Critical Care Nursing Practice Questions

Correct Answer: D

Rationale: The correct answer is D: Determine the patient�s work of breathing. Assessing the exhaled tidal volume (EV) in a mechanically ventilated patient helps determine how much effort the patient is exerting to breathe. By monitoring the EV, the nurse can evaluate the patient's respiratory status and adjust ventilator settings if needed. It is crucial to ensure that the patient is not working too hard to breathe, as this can lead to respiratory distress. Incorrect answers: A: Assess for tension pneumothorax - Tension pneumothorax is typically assessed through other means such as physical examination and chest X-ray. B: Assess the level of positive end-expiratory pressure - The level of positive end-expiratory pressure is usually set based on the patient's condition and not solely based on the exhaled tidal volume. C: Compare the tidal volume delivered with the tidal volume prescribed - This comparison is important but does not directly relate to assessing the patient's work of breathing.

Correct Answer: C

Rationale: The correct answer is C: Provide for oxygen administration. The first intervention for hypoxemia is to increase oxygen levels to improve oxygen saturation in the blood. Oxygen administration can be achieved through various devices such as nasal cannula, face mask, or non-rebreather mask. This intervention helps to increase the oxygen supply to the patient's tissues and organs, addressing the underlying cause of hypoxemia. Calling for emergency intubation (choice A) is not the first step unless the patient's condition deteriorates. Obtaining an order for BiPAP (choice B) may be beneficial in some cases but is not the initial intervention for hypoxemia. Suctioning secretions (choice D) may be necessary if airway obstruction is present but is not the first step in addressing hypoxemia.

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.

Correct Answer: B

Rationale: The correct answer is B: Offering the patient a patient-controlled analgesic device. This intervention allows the patient to self-administer pain relief, which can help alleviate discomfort associated with mechanical ventilation and reduce agitation. Breathing exercises (choice A) may not address the root cause of agitation. Asking for antianxiety medication (choice C) may not be immediate or ideal due to potential side effects. Offering an MP3 player (choice D) may provide distraction but may not effectively address the agitation caused by the ventilator.

Correct Answer: A

Rationale: Rationale: The correct answer is A: A card from the girl's family. The nurse would value this form of recognition the most because it directly reflects the impact of her care on the patient and her family. It is a personal, heartfelt gesture that acknowledges the nurse's compassion and dedication. A card from the family shows genuine appreciation and gratitude for the nurse's efforts, making it the most meaningful form of recognition. Summary: - Choice B: A plaque from the ICU physicians could be seen as a formal recognition but lacks the personal touch and direct impact of the nurse's care on the patient and family. - Choice C: A letter of commendation from the hospital's administration is a professional acknowledgment but may not capture the emotional connection and impact that the nurse had on the family. - Choice D: A bouquet of flowers from her supervisor is a nice gesture but does not necessarily reflect the specific impact of the nurse's care on the patient and family.