CNN Exam 1 with Complete Questions and Answers – 100% Solved
A 56-year-old man with acute respiratory distress syndrome (ARDS) is on positive pressure
ventilation (PPV). The patient's cardiac index is 1.4 L/minute and pulmonary artery wedge
pressure is 8 mm Hg. What order by the physician is important for the nurse to question?
A. Initiate a dobutamine (Dobutrex) infusion at 3 mcg/kg/minute.
B. Administer one unit of packed red blood cells over the next 2 hours.
C. Change the maintenance intravenous (IV) rate from 75 to 125 mL/hr.
D. Increase positive end-expiratory pressure (PEEP) from 10 to 15 cm H2O. - ✔✔✔-D.
Patients on PPV and PEEP frequently experience decreased cardiac output (CO) and cardiac
index (CI). High levels of PEEP increase intrathoracic pressure and cause decreased venous
return which results in decreased CO. Interventions to improve CO include lowering the PEEP,
administering crystalloid fluids or colloid solutions, and use of inotropic drugs (e.g.,
dobutamine, dopamine). Packed red blood cells may also be administered to improve CO and
oxygenation if the hemoglobin is less than 9 or 10 mg/dL.
A 64-year-old male patient admitted to the critical care unit for gastrointestinal hemorrhage
complains of feeling tense and nervous. He appears restless with an increase in blood pressure
and pulse. If the physical assessment shows no other changes, it is most important for the
critical care nurse to take which action?
A. Administer prescribed IV dose of lorazepam (Ativan).
B. Stay with the patient and encourage expression of concerns.
C. Ask a family member to remain at the bedside with the patient.
D. Teach the patient how to use guided imagery to reduce anxiety. - ✔✔✔-B.
Anxiety is a common problem for critically ill patients. The nurse should first stay with the
patient and encourage the patient to express concerns and needs. After expression of feelings,
the nurse should determine the appropriate intervention if needed (e.g., lorazepam, guided
imagery, family presence) and closely monitor the patient's hemodynamic parameters.
,CNN Exam 1 with Complete Questions and Answers – 100% Solved
A 68-year-old male patient diagnosed with sepsis is orally intubated on mechanical ventilation.
Which action is most important for the nurse to take?
A. Use the open-suctioning technique.
B. Administer morphine for discomfort.
C. Limit noise and cluster care activities.
D. Elevate the head of the bed 30 degrees. - ✔✔✔-D.
The two major complications of endotracheal intubation are unplanned extubation and
aspiration. To prevent aspiration all intubated patients and patients receiving enteral feedings
must have the head of the bed (HOB) elevated a minimum of 30 to 45 degrees unless medically
contraindicated. Closed-suction technique is preferred over the open-suction technique
because oxygenation and ventilation are maintained during suctioning, and exposure to
secretions is reduced. The nurse should provide comfort measures such as morphine to relieve
anxiety and pain associated with intubation. To promote rest and sleep the nurse should limit
noise and cluster activities.
A 70-year-old patient in the ICU has become agitated and inattentive since his heart surgery.
The nurse knows that this ICU psychosis frequently occurs in individuals with pre-existing
dementia, history of alcohol abuse, and severe disease. What interventions should the nurse
provide this patient to improve the patient's cognition (select all that apply)?
A. Improve oxygenation.
B. Provide a small amount of beer.
C. Have the family stay with the patient.
D. Enable the patient to sleep on a schedule with dim lights.
E. Decrease sensory overload by conversing away from patient's room. - ✔✔✔-A,D,E
, CNN Exam 1 with Complete Questions and Answers – 100% Solved
ICU psychosis is from delirium in most ICU patients. Improving oxygenation, enabling the patient
to sleep, and decreasing sensory overload along with orientation is all helpful in improving the
patient's cognition. The beer may or may not be allowed for this patient, and the nurse should
not assume that it will help. Having a family member stay with the patient to reorient the
patient is helpful, but the family group may increase sensory overload with conversations not
involving the patient.
A 72-year-old woman with aspiration pneumonia develops severe respiratory distress. Which
diagnostic finding would indicate to the nurse that the patient has developed acute respiratory
distress syndrome (ARDS)?
A. PaO2 of 42 mm Hg on 80% FIO2
B. PaO2 of 64 mm Hg on 24% FIO2
C. PaCO2 of 31 mm Hg and pH 7.51
D. PaCO2 of 70 mm Hg and pH 7.29 - ✔✔✔-A.
Refractory hypoxemia indicates ARDS. If the PaO2 is 42 mm Hg on 80% FIO2, then the
PaO2/FIO2 ratio is 52.5, indicating ARDS (PaO2/FIO2 ratio < 200). PaCO2 of 31 mm Hg and pH
7.51 indicates respiratory alkalosis. If PaO2 of 64 mm Hg on 24% FIO2, the PaO2/FIO2 ratio is
267, which indicates an acute lung injury (PaO2/FIO2 ratio between 200 to 300). PaCO2 of 70
mm Hg and pH 7.29 indicates respiratory acidosis.
(FIO2, Fraction of inspired oxygen,)
A patient develops increasing dyspnea and hypoxemia 2 days after having cardiac surgery. To
determine whether the patient has acute respiratory distress syndrome (ARDS) or pulmonary
edema caused by left ventricular failure, the nurse will anticipate assisting with
a. inserting a pulmonary artery catheter.
b. obtaining a ventilation-perfusion scan.
c. drawing blood for arterial blood gases.
d. positioning the patient for a chest radiograph. - ✔✔✔-ANS: A
A 56-year-old man with acute respiratory distress syndrome (ARDS) is on positive pressure
ventilation (PPV). The patient's cardiac index is 1.4 L/minute and pulmonary artery wedge
pressure is 8 mm Hg. What order by the physician is important for the nurse to question?
A. Initiate a dobutamine (Dobutrex) infusion at 3 mcg/kg/minute.
B. Administer one unit of packed red blood cells over the next 2 hours.
C. Change the maintenance intravenous (IV) rate from 75 to 125 mL/hr.
D. Increase positive end-expiratory pressure (PEEP) from 10 to 15 cm H2O. - ✔✔✔-D.
Patients on PPV and PEEP frequently experience decreased cardiac output (CO) and cardiac
index (CI). High levels of PEEP increase intrathoracic pressure and cause decreased venous
return which results in decreased CO. Interventions to improve CO include lowering the PEEP,
administering crystalloid fluids or colloid solutions, and use of inotropic drugs (e.g.,
dobutamine, dopamine). Packed red blood cells may also be administered to improve CO and
oxygenation if the hemoglobin is less than 9 or 10 mg/dL.
A 64-year-old male patient admitted to the critical care unit for gastrointestinal hemorrhage
complains of feeling tense and nervous. He appears restless with an increase in blood pressure
and pulse. If the physical assessment shows no other changes, it is most important for the
critical care nurse to take which action?
A. Administer prescribed IV dose of lorazepam (Ativan).
B. Stay with the patient and encourage expression of concerns.
C. Ask a family member to remain at the bedside with the patient.
D. Teach the patient how to use guided imagery to reduce anxiety. - ✔✔✔-B.
Anxiety is a common problem for critically ill patients. The nurse should first stay with the
patient and encourage the patient to express concerns and needs. After expression of feelings,
the nurse should determine the appropriate intervention if needed (e.g., lorazepam, guided
imagery, family presence) and closely monitor the patient's hemodynamic parameters.
,CNN Exam 1 with Complete Questions and Answers – 100% Solved
A 68-year-old male patient diagnosed with sepsis is orally intubated on mechanical ventilation.
Which action is most important for the nurse to take?
A. Use the open-suctioning technique.
B. Administer morphine for discomfort.
C. Limit noise and cluster care activities.
D. Elevate the head of the bed 30 degrees. - ✔✔✔-D.
The two major complications of endotracheal intubation are unplanned extubation and
aspiration. To prevent aspiration all intubated patients and patients receiving enteral feedings
must have the head of the bed (HOB) elevated a minimum of 30 to 45 degrees unless medically
contraindicated. Closed-suction technique is preferred over the open-suction technique
because oxygenation and ventilation are maintained during suctioning, and exposure to
secretions is reduced. The nurse should provide comfort measures such as morphine to relieve
anxiety and pain associated with intubation. To promote rest and sleep the nurse should limit
noise and cluster activities.
A 70-year-old patient in the ICU has become agitated and inattentive since his heart surgery.
The nurse knows that this ICU psychosis frequently occurs in individuals with pre-existing
dementia, history of alcohol abuse, and severe disease. What interventions should the nurse
provide this patient to improve the patient's cognition (select all that apply)?
A. Improve oxygenation.
B. Provide a small amount of beer.
C. Have the family stay with the patient.
D. Enable the patient to sleep on a schedule with dim lights.
E. Decrease sensory overload by conversing away from patient's room. - ✔✔✔-A,D,E
, CNN Exam 1 with Complete Questions and Answers – 100% Solved
ICU psychosis is from delirium in most ICU patients. Improving oxygenation, enabling the patient
to sleep, and decreasing sensory overload along with orientation is all helpful in improving the
patient's cognition. The beer may or may not be allowed for this patient, and the nurse should
not assume that it will help. Having a family member stay with the patient to reorient the
patient is helpful, but the family group may increase sensory overload with conversations not
involving the patient.
A 72-year-old woman with aspiration pneumonia develops severe respiratory distress. Which
diagnostic finding would indicate to the nurse that the patient has developed acute respiratory
distress syndrome (ARDS)?
A. PaO2 of 42 mm Hg on 80% FIO2
B. PaO2 of 64 mm Hg on 24% FIO2
C. PaCO2 of 31 mm Hg and pH 7.51
D. PaCO2 of 70 mm Hg and pH 7.29 - ✔✔✔-A.
Refractory hypoxemia indicates ARDS. If the PaO2 is 42 mm Hg on 80% FIO2, then the
PaO2/FIO2 ratio is 52.5, indicating ARDS (PaO2/FIO2 ratio < 200). PaCO2 of 31 mm Hg and pH
7.51 indicates respiratory alkalosis. If PaO2 of 64 mm Hg on 24% FIO2, the PaO2/FIO2 ratio is
267, which indicates an acute lung injury (PaO2/FIO2 ratio between 200 to 300). PaCO2 of 70
mm Hg and pH 7.29 indicates respiratory acidosis.
(FIO2, Fraction of inspired oxygen,)
A patient develops increasing dyspnea and hypoxemia 2 days after having cardiac surgery. To
determine whether the patient has acute respiratory distress syndrome (ARDS) or pulmonary
edema caused by left ventricular failure, the nurse will anticipate assisting with
a. inserting a pulmonary artery catheter.
b. obtaining a ventilation-perfusion scan.
c. drawing blood for arterial blood gases.
d. positioning the patient for a chest radiograph. - ✔✔✔-ANS: A
