Written by students who passed Immediately available after payment Read online or as PDF Wrong document? Swap it for free 4.6 TrustPilot
logo-home
Document preview thumbnail
Preview 4 out of 32 pages
Exam (elaborations)

Critical care 1 Exam Questions and Correct Answers.

Document preview thumbnail
Preview 4 out of 32 pages

Critical care 1 Exam Questions and Correct Answers The critical care environment is stressful to the patient. Which interventions assist in reducing this stress? (Select all that apply.) (Points : 1) A. Adjust lighting to promote normal sleep-wake cycles B. Provide clocks, calendars, and personal photos in the patient's room. C. Talk to the patient about other patients you are caring for on the unit. D. Tell the patient the day and time when you are providing routine nursing interventions - Correct Answers: ABD Question 9 of 10Family presence is encouraged during resuscitation and invasive procedures. The nurse knows that nurses are often reluctant to allow this to occur, yet families often perceive benefits. Which findings have been reported in the literature? (Select all that apply.) (Points : 1) A. Families benefit by witnessing that everything possible was done. B. Families report reduced anxiety and fear about what is being done to the patient. C. Presence encourages family members to seek litigation for improper care. D Presence reduces nurses involvement in explaining things to the family - Correct Answers: AB The VALUE mnemonic is a helpful strategy to enhance communication with family members of critically ill patients. Which of the following statements describes a VALUE strategy? (Points : 1) A View the family as guests on the unit B Acknowledge family emotions. C Learn as much as you can about family structure and function. D Use a trained interpreter if the family does not speak English. E Evaluate each encounter with the family. - Correct Answers: B Family assessment is essential in order to meet family needs. Which of the following must be assessed first to assist the nurse in providing family-centered care? (Points : 1) A Assessment of patient and family's developmental stages and needs B Description of the patient's home environment C Identification of immediate family, extended family, and decision makers D Observation and assessment of how family members function with each other - Correct Answers: C Family members have a need for information. Which interventions best assist in meeting this need? (Points : 1) A Handing family members a pamphlet that explains all of the critical care equipment B Providing a daily update of the patient's progress and facilitating communication with the intensivist C Telling them that you are not permitted to give them a status report but that they can be present at 4:00 PM for family rounds with the intensivist D Writing down a list of all new medications and doses and giving the list to family members during visitation - Correct Answers: B Which of the following is a National Patient Safety Goal? (Select all that apply.) (Points : 1) A Accurately identify patients. B Eliminate use of patient restraints. C Reconcile medications across the continuum of care. D Reduce risks of healthcare-acquired infection - Correct Answers: ACD Comparing the patient's current (home) medications with those ordered during hospitalization and communicating a complete list of medications to the next provider when the patient is transferred within an organization or to another setting are strategies to: (Points : 1) A improve accuracy of patient identification B prevent errors related to look-alike and sound-alike medications. C reconcile medications across the continuum of care. D reduce harms associated with administration of anticoagulants - Correct Answers: C Question 3 of 10The most important outcome of effective communication is to: (Points : 1) A demonstrate caring practices to family members. B ensure that patient teaching is done. C meet the diversity needs of patients. D reduce patient errors - Correct Answers: D Question 2 of 10A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and is interested in certification. Which credential would be most applicable for her to seek? (Points : 1) A ACNPC B CCNS C CCRN D PCCN - Correct Answers: C Which of the following professional organizations best supports critical care nursing practice? (Points : 1) A American Association of Critical-Care Nurses B American Heart Association C American Nurses Association D Society of Critical Care Medicine - Correct Answers: A what is the synergy model?**** - Correct Answers: focused on the needs of patients and their families, which driving nursing competency The Joint Commission National Patient Safety Goals - Correct Answers: Communication Medication safety Reduce infections Reconcile medications The Joint commission is trying to reduce - - Correct Answers: - adverse drug effects - infections - injuries from falls + immobility - obstetric adverse events - pressure ulcers - VTE Professional organization that supports critical care nursing practice - - Correct Answers: -AACN what does AACN do? - Correct Answers: - provides resources to provide optimal care to critically ill patients - assist nurse to attain knowledge and influence Credentials for critical care nursing - - Correct Answers: CCRN - adult, peds, neonatal PCCN - step down Purpose of certification ********** - Correct Answers: Validate knowledge Promote professional excellence Help nurses maintain up-to-date knowledge. A nurse is informing the physician that family wants to talk to him. What kind of competency does this represent? - Correct Answers: Collaboration Name the national safety goal - - Correct Answers: - accurately identify the patient - Medications reconciliation across the continuum of care - reduce risks of healthcare-acquired infection Standards of professional practice for critical care nursing - - Correct Answers: - Guide clinical practice - establish goals for patient care - provide assessment of outcomes Current trends and issues in critical care nursing - - Correct Answers: - critical care pts more complex - increasing costs for care - reducing hospital readmission rates - increasing use of technology - ethical issues associated with prolonging life - telemedicine and eICU - Aging workforce - Pts are sicker among arrival. skip - Correct Answers: collaboration skip - Correct Answers: - accurately identify pt - medication reconcilation - reduce risk of healthcare-acquired infection. EPICS acronym - - Correct Answers: Evaluate - Plan - Involve - Communicate - Support EPICS helps address - - Correct Answers: family needs VALUE mnemonic - - Correct Answers: - Value what the family tells you - Acknowledge family emotions - Listen to family - Understand the patient as a person - Elicit questions from family Nursing interventions for family who need information about the ICU. - Correct Answers: - Explain to family about the equipment used - Provide family daily update Nursing interventions to reduce stress to family members - Correct Answers: - Noise reduction - music in room - private areas for communication - adequate lighting - night/day synchronization Pts recall of critical care - - Correct Answers: - difficult communication - pain - thirst - difficulty swallowing - anxiety - lack of control - depression - fear - lack of family - discomfort - sleeping problems - thoughts of dying - lonliness - physical restraint. How to prepare pts to be discharged from critical care units - - Correct Answers: - Pts will likely feel stress and anxiety/abandonment, so we need to: - tour the new area, - meet the receiving nurse, - provide reassurance. Post-critical care symtpoms - - Correct Answers: - fatigue - pain, muscle weakness - poor conecntration - poor appetite. Family needs from the nurse - - Correct Answers: - assurance - remaining near the pt - information - comfortable - having support Calgary Family Assessment: structural - - Correct Answers: - who comprises family - decision makers/spokesperson - Race, ethnicity, cultural factors Developmental - - Correct Answers: stages, tasks and attachments Functional - - Correct Answers: how family interacts with eachother. skip - Correct Answers: - facilitate visittion - provid information - encourage family involvement in care - consider family presence during procedures Ethical issues that confront critical care nurses everyday (GREATER FREQUENCY) - - Correct Answers: - informed consent - withholding or withdrawal of treatment - organ and tissue transplantation - distribution of healthcare resources - appropriate use of technology Ethical Dilemma Warning Signs - Correct Answers: - Emotionally charged - hyped up - Significant change in patient's condition - Confusion about facts - Hesitancy about what is right - Deviation from customary practice - Need for secrecy regarding proposed actions Ethical Decision-Making Process: - Correct Answers: 1. Assess 2. Consider options 3. Develop plan with pt, surrogate, family and team 4. act on plan 5. evaluate plan What options do you have? - Correct Answers: - pt wishes - burden vs benefit - ethical principles - potential outcomes skip - Correct Answers: - contextual factors - physiological factors - personal Autonomy - Correct Answers: Right of self-determination concerning medical care Beneficence - - Correct Answers: Duty to prevent harm, remove harm, and promote the good of another person nonmaleficence - - Correct Answers: Not to intentionally inflict harm Justice - - Correct Answers: fairness Veracity - - Correct Answers: -truthfulness Fidelity - - Correct Answers: - faithfulness Confidentiality - - Correct Answers: control info Living will - Durable power of attourney for health care - - Correct Answers: - treatment desured and what should be withheld - determines who makes decisions - healthcare surrogate. ski[p - Correct Answers: - right of self-determination concerning medical care. - let the pt make his/her own decisions regarding healthcare. Brain dead criteria - - Correct Answers: - Flat EEG - absence of brain stem reflexes - no profusion to brain • Name the warning signs of an ethical dilemma that may exists in critical area with patients family - Correct Answers: o Family members that are in conflict o Informed the nurse not to tell patient about the deteriorating condition o Physician trying more treatment option o Patient condition is changing and not responding to treatment Ordinary care - - Correct Answers: Common - noninvasive - tested treatment - ex, blood pressure Extraordinary care - - Correct Answers: - complex - invasive - experimental Ex. dialysis, ACLS, NG tube feedings Patient Self-Determination Act - Correct Answers: - Patient's right to initiate advance directive - Patient's right to consent for or refuse treatment If a pt has Cheynne Stokes Respirations, are they brain dead? - Correct Answers: no How can we increase organ donation in other cultures? - Correct Answers: - education Ethical and legal concerns related to end-of-life care - Correct Answers: - Advances in technology - use of invasive, costly resources in potentially futile situations - controversial Healthcare surrogate - - Correct Answers: - Designated by patient as part of advance directive - act as the pt would have acted in similar situation Proxy - - Correct Answers: - legally designated decision maker - state satute may designate order of succession - Ex. Prisoners. What is advance directive? - Correct Answers: - 1. Describe a patient's preference for treatment in terminal or vegetative state 2. Legally recognized 3. Presence of advance directive and end-of-life care desires should be shared with significant others long before they are needed 4. Problems related to the lack of an advance directive 5. Lack of advance directive common with many critically ill patients 6. Self-determination in absence of living will 7. Legal authority of surrogate decision maker 8. Ethical challenges faced when advance directive is not executed and surrogate decision maker identified Medical futility - - Correct Answers: - Situation in which therapy or interventions will not provide a foreseeable possibility of improvement in the patient health condition. Palliative care - - Correct Answers: - designed to relieve symptoms that negatively affect pt. - implemented with ALL pts, not just dying. Nursing interventions for palliative care - - Correct Answers: - frequent repositioning - good hygiene - skin care - creation of a peaceful environmeny - pain relief Communication and conflict resolution - Correct Answers: 1. Provide clear, ongoing, honest communication 2. Allow time for family members to express themselves 3. Agree on a treatment plan 4. Emphasize that patient will not be abandoned 5. Facilitate continuity of care 6. Communication between members of the healthcare team, patient, and family Withdrawal of treatment - - Correct Answers: -discontinuation of life-sustaining therapies in a terminally ill or vegetative pt. (like This us Us character) Ventilator Withdrawal - - Correct Answers: most common withdrawal intervention - called terminal weaning - titrate pain medications and sedation during this process. What do we do when someone is terminal weaning?****** - Correct Answers: - titration of ventilator settings to minimum levels. - removal of the ventilator but not the airway or ET tube. - Complete extubation Ethical principles related to withdrawal and withholding - - Correct Answers: 1. Death is a product of the underlying disease 2. Goal is to relieve suffering, not hasten death 3. Withholding life-sustaining treatment is moral equivalent of withdrawing treatment 4. Any treatment may be withheld or withdrawn with patient and family consent 5. Any dose of analgesic or anxiolytic medication may reasonably be used to control pain and relieve suffering 6. Life-sustaining treatment should not be withdrawn from patients on paralytic agents 7. Cultural and religious perspectives may affect patient and family decision making 8. Emphasize that paralytics need to be discontinued in order to do assessment. What things are commonly withheld therapies - - Correct Answers: - Vasopressors - Antibiotics - Blood and blood products - nutritional support - deactivation of implanted devices - What meds do you give for anxiety? Pain and dyspnea? - Correct Answers: - Benzodiazepines - morphine skip - Correct Answers: 1. Variable interventions based on the patient's and family's needs 2. Nonjudgmental, culturally sensitive assessments 3. Family involvement (comfort them) 4. Spiritual counseling if appropriate 5. Clear, concise information 6. Bereavement counselor 7. Life story (listen) 8. Discuss definitions of "family." 9. Coordinating the communication process between the patient, family, and the healthcare team is a key nursing action in end-of-life care. 10. The nurse should make time to listen to family accounts of the patient's life before the illness or injury and acknowledge the patient's individuality and humanity. 2. Caregiver Organizational Support - Correct Answers: 1. Adequate staffing 2. Co-worker support 3. Conduct family meetings and develop plan of care 4. Assistance with funeral arrangements 5. Educate the public 6. Professional development classes 7. End-of-life care requires much time. 8. Other staff assume some duties of the nurse. 9. Administration provides support for staffing, space for family meetings, assistance with funeral arrangements, etc. 10. Hold educational sessions for the public about end-of-life issues and life-support options. 11. Educate nurses regarding palliative care and end-of-life interventions. 3. Effects of End-of-Life Issues on Nurses and Healthcare Teams - Correct Answers: 1. Ethical conflicts 2. Moral distress 3. Concern for the patient's dignity 4. How to maintain a professional distance 5. Many clinicians experience personal ethical conflicts when providing painful interventions and aggressive care to patients when they believe the situation is futile; these conflicts cause significant moral distress that can lead to burnout. 6. Experiencing recurrent moral distress was cited as the cause of leaving a job by 45% of nurses in one recent study. Elements of Palliative care - - Correct Answers: - Early identification of end-of-life pts - pain management - pharmocological and nonpharmacological interventions The 5 Dimensions of Nursing Care at End of Life - Correct Answers: 1. Alleviation of distressing symptoms (palliation) 2. Communication and conflict resolution 3. Withdrawing, limiting, or withholding of therapy 4. Emotional and psychological care of the patient and family 5. Caregiver organizational support Define pain - - Correct Answers: -i. Unpleasant sensory and emotional experience associated with actual or potential tissue damage ii. Pain is what the patient says it is Define anxiety - - Correct Answers: i. Prolonged state of apprehension in response to fear ii. Marked by apprehension, agitation, and autonomic arousal Are pain and anxiety related? - Correct Answers: - yes, they are symbiotic. - they can aggravate each other. Indications for a neuromuscular agent - - Correct Answers: - i. Facilitate treatment or procedures, including emergency or difficult intubation ii. Improve tolerance of mechanical ventilation, especially non-traditional modes iii. Manage elevated ICP Properties of a neuromuscular agents - - Correct Answers: no sedative or analgesic properties - MUST PROVIDE SEDATION What do you monitor while administering a neruomuscular agent - - Correct Answers: - TOF - train of four what is the target of TOF? - Correct Answers: - 2 - peripheral nerve stimulator. Care of immobilize, paralyzed pt - - Correct Answers: 1. Mechanical ventilation and airway management 2. Eye lubrication 3. DVT prophylaxis 4. Repositioning and range of motion 5. Oral care 6. Urinary catheter 7. Routine vital signs and assessments Predisposing Factors of pain - - Correct Answers: - Disease - Procedures - Monitoring devices - nursing care - trauma Influences of pain perceptions - - Correct Answers: - Expectation - Previous pain experiences - emotional state - cognitive status Predisposing factors of anxiety - - Correct Answers: - endotracheal tube - monitor alarms - lack of mobility - unfamiliar surroundings - sleep deprivation Five-Step Assessment of Pain - Correct Answers: 1. Assess and treat promptly; document 2. Engage patient in management plan 3. Provide preemptive treatment 4. Reassess and treat to meet patient's needs 5. Institute quality improvement plan related to practice and outcomes i. Chest pain characteristics - Correct Answers: PQRST - Provocation or position - Quality - Radiation - Severity or associated symptoms - timing or triggers Behavioral pain scale items - - Correct Answers: - facial expression - upper limbs - compliance with ventilation Critical-care pain observation tool indicators - - Correct Answers: - facial expressions - body movements - upper extremities - compliance with ventilation - nonventilator, vocalization Management challenges in critically ill pts - - Correct Answers: - Invasive procedures - substance abuse - restraining devices - Elderly patients Problems with elderly patients - - Correct Answers: - comoribidities - multiple medications - physical frailty - cognitive or sensory deficits. Management of pain: opioids and their onset - - Correct Answers: - fentanyl - fastest onset - morphine - longer duration - hydromorphone Cocerns with opioids - - Correct Answers: - respiratory depression - hypotension Epidural - - Correct Answers: - facilitates mobility and pulmonary hygiene NSAIDS - - Correct Answers: - Risk of GI bleeding - Renal failure (ibuprofen) - liver (acetaminophen) Management for anxiety - - Correct Answers: - Benzodiazepines - Propofol - dexmedetomidine PCA pumps are best suited for patients with - - Correct Answers: -1. Elective surgery 2. Large surgical or traumatic wounds 3. Normal cognitive function 4. Normal motor skills ABG: Normal ph - paCo2? Hco3? - Correct Answers: - 7.34-7.45 - 35-45 - 22-26 If compensation is partial then the ph is - - Correct Answers: - abnormal still PaO2: what is it? normal range - - Correct Answers: - partial pressure of oxygen dissolved in arterial blood - 80-100 SaO2: what is it? normal range - - Correct Answers: - amount of O2 bound to hemoglobin - pulseox - 92-99% Methods for maintaining an open airway - - Correct Answers: - positioning - Oral airway device - Nasopharyngeal airway - Endotracheal intubation Endotracheal Intubation: preferred route - what do you do before this procedure? - Correct Answers: - orotracheal - through mouth or nose - PREMEDICATE ETT: used to - Correct Answers: - maintain airway - remove secretions - prevent aspiration - provide mechanical ventilation After you get it placed, then what do you do? - Correct Answers: - VERIFY PLACEMENT by - chest x-ray, or ausculate the breath sounds - if the tube is in the right bronchus, breath sounds in the left side should be absent. 6. What if the ET tube is in the esophagus - Correct Answers: Remove tube and manually ventilate with 100% O2 while preparing to re-intubate. Indications for initiation of mechanical ventilation - - Correct Answers: - Hypoxemia - Hypercapnea - Progressive deterioration How would you know if someone is hypoxemia: - Correct Answers: - PaO2 60 on FiO2 .50 Hypercapnea? - Correct Answers: PCO2 50 with pH 7.25 Progressive deterioration - Correct Answers: - Increased RR - Decreased Tital volume - Increased WOB Types and modes of ventilation - - Correct Answers: - Positive pressure ventilation - Volume assist/control ventilation - Synchronized Intermittent Mandatory Ventilation (SIMV) - Pressure Ventilation - Noninvasive positive-pressure ventilation (NPPV Positive Pressure Ventilation: what does it do? opposite of? - Correct Answers: - Movement of gases into lungs through positive pressure - normal respirations Ventilator settings for positive pressure: Tidal volume - PEEP - H2O- - Correct Answers: 6-8 - 5-20 - sensitivity Volume Assist/Control (V-A/C): Preset - Pt may - Tidal volume - - Correct Answers: - number of breaths at preset Tidal Volume - trigger additional breaths - does not vary with each breath Most important for V-A/C: - Ventilator performs - risk? - Correct Answers: - most of the WOB - hyperventilation - if they start breathing on their own If you have hyperventilation, what acidbase imbalance s it? - Correct Answers: - respiratory alkalosis Synchronized Intermittent Mandatory Ventilation (SIMV): Preset - Pt can still - Tidal volume - - Correct Answers: - tidal volume at a preset RR - initiate spontaneous breaths inbetween mandatory breaths - of spontaneous breaths do vary SIMV: helps to prevent - risk of - - Correct Answers: - repiratory muscle weakness - hypoventilation - preset to four, but doesn't take breaths on own Pressure Ventilation: Set to allow airflow until - Tidal volume is - PIP can be - - Correct Answers: - preset pressure is reached - variable - better controlled Pressure ventilation: Risk for - Types of this? - Correct Answers: - hypoventilation and respiratory acidosis - CPAP, pressure support, pressure A/C, inverse-ratio ventilation, and airway pressure release. Noninvasive positive-pressure ventilation (NPPV): what is it? - Correct Answers: - delivery of positive-pressure ventilation without artificial airway NPPV is via? - Correct Answers: - Face mask, nasal pillow NPPV is useful for pts with - - Correct Answers: - COPD - HF - Palliative care Alarms and ventilators - - Correct Answers: -NEVER TURN OFF ALARMS How to prevent complications - - Correct Answers: - Ventilator bundle Complications of Mechanical Ventilation - Correct Answers: - skin breakdown from tape - dislodged - unplanned extubation - Laryngeal/Tracheal Injury - Barotrauma - Valutrauma - Infection - Ventilator associated pneumonia Ventilator bundle - - Correct Answers: 1. Head of bed 30 degrees 2. Awaken daily and assess readiness to wean 3. Stress ulcer prophylaxis 4. DVT prophylaxis 5. Oral care How to prevent larygeanl/tracheal injury - - Correct Answers: 1. Prevent excessive head movement 2. Routine monitoring ETT cuff pressure 3. Keep no higher than 25 to 30 cm H2O Ex of barotrauma - - Correct Answers: - Pneumothorax - tension pneumothorax - (injury to the lungs associated with mechanical ventilation) How to detect barotrauma - - Correct Answers: 1. High PAP, mean airway pressure 2. Decreased breath sounds 3. Tracheal shift 4. Subcutaneous crepitus 5. Hypoxemia Treatment for barotrauma - - Correct Answers: - Manually ventilate - needle thorcostomy Volutrauma - - Correct Answers: - overdistention of alveoli - Damages lungs similarly to ARDS How to prevent volutrauma? - Correct Answers: - keep PIP 40 cm H20 VAP prevention - *********** - Correct Answers: 1. Elevate head of bed 30 to 45 degrees 2. Prevent drainage of condensate back to patient 3. Hand hygiene 4. ETT with subglottic suction capability 5. Aspirate secretions from above ETT 6. Oral hygiene program 7. Noninvasive ventilation as possible Liberating the weaning from a ventilator - - Correct Answers: - individualized decisions - Collaborative team effort 2. Readiness to Wean - Correct Answers: 2. Underlying cause for mechanical ventilation resolved 3. Hemodynamic stability; adequate cardiac output 4. Adequate respiratory muscle strength 5. Adequate oxygenation without a high FiO2 and/or high PEEP 6. Absence of factors that impair weaning 7. Mental readiness 8. Minimal need for medicines that cause respiratory depression Weaning methods - - Correct Answers: -1. Synchronized intermittent mechanical ventilation 2. Pressure support 3. T-piece trials 4. CPAP When to stop the weaning process - - Correct Answers: -1. Respiratory rate 35 or 8 breaths/min 2. Low spontaneous VT 5 mL/kg 3. Labored respirations 4. Use of accessory muscles 5. Low oxygen saturation 90% 6. HR or BP changes 20% from baseline 7. Dysrhythmias (e.g., PVCs) 8. ST-segment elevation 9. Decreased level of consciousness 10. Anxiety 8. What is the indications of the high inspiratory pressure alarms? - Correct Answers: 1. Kinking from biting 2. Coughing 3. Attempting to talk 4. Need suction How to respond to a ventilatory alarms - - Correct Answers: - never shut off alarm - go to bedside - check for cause - manually vent - call RT - connect if all is good - reassess Role of each person it Rapid response teams: Leader - Primary nurse - second nurse - - Correct Answers: - leads code, makes diagnosis and treatment decisions - knows pts - gives meds and gets equipment from crash cart another nurse - nursing supervisor - anesthesiologist - respirator therapist - - Correct Answers: - records - provides traffic control and secures ICU bed - intubation - manages airway, intubates, draws ABGs Pharmcist - Chaplain - ECG thechnician - - Correct Answers: - prepares meds - helps family - ecg Equipment used during code - - Correct Answers: - Crash cart - backboard - AED Transcutaneous pacemaker - bag-valve mask device - airway supplies/suction - medications - IV supplies - Nasogastric tube - BP cuff O2 concentration used prior to intubation - - Correct Answers: - during an arrest, 100% - 15 L/min via bag-valve device Difference between Basic life support and advnaced: BLS: goal - - Correct Answers: to support or restore effective circulation, oxygenation, and ventilation with return of spontaneous circulation. Early CPR and early defibrillation with an AED are stressed. order of CPR = - Correct Answers: CAB Advanced life support: used for ? - Correct Answers: 1. Hypovolemia, Hypoxia, Acidosis, Hypo/Hyperkalema, Hypothermia 2. Tension Pneumothorax, tamponade, toxins/ drug overdose, thrombosis skip - Correct Answers: -ABCD - AED - Advanced skills, diagnosis - Large bore IV, Medications in codes: Epinephrine: effects? use - - Correct Answers: - alpha and beta adrenergic effects - asystole, VT, Vasopressin: effect? - use - Correct Answers: - - intense vasoconstriction - VF Atropine: use - effect? - Correct Answers: - symptomatic bradycardia - decreased vagal tone - to increase HR Adenosine: important - use - - Correct Answers: half-life 10 seconds - SVD Amiodarone: Use - - Correct Answers: - VF, VT and atrial dysrhythmias skip - Correct Answers: Symptomatic bradycardia Dopamine use - - Correct Answers: - hypotension not related to hypovolemia Lidocaine: use - - Correct Answers: - cardiac arrest from VF and VT Magnesium use - - Correct Answers: - Torsades de pointes Norpeinephrine use - - Correct Answers: - hypotension Oxygen use - - Correct Answers: - cardiopulmonary arrest - chest pain - hypoexmia Before giving sodium bicarbinate, - Correct Answers: check ph special problems during a code - - Correct Answers: - therapeutic hypothermia Treatment for therapeutic hypothermia - Correct Answers: - handwashing - VAP prevention - control hyperglycemia - monitor electrolytes - rewarm after 24 hours Information documented during a code - - Correct Answers: - Medications given, - Time started - Actions taken and pts response o Joules given for defibrillation - Procedures - Pacemakers. - VS - Intubation and airway management. 8. Describe care of patients after resuscitation. - Correct Answers: - Optimize cardiopulmonary function - Transport to critical care unit - Determine cause of arrest to prevent - Maintain blood pressure and O2 - Control dysrhythmias - Airway placement. - Watch mental status drugs used for pulseless VT - - Correct Answers: - amiodarone Pulseless Electrical activity symptoms - Correct Answers: - No BP - rhythm without pulse - What can cause Pulseless Electrical Activiaty? (PEA) - Correct Answers: Drug overdose - pheumothorax - hypovolemia When to use defib vs cardioversion - - Correct Answers: - no pulse - defib - pulse - cardioversion How often to take blood sugars - - Correct Answers: -in ICU? every hour Describe methods for assessing the patient with acute respiratory failure, - Correct Answers: - dyspnea - tachypnea - hyperventilation - normal breath sounds - respiratory alkalosis - increased temp and pulse - worsening chest x-rays that progress to white out - increased PIP - severe hypoxemia. Diagnostic criteria for ARDS - - Correct Answers: - PaO2/Fio2 ratio of less than 200 - bilateral infiltrates - pulmonary capillary wedge pressure 18 mm Hg Medical management of the patient with acute respiratory failure. - Correct Answers: - Correct hypoxemia - Medications How to correct hypoxemia - - Correct Answers: - Cautious administration of O2 Noninvasive positive-pressure ventilation Ventilatory assistance Medications to correct ARF - - Correct Answers: - Beta 2 agonists - corticosteroids - antibiotics - sedatives (CAUTIOUS) What is intrapulmonary shunt? - Correct Answers: blood shunted from right to left side of heart without oxygenation. Why does administration of higher levels of oxygen not help in shunt disorders? - Correct Answers: - like COPD, they get used to living that low. Physiological effects of positive end expiratory pressure - Correct Answers: - increase functional residual volume, - prevent collapse of unstable alveoli, - improve arterial oxygenation, - open collapse alveoli 5. Signs of hypoxemia. - Correct Answers: - Hypoventilation - shunt - Ventilation-perfusion mismatch - PE - Diffusion defect due to increased intersitial fluid What patients would you identify as having a high risk of developing ARDS? - Correct Answers: Hospitalized, pneumonia, immunocompromised pts Why is hyperventilation an early sign seen in patients developing ARDS? - Correct Answers: Attempting to increase O2 Exacerbation of asthma - - Correct Answers: - wheezing - dyspnea - chest tightness - cough - hyperventilation

Content preview

Critical care 1 Exam Questions and
Correct Answers
The critical care environment is stressful to the patient. Which interventions assist in reducing this
stress? (Select all that apply.) (Points : 1)

A. Adjust lighting to promote normal sleep-wake cycles

B. Provide clocks, calendars, and personal photos in the patient's room.

C. Talk to the patient about other patients you are caring for on the unit.

D. Tell the patient the day and time when you are providing routine nursing interventions - Correct
Answers: ABD



Question 9 of 10Family presence is encouraged during resuscitation and invasive procedures. The nurse
knows that nurses are often reluctant to allow this to occur, yet families often perceive benefits. Which
findings have been reported in the literature? (Select all that apply.) (Points : 1)

A. Families benefit by witnessing that everything possible was done.

B. Families report reduced anxiety and fear about what is being done to the patient.

C. Presence encourages family members to seek litigation for improper care.

D Presence reduces nurses involvement in explaining things to the family - Correct Answers: AB



The VALUE mnemonic is a helpful strategy to enhance communication with family members of critically
ill patients. Which of the following statements describes a VALUE strategy? (Points : 1)

A View the family as guests on the unit

B Acknowledge family emotions.

C Learn as much as you can about family structure and function.

D Use a trained interpreter if the family does not speak English.

E Evaluate each encounter with the family. - Correct Answers: B



Family assessment is essential in order to meet family needs. Which of the following must be assessed
first to assist the nurse in providing family-centered care? (Points : 1)

A Assessment of patient and family's developmental stages and needs

,B Description of the patient's home environment

C Identification of immediate family, extended family, and decision makers

D Observation and assessment of how family members function with each other - Correct Answers: C



Family members have a need for information. Which interventions best assist in meeting this need?
(Points : 1)

A Handing family members a pamphlet that explains all of the critical care equipment

B Providing a daily update of the patient's progress and facilitating communication with the intensivist

C Telling them that you are not permitted to give them a status report but that they can be present at
4:00 PM for family rounds with the intensivist

D Writing down a list of all new medications and doses and giving the list to family members during
visitation - Correct Answers: B



Which of the following is a National Patient Safety Goal? (Select all that apply.) (Points : 1)

A Accurately identify patients.

B Eliminate use of patient restraints.

C Reconcile medications across the continuum of care.

D Reduce risks of healthcare-acquired infection - Correct Answers: ACD



Comparing the patient's current (home) medications with those ordered during hospitalization and
communicating a complete list of medications to the next provider when the patient is transferred
within an organization or to another setting are strategies to: (Points : 1)

A improve accuracy of patient identification

B prevent errors related to look-alike and sound-alike medications.

C reconcile medications across the continuum of care.

D reduce harms associated with administration of anticoagulants - Correct Answers: C



Question 3 of 10The most important outcome of effective communication is to: (Points : 1)

A demonstrate caring practices to family members.

B ensure that patient teaching is done.

,C meet the diversity needs of patients.

D reduce patient errors - Correct Answers: D



Question 2 of 10A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years
and is interested in certification. Which credential would be most applicable for her to seek? (Points : 1)

A ACNPC

B CCNS

C CCRN

D PCCN - Correct Answers: C



Which of the following professional organizations best supports critical care nursing practice? (Points : 1)

A American Association of Critical-Care Nurses

B American Heart Association

C American Nurses Association

D Society of Critical Care Medicine - Correct Answers: A



what is the synergy model?**** - Correct Answers: focused on the needs of patients and their families,
which driving nursing competency



The Joint Commission National Patient Safety Goals - Correct Answers: Communication

Medication safety

Reduce infections

Reconcile medications



The Joint commission is trying to reduce - - Correct Answers: - adverse drug effects

- infections

- injuries from falls + immobility

- obstetric adverse events

- pressure ulcers

, - VTE



Professional organization that supports critical care nursing practice - - Correct Answers: -AACN



what does AACN do? - Correct Answers: - provides resources to provide optimal care to critically ill
patients

- assist nurse to attain knowledge and influence



Credentials for critical care nursing - - Correct Answers: CCRN - adult, peds, neonatal

PCCN - step down



Purpose of certification ********** - Correct Answers: Validate knowledge

Promote professional excellence

Help nurses maintain up-to-date knowledge.



A nurse is informing the physician that family wants to talk to him. What kind of competency does this
represent? - Correct Answers: Collaboration



Name the national safety goal - - Correct Answers: - accurately identify the patient

- Medications reconciliation across the continuum of care

- reduce risks of healthcare-acquired infection



Standards of professional practice for critical care nursing - - Correct Answers: - Guide clinical practice

- establish goals for patient care

- provide assessment of outcomes



Current trends and issues in critical care nursing - - Correct Answers: - critical care pts more complex

- increasing costs for care

- reducing hospital readmission rates

Document information

Uploaded on
March 28, 2025
Number of pages
32
Written in
2024/2025
Type
Exam (elaborations)
Contains
Questions & answers
$17.29

Wrong document? Swap it for free Within 14 days of purchase and before downloading, you can choose a different document. You can simply spend the amount again.
Written by students who passed
Immediately available after payment
Read online or as PDF

Sold
2
Followers
2
Items
1654
Last sold
1 year ago




Why students choose Stuvia

Created by fellow students, verified by reviews

Quality you can trust: written by students who passed their tests and reviewed by others who've used these notes.

Didn't get what you expected? Choose another document

No worries! You can instantly pick a different document that better fits what you're looking for.

Pay as you like, start learning right away

No subscription, no commitments. Pay the way you're used to via credit card and download your PDF document instantly.

Student with book image

“Bought, downloaded, and aced it. It really can be that simple.”

Alisha Student

Working on your references?

Create accurate citations in APA, MLA and Harvard with our free citation generator.

Working on your references?

Frequently asked questions