Critical Care Nursing Cardiac Questions

Correct Answer: C

Rationale: The correct answer is C: Begin phenylephrine (Neo-Synephrine) for systolic BP < 90 mm Hg. The nurse should implement this order first because the patient's low blood pressure (75/50 mm Hg) indicates hypotension, which can lead to inadequate perfusion to vital organs. Phenylephrine is a vasoconstrictor that can help increase the patient's blood pressure and improve perfusion. It is crucial to address hypotension promptly to prevent further complications. Choice A is incorrect because maintaining the patient's temperature above 96.8�F is not the most urgent concern in this scenario. Choice B is incorrect as obtaining a basic metabolic panel every 4 hours is not the immediate priority when the patient is experiencing hypotension. Choice D is incorrect as drawing arterial blood gas every 4 hours is not the most urgent intervention needed to address the patient's low blood pressure.

Correct Answer: C

Rationale: The correct answer is C: Pressure support ventilation. This mode delivers a set pressure to support each spontaneous breath, decreasing the workload of breathing. Pressure support ventilation assists the patient's inspiratory efforts without providing a set tidal volume like in volume-targeted ventilation. Continuous positive airway pressure (Choice A) maintains a constant level of positive pressure throughout the respiratory cycle but does not actively support spontaneous breathing efforts. Positive end-expiratory pressure (Choice B) maintains positive pressure at the end of expiration to prevent alveolar collapse but does not directly support spontaneous breathing. T-piece adapter (Choice D) is a weaning device that allows the patient to breathe spontaneously without ventilatory support.

Correct Answer: B

Rationale: The correct answer is B: The RN uses a closed-suction technique to suction the patient. This is the safe action because closed-suction technique minimizes the risk of ventilator-associated infections by maintaining a closed system during suctioning, reducing the exposure to pathogens. Closed-suction systems also help maintain lung compliance and oxygenation levels during the suctioning process. Rationale: Option A is incorrect because suctioning every 1 to 2 hours may be too frequent and can lead to hypoxia and mucosal damage. Option C is incorrect as taping the connection between the ventilator tubing and ET can interfere with the proper functioning of the ventilator and increase the risk of disconnection. Option D is incorrect because changing ventilator circuit tubing routinely every 48 hours is not evidence-based practice and can increase the risk of contamination and unnecessary costs.

Correct Answer: A

Rationale: The correct answer is A: Advance directive. An advance directive is a legal document that outlines a person's wishes regarding medical treatment and care at the end of life. It allows individuals to specify their preferences for medical interventions if they become unable to communicate. Summary of other choices: B: Guardianship ad item - This does not specifically pertain to an individual's end-of-life care wishes. C: Healthcare proxy - While similar to an advance directive, a healthcare proxy specifically designates a person to make medical decisions on behalf of the individual, rather than specifying their own wishes. D: Power of attorney - This grants someone the authority to make legal decisions on behalf of the individual, but it does not specifically address end-of-life care preferences.

Correct Answer: B

Rationale: The correct answer is B: Cardiac output (CO) of 4 L/min. In this scenario, the patient is presenting with signs of pulmonary congestion and hypoxemia, indicating possible cardiogenic pulmonary edema. As the cardiac output is a key indicator of how well the heart is functioning and delivering blood to the body, a low cardiac output can lead to inadequate tissue perfusion and worsen the patient's condition. Therefore, immediate action is required to address the low cardiac output to improve tissue perfusion and oxygenation. Choices A, C, and D are incorrect as they do not directly address the primary concern of inadequate cardiac output in this patient. Cardiac index, pulmonary vascular resistance, and systemic vascular resistance are important parameters to monitor, but in this case, the priority is to address the low cardiac output to improve the patient's condition.