Chapter 66 Nursing Management Critical Care
Chapter 66: Nursing Management: Critical
Care Test Bank
MULTIPLE CHOICE
1. A 68-year-old patient has been in the intensive care unit for 4 days and has a nursing diagnosis
of disturbed sensory perception related to sleep deprivation. Which action should the nurse
include in the plan of care?
a. Administer prescribed sedatives or opioids at bedtime to promote sleep.
b. Cluster nursing activities so that the patient has uninterrupted rest periods.
c. Silence the alarms on the cardiac monitors to allow 30- to 40-minute naps.
d. Eliminate assessments between 0100 and 0600 to allow uninterrupted sleep.
ANS: B
Clustering nursing activities and providing uninterrupted rest periods will minimize sleep-cycle
disruption. Sedative and opioid medications tend to decrease the amount of rapid eye movement
(REM) sleep and can contribute to sleep disturbance and disturbed sensory perception. Silencing
the alarms on the cardiac monitors would be unsafe in a critically ill patient, as would
discontinuing assessments during the night.
DIF: Cognitive Level: Apply (application) REF: 1601
TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity
2. Which hemodynamic parameter is most appropriate for the nurse to monitor to determine the
effectiveness of medications given to a patient to reduce left ventricular afterload?
a. Mean arterial pressure (MAP)
,Chapter 66 Nursing Management Critical Care
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
ANS: B
Systemic vascular resistance reflects the resistance to ventricular ejection, or afterload. The other
parameters will be monitored, but do not reflect afterload as directly.
DIF: Cognitive Level: Apply (application) REF: 1604
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
3. While family members are visiting, a patient has a respiratory arrest and is being
resuscitated. Which action by the nurse is best?
a. Tell the family members that watching the resuscitation will be very stressful.
b. Ask family members if they wish to remain in the room during the resuscitation.
c. Take the family members quickly out of the patient room and remain with them.
d. Assign a staff member to wait with family members just outside the patient room.
ANS: B
Research indicates that family members want the option of remaining in the room during
procedures such as cardiopulmonary resuscitation (CPR) and that this decreases anxiety and
facilitates grieving. The other options may be appropriate if the family decides not to remain
with the patient.
, Chapter 66 Nursing Management Critical Care
DIF: Cognitive Level: Apply (application) REF: 1602
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. Following
surgery for an abdominal aortic aneurysm, a patient’s central venous pressure
(CVP) monitor indicates low pressures. Which action is a priority for the nurse to take?
a. Administer IV diuretic medications.
b. Increase the IV fluid infusion per protocol.
c. Document the CVP and continue to monitor.
d. Elevate the head of the patient’s bed to 45 degrees.
ANS: B
A low CVP indicates hypovolemia and a need for an increase in the infusion rate. Diuretic
administration will contribute to hypovolemia and elevation of the head may decrease cerebral
perfusion. Documentation and continued monitoring is an inadequate response to the low CVP.
DIF: Cognitive Level: Apply (application) REF: 1609
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
5. When caring for a patient with pulmonary hypertension, which parameter is most appropriate
for the nurse to monitor to evaluate the effectiveness of the treatment?
a. Central venous pressure (CVP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
Chapter 66: Nursing Management: Critical
Care Test Bank
MULTIPLE CHOICE
1. A 68-year-old patient has been in the intensive care unit for 4 days and has a nursing diagnosis
of disturbed sensory perception related to sleep deprivation. Which action should the nurse
include in the plan of care?
a. Administer prescribed sedatives or opioids at bedtime to promote sleep.
b. Cluster nursing activities so that the patient has uninterrupted rest periods.
c. Silence the alarms on the cardiac monitors to allow 30- to 40-minute naps.
d. Eliminate assessments between 0100 and 0600 to allow uninterrupted sleep.
ANS: B
Clustering nursing activities and providing uninterrupted rest periods will minimize sleep-cycle
disruption. Sedative and opioid medications tend to decrease the amount of rapid eye movement
(REM) sleep and can contribute to sleep disturbance and disturbed sensory perception. Silencing
the alarms on the cardiac monitors would be unsafe in a critically ill patient, as would
discontinuing assessments during the night.
DIF: Cognitive Level: Apply (application) REF: 1601
TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity
2. Which hemodynamic parameter is most appropriate for the nurse to monitor to determine the
effectiveness of medications given to a patient to reduce left ventricular afterload?
a. Mean arterial pressure (MAP)
,Chapter 66 Nursing Management Critical Care
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
ANS: B
Systemic vascular resistance reflects the resistance to ventricular ejection, or afterload. The other
parameters will be monitored, but do not reflect afterload as directly.
DIF: Cognitive Level: Apply (application) REF: 1604
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
3. While family members are visiting, a patient has a respiratory arrest and is being
resuscitated. Which action by the nurse is best?
a. Tell the family members that watching the resuscitation will be very stressful.
b. Ask family members if they wish to remain in the room during the resuscitation.
c. Take the family members quickly out of the patient room and remain with them.
d. Assign a staff member to wait with family members just outside the patient room.
ANS: B
Research indicates that family members want the option of remaining in the room during
procedures such as cardiopulmonary resuscitation (CPR) and that this decreases anxiety and
facilitates grieving. The other options may be appropriate if the family decides not to remain
with the patient.
, Chapter 66 Nursing Management Critical Care
DIF: Cognitive Level: Apply (application) REF: 1602
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. Following
surgery for an abdominal aortic aneurysm, a patient’s central venous pressure
(CVP) monitor indicates low pressures. Which action is a priority for the nurse to take?
a. Administer IV diuretic medications.
b. Increase the IV fluid infusion per protocol.
c. Document the CVP and continue to monitor.
d. Elevate the head of the patient’s bed to 45 degrees.
ANS: B
A low CVP indicates hypovolemia and a need for an increase in the infusion rate. Diuretic
administration will contribute to hypovolemia and elevation of the head may decrease cerebral
perfusion. Documentation and continued monitoring is an inadequate response to the low CVP.
DIF: Cognitive Level: Apply (application) REF: 1609
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
5. When caring for a patient with pulmonary hypertension, which parameter is most appropriate
for the nurse to monitor to evaluate the effectiveness of the treatment?
a. Central venous pressure (CVP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
