ICU Exam 1 With Latest Updated
Questions And Answers 2024
1. hWhich hof hthe hfollowing his hNOT han hindication hfor hthe hnurse hto hstart ha hpt hon
hmechanical hventilation?
h
a. hIf hthe hpt his hin hhypercarbic hor hhypoxemic hrespiratory hfailure
b. hTo hprevent hor hreverse hatelectasis
c. hIf hthe hpt hhas haspirated hor his hat hrisk hfor haspiration
d. hTo hprevent hor hreverse hrespiratory hmuscle hfatigue h- hcorrect hanswer.Correct hAnswer:
hc.
Rationale: hA hpatient hshould hnot hbe hintubated hand hput hon hmechanical hventilation hsimply
hbecause hof haspiration hor ha hrisk hfor haspiration. hTo htreat haspiration, hclear hthe hairway hof
hwhatever his hcausing hthe haspiration, hprovide hextra hoxygen hif hnecessary, hand htake
hantibiotics hif ha hresulting hinfection hhas hoccurred. hAll hother hchoices hare hindications hfor
hstarting ha hpatient hon hmechanical hventilation.
2. hWhich hof hthe hfollowing hevidence-based hstrategies hused hby hthe hnurse hbest hsupport
hthe hfamily hmembers hof hICU hpatients hat hhigh hrisk hof hdying? hSelect hall hthat happly.
h
a. hBuilding hrapport
b. hCommunicating hwith hthe hfamily hinfrequently
c. hDemonstrating hno hconcern
d. hDemonstrating hprofessionalism
e. hSupporting hdecision-making h- hcorrect hanswer.Correct hAnswers: ha, hd, he.
Rationale: hStrategies hsuch has hbuilding hrapport, hdemonstrating hprofessionalism, hand
hsupporting hdecision-making hhave hshown hto hhelp hfamily hmembers hcope; hto hhave hhope,
hconfidence, hand htrust; hto hprepare hfor hand haccept himpending hdeath; hand hto hmake
hdecisions. hOther hstrategies hthat hwork hinclude hfrequent hcommunication, hdemonstrating
hconcern, hand hproviding hfactual hinformation.
3. hThe hnurse hsuspects hhypoxemia hin hher hpatient hwhen hshe hnotices hthe hfollowing hsigns
hand hsymptoms. hSelect hall hthat happly.
h
a. hConfusion
b. hIncrease hin hblood hpressure
c. hWarm hextremities
d. hDysrhythmias hor ha hchange hin hheart hrate
e. hA hlack hof hsweating h- hcorrect hanswer.Correct hAnswers: ha, hb, hd.
,Rational: hHypoxemia, ha hdecrease hin hthe harterial hoxygen htension hin hthe hblood, his
hmanifested hby hchanged hin hmental hstatus h(progressing hthrough himpaired hjudgment,
hagitation, hdisorientation, hconfusion, hlethargy, hand hcoma), hdyspnea, hincrease hin hblood
hpressure, hchanges hin hheart hrate, hdysrhythmias, hcentral hcyanosis h(late hsign),
hdiaphoresis, hand hcool hextremities. hHypoxemia hcan hlead hto hhypoxia, ha hdecrease hin
hoxygen hsupply hto hthe htissues hand hcells, hwhich hcan hbe hlife hthreatening hif hleft huntreated.
4. hThe hnurse hknows hthat hone hof hthe hfollowing hblood hchemistry hvalues his hNOT hessential
hto hmonitoring hheart hfunction:
h
a. hPhosphate h(2.5-4.5 hmg/dL)
b. hCalcium h(8.6-10.2 hmg/dL)
c. hMagnesium h(1.3-2.3 hmEq/dL)
d. hPotassium h(3.5-5 hmEq/dL) h- hcorrect hanswer.Correct hAnswers: ha.
Rationale: hPhosphate hplays hno hrole hin hcardiac hfunction. h
-Calcium his hnecessary hfor hblood hcoagulability, hneuromuscular hactivity, hand hautomaticity
hof hthe hnodal hcells h(sinus hand hatrioventricular hnodes). h
-Magnesium his hnecessary hfor hthe habsorption hof hcalcium, hmaintenance hof hpotassium
hstores, hand hmetabolism hof hadenosine htriphosphate. h
-Potassium hhas ha hmajor hrole hin hcardiac helectrophysiologic hfunction.
5. hThe hnurse hknows hthat helectrophysiologic htesting his hdone hprimarily hto:
h
a. hDetermine hthe hsize, hcontour, hand hposition hof hthe hheart
b. hDiagnose hand hdetermine hthe hsource hof hdysrhythmias
c. hProduce han himage hof hthe hheart
d. hEvaluate hmyocardial hblood hflow hand hperfusion h- hcorrect hanswer.Correct hAnswer: hb.
Rationale: hThe helectrophysiology hstudy h(EPS) his han hinvasive hprocedure hthat hplays ha
hmajor hrole hin hthe hdiagnosis hand hmanagement hof hserious hdysrhythmias. hEPS hmay hbe
hindicated hfor hpatients hwith hsyncope, hpalpitations, hor hboth, hand hfor hsurvivors hof hcardiac
harrest hfrom hventricular hfibrillation. hEPS hdoes hnot hdetermine hthe hsize, hcontour, hand
hposition hof hthe hheart; hproduce han himage hof hthe hheart; hor hevaluate hmyocardial hblood
hflow hand hperfusion.
1) hRegarding hPEEP h(Positive hEnd-Expiratory hPressure), hwhich hof hthe hfollowing hare
htrue: hSelect hall hthat happly.
a. hit his hthe hpressure hmaintained hin hthe hlungs hat hthe hend hof hexpiration
b. hkeeps hthe halveoli hopen hat hthe hend hof hexpiration hto hmaximize hgas hexchange
c. hPaCO2 hvalues hare hgreater hthan h50mmHg
d. hNormal hvalue his h5-15 hcm hof hH20
e. hNormal hvalue his h25-30cm hof hH20 h- hcorrect hanswer.Answer: ha, hb, hd
Reasoning: hAs hwe hlearned hin hclass hthe habove hunderlined hanswers hare htrue. hThe
hPaCO2 hanswer hdoes hnot happly hto hPEEP hand hthe hvalues hin hthe hlast hanswer hare
hincorrect. hThe hnormal hvalue hshould hbe h5-15 hcm hof hH20.
2) hHow hcan ha hmechanical hventilator haffect hthe hcardiac hsystem?
, a. hDelivers hhigh hlevels hof hPEEP hand hincreases hthe hintra-thoracic hpressure hand hthe
hpressure hin hthe hchest hcan hcompress hthe hheart
b. hDecreases hintra-throacic hpressure
c. hDelivers hlow hlevels hof hPEEP
d. hDelivers hlow hlevels hof hPEEP hand hdecreases hthe hintra-thoracic hpressure hand hthe
hpressure hin hthe hchest hcan hcompress hthe hheart. h- hcorrect hanswer.Answer: ha
Reasoning: hRespiration hhas ha hhydraulic hinfluence hon hcardiovascular hfunction. hThe
hventilator hdelivers hhigh hlevels hof hPEEP hand hit hincreases hthe hintra-thoracic hpressure
hand hpressure hin hthe hchest hwhich hcan hcompress hthe hheart.
3) hYou hare hthe hnurse hon hduty hand hwalk hinto hMr. hJensen's hroom. hYou hnotice hthat hhe hhas
ha htrachea htube. hHe hhas hmucous-like hsecretions hhanging hoff hthe hend hof hthe htrachea
htube. hWhat helse hare hindications hfor hsuctioning hthe hpatient?
a. hincrease hin htidal hvolume, hpatient hlungs hsound hclear
b. hdecrease hin htidal hvolume, hhypoxia, hand hcan hhear hrhonchi, hmucus, hcough
c. hgood hoxygen hsaturation hwith hincreased htidal hvolume
d. hpatient hcan hclear htheir hown hairway, hand hyou hhear hrhonchi, hsee hmucus, hand hthey
hhave ha hcough h- hcorrect hanswer.Asnwer: hb
Reasoning: hIndications hfor hsuction hinclude ha hdecrease hin htidal hvolume, hhypoxia,
hhearing hrhonchi, hthe hpresence hof hmucous, hpatient hcoughing hand hunable hto hclear htheir
hairway. hIf htidal hvolume hincreases hand hthe hpatient hcan hclear htheir hown hairway hthere his
hno hneed hfor hsuction.
4) hWith hcontinuous hmechanical hventilation h(CMV), hwhat hhappens hif hthe hinspiratory hflow
his hinadequate?
a. hDecreased hwork hof hbreathing
b. hIncreased hwork hof hbreathing
c. hIncreased hperfusion
d. hIncreases hP-peak h- hcorrect hanswer.Answer: hb
Reasoning: hIf hinspiratory hflow his hinadequate hthe hpatient hwill hhave hto hwork hmore hto
hbreathe. hAll hother hoptions hare hincorrect.
5) hIf habout h4/5 hof hthe hblood his hleft hin hthe hventricle hafter hthe hcontraction hof hthe hheart,
hwhat his hthe hmost hlikely hejection hfraction h(EF)?
a. h70%
b. h50%
c. h20%
d. h87% h- hcorrect hanswer.Answer: hc
Reasoning: hEjection hfraction hin ha hhealthy hheart his h70%. hIf hthe hejection hfraction his hunder
h50% hit hmeans hthat hthere his ha hlarger hvolume hof hblood hleft hin hthe hventricle hafter hthe
hcontraction. hThis hmeans hthat hthere his hless hroom hfor h"new" hblood hin hthe hventricle hand
hless hblood his hgoing hout hto hperfuse hthe hbody. hAn hejection hfraction hof h20% his hnot hgood!
Questions And Answers 2024
1. hWhich hof hthe hfollowing his hNOT han hindication hfor hthe hnurse hto hstart ha hpt hon
hmechanical hventilation?
h
a. hIf hthe hpt his hin hhypercarbic hor hhypoxemic hrespiratory hfailure
b. hTo hprevent hor hreverse hatelectasis
c. hIf hthe hpt hhas haspirated hor his hat hrisk hfor haspiration
d. hTo hprevent hor hreverse hrespiratory hmuscle hfatigue h- hcorrect hanswer.Correct hAnswer:
hc.
Rationale: hA hpatient hshould hnot hbe hintubated hand hput hon hmechanical hventilation hsimply
hbecause hof haspiration hor ha hrisk hfor haspiration. hTo htreat haspiration, hclear hthe hairway hof
hwhatever his hcausing hthe haspiration, hprovide hextra hoxygen hif hnecessary, hand htake
hantibiotics hif ha hresulting hinfection hhas hoccurred. hAll hother hchoices hare hindications hfor
hstarting ha hpatient hon hmechanical hventilation.
2. hWhich hof hthe hfollowing hevidence-based hstrategies hused hby hthe hnurse hbest hsupport
hthe hfamily hmembers hof hICU hpatients hat hhigh hrisk hof hdying? hSelect hall hthat happly.
h
a. hBuilding hrapport
b. hCommunicating hwith hthe hfamily hinfrequently
c. hDemonstrating hno hconcern
d. hDemonstrating hprofessionalism
e. hSupporting hdecision-making h- hcorrect hanswer.Correct hAnswers: ha, hd, he.
Rationale: hStrategies hsuch has hbuilding hrapport, hdemonstrating hprofessionalism, hand
hsupporting hdecision-making hhave hshown hto hhelp hfamily hmembers hcope; hto hhave hhope,
hconfidence, hand htrust; hto hprepare hfor hand haccept himpending hdeath; hand hto hmake
hdecisions. hOther hstrategies hthat hwork hinclude hfrequent hcommunication, hdemonstrating
hconcern, hand hproviding hfactual hinformation.
3. hThe hnurse hsuspects hhypoxemia hin hher hpatient hwhen hshe hnotices hthe hfollowing hsigns
hand hsymptoms. hSelect hall hthat happly.
h
a. hConfusion
b. hIncrease hin hblood hpressure
c. hWarm hextremities
d. hDysrhythmias hor ha hchange hin hheart hrate
e. hA hlack hof hsweating h- hcorrect hanswer.Correct hAnswers: ha, hb, hd.
,Rational: hHypoxemia, ha hdecrease hin hthe harterial hoxygen htension hin hthe hblood, his
hmanifested hby hchanged hin hmental hstatus h(progressing hthrough himpaired hjudgment,
hagitation, hdisorientation, hconfusion, hlethargy, hand hcoma), hdyspnea, hincrease hin hblood
hpressure, hchanges hin hheart hrate, hdysrhythmias, hcentral hcyanosis h(late hsign),
hdiaphoresis, hand hcool hextremities. hHypoxemia hcan hlead hto hhypoxia, ha hdecrease hin
hoxygen hsupply hto hthe htissues hand hcells, hwhich hcan hbe hlife hthreatening hif hleft huntreated.
4. hThe hnurse hknows hthat hone hof hthe hfollowing hblood hchemistry hvalues his hNOT hessential
hto hmonitoring hheart hfunction:
h
a. hPhosphate h(2.5-4.5 hmg/dL)
b. hCalcium h(8.6-10.2 hmg/dL)
c. hMagnesium h(1.3-2.3 hmEq/dL)
d. hPotassium h(3.5-5 hmEq/dL) h- hcorrect hanswer.Correct hAnswers: ha.
Rationale: hPhosphate hplays hno hrole hin hcardiac hfunction. h
-Calcium his hnecessary hfor hblood hcoagulability, hneuromuscular hactivity, hand hautomaticity
hof hthe hnodal hcells h(sinus hand hatrioventricular hnodes). h
-Magnesium his hnecessary hfor hthe habsorption hof hcalcium, hmaintenance hof hpotassium
hstores, hand hmetabolism hof hadenosine htriphosphate. h
-Potassium hhas ha hmajor hrole hin hcardiac helectrophysiologic hfunction.
5. hThe hnurse hknows hthat helectrophysiologic htesting his hdone hprimarily hto:
h
a. hDetermine hthe hsize, hcontour, hand hposition hof hthe hheart
b. hDiagnose hand hdetermine hthe hsource hof hdysrhythmias
c. hProduce han himage hof hthe hheart
d. hEvaluate hmyocardial hblood hflow hand hperfusion h- hcorrect hanswer.Correct hAnswer: hb.
Rationale: hThe helectrophysiology hstudy h(EPS) his han hinvasive hprocedure hthat hplays ha
hmajor hrole hin hthe hdiagnosis hand hmanagement hof hserious hdysrhythmias. hEPS hmay hbe
hindicated hfor hpatients hwith hsyncope, hpalpitations, hor hboth, hand hfor hsurvivors hof hcardiac
harrest hfrom hventricular hfibrillation. hEPS hdoes hnot hdetermine hthe hsize, hcontour, hand
hposition hof hthe hheart; hproduce han himage hof hthe hheart; hor hevaluate hmyocardial hblood
hflow hand hperfusion.
1) hRegarding hPEEP h(Positive hEnd-Expiratory hPressure), hwhich hof hthe hfollowing hare
htrue: hSelect hall hthat happly.
a. hit his hthe hpressure hmaintained hin hthe hlungs hat hthe hend hof hexpiration
b. hkeeps hthe halveoli hopen hat hthe hend hof hexpiration hto hmaximize hgas hexchange
c. hPaCO2 hvalues hare hgreater hthan h50mmHg
d. hNormal hvalue his h5-15 hcm hof hH20
e. hNormal hvalue his h25-30cm hof hH20 h- hcorrect hanswer.Answer: ha, hb, hd
Reasoning: hAs hwe hlearned hin hclass hthe habove hunderlined hanswers hare htrue. hThe
hPaCO2 hanswer hdoes hnot happly hto hPEEP hand hthe hvalues hin hthe hlast hanswer hare
hincorrect. hThe hnormal hvalue hshould hbe h5-15 hcm hof hH20.
2) hHow hcan ha hmechanical hventilator haffect hthe hcardiac hsystem?
, a. hDelivers hhigh hlevels hof hPEEP hand hincreases hthe hintra-thoracic hpressure hand hthe
hpressure hin hthe hchest hcan hcompress hthe hheart
b. hDecreases hintra-throacic hpressure
c. hDelivers hlow hlevels hof hPEEP
d. hDelivers hlow hlevels hof hPEEP hand hdecreases hthe hintra-thoracic hpressure hand hthe
hpressure hin hthe hchest hcan hcompress hthe hheart. h- hcorrect hanswer.Answer: ha
Reasoning: hRespiration hhas ha hhydraulic hinfluence hon hcardiovascular hfunction. hThe
hventilator hdelivers hhigh hlevels hof hPEEP hand hit hincreases hthe hintra-thoracic hpressure
hand hpressure hin hthe hchest hwhich hcan hcompress hthe hheart.
3) hYou hare hthe hnurse hon hduty hand hwalk hinto hMr. hJensen's hroom. hYou hnotice hthat hhe hhas
ha htrachea htube. hHe hhas hmucous-like hsecretions hhanging hoff hthe hend hof hthe htrachea
htube. hWhat helse hare hindications hfor hsuctioning hthe hpatient?
a. hincrease hin htidal hvolume, hpatient hlungs hsound hclear
b. hdecrease hin htidal hvolume, hhypoxia, hand hcan hhear hrhonchi, hmucus, hcough
c. hgood hoxygen hsaturation hwith hincreased htidal hvolume
d. hpatient hcan hclear htheir hown hairway, hand hyou hhear hrhonchi, hsee hmucus, hand hthey
hhave ha hcough h- hcorrect hanswer.Asnwer: hb
Reasoning: hIndications hfor hsuction hinclude ha hdecrease hin htidal hvolume, hhypoxia,
hhearing hrhonchi, hthe hpresence hof hmucous, hpatient hcoughing hand hunable hto hclear htheir
hairway. hIf htidal hvolume hincreases hand hthe hpatient hcan hclear htheir hown hairway hthere his
hno hneed hfor hsuction.
4) hWith hcontinuous hmechanical hventilation h(CMV), hwhat hhappens hif hthe hinspiratory hflow
his hinadequate?
a. hDecreased hwork hof hbreathing
b. hIncreased hwork hof hbreathing
c. hIncreased hperfusion
d. hIncreases hP-peak h- hcorrect hanswer.Answer: hb
Reasoning: hIf hinspiratory hflow his hinadequate hthe hpatient hwill hhave hto hwork hmore hto
hbreathe. hAll hother hoptions hare hincorrect.
5) hIf habout h4/5 hof hthe hblood his hleft hin hthe hventricle hafter hthe hcontraction hof hthe hheart,
hwhat his hthe hmost hlikely hejection hfraction h(EF)?
a. h70%
b. h50%
c. h20%
d. h87% h- hcorrect hanswer.Answer: hc
Reasoning: hEjection hfraction hin ha hhealthy hheart his h70%. hIf hthe hejection hfraction his hunder
h50% hit hmeans hthat hthere his ha hlarger hvolume hof hblood hleft hin hthe hventricle hafter hthe
hcontraction. hThis hmeans hthat hthere his hless hroom hfor h"new" hblood hin hthe hventricle hand
hless hblood his hgoing hout hto hperfuse hthe hbody. hAn hejection hfraction hof h20% his hnot hgood!
