ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 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 2 of 9
Which of the following are physiological effects of positive end-expiratory pressure (PEEP) used in the treatment of acute respiratory distress syndrom e (ARDS)? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Increase functional residual capacity. Positive end-expiratory pressure (PEEP) helps increase the functional residual capacity by keeping the alveoli open at the end of expiration. This prevents alveolar collapse, improves ventilation-perfusion matching, and enhances oxygenation. B: Prevent collapse of unstable alveoli - This is incorrect because PEEP actually helps prevent the collapse of all alveoli, not just unstable ones. C: Improve arterial oxygenation - This is partially correct, but the primary mechanism through which PEEP improves oxygenation is by increasing functional residual capacity. D: Open collapsed alveoli - This is incorrect because PEEP helps prevent alveolar collapse rather than actively opening already collapsed alveoli.
Question 3 of 9
Which interventions may be included during “terminal we aning”? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B because during terminal weaning, the artificial ventilation is discontinued while maintaining the artificial airway to ensure comfort and support. This allows the patient to breathe on their own with support as needed. Explanation: 1. Option A: Complete extubation following ventilator withdrawal may not be suitable during terminal weaning as it involves removing the breathing tube entirely. 2. Option C: Discontinuation of anxiolytic and pain medications may not always be appropriate during terminal weaning as it depends on the patient's comfort needs. 3. Option D: Titration of ventilator support based on blood gas determinations is not typically done during terminal weaning as the focus is on gradual withdrawal of ventilation support while maintaining comfort.
Question 4 of 9
A statement that provides a legally recognized descriptiona obifrb a.cno min/tedsitv idual’s desires regarding care at the end of life is referred to as what?
Correct Answer: A
Rationale: The correct answer is A: Advance directive. An advance directive is a legal document that outlines a person's wishes regarding medical treatment and care at the end of life. It allows individuals to specify their preferences for medical interventions if they become unable to communicate. Summary of other choices: B: Guardianship ad item - This does not specifically pertain to an individual's end-of-life care wishes. C: Healthcare proxy - While similar to an advance directive, a healthcare proxy specifically designates a person to make medical decisions on behalf of the individual, rather than specifying their own wishes. D: Power of attorney - This grants someone the authority to make legal decisions on behalf of the individual, but it does not specifically address end-of-life care preferences.
Question 5 of 9
Which nursing strategies help the patient to feel safe in the critical care setting? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A because allowing family members to remain at the bedside can provide emotional support and comfort to the patient, helping them feel safe in the critical care setting. Family presence can also facilitate communication and understanding between the healthcare team and the patient. Choice B is incorrect because consulting with the charge nurse before making patient care decisions may not directly contribute to the patient feeling safe. Choice C is incorrect because providing informal conversation about work-related topics may not address the patient's need for safety and security in the critical care setting. Choice D is incorrect because explaining how to communicate for assistance is important for patient care but may not directly contribute to the patient's sense of safety in the critical care setting.
Question 6 of 9
A patient with respiratory failure has arterial pressure-based cardiac output (APCO) monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 12 cm H2O. Which information indicates that a change in the ventilator settings may be required?
Correct Answer: A
Rationale: The correct answer is A. A decrease in the arterial pressure (hypotension) with a low diastolic pressure (46 mmHg) may indicate inadequate perfusion, possibly due to inadequate cardiac output from the mechanical ventilation. This suggests that a change in ventilator settings may be required to improve oxygenation and perfusion. Option B is incorrect because a heart rate of 58 beats/minute alone does not provide direct information on the patient's hemodynamic status. Option C is incorrect as an increased stroke volume would usually be a positive indicator; it does not necessarily indicate a need for changing the ventilator settings. Option D is incorrect as a stroke volume variation of 12% is within normal limits and does not necessarily require a change in ventilator settings.
Question 7 of 9
A critically ill patient is not expected to survive this admission. The family asks the nurse how the patient is doing. When answering this question, what should the nurse include?
Correct Answer: C
Rationale: The correct answer is C because providing specific information such as descending trends in parameters helps the family understand the patient's condition objectively. This allows them to prepare emotionally and make informed decisions. Option A is incorrect because false hope should not be given. Option B is not the best approach as the nurse should still provide some information to the family. Option D is inappropriate and insensitive as it focuses on funeral arrangements rather than addressing the family's concerns about the patient's condition.
Question 8 of 9
assessment, the patient is restless, heart rate has increased to 110 beats/min, respirat ions are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sin us tachycardia 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, who orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. In comambirubn.ciocma/tteinstg with the physician, which statement indicates the nurse understands what is likely occurring with the patient?
Correct Answer: B
Rationale: The correct answer is B: “My assessment indicates potential fluid overload.” The patient is showing signs of fluid overload, such as increased heart rate, respiratory rate, elevated blood pressure, pulmonary artery pressures, frothy secretions, and crackles in lung fields. These symptoms suggest fluid is accumulating in the lungs, causing pulmonary congestion. This can lead to impaired gas exchange and respiratory distress. The nurse's recognition of these signs is crucial for prompt intervention to prevent further complications. Other choices are incorrect because there are no indications of a myocardial infarction, PVCs compromising cardiac output, or a hypertensive crisis based on the given information.
Question 9 of 9
Comparing the patient’s current (home) medications with those ordered during hospitalization and communicating a complete list of medications to the next care provider when the patient is transferred within an organization or to another setting a re strategies toward best achieving what patient related goal?
Correct Answer: C
Rationale: Step 1: Reconciling medications is essential for patient safety as it involves comparing current and ordered medications to ensure accuracy. Step 2: This process helps prevent medication errors, adverse drug reactions, and duplications across different care settings. Step 3: Communicating a complete list of medications to the next care provider ensures continuity of care and reduces the risk of medication discrepancies. Step 4: By reconciling medications across the continuum of care, healthcare providers can better coordinate patient care and optimize treatment outcomes. In summary, choice C is correct as it focuses on medication reconciliation to improve patient safety and care coordination. Choices A, B, and D are incorrect as they do not directly address the comprehensive process of reconciling medications across care settings.