Critical Care Nursing Practice Questions

Correct Answer: C

Rationale: The correct answer is C (10 to 20 mg/dL). The normal BUN-to-creatinine ratio is approximately 10:1. With a serum creatinine level of 0.7 mg/dL, the expected BUN level should be around 7 to 14 mg/dL. Therefore, choice C (10 to 20 mg/dL) falls within this expected range. Choices A, B, and D are incorrect as they do not align with the typical BUN-to-creatinine ratio and would indicate abnormal kidney function.

Correct Answer: A

Rationale: The correct answer is A: Burden versus benefit. In ethical decision-making, considering the burden of treatment on the patient versus the potential benefits is crucial. This involves weighing the risks, benefits, and potential harm of treatment options. Family's wishes (B) and patient's wishes (C) are important factors but may not always align with what is ethically best for the patient. Potential outcomes of treatment options (D) are relevant but do not directly address the ethical dilemma of balancing burden and benefit. Therefore, A is the correct choice as it directly relates to the ethical principles guiding decision-making in this scenario.

Correct Answer: D

Rationale: The correct answer is D: Maintaining a quiet environment during hours of sleep. This action is directed at reducing environmental stress in the critical care unit because noise and disturbances during sleep can negatively impact patients' rest and recovery. By ensuring a quiet environment, patients can have uninterrupted sleep, which is crucial for healing. Rationale: 1. Constant expert evaluation of patient status (A) may be important but does not directly address environmental stress. 2. Limiting visits to immediate family (B) may hinder patients' emotional support and can be stressful for families. 3. Bathing all patients during hours of sleep (C) may disrupt patients' rest and increase stress levels rather than reduce it.

Correct Answer: D

Rationale: The correct answer is D because the patient has a high-risk wound (tissue avulsion) and no documented prior tetanus vaccination. TIG provides immediate passive immunity to tetanus, while Tdap stimulates active immunity. TIG covers immediate needs, while Tdap ensures long-term immunity. Choice A (TIG only) does not provide long-term immunity. Choice B (TIG and Td) does not include pertussis coverage, which Tdap (Choice D) does. Choice C (Tdap only) does not cover immediate needs as TIG does.

Correct Answer: C

Rationale: The correct answer is C because maintaining hydration and nutrition until the patient dies is not always appropriate in end-of-life care, as some patients may be unable to tolerate oral intake or may be close to the end of life where artificial nutrition and hydration may not provide benefit and may even cause discomfort. Explanation: A: A is correct because terminally ill patients may indeed benefit from continuous pain management to ensure comfort. B: B is correct because hospice care is typically initiated when curative treatment is no longer effective and focuses on providing comfort and quality of life. D: D is correct because emotional support is crucial in end-of-life care to address the patient's psychological well-being and provide comfort. In summary, choice C is incorrect as it does not consider individual patient needs and preferences in end-of-life care.