Critical Care Nursing Practice Questions

Correct Answer: A

Rationale: The correct answer is A: a percutaneous catheter at the bedside. This is the most appropriate option for immediate hemodialysis when the patient has no vascular access. A percutaneous catheter can be quickly inserted at the bedside, allowing for immediate initiation of hemodialysis. Choice B, a percutaneous tunneled catheter, involves a more complex insertion process and is not typically done at the bedside. Choices C and D, arteriovenous fistula and arteriovenous graft, require advanced planning and surgical procedures, making them unsuitable for immediate hemodialysis in this scenario.

Correct Answer: C

Rationale: Step-by-step rationale for choice C: 1. Activity intolerance is a priority nursing problem postoperatively due to pain. 2. Postoperative pain can limit the client's ability to perform activities. 3. Addressing activity intolerance is crucial for promoting recovery and preventing complications. 4. Delaying the teaching session helps the nurse focus on managing pain first. Summary of why other choices are incorrect: - Choice A: Knowledge deficit can be addressed after managing immediate postoperative issues. - Choice B: Treatment regimen management is important but may not be as urgent as addressing activity intolerance related to pain. - Choice D: Noncompliance with exercise plan can be addressed once the client's pain and activity intolerance are under control.

Correct Answer: D

Rationale: The correct answer is D: Ask the healthcare provider about tapering the drug dose over the next week. This answer is correct because propranolol is a beta-blocker, and abrupt discontinuation can lead to rebound hypertension, angina, or even myocardial infarction due to the sudden withdrawal of the medication. Tapering the drug dose over time allows the body to adjust gradually and reduces the risk of these adverse effects. Choice A is incorrect because obtaining another antihypertensive prescription is not necessary if the client's blood pressure has been normal for the past three months. Choice B is incorrect because abruptly stopping the medication without tapering can lead to withdrawal symptoms. Choice C is incorrect because simply reporting uncomfortable symptoms without taking appropriate action (tapering the drug dose) is not addressing the potential risks associated with abrupt discontinuation of propranolol.

Correct Answer: C

Rationale: The correct answer is C: Notify the organ procurement organization (OPO). This is the best action because the OPO is responsible for coordinating organ donation and transplantation. By involving the OPO, the nurse ensures that the donation process is handled appropriately and ethically. Choice A: Arranging a multidisciplinary meeting with physicians may be necessary but should not be the first step in this situation. Choice B: Consulting the hospital�s ethics committee may be helpful, but the immediate priority is to involve the OPO to facilitate organ donation. Choice D: Obtaining family consent to withdraw life support is not the nurse�s role in this situation. The focus should be on organ donation to honor the family's wishes.

Correct Answer: D

Rationale: The correct answer is D: Richmond Agitation Sedation Scale (RASS). RASS is specifically designed to monitor agitation and sedation levels in critically ill patients, providing a standardized and objective assessment. It includes clear descriptors for different levels of agitation and sedation, allowing for consistent monitoring and treatment adjustments. CAM-ICU is mainly used for delirium assessment, not agitation. FACES assessment tool is more appropriate for pain assessment. Glasgow Coma Scale is focused on assessing level of consciousness, not agitation specifically. By using RASS, healthcare providers can accurately track agitation levels and evaluate the effectiveness of interventions in managing agitation in critically ill patients.