Correct Answer: D

Rationale: The correct answer is D: To validate a nurse’s knowledge of critical care nursing. Certification in critical care nursing validates a nurse's expertise and knowledge in this specialized area of nursing. It demonstrates that the nurse has met certain standards and competencies in critical care practice. This certification ensures that the nurse is well-equipped to provide high-quality care to critically ill patients. A: To assure the consumer that critical nurses will not make a mistake - This choice is incorrect because certification does not guarantee that nurses will not make mistakes. It focuses on validating knowledge and skills rather than infallibility. B: To help prepare the critical care nurse for graduate school - This choice is incorrect as certification is more focused on practice readiness rather than academic preparation. C: To assist in promoting magnet status for a facility - This choice is incorrect as magnet status relates more to the overall excellence and quality of nursing care in a facility, not individual certification.

Correct Answer: C

Rationale: The correct answer is C: Mixed venous (SvO2) of 40%. In septic shock, improving oxygen delivery to tissues is vital. SvO2 reflects the balance between oxygen delivery and consumption. A value of 40% indicates adequate oxygen delivery to tissues. A: Arterial lactate level of 1.0 mEq/L - Although a low lactate level is good, it does not directly indicate improved oxygen delivery. B: Cardiac output of 2.5 L/min - Cardiac output should ideally increase to improve oxygen delivery, so 2.5 L/min is low for a 70-kg patient. D: Cardiac index of 1.5 L/min/m2 - Cardiac index is cardiac output adjusted for body surface area. 1.5 L/min/m2 is low and indicates inadequate cardiac function for a patient in septic shock.

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.

Correct Answer: A

Rationale: Step-by-step rationale for why Answer A is correct: 1. Patient-controlled analgesia (PCA) allows patients to self-administer pain medication within preset limits, promoting pain management. 2. PCA is considered safe and effective as it provides better pain control, reduces the risk of overdose, and allows for individualized dosing. 3. Healthcare providers can monitor and adjust the PCA settings as needed to ensure optimal pain relief. 4. Studies have shown that PCA is a preferred method for postoperative pain management due to its efficacy and safety profile. 5. Overall, PCA is a reliable and beneficial approach to analgesia administration in postoperative patients. Summary of why other choices are incorrect: B: While PCA may have fewer side effects compared to some routes, this is not a defining characteristic of PCA. C: While patients do have some control over their treatment with PCA, the primary focus is on pain management rather than giving control to critically ill patients. D: PCA can be used effectively without family

Correct Answer: D

Rationale: The correct answer is D: Respiratory alkalosis. Hyperventilation in severe asthma exacerbation leads to excessive removal of CO2, causing a decrease in carbonic acid levels, resulting in respiratory alkalosis. Metabolic acidosis (A) is not typically associated with hyperventilation. Metabolic alkalosis (B) is caused by excessive loss of acid or gain of bicarbonate, not by hyperventilation. Respiratory acidosis (C) is characterized by an increase in CO2 levels due to inadequate ventilation, which is the opposite of what occurs in severe asthma exacerbation.