Questions 9

ATI RN

ATI RN Test Bank

Critical Care Nursing NCLEX Questions Questions

Question 1 of 5

When evaluating a patient with a central venous catheter, the nurse observes that the insertion site is red and tender to touch and the patient’s temperature is 101.8°F. What should the nurse plan to do next?

Correct Answer: B

Rationale: The correct answer is B: Discontinue the catheter and culture the tip. The patient's symptoms indicate a possible catheter-related infection. Discontinuing the catheter will prevent further infection spread. Culturing the tip will identify the specific pathogen causing the infection, guiding appropriate antibiotic therapy. Choice A is incorrect because giving analgesics alone will not address the underlying infection. Choice C is incorrect as changing the flush system is not a priority when infection is suspected. Choice D is incorrect as checking the site more frequently does not address the need for immediate action to address the infection.

Question 2 of 5

Which strategy is important to addressing issues associated with the aging workforce? (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A: Allowing nurses to work flexible shift durations. This strategy is important in addressing issues associated with the aging workforce because it acknowledges the changing needs and preferences of older nurses. By offering flexible shift durations, older nurses can better manage their work-life balance, reduce physical strain, and continue contributing to the workforce effectively. Choices B, C, and D are incorrect because they do not directly address the specific needs of the aging workforce. Encouraging older nurses to transfer to a less stressful outpatient setting may not align with their career goals. Hiring nurse technicians to assist with patient care may not address the unique experience and expertise of older nurses. Developing a staffing model, while important, does not specifically cater to the needs of aging nurses in terms of flexibility and support.

Question 3 of 5

A patient who is unconscious after a fall from a ladder is transported to the emergency department by emergency medical personnel. During the primary survey of the patient, the nurse should:

Correct Answer: B

Rationale: The correct answer is B: Obtain a Glasgow Coma Scale score. During the primary survey, assessing the patient's level of consciousness is crucial as it helps determine the severity of the injury and guides further management. The Glasgow Coma Scale is a standardized tool used to assess the level of consciousness based on eye opening, verbal response, and motor response. It provides valuable information about the patient's neurological status. A: Obtaining a complete set of vital signs is important but assessing the level of consciousness takes priority in this scenario. C: Asking about chronic medical conditions is important but not as critical as assessing the patient's level of consciousness during the primary survey. D: Attaching a cardiac electrocardiogram monitor is not necessary during the primary survey unless there are specific indications of cardiac issues, which are not evident in this case. In summary, obtaining a Glasgow Coma Scale score is essential for assessing the patient's level of consciousness and determining the severity of the injury during the primary survey.

Question 4 of 5

The patient has elevated blood urea nitrogen (BUN) and serum creatinine levels with a normal BUN/creatinine ratio. These levels most likely indicate

Correct Answer: B

Rationale: The elevated BUN and creatinine levels with a normal BUN/creatinine ratio indicate impaired kidney function. This pattern is commonly seen in acute kidney injury, such as acute tubular necrosis (ATN). In ATN, there is damage to the renal tubules leading to decreased excretion of waste products, resulting in elevated BUN and creatinine levels. The normal BUN/creatinine ratio suggests that the impairment is due to renal tubular dysfunction rather than prerenal causes like hypovolemia or postrenal causes like urinary obstruction. Increased nitrogen intake would not produce this specific pattern of results. Fluid resuscitation would likely result in dilution of BUN and creatinine levels, leading to lower values.

Question 5 of 5

Upon entering the room of a patient with a right radial arte rial line, the nurse assesses the waveform to be slightly dampened and notices blood to bea bbirabc.ckoemd/te ustp into the pressure tubing. What is the best action by the nurse?

Correct Answer: B

Rationale: The correct answer is B: Disconnect the flush system from the arterial line catheter. This action is necessary to prevent air from entering the patient's bloodstream, which can lead to air embolism. By disconnecting the flush system, the nurse stops the flow of air and ensures patient safety. Checking the inflation volume of the pressurized bag (A) is not the immediate concern in this situation. Zero referencing the transducer system (C) is unrelated to the issue of air entering the arterial line. Reducing the number of stopcocks in the flush system tubing (D) does not address the immediate risk of air embolism.

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