Critical Care Quiz 1

Frage 1 von 34

1

A patient with a 10-year history of heart failure presents to the emergency department reporting severe shortness of breath. Assessment reveals crackles throughout the lung fields and labored breathing. The patient takes beta blockers, ACE inhibitors, and diuretics as directed. What treatment strategies does the nurse plan to implement for immediate short-term management? (Select all that apply.)

Wähle eine oder mehr der folgenden:

Nesiritide
Intraaortic balloon pump
Biventricular pacemaker
Ventricular assist device
Dobutamine

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Frage 2 von 34

1

During cardioversion, the nurse would synchronize the electrical charge to coincide with which wave of the ECG complex?

Wähle eine der folgenden:

P
R
S
T

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Frage 3 von 34

1

The patient is diagnosed with abrupt onset of supraventricular tachycardia (SVT). The nurse prepares which medication to administer to the patient?

Wähle eine der folgenden:

Adenosine
Amiodarone
Procainamide
Diltiazem

Erklärung

Frage 4 von 34

1

During a code situation, the nurse would prepare to use which preferred intravenous fluid?

Wähle eine der folgenden:

5% Dextrose in 0.45 normal saline
5% Dextrose in water
Dopamine infusion
Normal saline

Erklärung

Frage 5 von 34

1

The patient presents to the ED with severe chest discomfort. A cardiac catheterization and angiography shows an 80% occlusion of the left main coronary artery. Which procedure will be most likely performed on this patient?

Wähle eine der folgenden:

Intracoronary stent placement
Percutaneous transluminal coronary angioplasty (PTCA)
Transmyocardial revascularization
Coronary artery bypass graft surgery

Erklärung

Frage 6 von 34

1

A patient develops frequent ventricular ectopy. The nurse prepares to administer which drug?

Wähle eine der folgenden:

Atropine
Lidocaine
Adenosine
Magnesium

Erklärung

Frage 7 von 34

1

All of the following are major criteria for brain death EXCEPT no

Wähle eine der folgenden:

hyperthemia
response to pain
body movement
cranial nerve reflexes

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Frage 8 von 34

1

A patient who is undergoing withdrawal of mechanical ventilation appears anxious and agitated. The patient is on a continuous morphine infusion and has an additional order for lorazepam (Ativan) 1 to 2 mg IV as needed (prn). The patient has received no lorazepam (Ativan) during this course of illness. What is the most appropriate nursing intervention to control agitation?

Wähle eine der folgenden:

Administer lorazepam (Ativan) 1 mg IV now
Administer fentanyl (Duragesic) 25 mg IV bolus.
Request an order for a paralytic agent.
Increase the rate of the morphine infusion by 50%.

Erklärung

Frage 9 von 34

1

In the healthy individual, pain and anxiety: (Select all that apply.)

Wähle eine oder mehr der folgenden:

decrease stress levels
help remove one from harm.
limit sympathetic nervous system activity.
activate the sympathetic nervous system (SNS).
increase performance levels

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Frage 10 von 34

1

Which of the following statements about defibrillation are correct? (Select all that apply.)

Wähle eine oder mehr der folgenden:

Early defibrillation (if warranted) is recommended before other actions.
It is not necessary to ensure that personnel are clear of the patient if hands-off defibrillation is used.
It is not necessary to synchronize the defibrillation shocks.
Paddles/patches can be placed anteriorly and posteriorly on the chest.

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Frage 11 von 34

1

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

Wähle eine der folgenden:

Identification of immediate family, extended family, and decision makers
Description of the patient’s home environment
Assessment of patient and family’s developmental stages and needs
Observation and assessment of how family members function with each other

Erklärung

Frage 12 von 34

1

If pericardial tamponade is suspected during a code, which of the following procedures will be performed?

Wähle eine der folgenden:

Elective cardioversion
Emergency insertion of a chest tube
Needle inserted into pericardial sac to aspirate fluid
Needle inserted into third intercostal space to decompress the lungs

Erklärung

Frage 13 von 34

1

Following insertion of a central venous catheter, the nurse obtains a stat chest x-ray film to verify proper catheter placement. The radiologist reports to the nurse: “The tip of the catheter is located in the superior vena cava.” What is the best interpretation of these results by the nurse?

Wähle eine der folgenden:

The physician should be called to advance the catheter into the pulmonary artery.
The catheter position increases the risk of ventricular dysrhythmias.
The catheter is not positioned correctly and should be removed.
The distal tip of the catheter is in the appropriate position.

Erklärung

Frage 14 von 34

1

The assessment of pain and anxiety is a continuous process. When critically ill patients exhibit signs of anxiety, the nurse’s first priority is to

Wähle eine der folgenden:

reassess the patient hourly to determine whether symptoms resolve on their own.
administer pain medication as ordered.
administer antianxiety medications as ordered
identify and treat the underlying cause

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Frage 15 von 34

1

interpret the strip.

Wähle eine der folgenden:

Failure to pace
Failure to capture
Normal pacemaker function
Failure to sense

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Frage 16 von 34

1

The patient has a transcutaneous pacemaker in place. Pacemaker spikes followed by QRS complexes are noted on the cardiac rhythm strip. To determine if the pacemaker is working, the nurse must do which of the following?

Wähle eine der folgenden:

Obtain a 12-lead electrocardiogram (ECG).
Call for a pacemaker interrogation
Palpate the pulse
Run a 2-minute monitor strip for analysis.

Erklärung

Frage 17 von 34

1

A 75-year-old patient, who suffered a massive stroke 3 weeks ago, has been unresponsive and has required ventilatory support since the time of the stroke. The physician has approached the spouse regarding placement of a permanent feeding tube. The spouse states that the patient never wanted to be kept alive by tubes and personally didn’t want what was being done. After holding a family conference with the spouse, the medical team concurs, and the feeding tube is not placed. This situation is an example of

Wähle eine der folgenden:

withdrawal of life support.
palliative care.
euthanasia
withholding life support.

Erklärung

Frage 18 von 34

1

Changing visitation policies can be challenging. The nurse manager recognizes which of the following as an effective strategy for promoting changes in practice?

Wähle eine der folgenden:

Invite the nurses with the most experience to develop a revised policy.
Discuss the pros and cons of open visitation at the next staff meeting.
Task the unit-based nurse practice council to invite volunteers to serve on the council to revise the current policy toward more liberal visitation.
Ask the clinical nurse specialist to lead a journal club on open visitation after each nurse is tasked to read one research article about visitation.

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Frage 19 von 34

1

A patient is admitted to the critical care unit with bradycardia at a heart rate of 39 beats/min and frequent premature ventricular contractions. Upon assessment, you note that she is lethargic and has complained of dizziness for the past 12 hours. Which of the following are acceptable treatments for symptomatic bradycardia? (Select all that apply.)

Wähle eine oder mehr der folgenden:

Atropine
Epinephrine
Lidocaine
Transcutaneous pacemaker

Erklärung

Frage 20 von 34

1

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:

Wähle eine der folgenden:

improve accuracy of patient identification.
prevent errors related to look-alike and sound-alike medications.
reconcile medications across the continuum of care.
reduce harms associated with the administration of anticoagulants.

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Frage 21 von 34

1

The monitor technician notifies the nurse "stat" that the patient has a rapid, chaotic rhythm that looks like ventricular tachycardia. What is the nurse’s first action?

Wähle eine der folgenden:

Call a code overhead.
Check the patient immediately.
Go to the nurse’s station and look at the rhythm strip.
Take the crash cart to the room

Erklärung

Frage 22 von 34

1

The patient has an implanted cardioverter-defibrillator (ICD). He goes into sustained VF and loses consciousness. The responding RN should:

Wähle eine der folgenden:

avoid touching the patient in case the ICD fires.
call the code team, but tell them that the patient cannot be defibrillated.
initiate a code and prepare to defibrillate the patient.
prepare to administer adenosine intravenously.

Erklärung

Frage 23 von 34

1

It is important for critically ill patients to feel safe. Which nursing strategies help the patient to feel safe in the critical care setting? (Select all that apply.)

Wähle eine oder mehr der folgenden:

Inform the patient that you have cared for many similar patients.
Consult with the charge nurse before making any patient care decisions.
Allow family members to remain at the bedside
Provide informal conversation by discussing your plans for after work.
Respond promptly to call bells or other communication for assistance.

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Frage 24 von 34

1

Family presence is encouraged during resuscitation and invasive procedures. Which findings about this practice have been reported in the literature? (Select all that apply.)

Wähle eine oder mehr der folgenden:

Presence encourages family members to seek litigation for improper care.
Families benefit by witnessing that everything possible was done.
Families report that staff conversations during this time were distressing.
Presence reduces nurses’ involvement in explaining things to the family.
Families report reduced anxiety and fear about what is being done to the patient.

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Frage 25 von 34

1

A patient has been successfully converted from ventricular tachycardia with a pulse to a sinus rhythm. Upon further assessment, it is noted that the patient is hypotensive. The appropriate treatment for her hypotension may include (Select all that apply)

Wähle eine oder mehr der folgenden:

adenosine.
dopamine infusion.
sodium bicarbonate
normal saline infusion.
magnesium.

Erklärung

Frage 26 von 34

1

The patient has a rhythm but not pulse or blood pressure. Possible causes of this patient condition include: (Choose all that apply.)

Wähle eine oder mehr der folgenden:

cardiac tamponade.
drug overdose.
hypovolemia
tension pneumothorax.

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Frage 27 von 34

1

The patient is in VF. The nurse must defibrillate immediately. She must know what type of defibrillator is available and determine how many joules to use. She knows that she needs: (Choose all that apply.)

Wähle eine oder mehr der folgenden:

100 joules (biphasic).
200 joules (biphasic).
300 joules (monophasic)
360 joules (monophasic).

Erklärung

Frage 28 von 34

1

The patient is in ventricular tachycardia (VT) unresponsive to conventional treatment (epinephrine or vasopressin). Comparing the following drugs, which would be the most appropriate to use next?

Wähle eine der folgenden:

Adenosine
Amiodarone
Atropine
Dopamine

Erklärung

Frage 29 von 34

1

Elderly patients who require critical care treatment are at risk for increased mortality, functional decline, or decreased quality of life after hospitalization. Assuming each of these patients was discharged from the hospital, which of the following patients is at greatest risk for decreased functional status and quality of life?

Wähle eine der folgenden:

A 79-year-old woman admitted for exacerbation of heart failure. She manages her care independently but needed diuretic medications adjusted. She states that she is compliant with her medications but sometimes forgets to take them. She lives with her 82-year-old spouse. Both consider themselves to be independent and support each other.
An 84-year-old woman who had stents placed to treat coronary artery occlusion. She has diabetes that has been managed, lives alone, and was driving prior to hospitalization. She was discharged home within 3 days of the procedure.
A 90-year-old man admitted for a carotid endarterectomy. He lives in an assisted living facility (ALF) but is cognitively intact. He is the “social butterfly” at all of the events at the ALF. He is hospitalized for 4 days and discharged to the ALF.
A 70-year-old man who had coronary artery bypass surgery. He developed complications after surgery and had difficulty being weaned from mechanical ventilation. He required a tracheostomy and gastrostomy. He is being discharged to a long-term acute care hospital. He is a widower.

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Frage 30 von 34

1

Fülle die Lücke, um den Text zu vervollständigen

The vein should be the first target for IV access.

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Frage 31 von 34

1

Which rhythm would be an emergency indication for the application of a transcutaneous pacemaker?

Wähle eine der folgenden:

Asystole
Bradycardia (heart rate 40 beats/min) normotensive and alert
Bradycardia (heart rate 50 beats/min) with hypotension and syncope
Supraventricular tachycardia (heart rate 150 beats/min), hypotensive

Erklärung

Frage 32 von 34

1

Fülle die Lücke, um den Text zu vervollständigen

is beneficial in treating preexisting metabolic acidosis, hyperkalemia, or overdosage of tricyclic antidrepressant or phenobarbital.

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Frage 33 von 34

1

The nurse is preparing to obtain a right atrial pressure (RAP/CVP) reading. What are the most appropriate nursing actions? (Select all that apply.)

Wähle eine oder mehr der folgenden:

Compare measured pressures with other physiological parameters.
Inflate the balloon with 3 mL of air and record the pressure tracing.
Zero reference the transducer system at the level of the phlebostatic axis.
Flush the central venous catheter with 20 mL of sterile saline.
Obtain the right atrial pressure measurement during end exhalation.

Erklärung

Frage 34 von 34

1

Both the electroencephalogram (EEG) monitor and the Bispectral Index Score (BIS) or Patient State Index (PSI) analyzer monitors are used to assess patient sedation levels in critically ill patients. The BIS and PSI monitors are simpler to use because they

Wähle eine der folgenden:

require only five leads
provide raw EEG data and a numeric value.
can be used only on heavily sedated patients.
can be used only on pediatric patients.

	Erstellt von Breana C. vor fast 6 Jahre

Quiz am Critical Care Quiz 1, erstellt von Breana C. am 07/12/2018.

Critical Care Quiz 1

Frage 1 von 34

Wähle eine oder mehr der folgenden:

Erklärung

Frage 2 von 34

During cardioversion, the nurse would synchronize the electrical charge to coincide with which wave of the ECG complex?

Wähle eine der folgenden:

Erklärung

Frage 3 von 34

The patient is diagnosed with abrupt onset of supraventricular tachycardia (SVT). The nurse prepares which medication to administer to the patient?

Wähle eine der folgenden:

Erklärung

Frage 4 von 34

During a code situation, the nurse would prepare to use which preferred intravenous fluid?

Wähle eine der folgenden:

Erklärung

Frage 5 von 34

The patient presents to the ED with severe chest discomfort. A cardiac catheterization and angiography shows an 80% occlusion of the left main coronary artery. Which procedure will be most likely performed on this patient?

Wähle eine der folgenden:

Erklärung

Frage 6 von 34

A patient develops frequent ventricular ectopy. The nurse prepares to administer which drug?

Wähle eine der folgenden:

Erklärung

Frage 7 von 34

All of the following are major criteria for brain death EXCEPT no

Wähle eine der folgenden:

Erklärung

Frage 8 von 34

Wähle eine der folgenden:

Erklärung

Frage 9 von 34

In the healthy individual, pain and anxiety: (Select all that apply.)

Wähle eine oder mehr der folgenden:

Erklärung

Frage 10 von 34

Which of the following statements about defibrillation are correct? (Select all that apply.)

Wähle eine oder mehr der folgenden:

Erklärung

Frage 11 von 34

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

Wähle eine der folgenden:

Erklärung

Frage 12 von 34

If pericardial tamponade is suspected during a code, which of the following procedures will be performed?

Wähle eine der folgenden:

Erklärung

Frage 13 von 34

Following insertion of a central venous catheter, the nurse obtains a stat chest x-ray film to verify proper catheter placement. The radiologist reports to the nurse: “The tip of the catheter is located in the superior vena cava.” What is the best interpretation of these results by the nurse?

Wähle eine der folgenden:

Erklärung

Frage 14 von 34

The assessment of pain and anxiety is a continuous process. When critically ill patients exhibit signs of anxiety, the nurse’s first priority is to

Wähle eine der folgenden:

Erklärung

Frage 15 von 34

interpret the strip.

Wähle eine der folgenden:

Erklärung

Frage 16 von 34

The patient has a transcutaneous pacemaker in place. Pacemaker spikes followed by QRS complexes are noted on the cardiac rhythm strip. To determine if the pacemaker is working, the nurse must do which of the following?

Wähle eine der folgenden:

Erklärung

Frage 17 von 34

Wähle eine der folgenden:

Erklärung

Frage 18 von 34

Changing visitation policies can be challenging. The nurse manager recognizes which of the following as an effective strategy for promoting changes in practice?

Wähle eine der folgenden:

Erklärung

Frage 19 von 34

Wähle eine oder mehr der folgenden:

Erklärung

Frage 20 von 34

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:

Wähle eine der folgenden:

Erklärung

Frage 21 von 34

The monitor technician notifies the nurse "stat" that the patient has a rapid, chaotic rhythm that looks like ventricular tachycardia. What is the nurse’s first action?