ATI RN
Critical Care Nursing Exam Questions Questions
Question 1 of 5
What is an early signs of the effect of hypoxemia on the nervous system?
Correct Answer: B
Rationale: The correct answer is B: Restlessness. When the body experiences hypoxemia (low oxygen levels), the brain is deprived of oxygen, leading to early signs such as restlessness. This is due to the brain's attempt to increase oxygen intake by increasing activity. Cyanosis (A) is a late sign of hypoxemia when oxygen levels are critically low. Tachycardia (C) and tachypnea (D) are compensatory mechanisms in response to hypoxemia, but they are not early signs affecting the nervous system directly.
Question 2 of 5
The nurse is caring for a patient who is mechanically ventilated. The nurse understands that what statement should be considered when determining apapbrirob.pcormia/ttees tn ursing interventions?
Correct Answer: A
Rationale: The correct answer is A because communication with intubated patients is often challenging due to the presence of an artificial airway, which hinders speech. This understanding is crucial when determining appropriate nursing interventions to ensure effective patient care. Choice B is incorrect because different patients may require different modes of ventilation based on their specific condition, and controlled ventilation may not always be the preferred mode for all patients. Choice C is incorrect as patients with chronic obstructive pulmonary disease often have difficulty weaning from mechanical ventilation due to their underlying respiratory condition. Choice D is incorrect as wrist restraints are not applied to all patients on mechanical ventilation unless absolutely necessary for safety concerns, such as preventing self-extubation.
Question 3 of 5
The nurse is caring for a patient whose ventilator settings i nclude 15 cm H O of positive end-expiratory pressure (PEEP). The nurse understands that although beneficial, PEEP may result in what possible problem?
Correct Answer: D
Rationale: Rationale for Correct Answer (D - Low cardiac output secondary to increased intrathoracic pressure): 1. PEEP increases intrathoracic pressure, which can impede venous return to the heart. 2. Impaired venous return reduces preload, leading to decreased cardiac output. 3. Decreased cardiac output can result in inadequate tissue perfusion and oxygenation. 4. Therefore, PEEP may cause low cardiac output due to increased intrathoracic pressure. Summary of Incorrect Choices: A. Fluid overload is not directly related to PEEP but more to fluid administration or kidney function. B. High cardiac index is unlikely as PEEP can decrease cardiac output. C. Hypoxemia is not a direct result of PEEP but may occur due to other factors like inadequate ventilation or oxygenation settings.
Question 4 of 5
The nurse is assisting with endotracheal intubation and un derstands correct placement of the endotracheal tube in the trachea would be identified by which of the following? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B: Equal bilateral breath sounds upon auscultation. This indicates proper placement of the endotracheal tube in the trachea, ensuring both lungs are being ventilated equally. Rationale: 1. Auscultation of air over the epigastrium (Choice A) is incorrect as it indicates esophageal intubation, not tracheal intubation. 2. Position above the carina verified by chest x-ray (Choice C) is incorrect as it does not confirm proper placement at the trachea. 3. Positive detection of carbon dioxide (CO2) (Choice D) is incorrect as it indicates the presence of exhaled CO2, but not necessarily proper placement in the trachea.
Question 5 of 5
Intrapulmonary shunting refers to what outcome?
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct: 1. Intrapulmonary shunting refers to blood bypassing the normal oxygenation process in the lungs. 2. Choice C describes blood being shunted from the right side of the heart (deoxygenated blood) to the left side without oxygenation, leading to systemic circulation without oxygenation. 3. Choices A, B, and D do not accurately describe intrapulmonary shunting as they focus on other concepts like alveolar perfusion, heart failure, and unilateral lung blood supply, respectively.