Nursing Management Critical Care Environment

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Question 1
Free
Multiple Choice

Aclient has a nursing diagnosis of disturbed sleep pattern related to difficulty maintaing sleep state. Which of the following actions should the nurse include in the plan of care?

Choose correct answer/s
A

Discontinue assessments during the night to allow uninterrupted sleep.

B

Administer prescribed sedatives or opioids at bedtime to promote sleep.

C

Silence the alarms on the cardiac monitors to allow 30- to 40-minute naps.

D

Cluster nursing activities so that the client has uninterrupted rest periods.

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Question 2
Free
Multiple Choice

To determine the effectiveness of medications that a client has received to reduce left ventricular afterload, which of the following hemodynamic parameters should the nurse monitor?

Choose correct answer/s
A

Central venous pressure (CVP)

B

Systemic vascular resistance (SVR)

C

Pulmonary vascular resistance (PVR)

D

Pulmonary artery wedge pressure (PAWP)

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Question 3
Free
Multiple Choice

While family members are visiting, a client has a cardiac arrest and is being resuscitated. Which of the following actions by the nurse is best?

Choose correct answer/s
A

Ask family members if they wish to remain in the room during the resuscitation.

B

Explain to family members that watching the resuscitation will be very stressful.

C

Assign a staff member to wait with family members just outside the client room.

D

Escort family members quickly out of the client room and then remain with them.

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Question 4
Free
Multiple Choice

The nurse is caring for a client following surgery whose central venous pressure (CVP) monitor indicates low pressures. Which of the following actions should the nurse anticipate implementing?

Choose correct answer/s
A

Increase the IV fluid infusion rate.

B

Administer IV diuretic medications.

C

Elevate the head of the client's bed to 45 degrees.

D

Document the CVP and continue to monitor.

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Question 5
Free
Multiple Choice

The nurse is caring for a client with pulmonary hypertension. Which of the following parameters should the nurse monitor as an index of right ventricular afterload?

Choose correct answer/s
A

Mean arterial pressure (MAP)

B

Central venous pressure (CVP)

C

Pulmonary vascular resistance (PVR)

D

Pulmonary artery wedge pressure (PAWP)

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Question 6
Multiple Choice

The intensive care unit nurse educator is teaching a new staff nurse about hemodynamic monitoring. Which of the following actions indicates that the teaching has been effective?

Choose correct answer/s
A
Positions the zero-reference stopcock line level with the phlebostatic axis
B
Balances and calibrates the hemodynamic monitoring equipment every hour
C
Rechecks the location of the phlebostatic axis when changing the client's position
D
Ensures that the client is lying supine with the head of the bed flat for all readings
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Question 7
Multiple Choice

The nurse is monitoring for the effectiveness of treatment for a client with left ventricular failure. Which of the following assessments is most important for the nurse to evaluate?

Choose correct answer/s
A
Mean arterial pressure (MAP)
B
Systemic vascular resistance (SVR)
C
Pulmonary vascular resistance (PVR)
D
Pulmonary artery occlusive pressure (PAOP)
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Question 8
Multiple Choice

Which of the following actions should the nurse take when the low-pressure alarm sounds for a client who has an arterial line in the right radial artery?

Choose correct answer/s
A
Check the right hand for pallor.
B
Assess for cardiac dysrhythmias.
C
Flush the arterial line with saline.
D
Rezero the monitoring equipment.
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Question 9
Multiple Choice

The nurse is preparing to assist with the insertion of a pulmonary artery catheter in a client. Which of the following actions will the nurse implement?

Choose correct answer/s
A
Check cardiac enzymes before insertion.
B
Auscultate heart sounds during insertion.
C
Place the client on NPO status before the procedure.
D
Attach cardiac monitoring leads before the procedure.
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Question 10
Multiple Choice

The nurse is assisting with insertion of a pulmonary artery (PA) catheter in a client. Which of the following data identifies that the catheter is correctly placed?

Choose correct answer/s
A
Monitor shows a typical PAOP tracing.
B
PA waveform is observed on the monitor.
C
Systemic arterial pressure tracing appears on the monitor.
D
Catheter has been inserted to the 22-cm marking on the line.
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Question 11
Multiple Choice

The nurse is caring for a client with a left radial arterial line. Which of the following assessments indicates a need for the nurse to take action?

Choose correct answer/s
A
The left hand is cooler than the right hand.
B
The mean arterial pressure (MAP) is 75 mm Hg.
C
The system is delivering only 3 mL of flush solution per hour.
D
The flush bag and tubing were last changed 3 days previously.
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Question 12
Multiple Choice

The nurse is caring for a client who has severe pancreatitis and the mixed venous oxygen saturation (SvO2) is decreasing. Which of the following parameters should the nurse assess to determine the possible cause of the decreased SvO2?

Choose correct answer/s
A
Weight
B
Amylase
C
Temperature
D
Urinary output
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Question 13
Multiple Choice

The nurse is caring for a client who is in cardiogenic shock and has an intra-aortic balloon pump (IABP). Which of the following assessment findings indicates that the goals of treatment with the IABP are being met?

Choose correct answer/s
A
Heart rate of 110 beats/minute
B
Urine output of 20 mL/hour
C
Cardiac output (CO) of 5 L/minute
D
Stroke volume (SV) of 40 mL/beat
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Question 14
Multiple Choice

The nurse is caring for a client who has an intra-aortic balloon pump in place. Which of the following actions should be included in the plan of care?

Choose correct answer/s
A
Avoid the use of anticoagulant medications.
B
Keep the head of the bed elevated 45 degrees.
C
Measure the client's urinary output every hour.
D
Provide passive range of motion for all extremities.
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Question 15
Multiple Choice

The nurse is caring for a client with severe heart failure who has a ventricular assist device (VAD) implanted and is waiting for cardiac transplantation. Which of the following actions should the nurse include in the plan of care?

Choose correct answer/s
A
Administer of immuno-suppressive medications.
B
Monitor the surgical incision for signs of infection.
C
Teach the client the reason for continuous bed rest.
D
Prepare the client to have the VAD in place permanently.
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Question 16
Multiple Choice

Which of the following actions should the nurse implement to verify the correct placement of an endotracheal tube (ET) after insertion?

Choose correct answer/s
A
Auscultate for the presence of bilateral breath sounds.
B
Obtain a portable chest radiograph to check tube placement.
C
Observe the chest for symmetrical movement with ventilation.
D
Use an end-tidal CO2 monitor to check for placement in the trachea.
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Question 17
Multiple Choice

Which of the following actions should the nurse do to inflate the cuff of an endotracheal tube (ET) when the client is on mechanical ventilation?

Choose correct answer/s
A
Inflate the cuff until the pilot balloon is firm.
B
Inflate the cuff with a minimum of 10 mL of air.
C
Inject air into the cuff until a manometer shows 15 mm Hg pressure.
D
Inject air into the cuff until a slight leak is heard only at peak inflation.
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Question 18
Multiple Choice

Premature ventricular contractions (PVCs) occur while the nurse is suctioning a client's endotracheal tube. Which of the following actions by the nurse is best?

Choose correct answer/s
A
Decrease the suction pressure to 80 mm Hg.
B
Stop and ventilate the client with 100% oxygen.
C
Document the dysrhythmia in the client's chart.
D
Give prescribed PRN antidysrhythmic medications.
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Question 19
Multiple Choice

Which of the following information obtained by the nurse when caring for a client receiving mechanical ventilation indicates the need for suctioning?

Choose correct answer/s
A
The respiratory rate is 32 breaths/minute.
B
The pulse oximeter shows a SpO2 of 93%.
C
The client has not been suctioned for the last 6 hours.
D
The lungs have occasional audible expiratory wheezes.
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Question 20
Multiple Choice

The nurse notes thick, white respiratory secretions from a client who is receiving mechanical ventilation. Which of the following interventions will be most effective in resolving this problem?

Choose correct answer/s
A
Suction the client every hour.
B
Reposition the client every 2 hours.
C
Add additional water to the client's enteral feedings.
D
Instill 5 mL of sterile saline into the endotracheal tube (ET) before suctioning.
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