Critical Care Quiz 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.)

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

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

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

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?

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

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

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?

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

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

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?

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

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?

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

interpret the strip.

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?

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

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

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.)

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:

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?

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

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.)

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

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)

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

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.)

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?

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?

The [blank_start]antecubital[blank_end] vein should be the first target for IV access.

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

[blank_start]sodium bicarbonate[blank_end] is beneficial in treating preexisting metabolic acidosis, hyperkalemia, or overdosage of tricyclic antidrepressant or phenobarbital.

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

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