Question 1

Which action should the nurse take when the low pressure alarm sounds for a patient who has an arterial line in the left radial artery?

Accepted Answer

A) Fast flush the arterial line. 
B) Check the left hand for pallor. 
C) Assess for cardiac dysrhythmias. 
D) Re-zero the monitoring equipment.

Question 2

The nurse notes that a patient's endotracheal tube (ET),which was at the 22-cm mark,is now at the 25-cm mark,and the patient is anxious and restless. Which action should the nurse take next?

Accepted Answer

A) Check the O2 saturation. 
B) Offer reassurance to the patient. 
C) Listen to the patient's breath sounds. 
D) Notify the patient's health care provider.

Question 3

The nurse is caring for a patient receiving a continuous norepinephrine IV infusion. Which patient assessment finding indicates that the infusion rate may need to be adjusted?

Accepted Answer

A) Heart rate is slow at 58 beats/min. 
B) Mean arterial pressure (MAP) is 56 mm Hg. 
C) Systemic vascular resistance (SVR) is elevated. 
D) Pulmonary artery wedge pressure (PAWP) is low.

Question 4

After change-of-shift report,which patient should the progressive care nurse assess first?

Accepted Answer

A) Patient who was extubated this morning and has a temperature of 101.4°F (38.6°
C)  
B) Patient with bilevel positive airway pressure (BiPAP) for obstructive sleep apnea and a respiratory rate of 16 
C) Patient with arterial pressure monitoring who is 2 hours post-percutaneous coronary intervention and needs to void 
D) Patient who is receiving IV heparin for a venous thromboembolism and has a partial thromboplastin time (PTT) of 101 sec

Question 5

The nurse is caring for a patient who has an intraaortic balloon pump in place. Which action should be included in the plan of care?

Accepted Answer

A) Avoid the use of anticoagulant medications. 
B) Measure the patient's urinary output every hour. 
C) Provide passive range of motion for all extremities. 
D) Position the patient supine with head flat at all times.

Question 6

An 81-yr-old patient who has been in the intensive care unit (ICU)for a week is now stable and transfer to the progressive care unit is planned. On rounds,the nurse notices that the patient has new onset confusion. The nurse will plan to

Accepted Answer

A) give PRN lorazepam (Ativan) and cancel the transfer. 
B) inform the receiving nurse and then transfer the patient. 
C) notify the health care provider and postpone the transfer. 
D) obtain an order for restraints as needed and transfer the patient.

Question 7

The intensive care unit (ICU)nurse educator determines that teaching a new staff nurse about arterial pressure monitoring has been effective when the nurse

Accepted Answer

A) balances and calibrates the monitoring equipment every 2 hours. 
B) positions the zero-reference stopcock line level with the phlebostatic axis. 
C) ensures that the patient is supine with the head of the bed flat for all readings. 
D) rechecks the location of the phlebostatic axis with changes in the patient's position.

Question 8

The nurse is caring for a patient who has an arterial catheter in the left radial artery for arterial pressure-based cardiac output (APCO)monitoring. Which information obtained by the nurse requires a report to the health care provider?

Accepted Answer

A) The patient has a positive Allen test result. 
B) There is redness at the catheter insertion site. 
C) The mean arterial pressure (MAP) is 86 mm Hg. 
D) The dicrotic notch is visible in the arterial waveform.

Question 9

A patient with respiratory failure has arterial pressure-based cardiac output (APCO)monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP)of 12 cm H2O. Which information indicates that a change in the ventilator settings may be required?

Accepted Answer

A) The arterial pressure is 90/46. 
B) The stroke volume is increased. 
C) The heart rate is 58 beats/minute. 
D) The stroke volume variation is 12%.

Question 10

An intraaortic balloon pump (IABP)is being used for a patient who is in cardiogenic shock. Which assessment data indicate to the nurse that the goals of treatment with the IABP are being met?

Accepted Answer

A) Urine output of 25 mL/hr 
B) Heart rate of 110 beats/minute 
C) Cardiac output (CO) of 5 L/min 
D) Stroke volume (SV) of 40 mL/beat

Question 11

When assisting with oral intubation of a patient who is having respiratory distress,in which order will the nurse take these actions? (Put a comma and a space between each answer choice [A,B,C,D,E].)

Accepted Answer

A) Obtain a portable chest-x-ray. 
B) Position the patient in the supine position. 
C) Inflate the cuff of the endotracheal tube after insertion. 
D) Attach an end-tidal CO? detector to the endotracheal tube. 
E) Oxygenate the patient with a bag-valve-mask device for several minutes.

Question 12

The nurse educator is evaluating the performance of a new registered nurse (RN)who is providing care to a patient who is receiving mechanical ventilation with 15 cm H2O of peak end-expiratory pressure (PEEP). Which action indicates that the new RN is safe?

Accepted Answer

A) The RN plans to suction the patient every 1 to 2 hours. 
B) The RN uses a closed-suction technique to suction the patient. 
C) The RN tapes the connection between the ventilator tubing and the ET. 
D) The RN changes the ventilator circuit tubing routinely every 48 hours.

Question 13

A patient who is orally intubated and receiving mechanical ventilation is anxious and is "fighting" the ventilator. Which action should the nurse take next?

Accepted Answer

A) Verbally coach the patient to breathe with the ventilator. 
B) Sedate the patient with the ordered PRN lorazepam (Ativan). 
C) Manually ventilate the patient with a bag-valve-mask device. 
D) Increase the rate for the ordered propofol (Diprivan) infusion.

Question 14

Which hemodynamic parameter best reflects the effectiveness of drugs that the nurse gives to reduce a patient's left ventricular afterload?

Accepted Answer

A) Mean arterial pressure (MAP) 
B) Systemic vascular resistance (SVR) 
C) Pulmonary vascular resistance (PVR) 
D) Pulmonary artery wedge pressure (PAWP)

Question 15

The nurse notes premature ventricular contractions (PVCs)while suctioning a patient's endotracheal tube. Which next action by the nurse is indicated?

Accepted Answer

A) Plan to suction the patient more frequently. 
B) Decrease the suction pressure to 80 mm Hg. 
C) Give antidysrhythmic medications per protocol. 
D) Stop and ventilate the patient with 100% oxygen.

Question 16

To maintain proper cuff pressure of an endotracheal tube (ET)when the patient is on mechanical ventilation,the nurse should

Accepted Answer

A) inflate the cuff with a minimum of 10 mL of air. 
B) inflate the cuff until the pilot balloon is firm on palpation. 
C) inject air into the cuff until a manometer shows 15 mm Hg pressure. 
D) inject air into the cuff until a slight leak is heard only at peak inflation.

Question 17

After surgery for an abdominal aortic aneurysm,a patient's central venous pressure (CVP)monitor indicates low pressures. Which action should the nurse take?

Accepted Answer

A) Administer IV diuretic medications. 
B) Increase the IV fluid infusion per protocol. 
C) Increase the infusion rate of IV vasodilators. 
D) Elevate the head of the patient's bed to 45 degrees.

Question 18

A patient's vital signs are pulse 90,respirations 24,and BP 128/64 mm Hg,and cardiac output is 4.7 L/min. The patient's stroke volume is _____ mL. (Round to the nearest whole number.)

Accepted Answer

The answer of A patient's vital signs are pulse 90,respirations...

Question 19

When monitoring the effectiveness of treatment for a patient with a large anterior wall myocardial infarction,the most pertinent measurement for the nurse to obtain is

Accepted Answer

A) central venous pressure (CVP). 
B) systemic vascular resistance (SVR). 
C) pulmonary vascular resistance (PVR). 
D) pulmonary artery wedge pressure (PAWP).

Question 20

The nurse is caring for a patient with a subarachnoid hemorrhage who is intubated and placed on a mechanical ventilator with 10 cm H2O of peak end-expiratory pressure (PEEP). When monitoring the patient,the nurse will need to notify the health care provider immediately if the patient develops

Accepted Answer

A) O2 saturation of 93%. 
B) green nasogastric tube drainage. 
C) respirations of 20 breaths/minute. 
D) increased jugular venous distention.

Exam 65: Critical Care

Which action should the nurse take when the low pressure alarm sounds for a patient who has an arterial line in the left radial artery?

The nurse notes that a patient's endotracheal tube (ET) ,which was at the 22-cm mark,is now at the 25-cm mark,and the patient is anxious and restless. Which action should the nurse take next?

The nurse is caring for a patient receiving a continuous norepinephrine IV infusion. Which patient assessment finding indicates that the infusion rate may need to be adjusted?

After change-of-shift report,which patient should the progressive care nurse assess first?

The nurse is caring for a patient who has an intraaortic balloon pump in place. Which action should be included in the plan of care?

An 81-yr-old patient who has been in the intensive care unit (ICU) for a week is now stable and transfer to the progressive care unit is planned. On rounds,the nurse notices that the patient has new onset confusion. The nurse will plan to

The intensive care unit (ICU) nurse educator determines that teaching a new staff nurse about arterial pressure monitoring has been effective when the nurse

The nurse is caring for a patient who has an arterial catheter in the left radial artery for arterial pressure-based cardiac output (APCO) monitoring. Which information obtained by the nurse requires a report to the health care provider?

A patient with respiratory failure has arterial pressure-based cardiac output (APCO) monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 12 cm H₂O. Which information indicates that a change in the ventilator settings may be required?

An intraaortic balloon pump (IABP) is being used for a patient who is in cardiogenic shock. Which assessment data indicate to the nurse that the goals of treatment with the IABP are being met?

When assisting with oral intubation of a patient who is having respiratory distress,in which order will the nurse take these actions? (Put a comma and a space between each answer choice [A,B,C,D,E].)

The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H₂O of peak end-expiratory pressure (PEEP) . Which action indicates that the new RN is safe?

A patient who is orally intubated and receiving mechanical ventilation is anxious and is "fighting" the ventilator. Which action should the nurse take next?

Which hemodynamic parameter best reflects the effectiveness of drugs that the nurse gives to reduce a patient's left ventricular afterload?

The nurse notes premature ventricular contractions (PVCs) while suctioning a patient's endotracheal tube. Which next action by the nurse is indicated?

To maintain proper cuff pressure of an endotracheal tube (ET) when the patient is on mechanical ventilation,the nurse should

After surgery for an abdominal aortic aneurysm,a patient's central venous pressure (CVP) monitor indicates low pressures. Which action should the nurse take?

A patient's vital signs are pulse 90,respirations 24,and BP 128/64 mm Hg,and cardiac output is 4.7 L/min. The patient's stroke volume is _____ mL. (Round to the nearest whole number.)

When monitoring the effectiveness of treatment for a patient with a large anterior wall myocardial infarction,the most pertinent measurement for the nurse to obtain is

The nurse is caring for a patient with a subarachnoid hemorrhage who is intubated and placed on a mechanical ventilator with 10 cm H₂O of peak end-expiratory pressure (PEEP) . When monitoring the patient,the nurse will need to notify the health care provider immediately if the patient develops

Exam 65: Critical Care

Which action should the nurse take when the low pressure alarm sounds for a patient who has an arterial line in the left radial artery?

The nurse notes that a patient's endotracheal tube (ET) ,which was at the 22-cm mark,is now at the 25-cm mark,and the patient is anxious and restless. Which action should the nurse take next?

The nurse is caring for a patient receiving a continuous norepinephrine IV infusion. Which patient assessment finding indicates that the infusion rate may need to be adjusted?

After change-of-shift report,which patient should the progressive care nurse assess first?

The nurse is caring for a patient who has an intraaortic balloon pump in place. Which action should be included in the plan of care?

An 81-yr-old patient who has been in the intensive care unit (ICU) for a week is now stable and transfer to the progressive care unit is planned. On rounds,the nurse notices that the patient has new onset confusion. The nurse will plan to

The intensive care unit (ICU) nurse educator determines that teaching a new staff nurse about arterial pressure monitoring has been effective when the nurse

The nurse is caring for a patient who has an arterial catheter in the left radial artery for arterial pressure-based cardiac output (APCO) monitoring. Which information obtained by the nurse requires a report to the health care provider?

A patient with respiratory failure has arterial pressure-based cardiac output (APCO) monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 12 cm H2O. Which information indicates that a change in the ventilator settings may be required?

An intraaortic balloon pump (IABP) is being used for a patient who is in cardiogenic shock. Which assessment data indicate to the nurse that the goals of treatment with the IABP are being met?

When assisting with oral intubation of a patient who is having respiratory distress,in which order will the nurse take these actions? (Put a comma and a space between each answer choice [A,B,C,D,E].)

The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H2O of peak end-expiratory pressure (PEEP) . Which action indicates that the new RN is safe?

A patient who is orally intubated and receiving mechanical ventilation is anxious and is "fighting" the ventilator. Which action should the nurse take next?

Which hemodynamic parameter best reflects the effectiveness of drugs that the nurse gives to reduce a patient's left ventricular afterload?

The nurse notes premature ventricular contractions (PVCs) while suctioning a patient's endotracheal tube. Which next action by the nurse is indicated?

To maintain proper cuff pressure of an endotracheal tube (ET) when the patient is on mechanical ventilation,the nurse should

After surgery for an abdominal aortic aneurysm,a patient's central venous pressure (CVP) monitor indicates low pressures. Which action should the nurse take?

A patient's vital signs are pulse 90,respirations 24,and BP 128/64 mm Hg,and cardiac output is 4.7 L/min. The patient's stroke volume is _____ mL. (Round to the nearest whole number.)

When monitoring the effectiveness of treatment for a patient with a large anterior wall myocardial infarction,the most pertinent measurement for the nurse to obtain is

The nurse is caring for a patient with a subarachnoid hemorrhage who is intubated and placed on a mechanical ventilator with 10 cm H2O of peak end-expiratory pressure (PEEP) . When monitoring the patient,the nurse will need to notify the health care provider immediately if the patient develops

A patient with respiratory failure has arterial pressure-based cardiac output (APCO) monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 12 cm H₂O. Which information indicates that a change in the ventilator settings may be required?

The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H₂O of peak end-expiratory pressure (PEEP) . Which action indicates that the new RN is safe?

The nurse is caring for a patient with a subarachnoid hemorrhage who is intubated and placed on a mechanical ventilator with 10 cm H₂O of peak end-expiratory pressure (PEEP) . When monitoring the patient,the nurse will need to notify the health care provider immediately if the patient develops