Critical Care Nursing Exam Questions

Correct Answer: B

Rationale: The correct answer is B: Equal bilateral breath sounds upon auscultation. This indicates proper placement of the endotracheal tube in the trachea, ensuring both lungs are being ventilated equally. Rationale: 1. Auscultation of air over the epigastrium (Choice A) is incorrect as it indicates esophageal intubation, not tracheal intubation. 2. Position above the carina verified by chest x-ray (Choice C) is incorrect as it does not confirm proper placement at the trachea. 3. Positive detection of carbon dioxide (CO2) (Choice D) is incorrect as it indicates the presence of exhaled CO2, but not necessarily proper placement in the trachea.

Correct Answer: A

Rationale: The correct answer is A because continuous venovenous hemofiltration (CVVH) primarily removes fluids and solutes through the process of convection. In CVVH, blood flows through a filter where hydrostatic pressure drives plasma water and solutes across a semipermeable membrane. This process mimics the natural filtration that occurs in the kidneys. Choice B is incorrect because CVVH does not specifically target plasma water only but also removes solutes. Choice C is incorrect because CVVH does not involve adding dialysate to remove plasma water and solutes. Choice D is incorrect because while CVVH may involve ultrafiltration and convection, it does not typically include dialysis as a primary mechanism for solute removal.

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Limiting visitation to reduce emotional distress contradicts the principles of effective end-of-life care, which emphasize holistic support for the patient and family. 2. Effective end-of-life care encourages open communication and emotional support from loved ones. 3. Limiting visitation may hinder emotional closure and support for both the patient and family. 4. Options A, C, and D align with effective end-of-life care by focusing on symptom management, education, and spiritual support for the patient and family.

Correct Answer: C

Rationale: The correct answer is C: Obtain a portable x-ray to confirm placement. This is the priority intervention because it ensures the arterial line is correctly positioned, reducing the risk of complications such as dislodgement or improper placement. Applying a pressure dressing (choice A) may be necessary but is not the priority. Ensuring tubing connections are tightened (choice B) is important for preventing leaks but does not address placement. Restraining the affected extremity (choice D) is unnecessary and can lead to complications. The x-ray confirms correct placement, ensuring accurate monitoring and treatment.

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