Critical Care Nursing Practice Questions

Correct Answer: D

Rationale: The correct answer is D: Attach cardiac monitoring leads before the procedure. This is essential to monitor the patient's cardiac rhythm and detect any abnormalities during catheter insertion. Cardiac monitoring leads provide real-time information on the patient's heart rate and rhythm, allowing the nurse to promptly address any complications. A: Determining if the cardiac troponin level is elevated is not directly related to assisting with pulmonary artery catheter insertion. B: Auscultating heart and breath sounds during insertion is important but does not take precedence over attaching cardiac monitoring leads. C: Placing the patient on NPO status before the procedure may be necessary for other procedures, but it is not specifically required for assisting with pulmonary artery catheter insertion.

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.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Bladder catheterization helps relieve urinary obstruction, a common postrenal cause of acute kidney injury. 2. By draining urine from the bladder, it prevents further damage to the kidneys. 3. This intervention addresses the underlying cause of the kidney injury, leading to improvement. Summary: - Choice A is correct as it directly addresses the postrenal cause by relieving urinary obstruction. - Choices B, C, and D are incorrect as they do not target the specific postrenal cause of acute kidney injury.

Correct Answer: B

Rationale: The correct answer is B: Offering the patient a patient-controlled analgesic device. This intervention allows the patient to self-administer pain relief, which can help alleviate discomfort associated with mechanical ventilation and reduce agitation. Breathing exercises (choice A) may not address the root cause of agitation. Asking for antianxiety medication (choice C) may not be immediate or ideal due to potential side effects. Offering an MP3 player (choice D) may provide distraction but may not effectively address the agitation caused by the ventilator.

Correct Answer: C

Rationale: The correct answer is C: Hospitality programs. Given the family's long journey and the stressful situation of having a child diagnosed with leukemia, their immediate need would likely be for accommodations and support services provided by hospitality programs, such as lodging, meals, transportation assistance, and emotional support. This would help alleviate the burden of their travel and allow them to focus on being with their daughter in the ICU. Incorrect answers: A: Educational materials - While education is crucial for families, it may not be the most immediate need in this situation. B: Weekly group family information sessions - These sessions may be helpful for support and information-sharing, but they are not as urgent as addressing the family's immediate needs. D: Pet therapy - While pet therapy can provide emotional support, it may not be the most pressing need for this family at the moment.