Critical Care Nursing Practice Questions

Questions 81

ATI RN

ATI RN Test Bank

Critical Care Nursing Practice Questions Questions

Question 1 of 5

When addressing an ethical dilemma, contextual, physiolo gical, and personal factors of the situation must be considered. Which of the following is an example of a personal factor?

Correct Answer: C

Rationale: The correct answer is C because the patient's expressed beliefs and wishes regarding quality of life are personal factors that directly influence the ethical dilemma. This factor reflects the individual's values, beliefs, and preferences, which are essential in making ethical decisions that respect the patient's autonomy. Considering the patient's beliefs helps healthcare professionals navigate complex ethical situations by aligning the care provided with the patient's values. Choices A, B, and D do not directly relate to personal factors but rather focus on hospital policies, physiological symptoms, and the provider's perspective, respectively. Personal factors are crucial in ethical decision-making as they center on the patient's autonomy and preferences.

Question 2 of 5

Critical illness often results in family conflicts. Which scenario is most likely to result in the greatest conflict?

Correct Answer: D

Rationale: The correct answer is D because it involves a conflict between the patient's autonomy and her son's beliefs. The patient, a Jehovah's Witness, has clearly stated her refusal of a blood transfusion in her advance directive, which aligns with her religious beliefs. Her son's disagreement with her decision creates a significant ethical dilemma and conflict. This scenario highlights the clash between respecting the patient's autonomy and the son's concerns for her well-being. Choice A is less likely to result in the greatest conflict as both parents have similar values and are amicable, with the conflict being directed towards the daughter's boyfriend. Choice B involves a conflict between the patient's girlfriend and parents, but the patient's lack of advance directives and estranged relationship with his parents do not present as significant a conflict as in the correct answer. Choice C involves a designated healthcare proxy and a committed relationship, which are less likely to result in a conflict as compared to the clash of beliefs and autonomy seen in Choice D.

Question 3 of 5

Which of the following assists the critical care nurse in ensuring that care is appropriate and based on research?

Correct Answer: A

Rationale: The correct answer is A: Clinical practice guidelines. Clinical practice guidelines are evidence-based recommendations that assist nurses in providing appropriate care based on research. They outline best practices for specific patient populations or conditions, helping nurses make informed decisions. Summary: - B: Computerized physician order entry: While it may improve accuracy and efficiency, it does not specifically ensure care based on research. - C: Consulting with advanced practice nurses: While collaboration is valuable, it does not guarantee care based on research. - D: Implementing Joint Commission National Patient Safety Goals: Important for patient safety, but not directly related to ensuring care based on research.

Question 4 of 5

assessment, the patient is restless, heart rate has increased to 110 beats/min, respirations are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sinaubsir bt.acocmh/ytecsat rdia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretio ns. Loud crackles are audible throughout lung fields. The nurse notifies the physician, w ho orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. How d oes the nurse interpret the following blood gas levels? pH 7.28 PaCO 46 mm Hg Bicarbonate 22 mEq/L PaO 58 mm Hg O saturation 88% 2

Correct Answer: B

Rationale: The correct answer is B: Hypoxemia and uncompensated respiratory acidosis. Step-by-step rationale: 1. pH is low (7.28), indicating acidosis. 2. PaCO2 is elevated (46 mm Hg), indicating respiratory acidosis. 3. PaO2 is low (58 mm Hg), indicating hypoxemia. 4. Bicarbonate is within normal range (22 mEq/L), suggesting no compensation for the acidosis. 5. Oxygen saturation is low (88%), supporting the presence of hypoxemia. Summary: A: Incorrect - pH is low, not indicating compensated alkalosis. C: Incorrect - Various abnormalities in the blood gas levels are present. D: Incorrect - There is hypoxemia and uncompensated acidosis, not metabolic alkalosis.

Question 5 of 5

While waiting for cardiac transplantation, a patient with severe cardiomyopathy has a ventricular assist device (VAD) implanted. When planning care for this patient, the nurse should anticipate:

Correct Answer: D

Rationale: The correct answer is D because monitoring the surgical incision for signs of infection is essential post-VAD implantation to prevent complications. This step is crucial in early identification and treatment of any potential infection, which can lead to serious outcomes. A) Giving immunosuppressive medications is not typically required for VAD implantation, as the primary goal is to support cardiac function rather than prevent rejection. B) Preparing the patient for a permanent VAD is premature, as the goal is often to bridge to transplantation or recovery, not permanent VAD placement. C) Teaching the patient the reason for complete bed rest is not necessary for VAD implantation, as patients are typically encouraged to gradually increase activity levels under guidance.

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