Question 1

The nurse is caring for four patients on the progressive care unit.Which patient is at greatest risk for developing delirium?

Accepted Answer

A)  36-year-old recovering from a motor vehicle crash; being treated with an evidence-based alcohol withdrawal protocol. 
B)  54-year-old postoperative aortic aneurysm resection with a 40 pack-year history of smoking 
C)  86-year-old from nursing home with dementia, postoperative from colon resection, still being mechanically ventilated 
D)  95-year-old with community-acquired pneumonia; family has brought in eyeglasses and hearing aid 
A)  36-year-old recovering from a motor vehicle crash; being treated with an evidence-based alcohol withdrawal protocol. 
B)  54-year-old postoperative aortic aneurysm resection with a 40 pack-year history of smoking 
C)  86-year-old from nursing home with dementia, postoperative from colon resection, still being mechanically ventilated 
D)  95-year-old with community-acquired pneumonia; family has brought in eyeglasses and hearing aid

Question 2

The best way to monitor agitation and effectiveness of treating it in the critically ill patient is to use a/the:

Accepted Answer

A)  Confusion Assessment Method (CAM-ICU). 
B)  FACES assessment tool. 
C)  Glasgow Coma Scale. 
D)  Richmond Agitation Sedation Scale. 
A)  Confusion Assessment Method (CAM-ICU). 
B)  FACES assessment tool. 
C)  Glasgow Coma Scale. 
D)  Richmond Agitation Sedation Scale.

Question 3

The most important nursing intervention for patients who receive neuromuscular blocking agents is to

Accepted Answer

A)  administer sedatives in conjunction with the neuromuscular blocking agents. 
B)  assess neurological status every 30 minutes. 
C)  avoid interaction with the patient, because he or she won't be able to hear. 
D)  restrain the patient to avoid self-extubation. 
A)  administer sedatives in conjunction with the neuromuscular blocking agents. 
B)  assess neurological status every 30 minutes. 
C)  avoid interaction with the patient, because he or she won't be able to hear. 
D)  restrain the patient to avoid self-extubation.

Question 4

Which of the following statements regarding pain and anxiety are true?

Accepted Answer

A)  Anxiety is a state marked by apprehension, agitation, autonomic arousal, and/or fearful withdrawal. 
B)  Critically ill patients often experience anxiety, but they rarely experience pain. 
C)  Pain and anxiety are often interrelated and may be difficult to differentiate because their physiological and behavioral manifestations are similar. 
D)  Pain is defined by each patient; it is whatever the person experiencing the pain says it is. 
E)  While anxiety is unpleasant, it does not contribute to mortality or morbidity of the critically ill patient. 
A)  Anxiety is a state marked by apprehension, agitation, autonomic arousal, and/or fearful withdrawal. 
B)  Critically ill patients often experience anxiety, but they rarely experience pain. 
C)  Pain and anxiety are often interrelated and may be difficult to differentiate because their physiological and behavioral manifestations are similar. 
D)  Pain is defined by each patient; it is whatever the person experiencing the pain says it is. 
E)  While anxiety is unpleasant, it does not contribute to mortality or morbidity of the critically ill patient.

Question 5

A patient requires pancuronium as part of treatment of refractive increased intracranial pressure.The nursing care for this patient includes:

Accepted Answer

A)  administration of sedatives concurrently with neuromuscular blockade. 
B)  dangling the patient's feet over the edge of the bed and assisting the patient to sit up in a chair at least twice each day. 
C)  ensuring that deep vein thrombosis prophylaxis is initiated. 
D)  providing interventions for eye care, oral care, and skin care. 
E)  ensuring good nutrition with frequent feedings throughout the day. 
A)  administration of sedatives concurrently with neuromuscular blockade. 
B)  dangling the patient's feet over the edge of the bed and assisting the patient to sit up in a chair at least twice each day. 
C)  ensuring that deep vein thrombosis prophylaxis is initiated. 
D)  providing interventions for eye care, oral care, and skin care. 
E)  ensuring good nutrition with frequent feedings throughout the day.

Question 6

The nurse is caring for a patient receiving a benzodiazepine intermittently.The nurse understands that the best way to administer such drugs is to:

Accepted Answer

A)  administer around the clock, rather than as needed, to ensure constant sedation. 
B)  administer the medications through the feeding tube to prevent complications. 
C)  give the highest allowable dose for the greatest effect. 
D)  titrate to a predefined endpoint using a standard sedation scale. 
A)  administer around the clock, rather than as needed, to ensure constant sedation. 
B)  administer the medications through the feeding tube to prevent complications. 
C)  give the highest allowable dose for the greatest effect. 
D)  titrate to a predefined endpoint using a standard sedation scale.

Question 7

The primary mode of action for neuromuscular blocking agents used in the management of some ventilated patients is

Accepted Answer

A)  analgesia. 
B)  anticonvulsant therapy. 
C)  paralysis. 
D)  sedation. 
A)  analgesia. 
B)  anticonvulsant therapy. 
C)  paralysis. 
D)  sedation.

Question 8

A postsurgical patient is on a ventilator in the critical care unit.The patient has been tolerating the ventilator well and has not required any sedation.On assessment,the nurse notes the patient is tachycardic and hypertensive with an increased respiratory rate of 28 breaths/min.The patient has been suctioned recently via the endotracheal tube,and the airway is clear.The patient responds appropriately to the nurse's commands.The nurse should:

Accepted Answer

A)  assess the patient's level of pain. 
B)  decrease the ventilator rate. 
C)  provide sedation as ordered. 
D)  suction the patient again. 
A)  assess the patient's level of pain. 
B)  decrease the ventilator rate. 
C)  provide sedation as ordered. 
D)  suction the patient again.

Question 9

The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period.Which of the following nursing interventions would improve the patient's well-being and reduce anxiety the most?

Accepted Answer

A)  Arrange for the patient's dog to be brought into the unit (per protocol). 
B)  Provide aromatherapy with scents such as lavender that are known to help anxiety. 
C)  Secure the harpist to come and play soothing music for an hour every afternoon. 
D)  Wheel the patient out near the unit aquarium to observe the tropical fish. 
A)  Arrange for the patient's dog to be brought into the unit (per protocol). 
B)  Provide aromatherapy with scents such as lavender that are known to help anxiety. 
C)  Secure the harpist to come and play soothing music for an hour every afternoon. 
D)  Wheel the patient out near the unit aquarium to observe the tropical fish.

Question 10

The nurse is concerned about the risk of alcohol withdrawal syndrome in a postoperative patient.Which statement by the nurse indicates understanding of management of this patient?

Accepted Answer

A)  "Alcohol withdrawal is common; we see it all of the time in the trauma unit." 
B)  "There is no way to assess for alcohol withdrawal." 
C)  "This patient will require less pain medication." 
D)  "We have initiated the alcohol withdrawal protocol." 
A)  "Alcohol withdrawal is common; we see it all of the time in the trauma unit." 
B)  "There is no way to assess for alcohol withdrawal." 
C)  "This patient will require less pain medication." 
D)  "We have initiated the alcohol withdrawal protocol."

Question 11

In the healthy individual,pain and anxiety:

Accepted Answer

A)  activate the sympathetic nervous system (SNS). 
B)  decrease stress levels. 
C)  help remove one from harm. 
D)  increase performance levels. 
E)  limit sympathetic nervous system activity. 
A)  activate the sympathetic nervous system (SNS). 
B)  decrease stress levels. 
C)  help remove one from harm. 
D)  increase performance levels. 
E)  limit sympathetic nervous system activity.

Question 12

The nurse is caring for a patient who requires administration of a neuromuscular blocking agent to facilitate ventilation with nontraditional modes.The nurse understands that neuromuscular blocking agents provide:

Accepted Answer

A)  antianxiety effects. 
B)  complete analgesia. 
C)  high levels of sedation. 
D)  no sedation or analgesia. 
A)  antianxiety effects. 
B)  complete analgesia. 
C)  high levels of sedation. 
D)  no sedation or analgesia.

Question 13

The nurse is assessing the patient's pain using the Critical Care Pain Observation Tool.Which of the following assessments would indicate the greatest likelihood of pain and need for nursing intervention?

Accepted Answer

A)  Absence of vocal sounds 
B)  Fighting the ventilator 
C)  Moving legs in bed 
D)  Relaxed muscles in upper extremities 
A)  Absence of vocal sounds 
B)  Fighting the ventilator 
C)  Moving legs in bed 
D)  Relaxed muscles in upper extremities

The nurse is caring for four patients on the progressive care unit.Which patient is at greatest risk for developing delirium?

The best way to monitor agitation and effectiveness of treating it in the critically ill patient is to use a/the:

The most important nursing intervention for patients who receive neuromuscular blocking agents is to

Which of the following statements regarding pain and anxiety are true?

A patient requires pancuronium as part of treatment of refractive increased intracranial pressure.The nursing care for this patient includes:

The nurse is caring for a patient receiving a benzodiazepine intermittently.The nurse understands that the best way to administer such drugs is to:

The primary mode of action for neuromuscular blocking agents used in the management of some ventilated patients is

The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period.Which of the following nursing interventions would improve the patient's well-being and reduce anxiety the most?

The nurse is concerned about the risk of alcohol withdrawal syndrome in a postoperative patient.Which statement by the nurse indicates understanding of management of this patient?

In the healthy individual,pain and anxiety:

The nurse is caring for a patient who requires administration of a neuromuscular blocking agent to facilitate ventilation with nontraditional modes.The nurse understands that neuromuscular blocking agents provide:

The nurse is assessing the patient's pain using the Critical Care Pain Observation Tool.Which of the following assessments would indicate the greatest likelihood of pain and need for nursing intervention?

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-Of-Life Care and Palliative Care in Critical Care Settings

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Organ Donation

Shock,sepsis,and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Respiratory Failure

Acute Kidney Injury

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

Burns

Filters

Exam 5: Comfort and Sedation

The nurse is caring for four patients on the progressive care unit.Which patient is at greatest risk for developing delirium?

The best way to monitor agitation and effectiveness of treating it in the critically ill patient is to use a/the:

The most important nursing intervention for patients who receive neuromuscular blocking agents is to

Which of the following statements regarding pain and anxiety are true?

A patient requires pancuronium as part of treatment of refractive increased intracranial pressure.The nursing care for this patient includes:

The nurse is caring for a patient receiving a benzodiazepine intermittently.The nurse understands that the best way to administer such drugs is to:

The primary mode of action for neuromuscular blocking agents used in the management of some ventilated patients is

The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period.Which of the following nursing interventions would improve the patient's well-being and reduce anxiety the most?

The nurse is concerned about the risk of alcohol withdrawal syndrome in a postoperative patient.Which statement by the nurse indicates understanding of management of this patient?

In the healthy individual,pain and anxiety:

The nurse is caring for a patient who requires administration of a neuromuscular blocking agent to facilitate ventilation with nontraditional modes.The nurse understands that neuromuscular blocking agents provide:

The nurse is assessing the patient's pain using the Critical Care Pain Observation Tool.Which of the following assessments would indicate the greatest likelihood of pain and need for nursing intervention?

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-Of-Life Care and Palliative Care in Critical Care Settings

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Organ Donation

Shock,sepsis,and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Respiratory Failure

Acute Kidney Injury

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

Burns

Filters