Critical Care Nursing NCLEX Questions

Correct Answer: C

Rationale: The correct response is C: Your pain medication is already at the highest possible dose. This response acknowledges the patient's pain and reassures them that they are already receiving the maximum safe amount of pain medication. By stating this, the nurse is validating the patient's experience and showing empathy. It is important for the nurse to communicate clearly about the medication to manage the patient's expectations. Choice A is incorrect as it dismisses the patient's pain and can come across as insensitive. Choice B may be well-intentioned but does not address the immediate concern of the patient's pain. Choice D is irrelevant to the patient's statement about pain and does not offer any immediate support or reassurance regarding the pain management.

Correct Answer: C

Rationale: The correct answer is C: Collaboration with patients, families, and team members. By addressing the family's concern about lack of communication with the physician and arranging a meeting between the intensivist and the family, the nurse is demonstrating collaboration skills in facilitating communication and ensuring the family's questions are addressed. This competency emphasizes the importance of working together with patients, families, and the healthcare team to provide optimal care. Incorrect choices: A: Advocacy and moral agency in solving ethical issues - While advocacy is important in nursing, in this scenario, the focus is on communication and collaboration rather than ethical issues. B: Clinical judgment and clinical reasoning skills - Although these skills are crucial in critical care nursing, the situation described does not primarily involve clinical judgment but rather communication and collaboration. D: Facilitation of learning for patients, families, and team members - While patient education is important, the main focus of the scenario is on addressing the family's concerns and facilitating communication, rather than educational aspects.

Correct Answer: B

Rationale: The correct answer is B: Systemic vascular resistance (SVR). SVR reflects the resistance the heart must overcome to pump blood into the systemic circulation. By monitoring SVR, the nurse can assess the effectiveness of medications aimed at reducing left ventricular afterload, as these medications work by dilating blood vessels and reducing resistance. An effective reduction in afterload would lead to a decrease in SVR. A: Mean arterial pressure (MAP) is an indicator of perfusion pressure but may not directly reflect changes in afterload. C: Pulmonary vascular resistance (PVR) is specific to the pulmonary circulation and not directly related to left ventricular afterload. D: Pulmonary artery wedge pressure (PAWP) is a measure of left ventricular preload and filling pressures, not afterload.

Correct Answer: B

Rationale: The correct answer is B because assessing the hemofilter every 6 hours for clotting is essential in ensuring the effectiveness of CRRT. Clotting can obstruct blood flow, leading to treatment inefficiency and potential harm to the patient. This step helps the nurse to promptly address any clotting issues and prevent complications. A: Assessing that the blood tubing is warm to the touch is not a standard practice for monitoring CRRT and does not provide relevant information about the treatment's effectiveness. C: Covering the dialysis lines to protect them from light is not a priority in monitoring CRRT. Light exposure is not a common concern in this context. D: Using clean technique during vascular access dressing changes is important for infection prevention but is not directly related to monitoring the effectiveness of CRRT.

Correct Answer: A

Rationale: Step 1: Asking if these wishes have been discussed with the healthcare provider is important to ensure that the patient's wishes are documented and considered in the care plan. Step 2: The healthcare provider needs to be aware of the patient's preferences regarding resuscitation to provide appropriate care. Step 3: This step helps in clarifying the patient's preferences and ensures that the healthcare team follows the patient's wishes. Step 4: Placing a DNR notation without consulting the healthcare provider may not align with the patient's overall care plan and may lead to potential legal and ethical issues. Step 5: Informing the patient about notarized advance directives and designating a person for healthcare decisions are important but not the immediate step needed in this scenario. In summary, choice A is correct as it prioritizes communication with the healthcare provider to ensure the patient's wishes are properly documented and followed. Choices B, C, and D are incorrect because they do not involve confirming the patient's wishes