ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 of 9
Family members have a need for information. Which intervention best assists in meeting this need?
Correct Answer: B
Rationale: The correct answer is B because providing a daily update of the patient's progress and facilitating communication with the intensivist directly addresses the family members' need for information in a timely and personalized manner. This intervention ensures that the family is kept informed about the patient's condition and treatment plan, fostering transparency and trust. It also allows for any questions or concerns to be addressed promptly, aiding in the family's understanding and involvement in the patient's care. Now, let's summarize why the other choices are incorrect: A: Handing out a pamphlet may provide information, but it lacks the personalized touch and real-time updates that are crucial for meeting the family's need for information. C: Restricting information and only allowing family members to be present at specific times may create frustration and hinder communication, not effectively meeting their information needs. D: Providing a list of medications is helpful, but it does not offer a comprehensive update on the patient's progress or facilitate direct communication with the medical team, which are
Question 2 of 9
The patient has a temporary percutaneous catheter in place for treatment of acute kidney injury. The catheter has been in place for 5 days. The nurse should
Correct Answer: B
Rationale: The correct answer is B because after 5 days, the risk of infection increases. Evaluating the patient for signs and symptoms of infection is crucial for early detection and treatment. Choice A is incorrect because routine dialysis catheter changes are not necessary after only 5 days. Choice C is incorrect as percutaneous catheters are for short-term use. Choice D is incorrect as using the catheter for fluid administration may increase the risk of infection.
Question 3 of 9
In the critically ill patient, an incomplete assessment and/or management of pain or anxiety may be hampered by which of the following? (Select all that apply.)
Correct Answer: A
Rationale: Step-by-step rationale: 1. Administration of neuromuscular blocking agents can hinder pain or anxiety assessment as it paralyzes the patient, preventing them from communicating discomfort. 2. Delirium may affect the patient's ability to express pain or anxiety, but it does not directly impede assessment and management. 3. Effective nurse communication and assessment skills facilitate, rather than hamper, pain or anxiety assessment. 4. Nonverbal patients can still communicate pain or anxiety through nonverbal cues, so they do not necessarily hinder assessment.
Question 4 of 9
The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H2O of peak end-expiratory pressure (PEEP). Which action indicates that the new RN is safe?
Correct Answer: B
Rationale: The correct answer is B: The RN uses a closed-suction technique to suction the patient. This is the safe action because closed-suction technique minimizes the risk of ventilator-associated infections by maintaining a closed system during suctioning, reducing the exposure to pathogens. Closed-suction systems also help maintain lung compliance and oxygenation levels during the suctioning process. Rationale: Option A is incorrect because suctioning every 1 to 2 hours may be too frequent and can lead to hypoxia and mucosal damage. Option C is incorrect as taping the connection between the ventilator tubing and ET can interfere with the proper functioning of the ventilator and increase the risk of disconnection. Option D is incorrect because changing ventilator circuit tubing routinely every 48 hours is not evidence-based practice and can increase the risk of contamination and unnecessary costs.
Question 5 of 9
A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min. Spontaneous re spirations are 12 breaths/min. The patient receives a dose of morphine sulfate, and now respi rations decrease to 4 breaths/min. What adjustments may need to be made to the patient’s ve ntilator settings?
Correct Answer: C
Rationale: The correct answer is C: Change to assist/control ventilation at a rate of 4 breaths/min. When the patient's spontaneous respirations decrease to match the ventilator rate, it indicates that the patient is not actively participating in breathing. Changing to assist/control ventilation allows the patient to trigger breaths when they desire, ensuring a more synchronized and comfortable breathing pattern. A: Adding PEEP may help improve oxygenation but is not directly related to the issue of decreased spontaneous respirations. B: Adding pressure support provides additional support during inspiration but does not address the underlying issue of decreased spontaneous respirations. D: Increasing the SIMV respiratory rate would not address the patient's decreased spontaneous respirations and could potentially lead to overventilation.
Question 6 of 9
The nurse admits a terminally ill patient to the hospital. What is the first action that the nurse should complete when planning this patient care?
Correct Answer: A
Rationale: The correct answer is A because determining the patient's wishes regarding end-of-life care is crucial in providing patient-centered care and ensuring that the patient's preferences are respected. By understanding the patient's preferences, healthcare providers can tailor the care plan to align with the patient's values and goals. This helps in promoting autonomy, dignity, and quality of life for the patient. Choices B, C, and D are incorrect because although addressing family issues, discussing grief, and encouraging the patient to express fears are important aspects of caring for a terminally ill patient, they are not the first action that should be completed. Prioritizing the patient's wishes ensures that the care plan is centered around the patient's needs and preferences, which is essential in providing holistic and patient-centered care.
Question 7 of 9
The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter. The nurse assesses a blood pressure of 90/60 mm Hg, hear t rate 110 beats/min, respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which hemodynamic value reqaubiirrbe.sco imm/temste diate action by the nurse?
Correct Answer: B
Rationale: The correct answer is B: Cardiac output (CO) of 4 L/min. In this scenario, the patient is presenting with signs of pulmonary congestion and hypoxemia, indicating possible cardiogenic pulmonary edema. As the cardiac output is a key indicator of how well the heart is functioning and delivering blood to the body, a low cardiac output can lead to inadequate tissue perfusion and worsen the patient's condition. Therefore, immediate action is required to address the low cardiac output to improve tissue perfusion and oxygenation. Choices A, C, and D are incorrect as they do not directly address the primary concern of inadequate cardiac output in this patient. Cardiac index, pulmonary vascular resistance, and systemic vascular resistance are important parameters to monitor, but in this case, the priority is to address the low cardiac output to improve the patient's condition.
Question 8 of 9
The family members of a patient who has just been admitted to the intensive care unit (ICU) with multiple traumatic injuries have just arrived in the ICU waiting room. Which action should the nurse take next?
Correct Answer: A
Rationale: The correct answer is A: Explain ICU visitation policies and encourage family visits. This is the best course of action because it prioritizes the needs of the family members by providing them with information on visitation policies and encouraging them to visit the patient. This helps establish communication, support, and involvement in the patient's care. It also respects the family's emotional needs during a challenging time. Choices B, C, and D are incorrect: B: Immediately taking the family members to the patient's bedside may overwhelm them and disrupt the patient's care. C: Describing the patient's injuries and care being provided should be done in a more controlled environment to ensure the family's understanding and emotional readiness. D: Inviting the family to a multidisciplinary care conference may be premature without first addressing their immediate concerns and providing support.
Question 9 of 9
A male client is angry and is leaving the hospital against medical advice (AMA). The client demands to take his chart with him and states the chart is 'his' and he doesn’t want any more contact with the hospital. How should the nurse respond?
Correct Answer: D
Rationale: The correct answer is D because the client's medical chart is the property of the hospital, but the client has the right to a copy of the information. By offering to make a copy of the chart for the client, the nurse respects the client's autonomy while also ensuring that the hospital maintains the original medical record. This response balances the client's rights with legal and ethical considerations. Choice A is incorrect because the hospital is legally obligated to maintain the client's medical record even if the client leaves against medical advice. Choice B is incorrect as it denies the client access to their medical information, which goes against the principle of patient autonomy. Choice C is also incorrect as it does not address the client's request for a copy of their chart.