ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 of 5
Following surgery for an abdominal aortic aneurysm, the patient’s central venous pressure (CVP) monitor indicates low pressures. Which action is a priority for the nurse to take?
Correct Answer: B
Rationale: The correct answer is B: Increase the IV fluid infusion per protocol. Low CVP post-abdominal aortic aneurysm surgery could indicate hypovolemia, which requires fluid resuscitation. Increasing IV fluid infusion helps restore intravascular volume, improve tissue perfusion, and prevent hypotension. Administering diuretics (A) would worsen hypovolemia. Documenting (C) is important but not the priority when the patient needs immediate intervention. Elevating the head of the bed (D) may help with venous return but is not the priority over addressing hypovolemia.
Question 2 of 5
assessment, the patient is restless, heart rate has increased to 110 beats/min, respirat ions are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sin us tachycardia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretio ns. Loud crackles are audible throughout lung fields. The nurse notifies the physician, who orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. In comambirubn.ciocma/tteinstg with the physician, which statement indicates the nurse understands what is likely occurring with the patient?
Correct Answer: B
Rationale: The correct answer is B: “My assessment indicates potential fluid overload.” The patient is showing signs of fluid overload, such as increased heart rate, respiratory rate, elevated blood pressure, pulmonary artery pressures, frothy secretions, and crackles in lung fields. These symptoms suggest fluid is accumulating in the lungs, causing pulmonary congestion. This can lead to impaired gas exchange and respiratory distress. The nurse's recognition of these signs is crucial for prompt intervention to prevent further complications. Other choices are incorrect because there are no indications of a myocardial infarction, PVCs compromising cardiac output, or a hypertensive crisis based on the given information.
Question 3 of 5
The nurse is caring for a patient who has an intra-aortic balloon pump (IABP) following a massive heart attack. When assessing the patient, the nurse notices blood backing up into the IABP catheter. In which order should the nurse take the following actions?
Correct Answer: A
Rationale: Correct Answer: A Rationale: 1. Ensuring the IABP console is turned off is crucial to prevent further complications and stop potential harm to the patient. 2. By turning off the IABP console, the nurse can halt the pumping action, allowing assessment of the situation without interference. 3. This action takes priority over other steps as it addresses the immediate issue of blood backing up into the IABP catheter. 4. Once the console is turned off, the nurse can proceed with assessing the patient's vital signs, notifying the healthcare provider, and obtaining supplies if needed. Summary of Incorrect Choices: - Option B: Assessing vital signs and orientation is important, but addressing the malfunction of the IABP takes precedence to prevent harm. - Option C: Notifying the healthcare provider is necessary, but first, the immediate issue of blood backing up into the catheter must be addressed. - Option D: Obtaining supplies for a new catheter is premature without first addressing
Question 4 of 5
A patient is declared brain dead and a do not resuscitate (DNR) order is put in place. The nurse caring for the patient does not agree with this manne r of care but does not express any concerns to the charge nurse. The nurse’s feeling that the p atient is being killed will likely create what response for this nurse?
Correct Answer: C
Rationale: The correct answer is C: Moral distress. In this scenario, the nurse is experiencing conflicting moral values between the decision made for the patient and their own beliefs. This internal conflict leads to moral distress, a common response when healthcare professionals feel unable to act in accordance with their ethical beliefs. This can lead to emotional turmoil, frustration, and moral residue. A: A sense of abandonment is incorrect because the nurse is still caring for the patient, so there is no physical abandonment. B: Increased family stress is incorrect as the nurse's internal conflict does not directly impact family stress. D: A sense of negligence is incorrect as negligence implies failure to provide proper care, which is not the case here.
Question 5 of 5
The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period of time. Which of the following nursing interventions would improve the patient’s well-being and reduce anxiety the most?
Correct Answer: B
Rationale: The correct answer is B because pet therapy has been shown to reduce anxiety and improve well-being in hospitalized patients. Interacting with therapy dogs can provide comfort, companionship, and a distraction from the hospital environment. Bringing in a therapy dog can help the trauma patient feel more relaxed and supported during their extended hospital stay. Choice A may be comforting but does not address the therapeutic benefits of pet therapy. Choice C may provide soothing music, but pet therapy has been specifically proven to reduce anxiety in patients. Choice D, observing fish in an aquarium, may be calming but does not involve the interactive benefits of pet therapy.
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