TEST BANK FOR CRITICAL CARE NURSING DIAGNOSIS AND
MANAGEMENT LATEST UPDATED 2024 FINAL EXAM WITH
COMPLETE DETAILED QUESTIONS AND CORRECT VERIFIED
ANSWERS ALREADY A+ GRADED
1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Becauseenteraltubefeedingsare
notpossible,thedecisionistoinitiateparenteralfeedings.Whatarethemajorcomplicationsforthistherapy -
ANSWER-b. Fluidandelectrolyteimbalancesandsepsis
.Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastricsmall-
borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement? - ANSWER-d.
Topreventaspirationofthefeedings
3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcatheterinsertion? -
ANSWER-d. Subclavianvein
4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallowstudy,thepatientisplac
edonenteralfeedings.Followingplacementofanasogastrictubefortubefeeding,whatisthenextcriticalstep? -
ANSWER-c. Obtainachestradiograph.
5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinuousflowtubefeeding.T
henurseknowsthatthisapproachwaschosenbecause: - ANSWER-c.
theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves
6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewouldcarryoutwhichinterve
ntiontominimizeaspirationrisk? - ANSWER-Elevatetheheadofthebed30degrees.
7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilkygreenfluid.Thisisaconc
ernbecausethismostlikelydemonstratesthatthepatienthas: - ANSWER-d. tube feeding intolerance.
8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.Thenurseholdsthetube
feeding,whichhadbeeninfusingat100mL/hr.Thenurseknowsthatthenextactionshouldbe: - ANSWER-d.
recheck the residual in 2hours
9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolerance? - ANSWER-a.
Abdominal distention
10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrhea.Astoolspecimenisco
llectedtocheckforwhichpossiblecause? - ANSWER-a. Clostridium difficile
,11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurselistedpossibleintervent
ionsforthispatient.Whichinterventionneedscorrectionbeforefinalizingtheplanofcare? - ANSWER-b.
Infuseantibioticsthroughtheintravenousline.
12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemostsensitiveindicatorofp
roteinsynthesisandcatabolism? - ANSWER-c. Prealbumin
13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug-
nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug-
nutrientreactions? - ANSWER-d. Phenytoin
14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract? - ANSWER-d. Without
nutritional stimulation, mucosal villi atrophy.
15.An important nutritional consideration in the elderly population is: - ANSWER-c. potential for drug-
nutrient interaction related to polypharmacy.
16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude: - ANSWER-d. weight loss,
elevated glucose, and dehydration
17.In trauma patients ,enteral nutrition via nasogastric tube feedings into the small bowel is best
initiated within what time frame following the injury? - ANSWER-a. 24hours
18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalcareunitonaventilator.T
henutritionassessmentnotesthatthepatienthasaproteinandvitamindeficiencyandisunderweight.Whichfor
mulafornutritionalassessmentismostappropriate? - ANSWER-b. Fiber-addedformula
19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceofnutritionaltherapy -
ANSWER-d. Gut mucosa is preserved.
20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein? - ANSWER-b. The patient
with ileitis
21.Thebestnursingapproachtopreventfeedingtubeobstructionis: - ANSWER-b.
flushthetubeevery4hourswith20to30mLoftapwater.
22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequirementsto: - ANSWER-c.
35kcal/kg/day
23.Malnutritioncontributestoinfectionriskby - ANSWER-b. impairing immune function
, 24.Apatient,whohasatubefeeding,requiresachestx-
raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse: - ANSWER-d.
stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph.
1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?(Selectallthatapply.) - ANSWER-a.
Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsiderations.b.
Fingerstickglucoselevelsareassessedevery6hoursandprn.
d. Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydrates,andfats.
2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration?(Selectallthatapply). -
ANSWER-b. Changethetubingevery24hours.
d. Monitortriglyceridelevels.
3.Calorie-densefeedings:(Selectallthatapply.) - ANSWER-a. are most useful in heart failure and liver
disease.
4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.) - ANSWER-b. elevatedbloodsugar.
c. infectionatthecathetersite.
d. volumeoverload.
5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition?(Selectallthatapply.) -
ANSWER-a. Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues.
b. Insulinmaybeaddedtoaparenteralnutritionsolution.
c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition.
Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__ - ANSWER-
A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency. D.Obtainchestradiograph.
E.Assessresiduals. ANS: B,D,C,A,E
1.Apatienthascoronaryarterybypassgraftsurgeryandistransportedtothesurgicalintensivecareunitatnoon.
Heisplacedonmechanicalventilation.Interprethisinitialarterialbloodgaslevels:
pH7.31
PaCO248mmHg
Bicarbonate22mEq/L
PaO2115mmHg
O2saturation99% - ANSWER-d. Uncompensated
respiratory
acidosis;
hyperoxygenated
MANAGEMENT LATEST UPDATED 2024 FINAL EXAM WITH
COMPLETE DETAILED QUESTIONS AND CORRECT VERIFIED
ANSWERS ALREADY A+ GRADED
1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Becauseenteraltubefeedingsare
notpossible,thedecisionistoinitiateparenteralfeedings.Whatarethemajorcomplicationsforthistherapy -
ANSWER-b. Fluidandelectrolyteimbalancesandsepsis
.Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastricsmall-
borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement? - ANSWER-d.
Topreventaspirationofthefeedings
3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcatheterinsertion? -
ANSWER-d. Subclavianvein
4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallowstudy,thepatientisplac
edonenteralfeedings.Followingplacementofanasogastrictubefortubefeeding,whatisthenextcriticalstep? -
ANSWER-c. Obtainachestradiograph.
5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinuousflowtubefeeding.T
henurseknowsthatthisapproachwaschosenbecause: - ANSWER-c.
theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves
6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewouldcarryoutwhichinterve
ntiontominimizeaspirationrisk? - ANSWER-Elevatetheheadofthebed30degrees.
7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilkygreenfluid.Thisisaconc
ernbecausethismostlikelydemonstratesthatthepatienthas: - ANSWER-d. tube feeding intolerance.
8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.Thenurseholdsthetube
feeding,whichhadbeeninfusingat100mL/hr.Thenurseknowsthatthenextactionshouldbe: - ANSWER-d.
recheck the residual in 2hours
9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolerance? - ANSWER-a.
Abdominal distention
10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrhea.Astoolspecimenisco
llectedtocheckforwhichpossiblecause? - ANSWER-a. Clostridium difficile
,11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurselistedpossibleintervent
ionsforthispatient.Whichinterventionneedscorrectionbeforefinalizingtheplanofcare? - ANSWER-b.
Infuseantibioticsthroughtheintravenousline.
12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemostsensitiveindicatorofp
roteinsynthesisandcatabolism? - ANSWER-c. Prealbumin
13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug-
nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug-
nutrientreactions? - ANSWER-d. Phenytoin
14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract? - ANSWER-d. Without
nutritional stimulation, mucosal villi atrophy.
15.An important nutritional consideration in the elderly population is: - ANSWER-c. potential for drug-
nutrient interaction related to polypharmacy.
16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude: - ANSWER-d. weight loss,
elevated glucose, and dehydration
17.In trauma patients ,enteral nutrition via nasogastric tube feedings into the small bowel is best
initiated within what time frame following the injury? - ANSWER-a. 24hours
18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalcareunitonaventilator.T
henutritionassessmentnotesthatthepatienthasaproteinandvitamindeficiencyandisunderweight.Whichfor
mulafornutritionalassessmentismostappropriate? - ANSWER-b. Fiber-addedformula
19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceofnutritionaltherapy -
ANSWER-d. Gut mucosa is preserved.
20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein? - ANSWER-b. The patient
with ileitis
21.Thebestnursingapproachtopreventfeedingtubeobstructionis: - ANSWER-b.
flushthetubeevery4hourswith20to30mLoftapwater.
22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequirementsto: - ANSWER-c.
35kcal/kg/day
23.Malnutritioncontributestoinfectionriskby - ANSWER-b. impairing immune function
, 24.Apatient,whohasatubefeeding,requiresachestx-
raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse: - ANSWER-d.
stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph.
1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?(Selectallthatapply.) - ANSWER-a.
Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsiderations.b.
Fingerstickglucoselevelsareassessedevery6hoursandprn.
d. Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydrates,andfats.
2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration?(Selectallthatapply). -
ANSWER-b. Changethetubingevery24hours.
d. Monitortriglyceridelevels.
3.Calorie-densefeedings:(Selectallthatapply.) - ANSWER-a. are most useful in heart failure and liver
disease.
4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.) - ANSWER-b. elevatedbloodsugar.
c. infectionatthecathetersite.
d. volumeoverload.
5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition?(Selectallthatapply.) -
ANSWER-a. Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues.
b. Insulinmaybeaddedtoaparenteralnutritionsolution.
c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition.
Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__ - ANSWER-
A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency. D.Obtainchestradiograph.
E.Assessresiduals. ANS: B,D,C,A,E
1.Apatienthascoronaryarterybypassgraftsurgeryandistransportedtothesurgicalintensivecareunitatnoon.
Heisplacedonmechanicalventilation.Interprethisinitialarterialbloodgaslevels:
pH7.31
PaCO248mmHg
Bicarbonate22mEq/L
PaO2115mmHg
O2saturation99% - ANSWER-d. Uncompensated
respiratory
acidosis;
hyperoxygenated
