Critical-Care Nursing Practice Exam- Question and Answers [100% Correct] 2025 Latest Version!!

Critical-Care Nursing Practice Exam- Question and Answers [100% Correct] 2025 Latest Version!! The primary goal of effective communication in healthcare is to: minimize patient errors. In the management of critically ill patients, certain practices are implemented to prevent ventilator associated pneumonia. These include elevating the head of the bed to 30 degrees, waking the patient from sedation daily to assess readiness for weaning off the ventilator, and following a regular oral care protocol. This combination of interventions is referred to as a: care bundle. When working in a unit with high nursing turnover, the nurse manager is considered to have an autocratic leadership style, which is contributing to staff dissatisfaction. In this scenario, the manager refuses to involve a nurse in creating guidelines for pressure ulcer prevention due to lack of experience. This illustrates a: toxic work environment. What nursing intervention best supports the family of a critically ill patient? providing regular updates on the patient's condition each morning and whenever there are changes. Which intervention would be most effective in helping a patient cope with being admitted to a critical care unit? explaining each procedure in simple, understandable terms. Which statement about family assessments is incorrect? assessing family structure (who makes up the family) is typically the final step in the process. 1 Many critically ill patients experience anxiety. Which approach can the nurse take to reduce anxiety? saying, "Mr. J, it’s time to turn you. I’ll have another nurse assist. We’ll turn you to your left side. During the turn, I’ll check the skin on your back and apply some lotion. This should help you feel better." Which statement about resuscitation is accurate? it is both legal and ethical to withhold "extraordinary" resuscitation if specified in advance directives and physician orders. A 65-year-old patient with metastatic lung cancer has not responded to chemotherapy. The medical team has determined that no further treatments will improve survival or quality of life, yet the patient continues to receive chemotherapy and full nutritional support. This is an example of: medical futility. A patient with end-stage heart failure is experiencing significant shortness of breath. Which medication is most appropriate? 5 mg of morphine IV, followed by a continuous morphine infusion. Neuromuscular blocking agents are commonly used in managing ventilator patients. What is their primary mode of action? they induce paralysis. When using the critical care pain observation tool for a ventilated patient, which of the following signs would indicate a high likelihood of pain requiring intervention? resisting the ventilator. What is the best method for administering benzodiazepines intermittently? t itrating to a predefined endpoint using a standard sedation scale. A patient remains NPO following abdominal surgery complications, and feeding via an enteral tube is not possible. Parenteral feeding is required, but what major complication may arise from this therapy? f luid and electrolyte imbalances, and sepsis. 2 A patient's feeding tube has been correctly placed in the small intestine with continuous feeding. The nurse understands that this approach is chosen because: the intestinal mucosa typically receives nutrients from the stomach through peristaltic waves. Which patient is most at risk for malabsorption of protein? a patient with ileitis. A patient on tube feeding requires an X-ray for a cough evaluation. To minimize the risk of aspiration, the nurse should: stop feeding 10-15 minutes before positioning the patient flat for the radiograph. What is the normal resting rate of the SA node? 60-100 beats per minute. A nurse reviewing a cardiac rhythm strip in lead II notices that all the P waves are upright and identical, except for one that is inverted. The nurse concludes that the inverted P wave is most likely: from an area in the atrium other than the SA node. If there are 20 small boxes between each P wave and 20 small boxes between each R wave, what is the ventricular rate? 75. (Calculation: 0.04 x 20 = 0.08, and 60 / 0.08 = 75). A patient's heart rhythm shows an inverted P wave with a PR interval of 0.06 seconds and a heart rate of 54 beats per minute. The nurse identifies this rhythm as a junctional escape rhythm, which occurs due to: loss of sinus node activity. The patient's heart rate is 70 beats per minute, but the P waves follow the QRS complex. The nurse identifies the rhythm as: accelerated junctional rhythm. 3 What is the normal cardiac index? 1.2. What is the normal cardiac output? 4-8L/min. What is the normal pulmonary vascular resistance (PVR)? less than 250. What is the normal systemic vascular resistance (SVR)? 800-1200. A nurse is caring for a patient with an arterial line. To prevent complications, what is the priority action? ensure all tubing connections are secure. A nurse is explaining the purpose of a pulmonary artery catheter to a patient's family. Which statement by the family member indicates an understanding of the PAC's role? the catheter helps the physician manage fluid therapy more effectively. During the insertion of a pulmonary artery catheter, the physician requests the nurse to inflate the balloon with 1.5cc of air. As the catheter is advanced, the nurse observes a premature ventricular contraction on the monitor. What is the best course of action? ensure that lidocaine hydrochloride IV is readily available. A charge nurse has a Vigileo pulse contour cardiac output monitoring system available in the surgical intensive care unit. For which patient is the use of this device most appropriate? a mechanically ventilated patient admitted after an acute bowel obstruction repair. 4 5 A nurse is caring for a patient on mechanical ventilation with a left radial arterial line. During the inspiratory phase, there is a 20 mm Hg decrease in arterial blood pressure. What is the best interpretation of this finding? the patient may require fluid restriction. Neuromuscular blocking agents used in managing ventilator patients primarily work by: inducing paralysis. A patient is on mechanical ventilation in synchronized intermittent mandatory ventilation mode with a rate of 4 breaths/min, while their spontaneous respirations are 12 breaths/min. After receiving a dose of morphine sulfate, their respirations decrease to 4 breaths/min. What adjustment may be needed to the ventilator settings? increase the synchronized intermittent mandatory ventilation rate. SaO2 represents: total oxygen saturation. A PaCO2 level of 48 mmHg is associated with: hyperventilation. PEEP (Positive End-Expiratory Pressure) is a mode of ventilatory support that causes: pressure to remain in the lungs at the end of expiration, measured in cm H2O. During manual ventilation in a code situation, how should ventilations be administered? at a rate of 8-10 breaths per minute. Which rhythm would require the urgent application of a transcutaneous pacemaker? bradycardia (HR 50 beats/min) with hypotension and syncope. pt has pulseless electrical activity; MD decide cause of PEA is pericardial tamponade. appropriate tx is? pericardiocentesis pt admit after collapsing end of summer marathon. pt lethargic, hr 110, rr 30/min, bp 78/46; admit what? lactated ringer's bolus what is normal cardiac index? 2.5-4.0 caring for pt c insertion of IABP for cardiogenic shock unresponsive to therapy, which hemodynamic parameter is best indicates an appropriate response to therapy? CI 2.5 what is normal pulmonary diastolic pressure? normal artery occlusion pressure? 6-12 systemic vascular resistance normal values? 8-15 800-1200 nurse caring for pt 70kg in hypovolemic shock. upon initial assessment, nurse notes bp 90/50, HR 125/min, rr 32/min, central venous pressure (CVP/RAP) of 3 mm hg, urine 5cc past hr. following MD rounds, nurse review orders and question which? t itrate dopamine IV for bp 90 SBP pt admitted c dx of unstable angina. nurse knows that physiological mech present is most likely which of the following? partial occlusion of coronary artery c thrombus pt admitted c angina attack. nurse anticipates which drug regimen to be initiated? blockers what is myocardial infarction? death of cardiac muscle from lack of O2 MD order stress test for pt c activity intolerance, which drug to be used? nitro, o2, beta adenosine 6 cardiologist told pt and family that dx is hypertrophic cardiomyopathy; what cause this condition is? "inherited condition. you should give serious consideration to having family members screened for it" which statement from pt indicates good understanding of dx of coronary disease? "pain in my chest gets worse each time it happens. i think that there is more dmg to my heart vessels as time goes on" pt with ICP of 18, bp is 140/90, MAP is 108; what is cerebral perfusion pressure? how to calculate for CPP? MAP - ICP = CPP 90 pt c skull fracture c GCS of 3, vitals 100/70, 55 hr, rr 10, O2 @ 94% on 3L NC; what nursing action? monitor for patent airway pt new onset of slurred speech and r sided weakness, what priority action? symptom onset pt c ACRDS, identifies risk for ineffective airway clearance; what intevention? asthma exacerbation, what tx? determine time of reposition q 2 hrs inhaled bronchodilators and IV corticosteroids? d/c pt c asthma, part of d/c instructions, the nurse instruct pt to prevent exacerbation by asthma meds as prescribed nurse calculate pao2/fio2 ratio for the following values: PaO2 78, FiO2 0.6 (60%) taking all 130; meets criteria for ARDS PaO2/FiO2 = 200-300, ARDS severity? mild 7 PaO2/FiO2 = 100-200, ARDS severity? moderate PaO2/FiO2 = 100, ARDS severity? severe nurse assess pt c ARDS, assessment expected is? PAOP of 10mm and PaO2 of 55 pt turned prone as tx for ARDS, nurse understands priority nursing concern for this pt is which of the following? management and protection of the airway pt c AKI and being tx with hemodialysis, pt ask if he will need dialysis for rest of his life, which is best response? recovery is possible, but takes several month pt is admitted c complaint of general malaise and fatigue c decrease urinary output; pt uralysis shows coarse, muddy brown granular casts and hematuria; nurse determines pt has intrarenal disease, probably acute tubular necrosis daily weight recorded for pt. urine IV and oral intake. yesterday was 97.5kg and am is 99kg. nurse understands that this corresponds to: f luid retention of 1.5L slow continuous ultrafiltration is also known as isolated ultrafiltration and used to: water in case of volume overload remove plasma critical nurse is responsible for monitoring the patient receiving continuous renal replacement therapy (CRRT). in doing so, the nurse should: assess that blood tubing is warm to touch nurse examines the pt CBC, nurse notice elevated in eosinophil count. nurse realizes that eosinophil becomes elevated: in response to allergen and parasites minor vessel injury, primary hemostasis is acheived usually 8 care for neutropenic pt is same for all immunocompromised pt. desires pt outcome related to medical and nursing interventions include absence of infection, negative culture, and an absolute neutrophil count of? 1500 cell/mcl or higher pt c lymphoma and has normal wbc; nurse understands pt is: nurse assessing pt c pancreatitis, in doing so, nurse at risk for infection assesses symptoms that could indicate involvement of the stomach liver detoxifies the blood by: converting fat-soluble compounds to water-soluble compounds nurse assessing pt who admitted c abdominal pain. detects abdominal masses, the nurse has pt take a deep breath blood work includes h/h, nurse understands that nurse hematocrit values does not change substantially during the first few hours pt c end stage liver disease; nurse knows that pt at risk for hyperdynamic circulation and varies. which of the following assessment indicates hyperdynamic status? cardiac output of 8L/min nurse provide postoperative care to pt who had transphenoidal hypophysectomy for benign pituitary tumor. the nurse administers replacement hydrocortisone, thyroid hormone and vasopressin. the nurse evaluates that vasopressin replacement is effective when: 2L of urine are produced in 24 hr peroid management of DKA and hyperosmolar hyperglycemic syndrome, when is IV solution that contains dextrose be started? blood glucose reaches 250 mg/dl what would be seen in a patient c myxedema coma decreased reflexes pt who underwent pituitary surgery 12 hrs ago, nurse will give priority monitoring to which? hypovolemic shock 9 pt c head trauma, what his important assessment to assist nurse in early ID of endocrine disorder commonly associated c this condition? urine osmolarity pt c head trauma following a fall. pt vitals 112/min, 88/50; poor skin turgor, dry MM, pt confused and restless. labs 115 na, 50bun, cr 1.8; consistent c which disorder? cerebral salt wasting 18 YO sustain multiple traumatic injuries from MVA; bp 80/60, pt should be treated at which level trauma center? level I serum lactate level f luid resuscitation can be assessed best in trauma pt by monitoring and trending which of the following tests? during tx and management of trauma pt, maintaining tissue perfusion, oxygenation, and nutritional support are strategies to prevent: multisystem organ dysfunction t issue damage from brain injury activates inflammatory response that increases the pt's risk for infection pt c brain dead, 30 mins into shift, vitals 75/50, 85, 12, 99% 93.8 degrees; which MD order should be implemented first? begin phenylephride (neo-synephrine) for SBP 90 pt c renal transplant recipient in post-anestheisa care unit. vitals: 125/70, 115/min, 24 rr, 95% c 3L/min O2 via NC, 97.8 degrees, and CVP 2mm hg, best action by nurse? admin fluid replacement therapy; monitor intake and output closely which statement best describe lung allocation score (LAS) used to prioritize lung tansplant recipients? LAS based on lab values, dx test, med dx clinical senario represents hyperacute rejection? reperfusion, becomes cyanotic an implanted renal transplant that, upon renal transplant pt c acute rejection episode. how to know kidneys will be rejected? renal biopsy 10