ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 of 9
The nurse cares for a terminally ill patient who is experiencing pain that is continuous and severe. How should the nurse schedule the administration of opioid pain medications?
Correct Answer: A
Rationale: The correct answer is A: Give around-the-clock routine administration of analgesics. This is the best approach for managing continuous and severe pain in a terminally ill patient. By providing scheduled doses of opioid pain medications, the nurse ensures a consistent level of pain relief, preventing peaks and troughs in pain control. This approach also helps in preventing the patient from experiencing unnecessary suffering. Choice B (PRN doses) may lead to inadequate pain control as the patient may wait too long before requesting medication. Choice C (keeping the patient sedated) is not appropriate as the goal is pain management, not sedation. Choice D (balancing pain control and respiratory rate) is important, but the priority should be on effectively managing the pain first.
Question 2 of 9
One of the strategies shown to reduce perception of stress in critically ill patients and their families is support of spirituality. What nursing action is most clearly supportive of the patients spirituality?
Correct Answer: C
Rationale: The correct answer is C because asking about beliefs about the universe allows the nurse to understand the patient's spiritual needs and provide appropriate support. This action shows respect for the patient's beliefs and can help establish a connection between the patient and the nurse. Referring patients to a specific religious figure (choice A) may not align with the patient's beliefs. Providing prayer booklets (choice B) assumes the patient's belief system and may not be helpful. Avoiding discussing religion (choice D) can hinder the nurse-patient relationship and overlook potential sources of support for the patient.
Question 3 of 9
The nurse cares for a terminally ill patient who is experiencing pain that is continuous and severe. How should the nurse schedule the administration of opioid pain medications?
Correct Answer: A
Rationale: The correct answer is A: Give around-the-clock routine administration of analgesics. This is the best approach for managing continuous and severe pain in a terminally ill patient. By providing scheduled doses of opioid pain medications, the nurse ensures a consistent level of pain relief, preventing peaks and troughs in pain control. This approach also helps in preventing the patient from experiencing unnecessary suffering. Choice B (PRN doses) may lead to inadequate pain control as the patient may wait too long before requesting medication. Choice C (keeping the patient sedated) is not appropriate as the goal is pain management, not sedation. Choice D (balancing pain control and respiratory rate) is important, but the priority should be on effectively managing the pain first.
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
In determining the glomerular filtration rate (GFR) or creatinine clearance, a 24-hour urine is obtained. If a reliable 24-hour urine collection is not possible,
Correct Answer: D
Rationale: The correct answer is D because when a reliable 24-hour urine collection is not possible, a standardized formula can be used to estimate GFR. The Cockcroft-Gault equation or the Modification of Diet in Renal Disease (MDRD) equation are commonly used formulas to estimate GFR based on serum creatinine levels, age, gender, and race. These formulas provide a reasonable estimation of kidney function in the absence of a 24-hour urine collection. Choice A is incorrect because there are alternative methods available to estimate GFR. Choice B is incorrect because BUN alone is not sufficient to accurately determine renal function. Choice C is incorrect because an elevated BUN/creatinine ratio is not a direct measure of GFR and may be influenced by factors other than kidney function, such as hydration status or liver function.
Question 6 of 9
A patient in the ICU is recovering from open-heart surgery. The nurse enters his room and observes that his daughter is performing effleurage on his arms and talking in a low voice about an upcoming family vacation that is planned. The room is dimly lit, and she hears the constant beeping of his heart monitor. From the hall she hears the cries of a patient in pain. Which of the following are likely stressors for the patient? Select all that apply.
Correct Answer: C
Rationale: The correct answer is C: The beeping of the heart monitor is a likely stressor for the patient recovering from open-heart surgery in the ICU. The constant beeping can cause anxiety and uncertainty about their health status. The daughter's conversation and effleurage are likely comforting and supportive for the patient, reducing stress. The dim lighting may create a calming environment, and the distant cries of a patient in pain may evoke empathy but may not directly stress the recovering patient. Therefore, the beeping of the heart monitor stands out as a stressor among the choices provided.
Question 7 of 9
A patient with terminal cancer reports a sudden onset of severe pain. Which intervention should the nurse implement first?
Correct Answer: A
Rationale: The correct answer is A: Assess the patient’s pain using a standardized pain scale. The first step is to assess the severity and nature of the pain to determine the appropriate intervention. This allows the nurse to understand the pain intensity and characteristics, which guides the choice of analgesic and dosing. Administering analgesics (B) without proper assessment can lead to inappropriate treatment. Notifying the healthcare provider (C) is important but assessing the pain should come first. Repositioning the patient (D) may provide comfort but addressing the pain directly is the priority.
Question 8 of 9
Continuous renal replacement therapy (CRRT) differs from conventional intermittent hemodialysis in that
Correct Answer: D
Rationale: The correct answer is D because CRRT removes solutes and water slowly, which is beneficial for hemodynamically unstable patients. This slow removal allows for gradual fluid and electrolyte balance adjustments, reducing the risk of hemodynamic instability. A: Incorrect - A hemofilter is indeed used in CRRT, but this choice does not highlight the key difference between CRRT and intermittent hemodialysis. B: Incorrect - CRRT actually provides slower solute and water removal compared to intermittent hemodialysis. C: Incorrect - Diffusion does occur in CRRT, as it is a key mechanism for solute removal in the process. In summary, the key difference between CRRT and intermittent hemodialysis is the slow removal of solutes and water in CRRT, making choice D the correct answer.
Question 9 of 9
The nurse is managing a donor patient six hours prior to th e scheduled harvesting of the patient’s organs. Which assessment finding requires imme diate action by the nurse?
Correct Answer: B
Rationale: The correct answer is B. The patient's pH of 7.30 indicates acidosis, PaCO2 of 38 mm Hg is low, and HCO3 of 16 mEq/L is also low, suggesting metabolic acidosis. This finding requires immediate action as untreated acidosis can lead to serious complications. Choice A (morning serum blood glucose of 128 mg/dL) is within normal range and does not require immediate action. Choice C (pulmonary artery temperature of 97.8°F) is a normal temperature and does not require immediate action. Choice D (central venous pressure of 8 mm Hg) is within normal range and does not require immediate action.