Critical Care Nursing Cardiac Questions

Correct Answer: B

Rationale: The correct answer is B: Abdominal ultrasonography. This is because ultrasonography is a non-invasive imaging technique that can quickly evaluate for internal injuries such as organ damage or bleeding in patients with blunt abdominal trauma. It is a rapid and effective diagnostic tool to assess the extent of injury and guide further management. Peritoneal lavage (A) is an invasive procedure used in trauma settings to detect intra-abdominal bleeding but is not typically used for teaching purposes. Nasogastric tube placement (C) is used for decompression and drainage in certain conditions but is not relevant for assessing abdominal trauma. Magnetic resonance imaging (MRI) (D) is not typically used as the initial imaging modality for acute trauma due to time constraints and its limited availability in emergency settings.

Correct Answer: B

Rationale: The correct answer is B: Assess the patient�s lungs. Rhabdomyolysis can lead to acute kidney injury due to myoglobin release from damaged muscle cells. IV fluids and mannitol are given to prevent kidney damage by promoting myoglobin excretion. Assessing the patient�s lungs is crucial to monitor for potential complications such as acute respiratory distress syndrome (ARDS) which can occur as a result of rhabdomyolysis. This assessment helps to ensure early detection and prompt intervention if respiratory issues arise. Summary of Incorrect Choices: A: Assess the patient�s hearing - This is not directly related to rhabdomyolysis or its treatment. C: Decrease IV fluids once the diuretic has been administered - Decreasing IV fluids can exacerbate kidney injury in rhabdomyolysis. D: Give extra doses before giving radiological contrast agents - Mannitol is not routinely given before radiological contrast agents in the context of rhabdomyolysis management.

Correct Answer: D

Rationale: The correct answer is D: Synergy model of practice. The Synergy model emphasizes matching nurse competencies with patient needs for optimal outcomes. In this scenario, the charge nurse assigned the experienced, certified nurse to a complex patient requiring specialized care (sepsis, renal replacement therapy, ventilation), aligning with the model's principle of matching nurse expertise to patient acuity. Assigning the less experienced nurse to stable patients aligns with the model's focus on optimizing patient outcomes by matching nurse competencies appropriately. A: Crew resource management model focuses on teamwork and communication to enhance safety, not specifically on nurse-patient assignments. B: National Patient Safety Goals are broad guidelines for improving patient safety, not specific to nurse-patient assignments. C: Quality and Safety Education for Nurses (QSEN) model focuses on integrating quality and safety competencies into nursing education, not specifically on nurse-patient assignments.

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.

Correct Answer: A

Rationale: The correct answer is A. A decrease in the arterial pressure (hypotension) with a low diastolic pressure (46 mmHg) may indicate inadequate perfusion, possibly due to inadequate cardiac output from the mechanical ventilation. This suggests that a change in ventilator settings may be required to improve oxygenation and perfusion. Option B is incorrect because a heart rate of 58 beats/minute alone does not provide direct information on the patient's hemodynamic status. Option C is incorrect as an increased stroke volume would usually be a positive indicator; it does not necessarily indicate a need for changing the ventilator settings. Option D is incorrect as a stroke volume variation of 12% is within normal limits and does not necessarily require a change in ventilator settings.