Critical Care Nursing Questions and Answers PDF

Correct Answer: C

Rationale: The correct answer is C: administer intravenous sodium bicarbonate. In this case, the patient has metabolic acidosis with a low pH and low bicarbonate levels. Administering sodium bicarbonate can help correct the acidosis by increasing the bicarbonate levels and improving the pH. This treatment is essential to address the underlying metabolic imbalance. Choice A is incorrect because administering morphine would not address the root cause of the acidosis and could potentially worsen the respiratory status. Choice B is incorrect as intubation and mechanical ventilation are not indicated solely based on the acid-base imbalance. Choice D is also incorrect as canceling the dialysis session would not address the metabolic acidosis and could potentially worsen the patient's condition.

Correct Answer: C

Rationale: The correct answer is C: Ensuring that deep vein thrombosis prophylaxis is initiated. When a patient requires neuromuscular blockade for increased intracranial pressure, they are likely immobile, which increases the risk of deep vein thrombosis (DVT). Initiating DVT prophylaxis, such as compression stockings or anticoagulant therapy, helps prevent blood clot formation. Choice A is incorrect because sedatives can mask signs of neurologic deterioration in this patient population. Choice B is incorrect as it promotes activities that may increase intracranial pressure and could be harmful. Choice D, while important for overall patient care, is not directly related to the specific nursing interventions required for a patient receiving neuromuscular blockade for increased intracranial pressure.

Correct Answer: C

Rationale: The correct answer is C because maintaining eye contact with the patient during explanations is a non-verbal way to show attentiveness and empathy, which can help reduce the patient's anxiety. This behavior demonstrates active listening and engagement, making the patient feel heard and understood. A: Staying in the patient's room to complete documentation is not an effective use of presence as it does not involve direct interaction with the patient. B: Having a conversation in the patient's room that excludes the patient is also not an effective use of presence as it does not involve engaging with the patient. D: Focusing on specific nursing care tasks while in the patient's room, although important, may not necessarily demonstrate presence in reducing the patient's anxiety.

Correct Answer: D

Rationale: The correct answer is D: Administer furosemide 20 mg intravenously. In this scenario, the patient is hypotensive with a low cardiac output, low CVP, and low PAOP, indicating cardiogenic shock. Administering furosemide, a diuretic, can worsen the patient's condition by further decreasing preload. This can lead to a decrease in cardiac output and exacerbate the shock state. The other options are more appropriate: A: Titrate supplemental oxygen to achieve a SpO > 94% - Correct, as improving oxygenation is essential in cardiogenic shock. B: Infuse 500 mL 0.9% normal saline over 1 hour - Correct, as fluid resuscitation may be necessary to improve perfusion. C: Obtain arterial blood gas and serum electrolytes - Correct, as these tests provide valuable information about the patient's oxygenation and electrolyte balance.

Correct Answer: A

Rationale: The correct answer is A: sepsis. Sepsis is the most common cause of acute kidney injury in critically ill patients due to the systemic inflammatory response causing renal hypoperfusion. Sepsis leads to a decrease in renal blood flow, resulting in acute kidney injury. Fluid overload (B) can contribute to renal dysfunction but is not the primary cause in critically ill patients. Medications (C) can cause kidney injury, but sepsis is more prevalent. Hemodynamic instability (D) is a consequence of sepsis and can lead to acute kidney injury, making it an indirect cause.