ATI RN
Critical Care Nursing Questions Questions
Question 1 of 9
While neuromuscular blocking agents are used in the management of some ventilated patients what is their primary mode of action?
Correct Answer: C
Rationale: The correct answer is C: Paralysis. Neuromuscular blocking agents work by blocking the transmission of nerve impulses at the neuromuscular junction, leading to muscle paralysis. This is essential in ventilated patients to facilitate mechanical ventilation and prevent patient-ventilator dyssynchrony. Rationale: A: Analgesia - Neuromuscular blocking agents do not provide pain relief. They do not have any direct analgesic properties. B: Anticonvulsant - Neuromuscular blocking agents do not prevent or treat seizures. They do not have anticonvulsant effects. D: Sedation - While sedatives may be used in conjunction with neuromuscular blocking agents, the primary mode of action of these agents is muscle paralysis, not sedation.
Question 2 of 9
A 100-kg patient gets hemodialysis 3 days a week. In planning the care for this patient, the nurse recommends
Correct Answer: A
Rationale: The correct answer is A: a diet of 2500 to 3500 kcal per day. During hemodialysis, the patient loses nutrients and energy, so a high-calorie diet is necessary to maintain proper nutrition and energy levels. 2500-3500 kcal/day is a suitable range for a 100-kg patient. Choice B is incorrect because protein intake should be adequate to prevent malnutrition in hemodialysis patients, typically 1.2g/kg body weight/day. Choice C is incorrect as potassium intake should be restricted in hemodialysis patients due to impaired kidney function. Choice D is incorrect because fluid intake should be individualized based on the patient's fluid status and should not be limited to less than 500 mL per day.
Question 3 of 9
The patient has just returned from having an arteriovenous fistula placed. The patient asks, “When will they be able to use this and take this other catheter out?” The nurse should reply,
Correct Answer: C
Rationale: The correct answer is C: “The fistula will be usable in about 4 to 6 weeks.” The rationale for this is that an arteriovenous fistula typically requires 4 to 6 weeks to mature and be ready for use. During this time, the fistula develops the necessary blood flow for efficient dialysis. Choice A is incorrect because immediate use of the fistula is not recommended as it needs time to mature. Choice B is incorrect as it underestimates the time needed for the fistula to heal and mature. Choice D is incorrect as the usability of the fistula is not dependent on the manufacturer but rather on the patient's individual healing process.
Question 4 of 9
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 5 of 9
The nurse caring for a critically ill patient implements several components of care. What component is an example of the use of evidence-based practice?
Correct Answer: B
Rationale: The correct answer is B because applying an insulin sliding scale method based on research is an example of evidence-based practice. This method is derived from scientific evidence and research studies, ensuring the best outcomes for the patient. The other choices lack the same level of evidence-based rationale: A is based on a protocol, which may not be evidence-based; C is a standard safety practice, not necessarily evidence-based; D is a decision based on hospital policy or practicality, not specifically evidence-based.
Question 6 of 9
Which intervention is appropriate to assist the patient to co pe with admission to the critical care unit?
Correct Answer: B
Rationale: The correct answer is B: Explaining all procedures in easy-to-understand terms. This intervention is appropriate as it helps reduce the patient's anxiety by providing clear information about what to expect during their stay in the critical care unit. This promotes a sense of control and understanding, which can positively impact the patient's coping mechanisms. A: Allowing unrestricted visiting by several family members at one time may overwhelm the patient and interfere with their rest and recovery. C: Providing back massage and mouth care may be beneficial but may not directly address the patient's need for information and understanding. D: Turning down the alarm volume on the cardiac monitor may provide a more comfortable environment but does not address the patient's emotional and psychological needs related to coping with admission to the critical care unit.
Question 7 of 9
Slow continuous ultrafiltration is also known as isolated ultrafiltration and is used to
Correct Answer: A
Rationale: The correct answer is A because slow continuous ultrafiltration removes excess plasma water in cases of volume overload by applying a pressure gradient across a semipermeable membrane. This process helps to achieve fluid balance without removing solutes. Choice B is incorrect because convection is not the primary mechanism of slow continuous ultrafiltration. Choice C is incorrect as dialysate is not added in slow continuous ultrafiltration. Choice D is incorrect as slow continuous ultrafiltration does not combine all three processes of ultrafiltration, convection, and dialysis.
Question 8 of 9
A client has been admitted after experiencing multiple trauma and is intubated and sedated. When the five members of the immediate family arrive, they are anxious, angry, and very demanding. They all speak loudly at once and ask for many services and answers. What is the best nursing response?
Correct Answer: B
Rationale: The correct answer is B: Take them to a private area for initial explanations. This response is the best because it allows the nurse to address the family's concerns in a private and controlled environment. It promotes effective communication and enables the family to express their emotions and receive information without distractions. Choice A is incorrect because asking the family to leave may escalate the situation and not address their needs. Choice C is inappropriate as paging security to remove the family can worsen the family's distress and hinder communication. Choice D is not ideal as leaving the family alone may lead to misunderstandings and increased anxiety. Overall, choice B is the most therapeutic and effective approach in this situation.
Question 9 of 9
Which therapeutic interventions may be withdrawn or withabhirebl.dco mfr/otemst the terminally ill client? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B: Dialysis. In the context of terminally ill clients, withdrawing dialysis is appropriate as it can be burdensome without providing significant benefit towards the end of life. Dialysis does not cure terminal conditions and can prolong suffering unnecessarily. Antibiotics (A) may be necessary for managing infections in terminally ill clients. Nutrition (C) is important for comfort and quality of life. Pain medications (D) are essential for managing pain and should not be withdrawn unless no longer beneficial or requested by the patient.