The term used to describe an increase in blood urea nitrogen (BUN) and serum creatinine is

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Critical Care Nursing Exam Questions Questions

Question 1 of 9

The term used to describe an increase in blood urea nitrogen (BUN) and serum creatinine is

Correct Answer: B

Rationale: The correct answer is B: azotemia. Azotemia refers to an increase in BUN and serum creatinine levels, indicating impaired kidney function. Oliguria (A) is a decrease in urine output, not specific to BUN and creatinine levels. Acute kidney injury (C) is a broader term encompassing various causes of kidney dysfunction, not specific to elevated BUN and creatinine. Prerenal disease (D) refers to conditions affecting blood flow to the kidneys, not directly related to elevated BUN and creatinine levels.

Question 2 of 9

The nurse caring for a patient with an endotracheal tube un derstands that endotracheal suctioning is needed to facilitate removal of secretions. What additional information is the nurse aware of concerning this intervention?

Correct Answer: C

Rationale: Rationale for Correct Answer C: Endotracheal suctioning should be done as indicated by patient assessment because not all patients require routine suctioning. Performing unnecessary suctioning can lead to potential complications such as mucosal damage and increased risk of infection. Therefore, the nurse must assess the patient's respiratory status, auscultate lung sounds, monitor oxygen saturation levels, and observe for signs of increased secretions before deciding to perform suctioning. Summary of Incorrect Choices: A: Endotracheal suctioning does not directly impact intracranial pressure. It is primarily focused on maintaining airway patency and removing respiratory secretions. B: While endotracheal suctioning may temporarily suppress the cough reflex during the procedure, its primary purpose is to clear airway secretions to prevent complications such as atelectasis and respiratory distress. D: Saline instillation before suctioning is not recommended as it can lead to negative outcomes such as dehydration, mucosal damage, and increased risk of infection

Question 3 of 9

The constant noise of a ventilator, monitor alarms, and inf usion pumps predisposes the patient to what form of stress?

Correct Answer: D

Rationale: The correct answer is D: Sensory overload. Constant noise from medical equipment can overwhelm the patient's senses, leading to sensory overload. This can result in increased stress levels, difficulty concentrating, and overall discomfort. Anxiety (A) is related to worry and fear, but in this context, the primary stressor is sensory overload, not anxiety. Pain (B) is a physical sensation, not directly related to the sensory overload caused by noise. Powerlessness (C) refers to a lack of control or influence, which is not the primary form of stress induced by constant noise. Therefore, the correct choice is D as it directly correlates with the impact of the noise on the patient's sensory perception.

Question 4 of 9

The nurse is preparing to obtain a right atrial pressure (RA P/CVP) reading. What are the most appropriate nursing actions? (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A because comparing measured pressures with other physiological parameters ensures accuracy and consistency. This step helps in interpreting the RA P/CVP reading correctly. Choice B is incorrect as flushing the catheter with saline is not necessary for obtaining the pressure reading. Choice C is incorrect as inflating the balloon with air is not part of the correct procedure. Choice D is incorrect because obtaining the measurement during exhalation can affect the accuracy of the reading.

Question 5 of 9

The patient’s potassium level is 7.0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?

Correct Answer: C

Rationale: Correct Answer: C - Regular insulin Rationale: 1. Insulin promotes cellular uptake of potassium. 2. When insulin is administered, it moves potassium from extracellular to intracellular space. 3. This decreases plasma potassium levels safely. 4. Other options do not directly lower potassium levels in the same manner. Summary of Other Choices: A: Sodium polystyrene sulfonate - exchanges sodium for potassium in the intestines, not reducing total body potassium. B: Sodium polystyrene sulfonate with sorbitol - similar to A, does not reduce total body potassium. D: Calcium gluconate - does not directly lower potassium levels, used for treating hyperkalemia-induced cardiac toxicity.

Question 6 of 9

An Ethiopian man with AIDS has recently been admitted to the ICU with a case of pneumonia. The man is new to the U.S. and has no health insurance. He would likely be eligible for the states Medicaid coverage, but does not understand how to access this coverage. Which competency or competencies are most needed in this situation? Select all that apply.

Correct Answer: B

Rationale: The correct answer is B: Advocacy and moral agency. In this scenario, the Ethiopian man with AIDS is in a vulnerable position due to lack of health insurance and understanding of Medicaid coverage. Advocacy skills are crucial to help him navigate the complex healthcare system and access the necessary resources. Moral agency involves advocating for the patient's rights and well-being, ensuring that he receives appropriate care despite his socioeconomic status. Clinical judgment, collaboration, and systems thinking are important competencies but not as directly relevant in this specific situation of advocating for the patient's access to Medicaid coverage.

Question 7 of 9

Anxiety differs from pain in that way? (Select all that app ly.)

Correct Answer: B

Rationale: The correct answer is B because anxiety is indeed linked to reward and punishment centers in the limbic system, specifically involving the amygdala and prefrontal cortex. This connection influences emotional responses and behaviors related to anxiety. Choices A, C, and D are incorrect because anxiety involves both neurological and psychological processes beyond the brain, is highly subjective like pain, and can lead to physical symptoms without actual tissue injury.

Question 8 of 9

A patient is experiencing severe pain, despite receiving pain medication for the past 24 hours. The patients wife expresses concern about this to the nurse. Which response by the nurse would be most empowering to the patients family?

Correct Answer: C

Rationale: The correct answer is C because it empowers the family to take action by requesting a physician evaluation of the patient's pain control. This step is crucial in ensuring that the patient's pain is adequately managed. By involving the physician, the family can advocate for the patient's needs and potentially explore alternative pain management strategies. Choice A is incorrect because it dismisses the family's concerns and fails to address the need for further evaluation. Choice B may provide temporary relief but does not address the underlying issue of inadequate pain control. Choice D is incorrect as it suggests delaying action, which could lead to prolonged suffering for the patient.

Question 9 of 9

The client has been in the CCU for several weeks and has been very unstable. One family member stays at the bedside constantly and even naps in a bedside chair. The nurse understands that the family member is exhibiting which family member response to critical illness?

Correct Answer: C

Rationale: The correct answer is C: Trying to maintain a level of control over the situation. The family member staying at the bedside constantly and even napping there is likely trying to cope with the stressful situation by maintaining a sense of control and connection to the patient. This behavior can be a way for the family member to feel more involved and helpful during a time of uncertainty and powerlessness. Choices A and B involve negative assumptions about the family member's intentions without evidence. Choice D may be a result of the family member's actions but does not address the underlying motivation for their behavior.

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