Choice C is incorrect as proximity to the nurse's station may not necessarily reduce relocation stress for the family. Choice D is incorrect because meeting the new nurse in the current unit may not provide the same level of comfort and preparation compared to physically visiting the new unit.
Question 5 of 9
The patient is in a progressive care unit following arteriovenous fistula implantation in his left upper arm, and is due to have blood drawn with his next set of vital signs and assessment. When the nurse assesses the patient, the nurse should
Correct Answer: D
Rationale: The correct answer is D because after arteriovenous fistula implantation, it is essential to assess for the presence of a bruit (audible sound caused by turbulent blood flow) and thrill (vibratory sensation) in the access site, which indicates proper functioning of the fistula. This assessment ensures that blood is flowing adequately through the newly created access for dialysis or other procedures. Drawing blood or taking blood pressures from the fistula arm can lead to complications such as clot formation or damage to the fistula. Starting a new IV line in the same arm is contraindicated to avoid compromising the newly created fistula. Thus, auscultating for a bruit and palpating for a thrill are the appropriate nursing actions in this scenario.
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 who is receiving positive pressure ventilation is scheduled for a spontaneous breathing trial (SBT). Which finding by the nurse is most important to discuss with the health care provider before starting the SBT?
Correct Answer: A
Rationale: The correct answer is A: New ST segment elevation is noted on the cardiac monitor. This finding is concerning because it may indicate myocardial ischemia or infarction, which can be exacerbated by the physiological stress of weaning from mechanical ventilation. It is crucial to address any cardiac issues before initiating a spontaneous breathing trial to prevent potential cardiac complications during the weaning process. Explanation for why the other choices are incorrect: B: Enteral feedings being given through an orogastric tube are not contraindicated for starting a spontaneous breathing trial. C: Scattered rhonchi heard when auscultating breath sounds may indicate retained secretions but are not a contraindication for a spontaneous breathing trial. D: The use of HYDROmorphone to treat postoperative pain is not a contraindication for a spontaneous breathing trial unless it is causing respiratory depression, which would need to be addressed separately.
Question 8 of 9
A 22-year-old patient who experienced a near-drowning accident in a local pool, but now is awake and breathing spontaneously, is admitted for observation. Which assessment will be most important for the nurse to take during the observation period?
Correct Answer: C
Rationale: The correct answer is C: Auscultate breath sounds. After a near-drowning incident, the main concern is potential respiratory complications such as aspiration pneumonia or pulmonary edema. Auscultating breath sounds will help the nurse assess for any signs of respiratory distress or complications. This assessment is crucial for early detection and intervention. A: Auscultating heart sounds is important but not as crucial as assessing breath sounds in this scenario. B: Palpating peripheral pulses is important for circulation assessment but does not address the immediate concern of respiratory complications. D: Checking pupil reaction to light is more relevant for neurological assessment and not as critical as assessing breathing in this situation.
Question 9 of 9
A nurse walks into a patients room and begins preparing a syringe to perform a blood draw on the patient. The nurse observes that the patient is firmly gripping the side of the bed, averting her eyes, and sweating from her forehead when she sees the needle. What would be the best intervention for the nurse to make?
Correct Answer: D
Rationale: The correct answer is D because it shows empathy and promotes patient education. By describing the procedure and its necessity, the nurse can alleviate the patient's anxiety and build trust. This approach allows the patient to feel informed and in control, reducing fear and increasing cooperation. It also demonstrates respect for the patient's feelings and promotes a therapeutic relationship. Choice A is incorrect as it disregards the patient's fear and can lead to increased distress. Choice B might be an option, but it doesn't address the patient's anxiety in the moment. Choice C, while helpful in some cases, doesn't directly address the patient's specific fear of the blood draw procedure.