Critical Care Nursing Cardiac Questions

Correct Answer: D

Rationale: The correct answer is D: Elevate the head of the bed 45 degrees while recording pressures. Rationale: 1. Elevating the head of the bed will help improve the patient's breathing by reducing the pressure on the diaphragm. 2. This position will also help alleviate the patient's anxiety and tachypnea, promoting better oxygenation. 3. Recording pressures in this position will provide accurate data for monitoring the patient's condition. Summary: A: Limiting the supine position to 10 seconds does not address the underlying issues causing the patient's anxiety and tachypnea. B: Administering anxiety medications without addressing the positioning issue may not effectively manage the patient's symptoms. C: Encouraging the patient to take slow deep breaths is helpful, but changing the position of the patient is more crucial in this situation.

Correct Answer: B

Rationale: The correct answer is B: Administration of morphine, 5 mg IV bolus, and initiation of a continuous morphine infusion. Morphine is the preferred pharmacological management for severe dyspnea in end-stage heart failure due to its potent analgesic and anxiolytic properties. Step-by-step rationale: 1. Morphine is a potent opioid that helps relieve dyspnea by reducing anxiety, decreasing respiratory drive, and improving overall comfort. 2. The initial IV bolus of 5 mg provides rapid relief of dyspnea. 3. Initiating a continuous morphine infusion ensures sustained relief of dyspnea. 4. Midazolam (choice A) is a benzodiazepine used for sedation and anxiety, but it is not the first-line treatment for dyspnea in this scenario. 5. Increasing the midazolam (choice C) or morphine (choice D) infusions by 100% dose increments hourly is not appropriate as

Correct Answer: C

Rationale: The correct answer is C: Change to assist/control ventilation at a rate of 4 breaths/min. When the patient's spontaneous respirations decrease to match the ventilator rate, it indicates that the patient is not actively participating in breathing. Changing to assist/control ventilation allows the patient to trigger breaths when they desire, ensuring a more synchronized and comfortable breathing pattern. A: Adding PEEP may help improve oxygenation but is not directly related to the issue of decreased spontaneous respirations. B: Adding pressure support provides additional support during inspiration but does not address the underlying issue of decreased spontaneous respirations. D: Increasing the SIMV respiratory rate would not address the patient's decreased spontaneous respirations and could potentially lead to overventilation.

Correct Answer: C

Rationale: Step 1: Reconciling medications is essential for patient safety as it involves comparing current and ordered medications to ensure accuracy. Step 2: This process helps prevent medication errors, adverse drug reactions, and duplications across different care settings. Step 3: Communicating a complete list of medications to the next care provider ensures continuity of care and reduces the risk of medication discrepancies. Step 4: By reconciling medications across the continuum of care, healthcare providers can better coordinate patient care and optimize treatment outcomes. In summary, choice C is correct as it focuses on medication reconciliation to improve patient safety and care coordination. Choices A, B, and D are incorrect as they do not directly address the comprehensive process of reconciling medications across care settings.

Correct Answer: C

Rationale: The correct answer is C: Moral distress. In this scenario, the nurse is experiencing conflicting moral values between the decision made for the patient and their own beliefs. This internal conflict leads to moral distress, a common response when healthcare professionals feel unable to act in accordance with their ethical beliefs. This can lead to emotional turmoil, frustration, and moral residue. A: A sense of abandonment is incorrect because the nurse is still caring for the patient, so there is no physical abandonment. B: Increased family stress is incorrect as the nurse's internal conflict does not directly impact family stress. D: A sense of negligence is incorrect as negligence implies failure to provide proper care, which is not the case here.