Critical Care Nursing Practice Exam
the most important outcome of effective communication is to: - correct answer-reduce patient
error
As part of nursing management of critically ill patients, orders are written to keep the head of
the bed elevated at 30 degrees, awaken the patient from sedation each morning to assess
readiness to wean from mech vent, and implement oral care protocol every 4 hours. These
interventions are done as a group to reduce the risk of vent-associated pneumonia. This
group of evidence-based interventions is often called: - correct answer-bundle of care
working in an intermediate care unit that has experienced high nursing turnover. the nurse
manager is often considered to be an autocratic leader by staff members and her leadership
style is contributing to turnover. you have asked to involve in developing new guidelines to
prevent pressure ulcers in your patient population. The nurse manager tells you that you do
not yet have enough experience to be on the prevention task force. this situation and setting
is an example of: - correct answer-work environment that is unhealthy
which nursing interven would best support the family of a critically ill patient? - correct
answer-give condition update each morning and whenever changes occur
which intervention is appropriate to assist the patient to cope with admission to the critical
care unit - correct answer-explaining all procedures in easy-to-understand terms
which of the following statement about family assessment is false? - correct
answer-assessment of structure (who comprises the family) is the last step in assessment
many critically ill patients experience anxiety. the nurse can reduce anxiety with which
approach? - correct answer-state, "mr J, it's time to turn you. I'm going to ask another nurse
to come in and help me. We will turn you to your left. During the turn, I'm going to inspect the
skin on your back and rub some lotion on your back. This should help you feel better."
which of the following statement about resuscitation is true? - correct answer-withholding
"extraordinary" resuscitation is legal and ethical if specified in advance directives and
physician orders.
65 YO pt c history of metastatic lung carcinoma has been unresponsive to chemo. the
medical team has determined that there are no additional tx available that will prolong life or
improve the quality of life in any meaningful way. Despite the poor prognosis, the pt
continues to rc'd chemo and full nutrition support. what is this example of end of life
concept? - correct answer-medical futility
pt c end stage HF is experiencing considerable dyspnea. which med is appropriate? - correct
answer-morphing, 5 mg IV, and initiate continuous morphine infusion
, neuromuscular blocking agents are used in the management of some vent patient; their
primary mdoe of action is - correct answer-paralysis
patient on vent, using critical care pain observation tool; which of the following assessment
would indicate the greatest likelihood of pain and need for nursing intervent? - correct
answer-fighting the vent
best way to administer benzo intermittently is? - correct answer-titrate to a predefined
endpoint using a standard sedation scale
pt remains npo from abdominal surgery complication; ET tube feeding not possible; therefore
need parenteral feeding. major complication for this therapy? - correct answer-fluid and
electrolyte imblances and sepsis
a patient's feeding tube has been successfully placed in small intestine with continuous flow
tube feeding. the nurse knows that this approach was chosen because: - correct
answer-intestinal mucosa normally rc'd nutrient from stomach in peristaltic waves
which patient at greatest risk for malabsorption of protein? - correct answer-patient with ileitis
patient on tube feeding require xray for cough eval; to reduce risk of aspiration, the nurse: -
correct answer-stops feeding 10-15 minutes before placing flat to obtain the radiograph
normal rates of the SA node when the patient is at rest is - correct answer-60-100 beats per
minute
nurse is examining the patient's cardiac rhythm strip in lead II and notice all P waves are
upright and look the same except one that has a different shape and is inverted. the nurse
realizes that P wave with abnormal shape is probably: - correct answer-from some area in
the atria other than SA node
20 small boxes between each p wave and 20 boxes between each r waves; what's the
ventricular rate? - correct answer-75
0.04x20 = .08
60/.08 = 75
patient's heart rhythm shows an inverted p wave with PR interval of 0.06 seconds. the heart
rate is 54 beats per minute. The nurse recognize the rhythm as a junctional escape rhythm,
and understands that the rhythm is due to the - correct answer-loss of sinus node activity
the patient's heart rate is 70 beats per minute, but the p waves come after the QRS complex.
The nurse correctly determines that the patient's heart rhythm is: - correct
answer-accelerated junctional rhythm
normal cardiac index? - correct answer-1.2
normal cardiac output? - correct answer-4-8L/min
the most important outcome of effective communication is to: - correct answer-reduce patient
error
As part of nursing management of critically ill patients, orders are written to keep the head of
the bed elevated at 30 degrees, awaken the patient from sedation each morning to assess
readiness to wean from mech vent, and implement oral care protocol every 4 hours. These
interventions are done as a group to reduce the risk of vent-associated pneumonia. This
group of evidence-based interventions is often called: - correct answer-bundle of care
working in an intermediate care unit that has experienced high nursing turnover. the nurse
manager is often considered to be an autocratic leader by staff members and her leadership
style is contributing to turnover. you have asked to involve in developing new guidelines to
prevent pressure ulcers in your patient population. The nurse manager tells you that you do
not yet have enough experience to be on the prevention task force. this situation and setting
is an example of: - correct answer-work environment that is unhealthy
which nursing interven would best support the family of a critically ill patient? - correct
answer-give condition update each morning and whenever changes occur
which intervention is appropriate to assist the patient to cope with admission to the critical
care unit - correct answer-explaining all procedures in easy-to-understand terms
which of the following statement about family assessment is false? - correct
answer-assessment of structure (who comprises the family) is the last step in assessment
many critically ill patients experience anxiety. the nurse can reduce anxiety with which
approach? - correct answer-state, "mr J, it's time to turn you. I'm going to ask another nurse
to come in and help me. We will turn you to your left. During the turn, I'm going to inspect the
skin on your back and rub some lotion on your back. This should help you feel better."
which of the following statement about resuscitation is true? - correct answer-withholding
"extraordinary" resuscitation is legal and ethical if specified in advance directives and
physician orders.
65 YO pt c history of metastatic lung carcinoma has been unresponsive to chemo. the
medical team has determined that there are no additional tx available that will prolong life or
improve the quality of life in any meaningful way. Despite the poor prognosis, the pt
continues to rc'd chemo and full nutrition support. what is this example of end of life
concept? - correct answer-medical futility
pt c end stage HF is experiencing considerable dyspnea. which med is appropriate? - correct
answer-morphing, 5 mg IV, and initiate continuous morphine infusion
, neuromuscular blocking agents are used in the management of some vent patient; their
primary mdoe of action is - correct answer-paralysis
patient on vent, using critical care pain observation tool; which of the following assessment
would indicate the greatest likelihood of pain and need for nursing intervent? - correct
answer-fighting the vent
best way to administer benzo intermittently is? - correct answer-titrate to a predefined
endpoint using a standard sedation scale
pt remains npo from abdominal surgery complication; ET tube feeding not possible; therefore
need parenteral feeding. major complication for this therapy? - correct answer-fluid and
electrolyte imblances and sepsis
a patient's feeding tube has been successfully placed in small intestine with continuous flow
tube feeding. the nurse knows that this approach was chosen because: - correct
answer-intestinal mucosa normally rc'd nutrient from stomach in peristaltic waves
which patient at greatest risk for malabsorption of protein? - correct answer-patient with ileitis
patient on tube feeding require xray for cough eval; to reduce risk of aspiration, the nurse: -
correct answer-stops feeding 10-15 minutes before placing flat to obtain the radiograph
normal rates of the SA node when the patient is at rest is - correct answer-60-100 beats per
minute
nurse is examining the patient's cardiac rhythm strip in lead II and notice all P waves are
upright and look the same except one that has a different shape and is inverted. the nurse
realizes that P wave with abnormal shape is probably: - correct answer-from some area in
the atria other than SA node
20 small boxes between each p wave and 20 boxes between each r waves; what's the
ventricular rate? - correct answer-75
0.04x20 = .08
60/.08 = 75
patient's heart rhythm shows an inverted p wave with PR interval of 0.06 seconds. the heart
rate is 54 beats per minute. The nurse recognize the rhythm as a junctional escape rhythm,
and understands that the rhythm is due to the - correct answer-loss of sinus node activity
the patient's heart rate is 70 beats per minute, but the p waves come after the QRS complex.
The nurse correctly determines that the patient's heart rhythm is: - correct
answer-accelerated junctional rhythm
normal cardiac index? - correct answer-1.2
normal cardiac output? - correct answer-4-8L/min
