ATI RN
Critical Care Nursing Practice Questions Questions
Question 1 of 9
The wife of a patient who is hospitalized in the critical car e unit following resuscitation for a sudden cardiac arrest at work demands to meet with the nu rsing manager. She states, “I want you to reassign my husband to another nurse. His current n urse is not in the room enough to make sure he is okay.” The nurse recognizes that this respo nse most likely is due to what unspoken need?
Correct Answer: D
Rationale: The correct answer is D: Sense of loss of control of the situation. The wife's demand to reassign the nurse indicates her need for control over her husband's care, as she may feel overwhelmed by the sudden cardiac arrest and hospitalization. By requesting a different nurse, she seeks to regain a sense of control and assurance. The other choices are incorrect because: A does not align with the wife's immediate concern, B does not explain her request for a nurse reassignment, and C does not address her emotional response to the situation.
Question 2 of 9
The nurse is caring for a patient with an arterial monitoring system. The nurse assesses the patient’s noninvasive cuff blood pressure to be 70/40 mm Hg. The arterial blood pressure measurement via an intraarterial catheter in the same arm is assessed by the nurse to be 108/70 mm Hg. What is the best action by the nurse?
Correct Answer: C
Rationale: Rationale for Correct Answer (C - Assess the cuff for proper arm size): 1. The cuff blood pressure (70/40 mm Hg) is significantly lower than the arterial blood pressure (108/70 mm Hg). 2. Discrepancy suggests cuff size mismatch, leading to inaccurate readings. 3. Assessing cuff size ensures accurate blood pressure measurement. 4. Ensures appropriate interventions based on accurate readings. Summary of Incorrect Choices: A: Rapid response not warranted based solely on blood pressure discrepancy. B: Trendelenburg position not indicated for cuff size issue. D: Normal saline bolus not appropriate without accurate blood pressure measurement.
Question 3 of 9
Daily weights are being recorded for the patient with a urine output that has been less than the intravenous and oral intake. The weight yesterday was 97.5 kg. This morning it is 99 kg. The nurse understands that this corresponds to a(n)
Correct Answer: A
Rationale: The correct answer is A: fluid retention of 1.5 liters. The weight gain from 97.5 kg to 99 kg indicates an increase in fluid retention. This difference of 1.5 kg corresponds to fluid retention of 1.5 liters, as 1 liter of water weighs approximately 1 kg. This weight gain suggests that the patient is retaining more fluid than they are excreting, leading to an increase in weight. Incorrect choices: B: fluid loss of 1.5 liters - This is incorrect because the weight increased, indicating fluid retention. C: equal intake and output due to insensible losses - This is incorrect as weight increased, showing an imbalance in intake and output. D: fluid loss of 0.5 liters - This is incorrect as the weight increased, indicating fluid retention, not loss.
Question 4 of 9
When it is noted that a patient’s endotracheal tube is not se cured tightened, he respiratory care practitioner assists the nurse in taping the tube. After the tu be is retaped, the nurse auscultates the patient’s lungs and notes that the breath sounds over the left lung fields are absent. The nurse suspects is the cause of this finding?
Correct Answer: A
Rationale: The correct answer is A: The endotracheal tube is in the right mainstem bronchus. When the endotracheal tube is not secured properly and is retaped, there is a possibility that it may have migrated into the right mainstem bronchus, leading to absent breath sounds in the left lung fields. This condition is known as endobronchial intubation. In such cases, ventilation primarily occurs in the right lung, resulting in decreased or absent breath sounds on the contralateral side. Choices B, C, and D are incorrect as they do not explain the absence of breath sounds over the left lung fields in this specific scenario.
Question 5 of 9
The patient is getting hemodialysis for the second time when he complains of a headache and nausea and, a little later, of becoming confused. The nurse realizes these are symptoms of
Correct Answer: C
Rationale: The correct answer is C: dialysis disequilibrium syndrome. This occurs when there is a rapid decrease in urea concentration in the blood during hemodialysis, causing fluid shifts and cerebral edema leading to symptoms like headache, nausea, and confusion. Dialyzer membrane incompatibility (A) would present with allergic reactions, not neurological symptoms. A shift in potassium levels (B) may cause muscle weakness or cardiac arrhythmias, but not the described symptoms. Hypothermia (D) would present with low body temperature and shivering, not the neurological symptoms mentioned.
Question 6 of 9
Noise in the critical care unit can have negative effects on the patient. Which of the following interventions assists in reducing noise levels in the criticala cbiarbr.ec osme/ttetisnt g? (Select all that apply.)
Correct Answer: A
Rationale: Step 1: Bringing in the patient's i-Pod with favorite music can provide personalized, soothing sounds, reducing stress and anxiety for the patient. Step 2: Familiar music can create a calming environment, distracting the patient from external noise. Step 3: Listening to music may improve patient comfort and overall experience in the critical care unit. Summary: Option A is correct as it directly addresses noise reduction by providing a personalized, calming environment for the patient. Options B, C, and D do not specifically target noise reduction but focus on other aspects of care or facility improvement.
Question 7 of 9
The family is considering withdrawing life-sustaining measures from the patient. The nurse knows that ethical principles for withholding or withdrawi ng life-sustaining treatments include which of the following?
Correct Answer: A
Rationale: The correct answer is A because it aligns with the ethical principle of patient autonomy, which emphasizes the patient's right to make decisions about their own care. Withholding or withdrawing life-sustaining treatments, including nutrition, antibiotics, and blood products, respects the patient's autonomy. This choice also reflects the principle of beneficence, as it aims to prevent unnecessary suffering and respects the patient's wishes. Option B is incorrect because it focuses on pain and anxiety management rather than the broader ethical considerations of withholding life-sustaining treatments. Option C is incorrect because withdrawing life-sustaining treatments while a patient is receiving paralytic agents can pose additional risks and complications, potentially conflicting with the principles of nonmaleficence and beneficence. Option D is incorrect because the primary goal of withdrawing or withholding treatments is not to hasten death but to respect the patient's autonomy and quality of life. This choice does not align with the ethical principles of patient-centered care.
Question 8 of 9
Which action will the nurse need to do when preparing to assist with the insertion of a pulmonary artery catheter?
Correct Answer: D
Rationale: The correct answer is D: Attach cardiac monitoring leads before the procedure. This is essential to monitor the patient's cardiac rhythm and detect any abnormalities during catheter insertion. Cardiac monitoring leads provide real-time information on the patient's heart rate and rhythm, allowing the nurse to promptly address any complications. A: Determining if the cardiac troponin level is elevated is not directly related to assisting with pulmonary artery catheter insertion. B: Auscultating heart and breath sounds during insertion is important but does not take precedence over attaching cardiac monitoring leads. C: Placing the patient on NPO status before the procedure may be necessary for other procedures, but it is not specifically required for assisting with pulmonary artery catheter insertion.
Question 9 of 9
The family of a terminally ill patient is concerned about administering increasing doses of opioids for pain management. What is the nurse’s best response?
Correct Answer: B
Rationale: The correct answer is B because opioids are essential for effective pain management in terminally ill patients, improving their quality of life. Alternative methods may not provide sufficient pain relief. Choice A is incorrect as opioids do not necessarily hasten death when used appropriately for pain control. Choice C is incorrect because reducing opioid dose may lead to inadequate pain management. Choice D is incorrect as consulting a pain specialist to reduce medication may not be appropriate for terminally ill patients needing effective pain relief.