ATI RN
Critical Care Nursing Questions and Answers PDF Questions
Question 1 of 9
Her urine output for the past 2 hours totaled only 40 mL. She arrived from s urgery to repair an aortic aneurysm 4 hours ago and remains on mechanical ventilation. In the past 2 hours, her heart rate has increased from 80 to 100 beats per minute and he r blood pressure has decreased from 128/82 to 100/70 mm Hg. She is being given an infusaiboirnb .coofm n/toesrtm al saline at 100 mL per hour. Her right atrial pressure through the subclavian cen tral line is low at 3 mm Hg. Her urine is concentrated. Her BUN and creatinine levels have been stable and in normal range. Her abdominal dressing is dry with no indication of bleeding. My assessment suggests that Mrs. P. is hypovolemic and I would like you to consider in creasing her fluids or giving her a fluid challenge. Using the SBAR model for communication, the information the nurse gives about the patient’s history and vital signs is appropriate fo r what part of the model?
Correct Answer: C
Rationale: The correct answer is C: Assessment. In the SBAR communication model, the nurse's information about the patient's history and vital signs falls under the Assessment component. This is because the nurse is providing a detailed evaluation of the patient's current condition based on objective data such as urine output, heart rate, blood pressure, and other key indicators. The nurse is analyzing the situation and forming a judgment that the patient is hypovolemic, indicating a fluid deficit. This assessment is crucial for informing further actions or interventions, such as increasing fluids or providing a fluid challenge. Summary of other choices: A: Situation - This choice would refer to a brief summary of the current situation without detailed analysis or interpretation. B: Background - This choice would involve providing relevant background information about the patient, such as medical history or recent procedures, but not the current assessment of the patient's condition. D: Recommendation - This choice would involve suggesting a course of action or treatment based on the assessment, which comes after
Question 2 of 9
What does pulse oximetry measure?
Correct Answer: D
Rationale: Pulse oximetry measures oxygen saturation in the blood by analyzing the absorption of light by hemoglobin. Oxygen saturation indicates the percentage of hemoglobin molecules carrying oxygen. This is essential for assessing respiratory function and oxygen delivery to tissues. Arterial blood gases (Choice A) directly measure oxygen and carbon dioxide levels in the blood, not specifically oxygen saturation. Hemoglobin values (Choice B) provide information about the amount of hemoglobin present but not its oxygen-carrying capacity. Oxygen consumption (Choice C) is a measure of how much oxygen is used by tissues, not what pulse oximetry directly measures.
Question 3 of 9
What is the treatment for an acute exacerbation of asthma?
Correct Answer: B
Rationale: The correct answer is B: Inhaled bronchodilators and intravenous corticosteroids. Bronchodilators help to quickly open up the airways during an asthma exacerbation, providing immediate relief. Intravenous corticosteroids help reduce airway inflammation and prevent further worsening of symptoms. Corticosteroids by mouth (Choice A) are not as effective as intravenous administration during an acute exacerbation. Prone positioning or continuous lateral rotation (Choice C) is not a recommended treatment for asthma exacerbation. Sedation and inhaled bronchodilators (Choice D) are not appropriate as sedation can depress respiratory function and worsen the condition.
Question 4 of 9
The spouse of a patient with terminal cancer visits daily and cheerfully talks with the patient about wedding anniversary plans for the next year. When the nurse asks about any concerns, the spouse says, 'I’m busy at work, but otherwise, things are fine.' Which nursing diagnosis is most appropriate?
Correct Answer: A
Rationale: The correct answer is A: Ineffective coping related to lack of grieving. The spouse's behavior of avoiding the reality of the terminal illness and focusing on future plans indicates maladaptive coping. The cheerfulness and denial suggest a lack of acceptance and processing of the impending loss. This can lead to emotional distress and hinder the grieving process. Choice B (Anxiety related to the complicated grieving process) is incorrect because the spouse's behavior does not exhibit signs of anxiety but rather avoidance and denial. Choice C (Caregiver role strain related to feeling overwhelmed) is incorrect as the spouse does not express feeling overwhelmed but instead deflects by focusing on work. Choice D (Hopelessness related to knowledge deficit about cancer) is incorrect because the spouse's behavior does not indicate hopelessness or lack of understanding about cancer, but rather an avoidance of facing the reality of the situation.
Question 5 of 9
After a change-of-shift report on a ventilator weaning unit, which patient should the nurse assess first?
Correct Answer: D
Rationale: The correct answer is D - Patient who was successfully weaned and extubated 4 hours ago and now has no urine output for the last 6 hours. This patient should be assessed first because the absence of urine output for 6 hours after being extubated could indicate acute kidney injury or other serious complications that need immediate attention. Urine output is a crucial indicator of renal function and can reflect the patient's overall hemodynamic status. In contrast, the other choices do not present immediate life-threatening conditions. Choice A involves a patient in rest mode post-failed breathing trial, which does not require immediate assessment. Choice B mentions continuous PETCO2 monitoring, which is important but not as urgent as assessing a patient with no urine output. Choice C describes a patient with a ScvO2 of 69%, which may need monitoring but does not indicate an urgent priority compared to assessing a patient with no urine output after recent extubation.
Question 6 of 9
A 65-year-old patient admitted to the progressive care unit with a diagnosis of community-acquired pneumonia, has a history of chronic obstructive pulmonary disease and diabetes. A set of arterial blood gases obtained on admissiaobnir bw.coitmh/oteustt supplemental oxygen shows pH 7.35; PaCO 55 mm Hg; bicarbonate 30 mEq/L ; PaO 65 mm Hg. These blood 2 2 gases reflect what condition?
Correct Answer: B
Rationale: The correct answer is B: Hypoxemia and compensated respiratory acidosis. The patient's pH is within normal range (7.35), indicating compensation. The elevated PaCO2 (55 mm Hg) indicates respiratory acidosis due to inadequate ventilation, likely from COPD. The low PaO2 (65 mm Hg) indicates hypoxemia, common in pneumonia. The normal bicarbonate level (30 mEq/L) suggests metabolic compensation for respiratory acidosis. Choice A is incorrect as there is no metabolic alkalosis present. Choice C is incorrect as the patient has hypoxemia. Choice D is incorrect as the patient is showing compensated respiratory acidosis, not uncompensated.
Question 7 of 9
Sleep often is disrupted for critically ill patients. Which nu rsing intervention is most appropriate to promote sleep and rest?
Correct Answer: A
Rationale: The correct answer is A: Consult with the pharmacist to adjust medication times to allow periods of sleep or rest between intervals. This is the most appropriate intervention as medication timings can significantly impact sleep patterns of critically ill patients. Adjusting medication times can help synchronize rest periods, promoting uninterrupted sleep. Choice B is incorrect as encouraging constant conversation can disrupt sleep. Choice C is incorrect as the television noise can be stimulating and hinder rest. Choice D is incorrect as leaving the lights on can disrupt the patient's circadian rhythm and negatively impact sleep quality.
Question 8 of 9
The patient has been admitted to the hospital with nausea and vomiting that started 5 days earlier. Blood pressure is 80/44 mm Hg and heart rate is 122 beats/min; the patient has not voided in 8 hours, and the bladder is not distended. The nurse anticipates a prescription for “stat” administration of
Correct Answer: B
Rationale: The correct answer is B: fluid replacement with 0.45% saline. The patient's low blood pressure, tachycardia, and lack of urine output indicate hypovolemia. Fluid replacement with saline will help restore circulating volume, improve blood pressure, and support renal perfusion. A: Blood transfusion is not indicated as the primary issue is hypovolemia, not anemia. C: Inotropic agents are used to increase cardiac contractility but are not the initial treatment for hypovolemia. D: Antiemetics may help with symptoms but do not address the underlying issue of fluid loss and hypovolemia.
Question 9 of 9
The patient’s spouse is very upset because the patient, who is near death, has dyspnea and restlessness. The nurse explains what options to decrease the discomfort?
Correct Answer: B
Rationale: The correct answer is B: Opioid medications given as needed. Opioids are indicated for managing dyspnea and restlessness in palliative care by providing relief from symptoms. They act as potent analgesics and can help decrease the distress associated with difficult breathing and restlessness. Respiratory therapy treatments (A) and incentive spirometry treatments (C) may not address the immediate discomfort caused by dyspnea and restlessness. Increased hydration (D) may not directly alleviate the symptoms and could potentially worsen the patient's discomfort.