Urden Critical Care Nursing

MULTIPLE CHOICE 1. A patient is admitted to the intensive care unit (ICU) for observation of his grade II splenic laceration. Which signs and symptoms suggest that the patient has had a delayed rupture of his splenic capsule and is now in hemorrhagic shock? a. Blood pressure (BP), 110/70 mm Hg; HR, 120 beats/min; Hct, 42 mg/dL; UO, 40 mL/h; skin that is pink, warm, and dry, with capillary refill of 3 seconds b. BP, 90/70 mm Hg; HR, 140 beats/min; Hct, 21 mg/dL; UO, 10 mL/h; pale, cool, clam...

MULTIPLE CHOICE 1. The nurse is caring for a postoperative patient who is snoring and has stridor, nostril flaring, and intercostal retractions. The nurse knows that these findings are clinical manifestations of what problem? a. Angina b. Airway obstruction c. Pain d. Oversedation ANS: B Clinical manifestation of airway obstruction includes snoring, stridor, flaring of the nostrils, retractions at the intercostal spaces and suprasternal notch, abnormal use of accessory muscles, asyn...

MULTIPLE CHOICE 1. An older patient is admitted to the hospital with a hip fracture. Which nursing intervention would be a priority? a. Encourage frequent deep breathing. b. Administer stool softeners. c. Perform neurologic checks. d. Frequently offer liquids to drink. ANS: A Although all the items are important, age-related changes in respiratory mechanics lead to airflow restrictions, which are reflected in decreased forced expiratory volume in 1 second (FEV1). Age-related decreas...

MULTIPLE CHOICE 1. The nurse is caring for a patient with type 2 heparin-induced thrombocytopenia (HIT). The nurse knows that pulmonary embolism is a serious complication of HIT. Which findings would alert the nurse to the presence of this complication? a. Blanching of fingers and toes and loss of peripheral pulses b. Chest pain, pallor, and confusion c. Headache, impaired speech, and loss of motor function d. Dyspnea, pleuritic pain, and rales ANS: D The presence of blanching and t...

MULTIPLE CHOICE 1. Central cyanosis is associated with which phenomena? a. Decreased peripheral blood flow b. Desaturation of arterial blood c. Reduced hemoglobin of 15 g/dL d. Permanent cerebral hypoxia ANS: B Cyanosis is visible when hemoglobin is reduced by 5 g per 100 mL of blood. Cyanosis associated with desaturation of arterial blood is called central cyanosis. Peripheral cyanosis is a condition in which cyanosis exists but the child has normal arterial oxygen saturation. D...

MULTIPLE CHOICE 1. The treatment plan for management of an obstetric patient with peripartum cardiomyopathy (PPCM) includes which interventions? a. Oxygen therapy, pain management, and preload enhancement b. Walking exercises, diuretics, and anticoagulants c. Diuretics, digoxin, and anticoagulation d. Fluid resuscitation, beta-blockers, and vasoconstrictors ANS: C Symptoms are identical to those of classic cardiac failure, but treatment depends on the pregnancy status of the patient...

MULTIPLE CHOICE 1. A patient is being admitted from the emergency department (ED) with cardiogenic shock secondary to unstable angina unresponsive to medications. The patient was intubated and ventilated in the ED. Which intervention should the nurse prepare to initiate when the practitioner arrives in the unit? a. Administration of sodium bicarbonate b. Rapid infusion of crystalloids c. Insertion of an intraaortic balloon pump (IABP) d. Insertion of dialysis catheters for continuous rena...

MULTIPLE CHOICE 1. After a pancreatic transplant with bladder exocrine drainage, the nurse would anticipate which order? a. Continuous bladder irrigation b. Intermittent insulin injections c. Removal of the nasogastric tube as soon as the patient is alert d. Daily hematocrit and hemoglobin levels ANS: A An increased potential for urinary catheter occlusion exists for pancreas recipients who have undergone a urinary diversion procedure. The exocrine pancreatic enzymes make the urine ...

MULTIPLE CHOICE 1. Which topical antimicrobial agent is commonly used as a broad-spectrum and fights against gram-positive and -negative bacteria? a. Pure silver b. Bacitracin c. Mafenide acetate cream d. Silver sulfadiazine ANS: D Silver sulfadiazine (SSD; Silvadene cream) is a broad-spectrum antimicrobial agent with bactericidal action against many gram-negative and -positive bacteria associated with burn wound infection. Mafenide acetate cream penetrates through burn eschar and i...

MULTIPLE CHOICE 1. A patient is admitted with hypernatremia secondary to diabetes insipidus (DI). Which test would help the practitioner differentiate between central and nephrogenic DI? a. Water deprivation test b. Serum osmolality c. Serum antidiuretic hormone level d. Antidiuretic hormone (ADH) test ANS: D The antidiuretic hormone test is used to differentiate between neurogenic diabetes insipidus (DI) (central) and nephrogenic (kidney) DI. In severe central DI, in which the pitu...