ATI RN
Critical Care Nursing Cardiac Questions Questions
Question 1 of 5
Which of the following are physiological effects of positive end-expiratory pressure (PEEP) used in the treatment of acute respiratory distress syndrom e (ARDS)? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Increase functional residual capacity. Positive end-expiratory pressure (PEEP) helps increase the functional residual capacity by keeping the alveoli open at the end of expiration. This prevents alveolar collapse, improves ventilation-perfusion matching, and enhances oxygenation. B: Prevent collapse of unstable alveoli - This is incorrect because PEEP actually helps prevent the collapse of all alveoli, not just unstable ones. C: Improve arterial oxygenation - This is partially correct, but the primary mechanism through which PEEP improves oxygenation is by increasing functional residual capacity. D: Open collapsed alveoli - This is incorrect because PEEP helps prevent alveolar collapse rather than actively opening already collapsed alveoli.
Question 2 of 5
Following insertion of a central venous catheter, the nurse obtains a stat chest x-ray film to verify proper catheter placement. The radiologist reports to the nurse: “The tip of the catheter is located in the superior vena cava.” What is the best inter pretation of these results by the nurse?
Correct Answer: C
Rationale: The correct answer is C: The distal tip of the catheter is in the appropriate position. Rationale: 1. The superior vena cava is a desirable location for a central venous catheter tip placement as it is close to the heart for rapid medication delivery. 2. Catheter tip in the superior vena cava allows for proper venous return and minimizes the risk of complications. 3. The nurse does not need to remove or adjust the catheter if the tip is in the superior vena cava. 4. Advancing the catheter into the pulmonary artery (option D) would be incorrect as it can lead to serious complications. Incorrect choices: A: Incorrect because placement in the superior vena cava is acceptable. B: Incorrect as placement in the superior vena cava does not increase the risk of ventricular dysrhythmias. D: Incorrect as advancing the catheter into the pulmonary artery is unnecessary and risky.
Question 3 of 5
The nurse is caring for a patient following insertion of a left subclavian central venous catheter (CVC). Which action by the nurse best reduces th e risk of catheter-related bloodstream infection (CRBSI)?
Correct Answer: A
Rationale: The correct answer is A: Review daily the necessity of the central venous catheter. This action reduces the risk of CRBSI by promoting early removal of unnecessary catheters, which is a key strategy in preventing infections. Unnecessary catheters increase the risk of infection due to prolonged exposure to the patient's skin flora and possible contamination during insertion. Reviewing daily ensures the catheter is only kept when necessary, minimizing the duration of catheter use and reducing the chances of infection. Summary of other choices: B: Cleansing the insertion site daily with isopropyl alcohol is important for maintaining skin integrity but does not directly reduce the risk of CRBSI. C: Changing the pressurized tubing system and flush bag daily is important for maintaining catheter patency but does not directly reduce the risk of CRBSI. D: Maintaining a pressure of 300 mm Hg on the flush bag is important for proper catheter function but does not directly reduce the risk of CR
Question 4 of 5
The nurse is caring for a patient with an admitting diagnosis of congestive failure. While attempting to obtain a pulmonary artery occlusion pressure in the supine position, the patient becomes anxious and tachypneic. What is the best action by the nurse?
Correct Answer: D
Rationale: The correct answer is D: Elevate the head of the bed 45 degrees while recording pressures. Rationale: 1. Elevating the head of the bed will help improve the patient's breathing by reducing the pressure on the diaphragm. 2. This position will also help alleviate the patient's anxiety and tachypnea, promoting better oxygenation. 3. Recording pressures in this position will provide accurate data for monitoring the patient's condition. Summary: A: Limiting the supine position to 10 seconds does not address the underlying issues causing the patient's anxiety and tachypnea. B: Administering anxiety medications without addressing the positioning issue may not effectively manage the patient's symptoms. C: Encouraging the patient to take slow deep breaths is helpful, but changing the position of the patient is more crucial in this situation.
Question 5 of 5
The nurse is preparing to measure the thermodilution cardaiabicrb o.cuomtp/tuest t (TdCO) in a patient being monitored with a pulmonary artery catheter. Which action by the nurse best ensures the safety of the patient?
Correct Answer: B
Rationale: The correct answer is B: Avoid infusing vasoactive agents in the port used to obtain the TdCO measurement. This action ensures patient safety by preventing the introduction of vasoactive agents directly into the bloodstream during the measurement process. Infusing vasoactive agents can lead to inaccurate TdCO readings and potentially harm the patient. Choice A is incorrect because zero referencing the transducer system at the level of the phlebostatic axis is important for accurate pressure monitoring but not directly related to TdCO measurement safety. Choice C is incorrect as maintaining a pressure of 300 mm Hg on the flush solution bag is not directly related to the safety of TdCO measurement. Choice D is incorrect as limiting the length of noncompliant pressure tubing is important for accurate pressure readings but not directly related to the safety of TdCO measurement.