ATI RN
Critical Care Nursing Exam Questions Questions
Question 1 of 9
The nurse caring for a patient with an endotracheal tube un derstands that endotracheal suctioning is needed to facilitate removal of secretions. What additional information is the nurse aware of concerning this intervention?
Correct Answer: C
Rationale: Rationale for Correct Answer C: Endotracheal suctioning should be done as indicated by patient assessment because not all patients require routine suctioning. Performing unnecessary suctioning can lead to potential complications such as mucosal damage and increased risk of infection. Therefore, the nurse must assess the patient's respiratory status, auscultate lung sounds, monitor oxygen saturation levels, and observe for signs of increased secretions before deciding to perform suctioning. Summary of Incorrect Choices: A: Endotracheal suctioning does not directly impact intracranial pressure. It is primarily focused on maintaining airway patency and removing respiratory secretions. B: While endotracheal suctioning may temporarily suppress the cough reflex during the procedure, its primary purpose is to clear airway secretions to prevent complications such as atelectasis and respiratory distress. D: Saline instillation before suctioning is not recommended as it can lead to negative outcomes such as dehydration, mucosal damage, and increased risk of infection
Question 2 of 9
The family members are excited about being transferring t heir loved one from the critical care unit to the intermediate care unit. However, they are also fearful of the change in environment and nursing staff. To reduce relocation stress, the nurse ca n implement what intervention? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A (Arranging for the nurses on the intermediate care unit to give the family a tour of the new unit) because it helps familiarize the family with the new environment, alleviating their fears. The tour allows them to see where their loved one will be cared for, meet the nursing staff, and ask any questions they may have. This intervention promotes a smooth transition, reduces anxiety, and builds trust. Choice B is incorrect because delaying the transfer doesn't address the fear of change and can prolong stress. Choice C is incorrect as proximity to the nurse's station may not necessarily reduce relocation stress for the family. Choice D is incorrect because meeting the new nurse in the current unit may not provide the same level of comfort and preparation compared to physically visiting the new unit.
Question 3 of 9
A critically ill patient experiences stress and anxiety from many factors. Treatment of the patient focuses on reducing stressors and providing supportive care such as nutrition, oxygenation, pain management, control of anxiety, and specific care of the illness or injury. What is the best rationale for these interventions?
Correct Answer: A
Rationale: The correct answer is A: Helps to support the patient's immune system. Providing supportive care such as nutrition, oxygenation, pain management, and anxiety control can help reduce stress, which in turn supports the immune system. Stress weakens the immune system, making the patient more vulnerable to infections and complications. By addressing stress and anxiety through supportive care, the patient's immune system is better able to function optimally, aiding in the recovery process. Choices B, C, and D are incorrect because: B: Part of good nursing care - While supportive care is indeed part of good nursing care, the key rationale for these interventions in a critically ill patient is to support the immune system, not just to provide good nursing care. C: Mandated by hospital policy - Hospital policies may dictate certain aspects of care, but the primary goal of these interventions is to support the patient's immune system, not just to comply with hospital policies. D: Reassures the patient and family - While providing reass
Question 4 of 9
A hospice nurse who has become close to a terminally ill patient is present in the home when the patient dies and feels saddened and tearful as the family members begin to cry. Which action should the nurse take at this time?
Correct Answer: B
Rationale: The correct answer is B: Cry along with the patient’s family members. This action demonstrates empathy and support for the family's grief, showing that the nurse acknowledges and shares their feelings. It can help the family feel understood and supported during a difficult time. By crying with the family, the nurse can validate their emotions and provide comfort without intruding on their personal space. This approach fosters a sense of connection and trust between the nurse and the family, enhancing the quality of care provided. Incorrect Choices: A: Contact a grief counselor as soon as possible - This choice may be premature and could come across as impersonal or distancing in the immediate aftermath of the patient’s death. C: Leave the home as soon as possible - This choice would be insensitive and could make the family feel abandoned in their time of need. D: Consider whether working in hospice is desirable because patient losses are common - This choice is inappropriate as it suggests the nurse should reconsider their career choice based on emotional reactions,
Question 5 of 9
The nurse is caring for a 70-kg patient in septic shock with a pulmonary artery catheter. Which hemodynamic value indicates an appropriate response to therapy aimed at enhancing oxygen delivery to the organs and tissues?
Correct Answer: C
Rationale: The correct answer is C: Mixed venous (SvO2) of 40%. In septic shock, improving oxygen delivery to tissues is vital. SvO2 reflects the balance between oxygen delivery and consumption. A value of 40% indicates adequate oxygen delivery to tissues. A: Arterial lactate level of 1.0 mEq/L - Although a low lactate level is good, it does not directly indicate improved oxygen delivery. B: Cardiac output of 2.5 L/min - Cardiac output should ideally increase to improve oxygen delivery, so 2.5 L/min is low for a 70-kg patient. D: Cardiac index of 1.5 L/min/m2 - Cardiac index is cardiac output adjusted for body surface area. 1.5 L/min/m2 is low and indicates inadequate cardiac function for a patient in septic shock.
Question 6 of 9
The nurse is caring for a patient receiving continuous norepinephrine (Levophed) IV infusion. Which patient assessment finding indicates that the infusion rate may need to be adjusted?
Correct Answer: B
Rationale: The correct answer is B because a low Mean Arterial Pressure (MAP) indicates inadequate perfusion, which may require adjusting the norepinephrine infusion rate to increase blood pressure. A: A heart rate of 58 beats/minute is within a normal range and may not necessarily indicate a need for adjustment. C: Elevated Systemic Vascular Resistance (SVR) may be an expected response to norepinephrine and does not necessarily indicate a need for adjustment. D: A low Pulmonary Artery Wedge Pressure (PAWP) may indicate fluid volume deficit but does not directly relate to the need for adjusting norepinephrine infusion rate.
Question 7 of 9
While caring for a critically ill patient, the nurse knows that fostering patient control over the environment is a method for stress reduction. What nursing intervention gives the patient the most environmental control while still adhering to best practice principles?
Correct Answer: A
Rationale: Step 1: Asking the patient whether he or she wants to get out of bed allows the patient to make a decision regarding their immediate environment, promoting autonomy and control. Step 2: This intervention respects the patient's preferences and fosters a sense of dignity and empowerment, reducing stress. Step 3: Best practice principles in nursing emphasize patient-centered care and promoting patient autonomy. Summary: Choice A is correct as it directly involves the patient in decision-making, enhancing their sense of control. Choices B, C, and D do not provide the same level of autonomy and control to the patient, making them less effective in reducing stress and promoting patient well-being.
Question 8 of 9
Which nursing actions for the care of a dying patient can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN) (select all that apply)?
Correct Answer: A
Rationale: The correct answer is A because providing postmortem care to a dying patient is a task that can be safely delegated to an LPN/LVN. This includes tasks such as preparing the body, cleaning, and positioning after death. LPNs/LVNs are trained and competent in performing these duties under the supervision of a registered nurse or physician. Choices B, C, and D are incorrect because they involve critical thinking, assessment, and teaching skills that are typically within the scope of practice of a registered nurse. Encouraging family members to talk with the patient, determining assessment frequency, and educating about signs of approaching death require a higher level of nursing judgment and expertise, which is beyond the scope of an LPN/LVN's role.
Question 9 of 9
The nurse is discussing the role of hospice care with a patient and family. Which statement by the nurse accurately describes hospice care?
Correct Answer: B
Rationale: The correct answer is B because hospice care indeed focuses on providing support and comfort for patients at the end of life. This is achieved through pain management, emotional support, and enhancing quality of life. Choice A is incorrect because hospice care does not aim to cure serious illnesses but rather to provide comfort and care. Choice C is incorrect as hospice care is not limited to patients with cancer but is available to individuals with various terminal illnesses. Choice D is incorrect as hospice care does not focus on extending life expectancy but rather on improving the quality of life during the end-of-life period.