INTRODUCTION TO CRITICAL CARE
NURSING 7TH EDITION 2026
COMPREHENSIVE TEST PAPER QUESTIONS
AND SOLUTIONS GRADED A+
⩥ Improving Cardiopulmonary Tissue Perfusion Thrombolytic Therapy:
Answer: *Most effective if administered within first 6 hours
i.e. t-PA, Retavase, TNK p.778
Indications: Chest pain>30mins unrelieved by Nitroglycerin, with
indications of STEMI on the EKG.
Contraindications: Recent abdominal surgery, stroke, bleeding
tendencies; most effective when administered within first 6 hours of
coronary event. indicaed for chest pain of longer than 30 minutes
duration that is unrelieved by nitro. those who require this eventually
need PCI.resolved when cessation of pain, onset of ventricual
dysrhythmias, resolution of ST segment depression/elevation or t wave
inversion; dissolves thromi in coronary arteris and resores myocardial
blood flow
⩥ Improving Cardiopulmonary tissue perfusion.
Answer: Increasing Activity Tolerance
Identifying and Managing Dysrhythmias
,Monitoring and Managing for Heart Failure; review pages 776- 780
under these headings
⩥ Key Points of
Cardiovascular 1 content.
Answer: Review Get Ready for NClex Examination, all chapters
Note QSEN competencies for each Client Needs category
Review all Nursing Safety Priorities
Review Evidence-Base Practice points.
⩥ CHEST TUBES.
Answer: a drain placed in the pleural space. prevents air and fluid from
returning tothe chest. one or more chest tubes or drains, collection
container below chest level, and water seal to keep air from entering
chest. . ensure integrity of system, promote comfort, ensuer chest tupbe
patency and prevent complications.; never raise above chest of pt. and
you need kelly clamp (if part comes out then clamp) and vasoline gauze
at bedside (put over if removed)
Ignatavicius, D. & Workman, L. (2016). Medical-Surgical Nursing,
Patient Centered Collaborative Care, 8th ed.Elsevier: St. Louis., pgs.
577-579.
,⩥ Purposes of Closed-Chest Drainage:.
Answer: Ø Promote evacuation of air and serosanguinous fluid from the
pleural space to allow lung expansion
Ø Help re-expand the remaining lung tissue by reestablishing normal
negative
pressure in the pleural space
Ø Prevent mediastinal shift and pneumothorax by equalizing pressures
on the two sides of the thoracic cavity
⩥ Chest Tube Nursing Interventions.
Answer: Ø Make certain the chest tube is intact and that the dressing
surrounding the tube in dry and intact.
Ø Assess breath sounds and document.
Ø Encourage patient to cough and deep breathe.
Ø Assess breathing effectiveness with pulse oximetry
Ø Assess tubes for fluctuation (oscillating) of fluid with respirations
Ø Check tube insertion site for condition of skin
Ø Assess for subcutaneous emphysema
Ø Make certain all connections are tight and secure
Ø Assess tubes for patency
Ø KEEP THE DRAINAGE SYSTEM LOWER THAN THE PATIENT'S
CHEST
Ø Check for rapid bubbling (air leak). Notify physician
, Ø Keep tubing straight
Ø Do NOT milk tubing
Ø Check and document amount, color, and characteristics of fluid in the
collection chamber.
⩥ Chest Tube IMMEDIATEY NOTIFY PHYSICIAN IF:.
Answer: Ø Tracheal deviation occurs
Ø Sudden onset or increased dyspnea
Ø O2 saturation < 90%
Ø Drainage > 70cc/hour
Ø Chest tube falls out. Cover immediately with petroleum gauze.
*Clamp chest tube closest to chest.
Ø Drainage stops within the first 24 hours.
⩥ FLUID & ELECTROLYTE BALANCE Questions to be considered in
nursing history and assessment:.
Answer: Is there a disease process or injury state present that can disrupt
fluid and electrolyte balance. (i.e. pancreatitis, bowel obstruction) What
type of imbalance has occurred?
Is the patient receiving any medication or treatment that can disrupt
fluid and electrolyte balance. (i.e. steroids, diuretics, TPN) If so, how
might
this therapy upset fluid and electrolyte balance?
NURSING 7TH EDITION 2026
COMPREHENSIVE TEST PAPER QUESTIONS
AND SOLUTIONS GRADED A+
⩥ Improving Cardiopulmonary Tissue Perfusion Thrombolytic Therapy:
Answer: *Most effective if administered within first 6 hours
i.e. t-PA, Retavase, TNK p.778
Indications: Chest pain>30mins unrelieved by Nitroglycerin, with
indications of STEMI on the EKG.
Contraindications: Recent abdominal surgery, stroke, bleeding
tendencies; most effective when administered within first 6 hours of
coronary event. indicaed for chest pain of longer than 30 minutes
duration that is unrelieved by nitro. those who require this eventually
need PCI.resolved when cessation of pain, onset of ventricual
dysrhythmias, resolution of ST segment depression/elevation or t wave
inversion; dissolves thromi in coronary arteris and resores myocardial
blood flow
⩥ Improving Cardiopulmonary tissue perfusion.
Answer: Increasing Activity Tolerance
Identifying and Managing Dysrhythmias
,Monitoring and Managing for Heart Failure; review pages 776- 780
under these headings
⩥ Key Points of
Cardiovascular 1 content.
Answer: Review Get Ready for NClex Examination, all chapters
Note QSEN competencies for each Client Needs category
Review all Nursing Safety Priorities
Review Evidence-Base Practice points.
⩥ CHEST TUBES.
Answer: a drain placed in the pleural space. prevents air and fluid from
returning tothe chest. one or more chest tubes or drains, collection
container below chest level, and water seal to keep air from entering
chest. . ensure integrity of system, promote comfort, ensuer chest tupbe
patency and prevent complications.; never raise above chest of pt. and
you need kelly clamp (if part comes out then clamp) and vasoline gauze
at bedside (put over if removed)
Ignatavicius, D. & Workman, L. (2016). Medical-Surgical Nursing,
Patient Centered Collaborative Care, 8th ed.Elsevier: St. Louis., pgs.
577-579.
,⩥ Purposes of Closed-Chest Drainage:.
Answer: Ø Promote evacuation of air and serosanguinous fluid from the
pleural space to allow lung expansion
Ø Help re-expand the remaining lung tissue by reestablishing normal
negative
pressure in the pleural space
Ø Prevent mediastinal shift and pneumothorax by equalizing pressures
on the two sides of the thoracic cavity
⩥ Chest Tube Nursing Interventions.
Answer: Ø Make certain the chest tube is intact and that the dressing
surrounding the tube in dry and intact.
Ø Assess breath sounds and document.
Ø Encourage patient to cough and deep breathe.
Ø Assess breathing effectiveness with pulse oximetry
Ø Assess tubes for fluctuation (oscillating) of fluid with respirations
Ø Check tube insertion site for condition of skin
Ø Assess for subcutaneous emphysema
Ø Make certain all connections are tight and secure
Ø Assess tubes for patency
Ø KEEP THE DRAINAGE SYSTEM LOWER THAN THE PATIENT'S
CHEST
Ø Check for rapid bubbling (air leak). Notify physician
, Ø Keep tubing straight
Ø Do NOT milk tubing
Ø Check and document amount, color, and characteristics of fluid in the
collection chamber.
⩥ Chest Tube IMMEDIATEY NOTIFY PHYSICIAN IF:.
Answer: Ø Tracheal deviation occurs
Ø Sudden onset or increased dyspnea
Ø O2 saturation < 90%
Ø Drainage > 70cc/hour
Ø Chest tube falls out. Cover immediately with petroleum gauze.
*Clamp chest tube closest to chest.
Ø Drainage stops within the first 24 hours.
⩥ FLUID & ELECTROLYTE BALANCE Questions to be considered in
nursing history and assessment:.
Answer: Is there a disease process or injury state present that can disrupt
fluid and electrolyte balance. (i.e. pancreatitis, bowel obstruction) What
type of imbalance has occurred?
Is the patient receiving any medication or treatment that can disrupt
fluid and electrolyte balance. (i.e. steroids, diuretics, TPN) If so, how
might
this therapy upset fluid and electrolyte balance?
