ATI RN
Critical Care Nursing Questions Questions
Question 1 of 5
Which treatment can be used to dissolve a thrombus that is lodged in the pulmonary artery?
Correct Answer: D
Rationale: The correct answer is D: Thrombolytics. Thrombolytics are medications that can dissolve blood clots, making them effective in treating a thrombus lodged in the pulmonary artery. They work by activating the body's natural clot-dissolving system. Aspirin (A) is an antiplatelet drug and may prevent further clot formation but cannot dissolve an existing thrombus. Embolectomy (B) is a surgical procedure to remove a clot and is invasive, usually reserved for cases where thrombolytics are contraindicated. Heparin (C) is an anticoagulant that prevents clot formation but does not dissolve existing clots like thrombolytics do.
Question 2 of 5
While caring for a patient with a small bowel obstruction, the nurse assesses a pulmonary artery occlusion pressure (PAOP) of 1 mm Hg and hourly urine output of 5 mL. The nurse anticipates which therapeutic intervention?
Correct Answer: B
Rationale: The correct answer is B: Intravenous fluids. In the scenario of a small bowel obstruction, a PAOP of 1 mm Hg indicates hypovolemia requiring fluid resuscitation to improve cardiac output and tissue perfusion. The low urine output suggests inadequate renal perfusion, further supporting the need for fluids. Diuretics (choice A) would worsen the hypovolemia. Negative inotropic agents (choice C) decrease cardiac contractility, which is not indicated in this scenario. Vasopressors (choice D) are used for hypotension, not for hypovolemia. Therefore, the most appropriate intervention is to administer intravenous fluids to address the hypovolemia and improve tissue perfusion.
Question 3 of 5
The nurse is caring for a patient following insertion of a left subclavian central venous catheter (CVC). Which assessment finding 2 hours after insertion by the nurse warrants immediate action?
Correct Answer: A
Rationale: The correct answer is A: Diminished breath sounds over the left lung field. This finding could indicate a pneumothorax, a serious complication of subclavian CVC insertion. Immediate action is required to prevent respiratory distress. Incorrect answers: B: Localized pain at insertion site is common post-procedure and may not indicate a serious issue. C: A central venous pressure of 5 mm Hg is within the normal range and does not require immediate action. D: Slight bloody drainage is expected initially and can be managed with routine care.
Question 4 of 5
Following insertion of a pulmonary artery catheter (PAC),a bthirbe. cpohmy/tessitc ian orders the nurse to obtain a blood sample for mixed venous oxygen saturation (SvO ). Which action by the nurse best ensures the obtained value is accurate?
Correct Answer: B
Rationale: The correct answer is B because calibrating the system with central venous and arterial blood samples ensures accuracy of the mixed venous oxygen saturation (SvO2) measurement. This calibration allows for comparison of the values obtained from both sources to confirm the accuracy of the measurement. Choice A is incorrect because zero referencing the transducer at the level of the phlebostatic axis does not directly address the accuracy of the SvO2 measurement. Choice C is incorrect because ensuring patency of the catheter using normal saline pressurized at 300 mm Hg does not directly impact the accuracy of the SvO2 measurement. Choice D is incorrect because using noncompliant pressure tubing does not ensure the accuracy of the SvO2 measurement. The length of the tubing and the presence of stopcocks are not directly related to obtaining an accurate SvO2 value.
Question 5 of 5
The nurse returns from the cardiac catheterization laboratory with a patient following insertion of a pulmonary artery catheter and assists in transferring th e patient from the stretcher to the bed. Prior to obtaining a cardiac output, which action is m ost important for the nurse to complete?
Correct Answer: B
Rationale: The correct answer is B: Zero reference the transducer system at the phlebostatic axis. This is the most important action before obtaining a cardiac output because zero referencing ensures accurate pressure readings. The phlebostatic axis is the level of the atria when the patient is supine, and zeroing at this point minimizes errors in pressure measurements. Choice A is incorrect because documenting a pulmonary artery catheter occlusion pressure is not the priority at this stage. Choice C is incorrect as inflating the balloon with air should be done after zero referencing. Choice D is incorrect as injecting normal saline into the port is not necessary before zero referencing.