Critical Care Nursing Questions and Answers PDF

Correct Answer: C

Rationale: The correct answer is C: intrarenal. The presence of sediment, crystals, and bacteria in the urinalysis indicates an issue originating within the kidney itself. This suggests a problem like a urinary tract infection or kidney stone causing the severe flank pain. Prerenal and postrenal conditions usually involve issues outside the kidney such as dehydration or urinary tract obstruction, which are not supported by the urinalysis findings. Choice D, not renal related, is incorrect as the symptoms and urinalysis results clearly point towards a renal issue.

Correct Answer: A

Rationale: The correct answer is A: Remove the patient's rings first. This is crucial to prevent constriction and swelling due to potential allergic reactions or inflammation from bee stings. Removing rings allows for proper circulation and prevents complications like compartment syndrome. Ice packs (B) can be applied after removing the rings to reduce swelling. Calamine lotion (C) can provide relief for itching but is not as urgent as ring removal. Diphenhydramine (D) can be given later for systemic allergic reactions but should not take precedence over removing the rings.

Correct Answer: A

Rationale: The correct answer is A, absence of a corneal reflex, because in brain death, all brainstem reflexes, including the corneal reflex, are absent. This indicates complete loss of brain function. Choice B, unequal reactive pupils, is incorrect as it suggests some level of brainstem function. Choice C, withdrawal from painful stimuli, is also incorrect as it is a spinal reflex and can occur even in the absence of brain function. Choice D, core temperature of 100.8� F, is irrelevant to assessing brain death.

Correct Answer: B

Rationale: The correct answer is B: Cluster nursing activities so that the patient has uninterrupted rest periods. Rationale: 1. Clustering nursing activities allows for uninterrupted rest periods, essential for improving sleep quality and addressing disturbed sensory perception. 2. Administering sedatives or opioids (Option A) can lead to drug dependence, tolerance, and adverse effects in older adults. 3. Silencing alarms (Option C) compromises patient safety by impeding timely monitoring and response to critical events. 4. Eliminating assessments (Option D) between 0100 and 0600 disregards the necessity of monitoring vital signs and assessing patient condition around the clock.

Correct Answer: C

Rationale: The correct answer is C because inquiring about specific cultural rituals and preferences shows respect for the patient's cultural beliefs and values. By asking about these aspects, the nurse can provide care that aligns with the patient's cultural background, promoting comfort and understanding. This action also demonstrates a commitment to individualized care. Choice A is incorrect because standardized care may not always be culturally appropriate. Choice B is incorrect as avoiding discussions about death can hinder effective communication and support. Choice D is incorrect as advising families to strictly follow hospital guidelines may overlook the importance of cultural considerations in end-of-life care.