Critical Care Nursing Cardiac Questions

Correct Answer: D

Rationale: The correct answer is D because CRRT removes solutes and water slowly, which is beneficial for hemodynamically unstable patients. This slow removal allows for gradual fluid and electrolyte balance adjustments, reducing the risk of hemodynamic instability. A: Incorrect - A hemofilter is indeed used in CRRT, but this choice does not highlight the key difference between CRRT and intermittent hemodialysis. B: Incorrect - CRRT actually provides slower solute and water removal compared to intermittent hemodialysis. C: Incorrect - Diffusion does occur in CRRT, as it is a key mechanism for solute removal in the process. In summary, the key difference between CRRT and intermittent hemodialysis is the slow removal of solutes and water in CRRT, making choice D the correct answer.

Correct Answer: D

Rationale: The correct answer is D because the client's medical chart is the property of the hospital, but the client has the right to a copy of the information. By offering to make a copy of the chart for the client, the nurse respects the client's autonomy while also ensuring that the hospital maintains the original medical record. This response balances the client's rights with legal and ethical considerations. Choice A is incorrect because the hospital is legally obligated to maintain the client's medical record even if the client leaves against medical advice. Choice B is incorrect as it denies the client access to their medical information, which goes against the principle of patient autonomy. Choice C is also incorrect as it does not address the client's request for a copy of their chart.

Correct Answer: B

Rationale: The correct answer is B: Administration of morphine, 5 mg IV bolus, and initiation of a continuous morphine infusion. Morphine is the preferred pharmacological management for severe dyspnea in end-stage heart failure due to its potent analgesic and anxiolytic properties. Step-by-step rationale: 1. Morphine is a potent opioid that helps relieve dyspnea by reducing anxiety, decreasing respiratory drive, and improving overall comfort. 2. The initial IV bolus of 5 mg provides rapid relief of dyspnea. 3. Initiating a continuous morphine infusion ensures sustained relief of dyspnea. 4. Midazolam (choice A) is a benzodiazepine used for sedation and anxiety, but it is not the first-line treatment for dyspnea in this scenario. 5. Increasing the midazolam (choice C) or morphine (choice D) infusions by 100% dose increments hourly is not appropriate as

Correct Answer: D

Rationale: The correct answer is D: No sedation or analgesia. Neuromuscular blocking agents do not provide sedation or pain relief; they solely act on skeletal muscles to induce paralysis for procedures like intubation. Choice A is incorrect because NMB agents do not affect anxiety levels. Choice B is incorrect because NMB agents do not provide analgesia. Choice C is incorrect because NMB agents do not induce sedation. The primary purpose of NMB agents is to induce muscle paralysis without affecting consciousness or pain perception.

Correct Answer: B

Rationale: The correct answer is B: To strengthen the relationship between the family and health care provider. Rationale: 1. Open visiting hours encourage family involvement in care, fostering a partnership between healthcare providers and families. 2. Family support can positively impact patient outcomes and satisfaction. 3. It allows families to be updated on the patient's condition and involved in decision-making. 4. Strengthening the relationship can lead to better communication and trust between all parties. Summary of Incorrect Choices: A: Open visiting hours may disrupt rest and quiet, but the primary purpose is not to provide rest. C: Open visiting hours do not aim to control the number of visitors but rather encourage family involvement. D: While open visiting hours may not provide an entirely undisturbed environment, the focus is on improving family-provider relationships.