ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 of 9
The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter. The nurse assesses a blood pressure of 90/60 mm Hg, hear t rate 110 beats/min, respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which hemodynamic value reqaubiirrbe.sco imm/temste diate action by the nurse?
Correct Answer: B
Rationale: The correct answer is B: Cardiac output (CO) of 4 L/min. In this scenario, the patient is presenting with signs of pulmonary congestion and hypoxemia, indicating possible cardiogenic pulmonary edema. As the cardiac output is a key indicator of how well the heart is functioning and delivering blood to the body, a low cardiac output can lead to inadequate tissue perfusion and worsen the patient's condition. Therefore, immediate action is required to address the low cardiac output to improve tissue perfusion and oxygenation. Choices A, C, and D are incorrect as they do not directly address the primary concern of inadequate cardiac output in this patient. Cardiac index, pulmonary vascular resistance, and systemic vascular resistance are important parameters to monitor, but in this case, the priority is to address the low cardiac output to improve the patient's condition.
Question 2 of 9
Which of the following is (are) official journal(s) of the A merican Association of Critical-Care Nurses? (Select all that apply.)
Correct Answer: A
Rationale: Step-by-step rationale: 1. The American Association of Critical-Care Nurses (AACN) publishes the American Journal of Critical Care (AJCC). 2. The AJCC is a peer-reviewed journal that covers critical care nursing practice, research, and education. 3. The content in AJCC aligns with AACN's mission and standards for critical care nursing. 4. Hence, AJCC is an official journal of AACN. Summary of other choices: - B: Critical Care Clinics of North America - Not an official journal of AACN. - C: Critical Care Nurse - Not an official journal of AACN. - D: Critical Care Nursing Quarterly - Not an official journal of AACN.
Question 3 of 9
The patient diagnosed with acute respiratory distress synd rome (ARDS) would exhibit which symptom?
Correct Answer: A
Rationale: The correct answer is A because in ARDS, there is a severe impairment in gas exchange leading to hypoxemia. Decreasing PaO2 levels despite increased FiO2 administration indicate poor oxygenation, a hallmark of ARDS. Elevated alveolar surfactant levels (Choice B) do not directly correlate with ARDS pathophysiology. Increased lung compliance with increased FiO2 administration (Choice C) is not characteristic of ARDS, as ARDS leads to decreased lung compliance. Respiratory acidosis associated with hyperventilation (Choice D) is not a typical finding in ARDS, as hyperventilation is usually present in an attempt to compensate for hypoxemia.
Question 4 of 9
The nurse is caring for a patient following insertion of a left subclavian central venous catheter (CVC). Which action by the nurse best reduces th e risk of catheter-related bloodstream infection (CRBSI)?
Correct Answer: A
Rationale: The correct answer is A: Review daily the necessity of the central venous catheter. This action reduces the risk of CRBSI by promoting early removal of unnecessary catheters, which is a key strategy in preventing infections. Unnecessary catheters increase the risk of infection due to prolonged exposure to the patient's skin flora and possible contamination during insertion. Reviewing daily ensures the catheter is only kept when necessary, minimizing the duration of catheter use and reducing the chances of infection. Summary of other choices: B: Cleansing the insertion site daily with isopropyl alcohol is important for maintaining skin integrity but does not directly reduce the risk of CRBSI. C: Changing the pressurized tubing system and flush bag daily is important for maintaining catheter patency but does not directly reduce the risk of CRBSI. D: Maintaining a pressure of 300 mm Hg on the flush bag is important for proper catheter function but does not directly reduce the risk of CR
Question 5 of 9
An unresponsive 79-year-old is admitted to the emergency department (ED) during a summer heat wave. The patient’s core temperature is 105.4°F (40.8°C), blood pressure (BP) 88/50, and pulse 112. The nurse initially will plan to:
Correct Answer: A
Rationale: The correct answer is A: Apply wet sheets and a fan to the patient. This is the initial treatment for hyperthermia to aid in lowering the body temperature. Wet sheets help in evaporative cooling, while a fan enhances heat loss through convection. This approach is crucial in managing heat-related illnesses quickly. Choices B, C, and D are incorrect as they do not directly address the urgent need to reduce the patient's elevated core temperature. Providing O2, IV fluids, or acetaminophen can be considered later in the management, but the priority is to rapidly lower the body temperature in a hyperthermic patient to prevent further complications.
Question 6 of 9
The nurse is caring for a postoperative patient with chroni c obstructive pulmonary disease (COPD). Which assessment would be a cue to the patient developing postoperative pneumonia?
Correct Answer: B
Rationale: The correct answer is B: Change in sputum characteristics. This is a cue for postoperative pneumonia in a COPD patient because it can indicate an infection in the lungs. Postoperative pneumonia is a common complication in patients with COPD due to impaired lung function and weakened immune system. Other choices are incorrect: A) Bradycardia is not a specific indicator of postoperative pneumonia. C) Hypoventilation and respiratory acidosis can be seen in patients with COPD but are not specific to postoperative pneumonia. D) Pursed-lip breathing is a coping mechanism for patients with COPD and is not directly related to postoperative pneumonia.
Question 7 of 9
When assisting with the placement of a pulmonary artery (PA) catheter, the nurse notes that the catheter is correctly placed when the monitor shows a:
Correct Answer: D
Rationale: Step-by-step rationale for Answer D being correct: 1. PA catheter measures PA pressures. 2. PAWP reflects left atrial pressure. 3. Correct placement shows typical PAWP tracing. 4. PA pressure waveform (A) is not specific to PAWP. 5. Systemic arterial pressure tracing (B) is unrelated. 6. Systemic vascular resistance tracing (C) is not monitored by PA catheter.
Question 8 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 9 of 9
Which of the following professional organizations best supports critical care nursing practice?
Correct Answer: A
Rationale: The correct answer is A: American Association of Critical-Care Nurses (AACN). This organization focuses exclusively on critical care nursing, offering specialized education, resources, and certifications for critical care nurses. AACN advocates for high standards of care in critical care settings. The other choices do not specifically cater to critical care nursing practice. The American Heart Association focuses on cardiovascular health, the American Nurses Association is a general nursing organization, and the Society of Critical Care Medicine is more physician-centric. Therefore, A is the best choice for supporting critical care nursing practice.