ATI RN
Critical Care Nursing Practice Questions Questions
Question 1 of 9
The nurse is assessing the exhaled tidal volume (EV ) in a mechanically ventilated patient. T What is the rationale for this assessment?
Correct Answer: D
Rationale: The correct answer is D: Determine the patient’s work of breathing. Assessing the exhaled tidal volume (EV) in a mechanically ventilated patient helps determine how much effort the patient is exerting to breathe. By monitoring the EV, the nurse can evaluate the patient's respiratory status and adjust ventilator settings if needed. It is crucial to ensure that the patient is not working too hard to breathe, as this can lead to respiratory distress. Incorrect answers: A: Assess for tension pneumothorax - Tension pneumothorax is typically assessed through other means such as physical examination and chest X-ray. B: Assess the level of positive end-expiratory pressure - The level of positive end-expiratory pressure is usually set based on the patient's condition and not solely based on the exhaled tidal volume. C: Compare the tidal volume delivered with the tidal volume prescribed - This comparison is important but does not directly relate to assessing the patient's work of breathing.
Question 2 of 9
A hospital interviews two different candidates for a position in the ICU. Both candidates have around 10 years of experience working in the ICU. Both have excellent interpersonal skills and highly positive references. One, however, has certification in critical care nursing. Which of the following is the most compelling and accurate reason for the hospital to hire the candidate with certification?
Correct Answer: A
Rationale: The correct answer is A: The certified nurse will have more knowledge and expertise. Certification in critical care nursing indicates that the candidate has undergone specialized training and passed a standardized exam, demonstrating a higher level of knowledge and skill in critical care practices compared to a non-certified candidate. This certification ensures that the nurse has met specific competency standards in critical care, making them better equipped to handle complex situations in the ICU. Summary: - Choice B (ethical behavior) and Choice C (caring towards patients) are subjective qualities that can be present in both certified and non-certified nurses. - Choice D (collaboration with other nurses) is not directly related to certification but can be influenced by the individual's interpersonal skills. - Ultimately, the certification in critical care nursing provides concrete evidence of the candidate's advanced knowledge and expertise, making them the most compelling choice for the hospital to hire.
Question 3 of 9
A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min. Spontaneous reabsiprbi.rcaotmio/tensst are 12 breaths/min. After receiving a dose of morphine sulfate, respirations decrease to 4 breaths/min. Which acid-base disturbance will likely occur?
Correct Answer: D
Rationale: The correct answer is D (Respiratory alkalosis). Morphine sulfate can cause respiratory depression, leading to decreased respiratory rate. In this case, the patient's breaths decrease from 12 to 4 breaths/min, indicating hypoventilation. With decreased ventilation, there is less CO2 elimination, resulting in respiratory alkalosis. The other choices can be ruled out: A (Metabolic acidosis) and B (Metabolic alkalosis) are less likely caused by morphine sulfate, and C (Respiratory acidosis) is incorrect because the scenario describes hypoventilation, not hyperventilation.
Question 4 of 9
A patient is admitted to the ICU with injuries sustained from a fall from a third-story window. The patient is conscious, his breathing is labored, and he is bleeding heavily from the abdomen. He groans constantly and complains of severe pain, but his movements are minimal. His heart rate is elevated. Which of these is a sign that he is in the second phase of the stress response? Select all that apply.
Correct Answer: C
Rationale: The correct answer is C: Severe pain. In the second phase of the stress response (resistance phase), the body is trying to cope with the stressor. Severe pain is a sign of the body's response to the injury, indicating the activation of the stress response. Labored breathing and elevated heart rate are more likely to be signs of the initial phase (alarm phase) of the stress response. Bleeding heavily from the abdomen is a medical emergency and does not specifically indicate the stress response phase.
Question 5 of 9
Which of the following statements regarding pain and anxiety are true? (Select all that apply.)
Correct Answer: A
Rationale: Rationale: A: Correct. Anxiety is characterized by apprehension, agitation, autonomic arousal, and fearful withdrawal, which are distinct from pain. B: Incorrect. Critically ill patients can experience both anxiety and pain, as pain is not exclusive to them. C: Incorrect. While pain and anxiety can be interrelated, they can be differentiated based on their unique physiological and behavioral manifestations. D: Incorrect. Pain is a subjective experience, but it is not solely defined by the individual; objective assessments are also important.
Question 6 of 9
Which of the following strategies will assist in creating a h ealthy work environment for the critical care nurse? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B because implementing a medication safety program designed by pharmacists promotes a safe work environment for critical care nurses by reducing medication errors. Pharmacists are experts in medications and can provide valuable insights to improve safety. A: Celebrating with a pizza party may boost morale but does not directly address work environment factors. C: Modifying staffing ratios may improve patient care but doesn't necessarily address the overall work environment. D: Joint workshops foster collaboration but may not directly impact the work environment's safety and health.
Question 7 of 9
Acute kidney injury from postrenal etiology is caused by
Correct Answer: A
Rationale: The correct answer is A because postrenal acute kidney injury is caused by obstruction of urine flow, leading to pressure build-up in the kidneys and subsequent damage. Obstructions can be due to conditions such as kidney stones, tumors, or enlarged prostate. Choices B, C, and D are incorrect as they relate to pre-renal and intrinsic renal causes of acute kidney injury, not specifically postrenal obstruction. B refers to decreased blood flow to the kidneys, C to low volume or poor heart function affecting kidney perfusion, and D to direct damage to kidney tissue, which do not characterize postrenal etiology.
Question 8 of 9
A nurse is caring for a patient in the final stages of dying. What is the most appropriate nursing action?
Correct Answer: B
Rationale: The correct answer is B: Provide emotional support and comfort measures. In the final stages of dying, the focus shifts from curative treatment to providing comfort and dignity. Emotional support helps alleviate anxiety and fear, promoting a peaceful transition. Comfort measures like pain management improve quality of life. Encouraging the patient to eat may be futile as the body shuts down. Performing frequent assessments for recovery signs is not appropriate in this situation. Implementing aggressive interventions could go against the patient's wishes for a natural death.
Question 9 of 9
Which organization requires a mechanism for addressing ethical issues?
Correct Answer: D
Rationale: The correct answer is D, The Joint Commission, because it is a regulatory body that accredits healthcare organizations and requires them to have mechanisms for addressing ethical issues to ensure patient safety and quality of care. The other choices (A, B, C) are professional organizations that focus on specific areas of healthcare practice and do not have the authority to set regulatory standards for addressing ethical issues in healthcare organizations.