ATI RN
Critical Care Nursing Practice Questions Questions
Question 1 of 9
The nurse is caring for a patient diagnosed with hyperactivaebi rdb.ecloimri/tuemst . The nurse focuses interventions toward which priority need?
Correct Answer: C
Rationale: The correct answer is C: Safety. In hyperactive delirium, the patient may be agitated, disoriented, and at risk of harm. Safety is the priority to prevent falls or injury. Comfort (A) is important but secondary to safety in this case. Nourishment (B) can wait until safety is ensured. Sedation (D) may be considered but only after safety measures are in place.
Question 2 of 9
The nurse is caring for a patient whose condition has deter iorated and is now not responding to standard treatment. The primary health care provider ca lls for an ethical consultation with the family to discuss potential withdrawal versus aggressivabei rtbr.ceoamtm/teestn t. The nurse understands that applying a model for ethical decision making involves which of the following? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Burden versus benefit. In ethical decision-making, considering the burden of treatment on the patient versus the potential benefits is crucial. This involves weighing the risks, benefits, and potential harm of treatment options. Family's wishes (B) and patient's wishes (C) are important factors but may not always align with what is ethically best for the patient. Potential outcomes of treatment options (D) are relevant but do not directly address the ethical dilemma of balancing burden and benefit. Therefore, A is the correct choice as it directly relates to the ethical principles guiding decision-making in this scenario.
Question 3 of 9
Critical illness often results in family conflicts. Which scenario is most likely to result in the greatest conflict?
Correct Answer: D
Rationale: The correct answer is D because it involves a conflict between the patient's autonomy and her son's beliefs. The patient, a Jehovah's Witness, has clearly stated her refusal of a blood transfusion in her advance directive, which aligns with her religious beliefs. Her son's disagreement with her decision creates a significant ethical dilemma and conflict. This scenario highlights the clash between respecting the patient's autonomy and the son's concerns for her well-being. Choice A is less likely to result in the greatest conflict as both parents have similar values and are amicable, with the conflict being directed towards the daughter's boyfriend. Choice B involves a conflict between the patient's girlfriend and parents, but the patient's lack of advance directives and estranged relationship with his parents do not present as significant a conflict as in the correct answer. Choice C involves a designated healthcare proxy and a committed relationship, which are less likely to result in a conflict as compared to the clash of beliefs and autonomy seen in Choice D.
Question 4 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 5 of 9
assessment, the patient is restless, heart rate has increased to 110 beats/min, respirations are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sinaubsir bt.acocmh/ytecsat rdia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretio ns. Loud crackles are audible throughout lung fields. The nurse notifies the physician, w ho orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. How d oes the nurse interpret the following blood gas levels? pH 7.28 PaCO 46 mm Hg Bicarbonate 22 mEq/L PaO 58 mm Hg O saturation 88% 2
Correct Answer: B
Rationale: The correct answer is B: Hypoxemia and uncompensated respiratory acidosis. Step-by-step rationale: 1. pH is low (7.28), indicating acidosis. 2. PaCO2 is elevated (46 mm Hg), indicating respiratory acidosis. 3. PaO2 is low (58 mm Hg), indicating hypoxemia. 4. Bicarbonate is within normal range (22 mEq/L), suggesting no compensation for the acidosis. 5. Oxygen saturation is low (88%), supporting the presence of hypoxemia. Summary: A: Incorrect - pH is low, not indicating compensated alkalosis. C: Incorrect - Various abnormalities in the blood gas levels are present. D: Incorrect - There is hypoxemia and uncompensated acidosis, not metabolic alkalosis.
Question 6 of 9
On their first visit to a critically ill patient, family members stand in the doorway of the room, making no effort to approach the patient. What is the most appropriate nursing action?
Correct Answer: A
Rationale: The correct answer is A because instructing the family on where the patient can be touched and what to say helps empower them to interact appropriately with the patient. This action promotes the family's involvement in the patient's care, encourages communication, and fosters a supportive environment. Choice B is incorrect as engaging in social conversation may not address the family's hesitance to approach the patient directly. Choice C is incorrect because waiting for visiting hours to provide information may delay necessary support for the family. Choice D is incorrect as leaving the family without guidance may perpetuate their discomfort and hinder their ability to provide emotional support to the patient.
Question 7 of 9
The primary health care provider writes an order to discon tinue a patient’s left radial arterial line. When discontinuing the patient’s invasive line, what is the priority nursing action?
Correct Answer: B
Rationale: The correct answer is B: Apply pressure to the insertion site for 5 minutes. This is the priority nursing action because it helps prevent bleeding and hematoma formation after removing the arterial line. Applying pressure for 5 minutes allows for adequate hemostasis. A: Applying an air occlusion dressing to the insertion site is not the priority action. It does not address the immediate need to control bleeding. C: Elevating the affected limb on pillows for 24 hours is not necessary and does not address the immediate need for hemostasis. D: Keeping the patient's wrist in a neutral position is not the priority action when discontinuing an arterial line. It does not address the need for hemostasis and preventing bleeding.
Question 8 of 9
An 81-year-old patient who has been in the intensive care unit (ICU) for a week is now stable, and transfer to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset confusion. The nurse will plan to:
Correct Answer: C
Rationale: The correct answer is C: Notify the health care provider and postpone the transfer. The new onset confusion in an elderly patient in the ICU can be a sign of delirium, which is a serious condition that requires prompt evaluation and management. By notifying the healthcare provider, they can assess the patient's condition, order appropriate tests, and adjust the treatment plan as needed. Postponing the transfer allows for further observation and intervention to address the underlying cause of the confusion. Choice A (Give PRN lorazepam and cancel the transfer) is incorrect because administering lorazepam may worsen the confusion in an elderly patient and should not be done without proper evaluation. Choice B (Inform the receiving nurse and then transfer the patient) is incorrect because transferring the patient without addressing the new onset confusion can lead to potential complications and delay in appropriate management. Choice D (Obtain an order for restraints as needed and transfer the patient) is incorrect because using restraints should only be considered as a
Question 9 of 9
Family members are in the patient’s room when the patient has a cardiac arrest and the staff starts resuscitation measures. Which action should the nurse take next?
Correct Answer: C
Rationale: The correct answer is C because it involves patient-centered care and respects the family's preferences. By asking the family members whether they would prefer to remain in the patient's room or wait outside, the nurse acknowledges their needs and allows them to make an informed decision based on their comfort level. This empowers the family members and promotes a supportive environment during a stressful situation. Choice A is incorrect because it assumes that keeping the family in the room without their input is the best approach, which may not be the case for all families. Choice B is incorrect because asking the family to wait outside without considering their preferences may not be the most supportive action. Choice D is incorrect because it makes a blanket statement about patient comfort without considering individual family dynamics and preferences.