Critical Care Nursing Exam Questions

Correct Answer: D

Rationale: The correct answer is D: A patient with paradoxical chest movements. This indicates flail chest, a life-threatening condition where a segment of the chest wall moves independently from the rest. 1. Flail chest can lead to respiratory compromise and potential respiratory failure. 2. Immediate intervention is needed to stabilize the chest wall and support breathing. 3. Without prompt treatment, the patient can develop hypoxia and potentially progress to cardiac arrest. Summary: - Choice A: No pedal pulses may indicate vascular compromise but does not pose an immediate threat to life. - Choice B: Open femur fracture requires urgent treatment but does not have the same immediate life-threatening implications as flail chest. - Choice C: Bleeding facial lacerations can be managed after addressing more critical injuries like flail chest.

Correct Answer: C

Rationale: Rationale: The correct answer is C because lack of knowledge about literature searches hinders the ability to find and utilize evidence-based practice guidelines. Nurses need to be skilled in conducting literature searches to access relevant research. Choices A, B, and D are incorrect as they do not directly impede the implementation of evidence-based practice in the critical care unit.

Correct Answer: B

Rationale: The correct answer is B. Increased peak inspiratory pressure on the ventilator would cue the nurse to the potential of ARDS in a patient with respiratory distress. ARDS is characterized by severe respiratory failure with bilateral pulmonary infiltrates. An increase in peak inspiratory pressure on the ventilator indicates that the lungs are becoming stiffer, which is a common finding in ARDS due to increased inflammation and fluid accumulation in the alveoli. This finding alerts the nurse to the possibility of ARDS and the need for further assessment and intervention. Summary of other choices: A: Increased oxygen saturation via pulse oximetry is a nonspecific finding and may not specifically indicate ARDS. C: Normal chest radiograph with enlarged cardiac structures is more indicative of heart failure rather than ARDS. D: PaO2/FiO2 ratio > 300 is a criterion used to diagnose ARDS, but a value higher than 300 actually indicates mild ARDS, so it would not necessarily cue the nurse

Correct Answer: B

Rationale: The correct answer is B: Cry along with the patient�s family members. This action demonstrates empathy and support for the family's grief, showing that the nurse acknowledges and shares their feelings. It can help the family feel understood and supported during a difficult time. By crying with the family, the nurse can validate their emotions and provide comfort without intruding on their personal space. This approach fosters a sense of connection and trust between the nurse and the family, enhancing the quality of care provided. Incorrect Choices: A: Contact a grief counselor as soon as possible - This choice may be premature and could come across as impersonal or distancing in the immediate aftermath of the patient�s death. C: Leave the home as soon as possible - This choice would be insensitive and could make the family feel abandoned in their time of need. D: Consider whether working in hospice is desirable because patient losses are common - This choice is inappropriate as it suggests the nurse should reconsider their career choice based on emotional reactions,

Correct Answer: C

Rationale: The correct answer is C: Trying to maintain a level of control over the situation. The family member staying at the bedside constantly and even napping there is likely trying to cope with the stressful situation by maintaining a sense of control and connection to the patient. This behavior can be a way for the family member to feel more involved and helpful during a time of uncertainty and powerlessness. Choices A and B involve negative assumptions about the family member's intentions without evidence. Choice D may be a result of the family member's actions but does not address the underlying motivation for their behavior.