Critical Care Quiz 1

Questão 1 de 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.)

Selecione uma ou mais das seguintes:

Nesiritide
Intraaortic balloon pump
Biventricular pacemaker
Ventricular assist device
Dobutamine

Explicação

Questão 2 de 34

1

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

Selecione uma das seguintes:

P
R
S
T

Explicação

Questão 3 de 34

1

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

Selecione uma das seguintes:

Adenosine
Amiodarone
Procainamide
Diltiazem

Explicação

Questão 4 de 34

1

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

Selecione uma das seguintes:

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

Explicação

Questão 5 de 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?

Selecione uma das seguintes:

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

Explicação

Questão 6 de 34

1

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

Selecione uma das seguintes:

Atropine
Lidocaine
Adenosine
Magnesium

Explicação

Questão 7 de 34

1

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

Selecione uma das seguintes:

hyperthemia
response to pain
body movement
cranial nerve reflexes

Explicação

Questão 8 de 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?

Selecione uma das seguintes:

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%.

Explicação

Questão 9 de 34

1

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

Selecione uma ou mais das seguintes:

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

Explicação

Questão 10 de 34

1

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

Selecione uma ou mais das seguintes:

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.

Explicação

Questão 11 de 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?

Selecione uma das seguintes:

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

Explicação

Questão 12 de 34

1

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

Selecione uma das seguintes:

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

Explicação

Questão 13 de 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?

Selecione uma das seguintes:

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.

Explicação

Questão 14 de 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

Selecione uma das seguintes:

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

Explicação

Questão 15 de 34

1

interpret the strip.

Selecione uma das seguintes:

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

Explicação

Questão 16 de 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?

Selecione uma das seguintes:

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

Explicação

Questão 17 de 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

Selecione uma das seguintes:

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

Explicação

Questão 18 de 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?

Selecione uma das seguintes:

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.

Explicação

Questão 19 de 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.)

Selecione uma ou mais das seguintes:

Atropine
Epinephrine
Lidocaine
Transcutaneous pacemaker

Explicação

Questão 20 de 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:

Selecione uma das seguintes:

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.

Explicação

Questão 21 de 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?

Selecione uma das seguintes:

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

Explicação

Questão 22 de 34

1

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

Selecione uma das seguintes:

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.

Explicação

Questão 23 de 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.)

Selecione uma ou mais das seguintes:

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.

Explicação

Questão 24 de 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.)

Selecione uma ou mais das seguintes:

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.

Explicação

Questão 25 de 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)

Selecione uma ou mais das seguintes:

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

Explicação

Questão 26 de 34

1

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

Selecione uma ou mais das seguintes:

cardiac tamponade.
drug overdose.
hypovolemia
tension pneumothorax.

Explicação

Questão 27 de 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.)

Selecione uma ou mais das seguintes:

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

Explicação

Questão 28 de 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?

Selecione uma das seguintes:

Adenosine
Amiodarone
Atropine
Dopamine

Explicação

Questão 29 de 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?

Selecione uma das seguintes:

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.

Explicação

Questão 30 de 34

1

Preencha o espaço em branco para completar o texto.

The vein should be the first target for IV access.

Explicação

Questão 31 de 34

1

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

Selecione uma das seguintes:

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

Explicação

Questão 32 de 34

1

Preencha o espaço em branco para completar o texto.

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

Explicação

Questão 33 de 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.)

Selecione uma ou mais das seguintes:

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.

Explicação

Questão 34 de 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

Selecione uma das seguintes:

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.

	Criado por Breana C. quase 6 anos atrás

Quiz sobre Critical Care Quiz 1, criado por Breana C. em 07-12-2018.

Critical Care Quiz 1

Questão 1 de 34

Selecione uma ou mais das seguintes:

Explicação

Questão 2 de 34

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

Selecione uma das seguintes:

Explicação

Questão 3 de 34

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

Selecione uma das seguintes:

Explicação

Questão 4 de 34

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

Selecione uma das seguintes:

Explicação

Questão 5 de 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?

Selecione uma das seguintes:

Explicação

Questão 6 de 34

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

Selecione uma das seguintes:

Explicação

Questão 7 de 34

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

Selecione uma das seguintes:

Explicação

Questão 8 de 34

Selecione uma das seguintes:

Explicação

Questão 9 de 34

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

Selecione uma ou mais das seguintes:

Explicação

Questão 10 de 34

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

Selecione uma ou mais das seguintes:

Explicação

Questão 11 de 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?

Selecione uma das seguintes:

Explicação

Questão 12 de 34

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

Selecione uma das seguintes:

Explicação

Questão 13 de 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?

Selecione uma das seguintes:

Explicação

Questão 14 de 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

Selecione uma das seguintes:

Explicação

Questão 15 de 34

interpret the strip.

Selecione uma das seguintes:

Explicação

Questão 16 de 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?

Selecione uma das seguintes:

Explicação

Questão 17 de 34

Selecione uma das seguintes:

Explicação

Questão 18 de 34

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

Selecione uma das seguintes:

Explicação

Questão 19 de 34

Selecione uma ou mais das seguintes:

Explicação

Questão 20 de 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:

Selecione uma das seguintes:

Explicação

Questão 21 de 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?