NR 341 Fundamentals of Critical Care Nursing Exam with Questions and Answers

NR 341 Fundamentals of Critical Care Nursing Exam with Questions and Answers A 68 year old man with COPD exacerbation (Mr. Ade) is on continuous pulse oximetry. His SpO₂ drops from 92% to 86% while resting. Which action should the nurse take first? a. Increase the oxygen flow rate. b. Notify the healthcare provider. c. Administer a bronchodilator via nebulizer. d. Assess the patient’s airway patency and respiratory effort. Correct Answer : D. Rationale: The first step in respiratory deterioration is to assess airway patency and effort. Assessment precedes interventions like increasing O₂ or bronchodilators because ineffective ventilation may not improve with O₂ alone. Mrs. Kamau, a 55 year old woman post CABG, is receiving norepinephrine to maintain MAP ≥ 65 mm Hg. The MAP drops to 58 mm Hg. Which parameter best indicates the need for adjusting the infusion? a. Hourly urine output. b. Peripheral pulse oximetry. c. Invasive arterial pressure readings. d. Respiratory rate and effort. Correct Answer : C. Rationale: In patients on vasoactive drips, invasive arterial pressure monitoring (MAP) is the most direct parameter for titration. Urine output and other signs are secondary and lag behind perfusion changes.