ATI RN
Critical Care Nursing Questions Questions
Question 1 of 5
Following insertion of a pulmonary artery catheter (PAC),a bthirbe. cpohmy/tessitc ian orders the nurse to obtain a blood sample for mixed venous oxygen saturation (SvO ). Which action by the nurse best ensures the obtained value is accurate?
Correct Answer: B
Rationale: The correct answer is B because calibrating the system with central venous and arterial blood samples ensures accuracy of the mixed venous oxygen saturation (SvO2) measurement. This calibration allows for comparison of the values obtained from both sources to confirm the accuracy of the measurement. Choice A is incorrect because zero referencing the transducer at the level of the phlebostatic axis does not directly address the accuracy of the SvO2 measurement. Choice C is incorrect because ensuring patency of the catheter using normal saline pressurized at 300 mm Hg does not directly impact the accuracy of the SvO2 measurement. Choice D is incorrect because using noncompliant pressure tubing does not ensure the accuracy of the SvO2 measurement. The length of the tubing and the presence of stopcocks are not directly related to obtaining an accurate SvO2 value.
Question 2 of 5
When performing an initial pulmonary artery occlusion pr essure (PAOP), what are the best nursing actions? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Inflate the balloon for no more than 8 to 10 seconds while noting the waveform change. This is because inflating the balloon within this time frame allows for accurate measurement of PAOP without causing complications like pulmonary edema. Noting the waveform change helps in determining the accurate pressure reading. Explanation of why other choices are incorrect: B: Inflating the balloon with air and recording the volume necessary is not a recommended practice as it can lead to inaccurate readings and potential harm to the patient. C: Maintaining the balloon inflated for 8 hours following insertion is unnecessary and could lead to complications such as vascular damage or thrombosis. D: Zero referencing and leveling the transducer at the phlebostatic axis are important steps but not directly related to performing an initial PAOP measurement.
Question 3 of 5
The nurse is caring for an elderly patient who was admitted with renal insufficiency. An expected laboratory finding for this patient may be
Correct Answer: B
Rationale: The correct answer is B: a normal serum creatinine level. In renal insufficiency, the kidneys are not able to filter waste products effectively, leading to an increase in serum creatinine levels. This is a common indicator of renal dysfunction. A: An increased GFR would not be expected in renal insufficiency, as it signifies improved kidney function. C: Increased ability to excrete drugs is not a typical finding in renal insufficiency, as impaired kidney function can lead to drug accumulation. D: Hypokalemia is not directly related to renal insufficiency. It is more commonly associated with factors like diuretic use or gastrointestinal losses.
Question 4 of 5
The patient undergoes a cardiac catheterization that requires the use of contrast dyes during the procedure. To detect signs of contrast-induced kidney injury, the nurse should
Correct Answer: B
Rationale: The correct answer is B because evaluating the patient's serum creatinine for up to 72 hours after the procedure is crucial in detecting contrast-induced kidney injury. An increase in serum creatinine levels indicates impaired kidney function due to the contrast dye. This monitoring allows for early detection and intervention to prevent further kidney damage. Choice A is incorrect because a decrease in urine output is a late sign of kidney injury and may not be present in the early stages. Choice C is incorrect as a renal ultrasound is not typically used to detect contrast-induced kidney injury. Choice D is incorrect as postvoid residual volume assessment is not specific to detecting intrarenal injury related to contrast dye use.
Question 5 of 5
In calculating the glomerular filtration rate (GFR) results for women, the creatinine clearance is usually:
Correct Answer: C
Rationale: The correct answer is C: multiplied by 0.85. This is because women typically have lower muscle mass compared to men, resulting in lower creatinine production. Therefore, to adjust for this difference, the creatinine clearance for women is multiplied by 0.85. This correction factor helps to more accurately estimate the GFR in women. Choices A and B are incorrect because the creatinine clearance for women is not the same as or greater than that for men due to the physiological differences in muscle mass. Choice D is also incorrect as multiplying by 1.15 would overestimate the GFR in women.