ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 of 5
The nurse is caring for a patient with acute respiratory dist ress syndrome who is hypoxemic despite mechanical ventilation. The primary care provider (PCP) orders a nontraditional ventilator mode as part of treatment. Despite sedation and aabnirba.lcgoems/tieas,t the patient remains restless and appears to be in discomfort. The nurse informs the PCP of this assessment and anticipates what order?
Correct Answer: C
Rationale: The correct answer is C: Neuromuscular blockade. 1. Neuromuscular blockade helps to achieve optimal ventilator synchrony by reducing patient-ventilator asynchrony and improving oxygenation in patients with acute respiratory distress syndrome (ARDS). 2. Despite sedation, the patient's restlessness and discomfort suggest inadequate ventilator synchrony, which can be addressed by neuromuscular blockade. 3. Continuous lateral rotation therapy (A) and prone positioning (D) are interventions for improving ventilation and oxygenation in ARDS but do not directly address patient-ventilator synchrony. 4. Guided imagery (B) is a non-pharmacological technique for relaxation and pain management, which may not address the underlying issue of ventilator synchrony in this case.
Question 2 of 5
What is a strategy for preventing thromboembolism in pat ients at risk who cannot take anticoagulants?
Correct Answer: C
Rationale: The correct answer is C: Insertion of a vena cava filter. This is a strategy for preventing thromboembolism in patients at risk who cannot take anticoagulants. The vena cava filter prevents blood clots from traveling to the lungs by trapping them in the inferior vena cava. It is a mechanical device that does not interfere with the body's clotting process. Explanation of why other choices are incorrect: A: Administration of two aspirin tablets every 4 hours is not an effective strategy for preventing thromboembolism in high-risk patients. Aspirin is an antiplatelet agent and may not be sufficient for preventing blood clots in these patients. B: Infusion of thrombolytics is used for breaking down blood clots that have already formed, not for prevention. It is not a suitable option for preventing thromboembolism in at-risk patients. D: Subcutaneous heparin administration every 12
Question 3 of 5
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 4 of 5
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 5 of 5
Following insertion of a central venous catheter, the nurse obtains a stat chest x-ray film to verify proper catheter placement. The radiologist reports to the nurse: “The tip of the catheter is located in the superior vena cava.” What is the best inter pretation of these results by the nurse?
Correct Answer: C
Rationale: The correct answer is C: The distal tip of the catheter is in the appropriate position. Rationale: 1. The superior vena cava is a desirable location for a central venous catheter tip placement as it is close to the heart for rapid medication delivery. 2. Catheter tip in the superior vena cava allows for proper venous return and minimizes the risk of complications. 3. The nurse does not need to remove or adjust the catheter if the tip is in the superior vena cava. 4. Advancing the catheter into the pulmonary artery (option D) would be incorrect as it can lead to serious complications. Incorrect choices: A: Incorrect because placement in the superior vena cava is acceptable. B: Incorrect as placement in the superior vena cava does not increase the risk of ventricular dysrhythmias. D: Incorrect as advancing the catheter into the pulmonary artery is unnecessary and risky.