Critical Care Nursing Questions

Correct Answer: B

Rationale: The correct answer is B. The nurse's priority is to ensure the patient's safety and well-being. Calling the rapid response team will allow for immediate assessment by a team of healthcare professionals to address the deteriorating condition. This step takes precedence over troubleshooting the ventilator or manually ventilating the patient. Asking for a new ventilator (A) or manually ventilating the patient (D) does not address the urgent need for a comprehensive assessment and intervention. Continuing to troubleshoot the alarm (C) can delay critical interventions needed for the patient's worsening condition. Thus, calling the rapid response team is the most appropriate action to address the escalating clinical situation promptly.

Correct Answer: C

Rationale: The correct answer is C: Treatment for elevated blood pressure. In the initial stress response, the body releases adrenaline and cortisol, leading to increased heart rate and blood pressure. Treating elevated blood pressure is crucial to prevent complications like heart attack or stroke. Adequate pain control (A) and intravenous sedation (B) may help manage symptoms but do not directly address the physiological response to stress. Ignoring an elevated glucose level (D) is not recommended as stress can impact blood sugar levels. Treatment for elevated blood pressure directly targets the physiological response to stress, making it the best nursing action in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Hypovolemia. When the ventilator settings are adjusted to treat hypoxemia by increasing FiO2 and PEEP, it can lead to increased oxygenation but also potentially decrease venous return to the heart, causing a decrease in blood pressure. This decrease in blood pressure is most likely due to hypovolemia, as the increased PEEP can increase intrathoracic pressure, reducing venous return and preload, leading to a decrease in cardiac output and subsequent decrease in blood pressure. This choice is the most likely cause as the other options (A: Decrease in cardiac output, C: Increase in venous return, D: Oxygen toxicity) do not directly correlate with the changes in ventilator settings described in the question.

Correct Answer: C

Rationale: The correct answer is C: �The fistula will be usable in about 4 to 6 weeks.� The rationale for this is that an arteriovenous fistula typically requires 4 to 6 weeks to mature and be ready for use. During this time, the fistula develops the necessary blood flow for efficient dialysis. Choice A is incorrect because immediate use of the fistula is not recommended as it needs time to mature. Choice B is incorrect as it underestimates the time needed for the fistula to heal and mature. Choice D is incorrect as the usability of the fistula is not dependent on the manufacturer but rather on the patient's individual healing process.

Correct Answer: B

Rationale: The correct answer is B because calibrating the system with central venous and arterial blood samples ensures accuracy of the mixed venous oxygen saturation (SvO2) measurement. This calibration allows for comparison of the values obtained from both sources to confirm the accuracy of the measurement. Choice A is incorrect because zero referencing the transducer at the level of the phlebostatic axis does not directly address the accuracy of the SvO2 measurement. Choice C is incorrect because ensuring patency of the catheter using normal saline pressurized at 300 mm Hg does not directly impact the accuracy of the SvO2 measurement. Choice D is incorrect because using noncompliant pressure tubing does not ensure the accuracy of the SvO2 measurement. The length of the tubing and the presence of stopcocks are not directly related to obtaining an accurate SvO2 value.