Critical Care Nursing Practice Questions

Correct Answer: D

Rationale: The correct answer is D (Respiratory alkalosis). Morphine sulfate can cause respiratory depression, leading to decreased respiratory rate. In this case, the patient's breaths decrease from 12 to 4 breaths/min, indicating hypoventilation. With decreased ventilation, there is less CO2 elimination, resulting in respiratory alkalosis. The other choices can be ruled out: A (Metabolic acidosis) and B (Metabolic alkalosis) are less likely caused by morphine sulfate, and C (Respiratory acidosis) is incorrect because the scenario describes hypoventilation, not hyperventilation.

Correct Answer: C

Rationale: Rationale for Correct Answer (C - Assess the cuff for proper arm size): 1. The cuff blood pressure (70/40 mm Hg) is significantly lower than the arterial blood pressure (108/70 mm Hg). 2. Discrepancy suggests cuff size mismatch, leading to inaccurate readings. 3. Assessing cuff size ensures accurate blood pressure measurement. 4. Ensures appropriate interventions based on accurate readings. Summary of Incorrect Choices: A: Rapid response not warranted based solely on blood pressure discrepancy. B: Trendelenburg position not indicated for cuff size issue. D: Normal saline bolus not appropriate without accurate blood pressure measurement.

Correct Answer: A

Rationale: The correct answer is A: Burden versus benefit. In ethical decision-making, considering the burden of treatment on the patient versus the potential benefits is crucial. This involves weighing the risks, benefits, and potential harm of treatment options. Family's wishes (B) and patient's wishes (C) are important factors but may not always align with what is ethically best for the patient. Potential outcomes of treatment options (D) are relevant but do not directly address the ethical dilemma of balancing burden and benefit. Therefore, A is the correct choice as it directly relates to the ethical principles guiding decision-making in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Verbally coach the patient to breathe with the ventilator. This approach allows the nurse to address the patient's anxiety and help them synchronize their breathing with the ventilator, promoting better ventilation and oxygenation. It is important to first try non-invasive interventions before resorting to sedation or manual ventilation. Sedating the patient (B) should be a last resort to avoid potential complications. Manual ventilation (C) may disrupt the ventilator settings and cause respiratory distress. Increasing the rate of propofol infusion (D) is not indicated unless the patient's sedation level is inadequate.

Correct Answer: A

Rationale: The correct answer is A: The certified nurse will have more knowledge and expertise. Certification in critical care nursing indicates that the candidate has undergone specialized training and passed a standardized exam, demonstrating a higher level of knowledge and skill in critical care practices compared to a non-certified candidate. This certification ensures that the nurse has met specific competency standards in critical care, making them better equipped to handle complex situations in the ICU. Summary: - Choice B (ethical behavior) and Choice C (caring towards patients) are subjective qualities that can be present in both certified and non-certified nurses. - Choice D (collaboration with other nurses) is not directly related to certification but can be influenced by the individual's interpersonal skills. - Ultimately, the certification in critical care nursing provides concrete evidence of the candidate's advanced knowledge and expertise, making them the most compelling choice for the hospital to hire.