Critical Care Nursing Questions

Correct Answer: A

Rationale: The correct answer is A, the 21-year-old with a C4 fracture and quadriplegia. This patient is likely to benefit most from patient-controlled analgesia (PCA) due to the inability to self-administer traditional pain medications. With quadriplegia, the patient may have limited mobility and sensation, making it challenging to communicate pain levels effectively. PCA allows the patient to control their pain relief within preset limits, enhancing autonomy and optimizing pain management. Summary: - Choice B: The 45-year-old with femur fracture and closed head injury may benefit from PCA, but the severity of the head injury could affect their ability to use the device effectively. - Choice C: The 59-year-old postoperative elective bariatric surgery patient can typically manage pain with traditional methods postoperatively. - Choice D: The 70-year-old postoperative cardiac surgery patient with mild dementia may have the cognitive ability to use PCA but could potentially benefit more from other pain management strategies due

Correct Answer: A

Rationale: The correct answer is A: Cyclical exacerbation of one another. Pain and anxiety can intensify each other in a cyclical manner. Pain can trigger anxiety, making the pain feel worse, and anxiety can heighten pain perception. This relationship is well-documented in research and clinical practice. Choice B is incorrect because although both pain and anxiety benefit from thorough nursing assessment, it is not a factor common to both conditions. Choice C is incorrect as both pain and anxiety can be influenced by real and perceived phenomena, not solely real phenomena. Choice D is incorrect because while previous experiences can impact pain and anxiety perception, it is not a factor common to both conditions.

Correct Answer: D

Rationale: The correct answer is D: Administer the medication. Atenolol is a beta-blocker used to reduce heart rate and blood pressure. In this scenario, the client's apical pulse of 65 beats per minute is within the normal range for a client taking atenolol after a myocardial infarction. Therefore, the nurse should proceed with administering the medication as prescribed to help maintain the client's heart rate and blood pressure within the therapeutic range. A: Measuring the blood pressure is important but not the immediate next step as the client's heart rate is within the normal range. B: Reassessing the apical pulse is unnecessary since it is already within the normal range for a client on atenolol. C: Notifying the healthcare provider is not indicated as there are no signs of concern with the client's heart rate at 65 bpm.

Correct Answer: C

Rationale: Correct Answer: C (Grimacing) Rationale: 1. Grimacing is a universal nonverbal sign of pain. 2. It involves facial muscles, indicating a high level of discomfort. 3. Brow lowering and eyelid closing are subtle signs, less indicative of severe pain. 4. Staring may signify concentration, not necessarily pain. Summary: Grimacing is the correct choice as it directly correlates with pain intensity, unlike the other options which are less specific or relevant indicators of severe pain.

Correct Answer: A

Rationale: The correct answer is A: Alarms that sound from various devices. In the critical care environment, alarms often indicate changes in the patient's condition, causing stress. Bright fluorescent lighting (B) may be bothersome but not directly related to patient stress. Lack of day-night cues (C) may disrupt sleep patterns but is not a direct stressor. Sounds from the mechanical ventilator (D) are essential for patient care and not inherently stressful.