Critical Care Nursing Practice Questions

Correct Answer: C

Rationale: The correct answer is C: High resolution multidetector CT angiogram. This diagnostic procedure is required for a definitive diagnosis of pulmonary embolism because it provides detailed imaging of the pulmonary vasculature, allowing visualization of blood clots in the pulmonary arteries. A: Arterial blood gas (ABG) analysis does not directly diagnose pulmonary embolism but may show signs of hypoxemia or respiratory alkalosis, which can be seen in some cases of pulmonary embolism. B: Chest x-ray examination may show nonspecific findings such as atelectasis or pleural effusion but cannot definitively diagnose pulmonary embolism. D: Ventilation-perfusion scanning is another imaging modality used in the diagnosis of pulmonary embolism, but it is less commonly used compared to CT angiogram due to lower sensitivity and specificity.

Correct Answer: C

Rationale: The correct answer is C because notifying the organ procurement organization (OPO) once the patient has been pronounced brain dead is a requirement to sustain CMS Conditions of Participation. This step ensures that the proper protocols are followed for organ donation. Choice A is incorrect because notifying the OPO of impending death is not a requirement for sustaining CMS Conditions of Participation. Choice B is incorrect because obtaining informed consent for organ donation is not directly related to meeting the requirements of CMS Conditions of Participation. Choice D is incorrect because while evaluating the patient's suitability for organ donation is important, it is not a specific requirement under CMS Conditions of Participation.

Correct Answer: C

Rationale: The correct answer is C: A woman who originally escorted the patient in. This choice is correct because she is most likely the person responsible for the patient's care and thus likely has legal authority to make medical decisions on behalf of the patient. The other choices are incorrect because simply being recognized as the patient's brother (A), being a teenage boy who approaches the nurse (B), or being a woman whom the others look at and call over (D) does not necessarily indicate that they have the legal authority to make medical decisions for the unconscious patient.

Correct Answer: A

Rationale: The correct answer is A because instructing the family on where the patient can be touched and what to say helps empower them to interact appropriately with the patient. This action promotes the family's involvement in the patient's care, encourages communication, and fosters a supportive environment. Choice B is incorrect as engaging in social conversation may not address the family's hesitance to approach the patient directly. Choice C is incorrect because waiting for visiting hours to provide information may delay necessary support for the family. Choice D is incorrect as leaving the family without guidance may perpetuate their discomfort and hinder their ability to provide emotional support to the patient.

Correct Answer: B

Rationale: The correct answer is B: Apply pressure to the insertion site for 5 minutes. This is the priority nursing action because it helps prevent bleeding and hematoma formation after removing the arterial line. Applying pressure for 5 minutes allows for adequate hemostasis. A: Applying an air occlusion dressing to the insertion site is not the priority action. It does not address the immediate need to control bleeding. C: Elevating the affected limb on pillows for 24 hours is not necessary and does not address the immediate need for hemostasis. D: Keeping the patient's wrist in a neutral position is not the priority action when discontinuing an arterial line. It does not address the need for hemostasis and preventing bleeding.