2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES E, Exams of Nursing

Download 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES E and more Exams Nursing in PDF only on Docsity! 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION A client is admitted postcraniotomy. Decadron 4 mg IV is ordered every six hours. The nurse understands the Decadron is ordered to 1. Incorrect prevent seizures. 2. Incorrect maintain the integrity of the gastric mucosa. 3. Correct decrease cerebral edema. 4. Incorrect stabilize the blood sugar. Answer Rationale: 3. Cerebral edema is common after surgery. Decadron (a corticosteroid) is given to decrease the edema. Question 102 of 385 A client is admitted with a C7 complete transection. In the immediate postinjury period, the nurse must plan for 1. Correct possible ventilatory support. 2. Incorrect bladder and bowel training. 3. Incorrect complications of autonomic dysreflexia. 4. Incorrect diaphragmatic pacing. Answer Rationale: 1. Edema above the area of the lesion can cause respiratory depression and arrest. Question 103 of 385 A client fell backward over a stair rail to the floor below, and is not breathing. After calling for assistance, how should the nurse proceed? 1. Incorrect After determining pulselessness, administer five chest compressions at the rate of 60 per minute. 2. Correct Initiate rescue breathing by performing a jaw thrust maneuver and administering two breaths. 3. Incorrect Initiate rescue breathing by performing a chin tilt maneuver and administering two breaths. 4. Incorrect After determining absence of breathing, administer 15 chest compressions at the rate of 60 per minute. Answer Rationale: 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2. When initiating rescue breathing for a client with a suspected spinal 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION behaviors by the client will be most effective in controlling manifestations? The client 1. Incorrect puts the affected arm through full range of motion daily. 2. Incorrect uses proper body mechanics in sitting and bending. 3. Correct avoids extremes in temperature of food and drink. 4. Incorrect exercises the facial muscles at least twice daily. Answer Rationale: 3. Extremes of temperature of food or drink can trigger paroxysms of severe facial pain along the pathways of the trigeminal nerve. Meals are better tolerated if served at room temperature. Question 107 of 385 A client with Bell's palsy asks the nurse why artificial tears were ordered by the physician. Select the best reply by the nurse. 1. Incorrect "Because your eye remains closed, foreign matter can be trapped beneath the lid." 2. Incorrect "Artificial tears will remove the purulent drainage from your eye, which speeds healing." 3. Correct "Because you cannot blink the affected eye, it can become dry and irritated." 4. Incorrect "When your affected eye fails to make tears, the eye can become irritated and ulcerated." Answer Rationale: 3. Bell's palsy may cause paralysis of the eyelid and loss of the blink reflex on the affected side. The eye may not close completely. These problems render the eye susceptible to drying and irritation from dust or other debris. Question 108 of 385 A nurse is caring for a client with Guillain-Barré syndrome. Which of the following strategies is of the most importance in the plan of care? 1. Incorrect Use of artificial tears. 2. Incorrect Starting an enteral feeding. 3. Correct Frequent measurement of vital capacity. 4. Incorrect Range of motion exercises three to four times per day. Answer Rationale: 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 3. Clients with Guillain-Barré have respiratory muscle weakness and respiratory failure. Question 109 of 385 The nurse has presented information about amyotrophic lateral sclerosis (ALS) to a newly diagnosed client. Which question by the client indicates that he understands the nature of the disease? 1. Incorrect "How can I avoid infecting my family with the virus?" 2. Incorrect "How can I prevent an exacerbation of the disease?" 3. Incorrect "How many people achieve remission with chemotherapy?" 4. Correct "How can I execute a living will?" Answer Rationale: 4. Clients with ALS often experience respiratory failure as the disease progresses, and need to communicate their wishes regarding ventilator support. The nurse should explore the client's wishes and facilitate discussion within the family. Arranging for the client to sign a living will, if the client wishes to do so, is also a nursing responsibility. Question 110 of 385 A client reports gradual painless blurring of vision. On assessment, the nurse notes a cloudy opaque lens. Based on this assessment, the nurse suspects the client has 1. Incorrect retinal detachment. 2. Correct cataracts. 3. Incorrect diabetic retinopathy. 4. Incorrect glaucoma. Answer Rationale: 2. These are the assessment findings of cataracts. Question 111 of 385 Which of the following risk factors would the nurse assess for in a client with glaucoma? 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION of vision. Answer Rationale: 3. Eye pain is present with open and narrow angle glaucoma, but not with a detached retina. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION Question 114 of 385 Which of the following techniques should the nurse use to evaluate a client's understanding of self-care for chronic (primary) open angle glaucoma? 1. Correct The nurse observes the client's administration of eye drops. 2. Incorrect The nurse observes the client's technique for monitoring blood glucose. 3. Incorrect The nurse measures the client's blood pressure at each visit. 4. Incorrect The nurse measures hearing acuity at each visit. Answer Rationale: 1. Glaucoma is usually treated with eye drops, such as betaxolol (Timoptic), a beta- adrenergic antagonist. The eye can be damaged when eye drops are used incorrectly. Question 115 of 385 A client is admitted with a detached retina of the left eye. The nurse patches both eyes. What is the rationale for patching both eyes? 1. Incorrect To prevent photophobia. 2. Correct To decrease eye movement. 3. Incorrect To prevent nystagmus. 4. Incorrect To prevent eye infections. Answer Rationale: 2. Eye movements can increase the amount of detachment. Question 116 of 385 A neighbor splashes chlorine bleach in her eyes and calls the nurse for immediate help. The first action the nurse should take is to 1. Incorrect lift the upper lid over the lower lid of each eye. 2. Incorrect close and patch both eyes with a loose bandage. 3. Correct continuously flush the eyes with tap water for 20 minutes. 4. Incorrect instill an over-the-counter anti-irritant solution, such as Visine. Answer Rationale: 3. Immediate irrigation with copious amounts of water or normal saline solution may reduce alkaline burns of the cornea and 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION conjunctiva. Any 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 4. Incorrect cholesteatoma. Answer Rationale: 3. These are classic signs of Ménière's disease. Question 120 of 385 What is the priority nursing diagnosis for a client with very loud overpowering ringing in his ears, fluctuating hearing loss on the right side with severe vertigo accompanied by nausea and vomiting and a feeling of fullness in the right ear? 1. Incorrect Pain. 2. Incorrect Anxiety. 3. Incorrect Impaired physical mobility. 4. Correct Knowledge deficit related to the disease process. Answer Rationale: 4. This client most likely has Ménière's disease. In Ménière's disease, patient education is paramount. The client needs to be taught that with the increased volume of hydrolymph, excessive fluid intake increases the volume even more and exacerbates the disease. They should also be taught not to ambulate or make extreme movements during the acute attacks. Question 121 of 385 A client is being assessed to rule out cardiovascular problems. The nurse understands that some of the common symptoms associated with cardiovascular disease are 1. Incorrect fatigue, weight changes, mood swings. 2. Correct shortness of breath, chest discomfort, palpitations. 3. Incorrect mood swings, headaches, fainting. 4. Incorrect dyspnea, chest discomfort, sputum production. Answer Rationale: 2. Some of the most common clinical manifestations of cardiovascular disease are shortness of breath, chest pain or discomfort, dyspnea, palpitations, fainting, and peripheral skin changes such as edema. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION Question 122 of 385 Which of the following assessment findings by the nurse is abnormal? 1. Correct S4 heard at the apex in an 80-year-old male. 2. Incorrect S3 heard at the apex in a 15-year-old female. 3. Incorrect S1 heard at the fourth-fifth left intercostal space in a 35-year-old man. 4. Incorrect S2 heard at the second-third left intercostal space in a 40- year-old female. Answer Rationale: 1. S4 is an abnormal heart sound. It is indicative of decreased ventricular compliance. Question 123 of 385 Which of the following instructions should the nurse give to a client prior to an exercise electrocardiogram? 1. Incorrect Smoking is permitted up to the time of the test. 2. Incorrect Allow only three hours of sleep the night prior to the test. 3. Correct Avoid coffee, tea, and alcohol the day of the test. 4. Incorrect Take all medications as prescribed prior to the test. Answer Rationale: 3. Avoid any stimulants such as coffee, tea, or a depressant such as alcohol. Question 124 of 385 To prevent possible complication, which of the following questions should a nurse ask a client prior to a cardiac catheterization? 1. Incorrect "Do you understand the procedure?" 2. Correct "Can you eat shellfish?" 3. Incorrect "Have you ever had a heart attack?" 4. Incorrect "Have you ever had a cardiac catheterization before?" Answer Rationale: 2. Shellfish contains iodine, which is also in the contrast media used during a catheterization. It is imperative to obtain information regarding iodine allergies. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 4. Correct ventricular fibrillation. Answer Rationale: 4. The above rhythm is ventricular fibrillation. Question 128 of 385 A client had a myocardial infarction yesterday. His cardiac monitor shows six to eight PVCs per minute, with occasional couplets. The best action by the nurse at this time is to 1. Incorrect initiate manual chest compressions. 2. Incorrect monitor the client for development of ventricular tachycardia. 3. Incorrect perform a precordial thump. 4. Correct administer the ordered prn dose of lidocaine. Answer Rationale: 4. Lidocaine, a class I antidysrhythmic drug, is indicated when the client has six or more PVCs per minute, multifocal PVCs, couplets or triplets, or PVCs occurring on the downslope of the T wave. Any of these situations is likely to progress to the more dangerous ventricular tachycardia or ventricular fibrillation if not treated immediately. Question 129 of 385 A client is admitted in cardiogenic shock. To best evaluate the heart's hemodynamic performance, the nurse anticipates the insertion of a(n) 1. Incorrect intra-arterial line. 2. Incorrect intra-aortic balloon pump (IABP). 3. Correct pulmonary artery catheter. 4. Incorrect central venous pressure line (CVP). Answer Rationale: 3. A pulmonary artery catheter will show all right and left heart hemodynamic pressures and provide for cardiac output measurements. Question 130 of 385 Which of the following statements by a client to the nurse indicates a risk factor for coronary artery disease? 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. Incorrect "No one in my family has heart problems." 2. Correct "I smoke 1 1/2 packs of cigarettes per day." 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION evening snack? 1. Incorrect Half tuna salad sandwich. 2. Incorrect Yogurt with fresh strawberries. 3. Incorrect Cheese cubes and crackers. 4. Correct Jello mold with fruit slices. Answer Rationale: 4. Most fruits and vegetables are low in fat and cholesterol-free. Jello also has no fat or cholesterol. Question 134 of 385 Lidocaine is mixed 2 g in 500 ml D5W. The nurse prepared to start an infusion at 2 mg/h using a 60-drop tubing. Which of the following is the correct rate to start the infusion on a pump? 1. Correct 30 ml. 2. Incorrect 45 ml. 3. Incorrect 15 ml. 4. Incorrect 60 ml. Answer Rationale: 1. 30 ml is 2 mg/h. 1000 mg = 1 g. 2 g is 200 mg. 2000mg:500ml::2mg: x ml 2000 x = 1000 x = 0.5 ml/hr 60 drops = 1 ml. 60 drops × 0.5 ml. = 30 ml/hr. Question 135 of 385 An adult male is transferred to the step-down unit on the third day after a myocardial infarction. Which of the following should the nurse include in his care plan at this time? 1. Correct Supervising short walks in the hallway. 2. Incorrect Performing passive range of motion exercises. 3. Incorrect Enforcing complete bedrest. 4. Incorrect Having him sit on the side of the bed and dangle his legs. Answer Rationale: 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. To improve activity tolerance, supervised walks for gradually increasing distances are encouraged when the client is transferred out 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION of the coronary care unit. Question 136 of 385 A 55-year-old man with a history of angina pectoris, complains of chest pain radiating to the jaw. After taking three nitroglycerin gr 1/150 tablets he is still having the chest pain. His skin is cool and pale and he is diaphoretic and mildly short of breath. The best initial action for the nurse to take is to 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2. Incorrect "A tiny rotating blade is used to scrape off the plaque that is blocking your artery." 3. Correct "A balloon is placed next to the plaque blocking your artery, then the balloon is inflated to crush the plaque." section of your artery." Question 139 of 385 Mr. P. is being discharged following coronary artery bypass graft surgery (CABG). The nurse recognizes that Mr. P. needs additional teaching if he makes which of the following statements? 1. Incorrect "I'll be going to a support group to help me quit smoking." 2. Incorrect "I've learned a breathing exercise to help me calm down if I get upset." 3. Correct "I need to use a golf cart instead of walking around the course." 4. Incorrect "I should bake or broil my chicken instead of frying it." Answer Rationale: 3. Aerobic exercise, such as walking, helps to slow formation of atherosclerotic plaques in coronary artery disease. Mr. P. needs to make the necessary lifestyle changes to prevent further progression of his disease. Riding instead of walking would not provide aerobic exercise. Therefore this statement shows that Mr. P. needs further teaching. Question 140 of 385 Which of the following assessment findings by the nurse indicates right ventricular failure in a client? 1. Incorrect Pink frothy sputum. 2. Incorrect Crackles. 3. Correct Jugular venous distention. 4. Incorrect Paroxysmal nocturnal dyspnea. Answer Rationale: 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 3. Jugular venous distention is seen in right ventricular failure as 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2. Incorrect Provides an analgesic and sedative effect. 3. Incorrect Decreases respiratory rate. 4. Incorrect Decreases anxiety and vasoconstricts. Answer Rationale: 1. This is the beneficial effect of morphine in pulmonary edema. Question 144 of 385 An adult female is being discharged after having a ventricular demand pacemaker inserted. The nurse should include which of the following in the teaching plan for this client? 1. Incorrect She will need to avoid air travel. 2. Correct She should not pass through metal detectors. 3. Incorrect She must leave the room while a microwave oven is in operation. 4. Incorrect She should not use remote control devices (e.g., TV channel selector). Answer Rationale: 2. Metal detectors generate strong magnetic fields that can alter pacemaker settings or produce interference that causes malfunction. Question 145 of 385 Ms. T. has a ventricular demand pacemaker that is set at 72 beats per minute. The nurse knows that Ms. T.'s pacemaker is functioning correctly if which of the following appears on the ECG? 1. Incorrect Pacemaker spikes instead of QRS complexes. 2. Incorrect Pacemaker spikes appearing only if the heart rate is over 72. 3. Correct Pacemaker spikes followed by QRS complexes. 4. Incorrect Pacemaker spikes before each P wave. Answer Rationale: 3. The ventricular pacemaker stimulates the ventricle if no atrial impulse is transmitted through the AV node. The appearance of the QRS complex shows that the ventricle has responded to the stimulus. Question 146 of 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 385 Which strategy by the nurse provides safety during a defibrillation attempt? 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. Incorrect No lubricant on the paddles. 2. Incorrect Standing in alignment with the bed while administering the shock. 3. Correct A verbal and visual check of "all clear." 4. Incorrect Placing paddles lightly on the chest. Answer Rationale: 3. The nurse must make sure both verbally and visually that all healthcare providers are clear. Question 147 of 385 An adult client has experienced a cardiac arrest and the nurse is performing CPR. The correct position of the nurse's hands on the client's chest is 1. Incorrect two finger widths below the sternal notch. 2. Incorrect over the upper half of the sternum. 3. Incorrect over the xiphoid process. 4. Correct two finger widths above the xiphoid process. Answer Rationale: 4. This hand position would depress the lower half of the sternum, which would compress the heart effectively. Question 148 of 385 A client with a history of a myocardial infarction two days ago reports chest pain that is worse on inspiration but is relieved on sitting forward. Based on this finding, the nurse suspects the client is experiencing the pain of 1. Correct pericarditis. 2. Incorrect angina pectoris. 3. Incorrect endocarditis. 4. Incorrect recurrent myocardial infarction. Answer Rationale: 1. The pain of pericarditis is exacerbated with respirations. Rotating the trunk and sitting up frequently relieves the pain. Question 149 of 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION Rationale: 2. Oranges are high in potassium. Thiazide diuretics, such as Diuril, deplete body potassium by increasing urinary excretion, so potassium intake should be increased. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION Question 152 of 385 A client reports an aching pain and cramping sensation that occurs while walking. The pain disappears after cessation of walking. The pain is in both legs. Based on these clinical findings, the nurse suspects the client has (a) 1. Incorrect deep vein thrombosis (DVT). 2. Incorrect thrombophlebitis. 3. Correct arteriosclerosis obliterans. 4. Incorrect Raynauds' disease. Answer Rationale: 3. Intermittent claudication is the main symptom of narrowing of the arteries. Question 153 of 385 Ms. M. has severe arteriosclerosis obliterans and complains of intermittent claudication after walking 20 feet. How should the nurse plan to position Ms. M. when she is in bed? 1. Incorrect In Trendelenburg position. 2. Correct In reverse Trendelenburg position. 3. Incorrect In semi-Fowler's position with knees extended. 4. Incorrect Supine with legs elevated. Answer Rationale: 2. Gravity facilitates improved arterial blood flow. The reverse Trendelenburg position, in which the feet are below heart level, is used to improve circulation to the lower extremities. Question 154 of 385 An adult female experiences painful arterial spasms in her hands due to Raynaud's phenomenon. Which of the following should the nurse include in the teaching plan for her? 1. Incorrect Reduce intake of high fat or high cholesterol foods. 2. Incorrect Drink a hot beverage, such as tea or coffee, to relieve spasms. 3. Incorrect Raise the hands above the head to relieve spasms. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 4. Correct Wear gloves when handling refrigerated foods. Answer Rationale: 4. Cold induces arterial spasms. When the hands will be exposed to cold, 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION state1m. eI nctosrrbeycMt s."RI .nienedictaotesathmatorsehesaulandserasntadnfdressth efrueifftse.c"ts of Incorrect"I'll have a podiatrist cut my toenails." Correct"I'll use an electric razor to shave my legs." Incorrect"I will take aspirin instead of Tylenol for headaches." 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION impair circulation. Question 158 of 385 The client has a large, venous stasis ulcer on her left ankle. Wound care is performed three times a week by a home health nurse. The nurse should teach her to 1. Incorrect soak the feet in tepid water three or four times daily. 2. Incorrect wear heavy cotton or wool socks when going outdoors. 3. Incorrect dangle the legs for 5–10 minutes several times a day. 4. Correct take frequent rest periods with her legs elevated. Answer Rationale: 4. Elevating the legs improves venous drainage and reduces edema, which will promote wound healing. Question 159 of 385 An adult is hospitalized with deep vein thrombophlebitis. During the first tfehweradpay,stohfe nurse 1. Incorrect massage the affected leg once a shift. 2. Incorrect apply ice packs three or four times daily to relieve pain. 3. Correct keep the client in Trendelenburg position. 4. Incorrect encourage the client to perform active range of motion exercises with both legs each shift. A3n. sEwl evration of the legs by raising the foot of the bed 6 inches (Trendelenburg position) reduces venous stasis, decreasing the risk of further thrombus formation. Question 160 of 385 Ms. R. is being discharged after treatment of deep vein thrombosis. Coumadin (warfarin) 2.5 mg daily is prescribed for her. The nurse recognizes that which of the following 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION A3n. sWwaerfarin is an anticoagulant, which increases the risk of bleeding from any injury. Use of an electric razor reduces the risk of a cut, which might bleed excessively. Question 161 of 385 An adult, who was admitted four hours ago with thrombophlebitis in the left leg, suddenly becomes confused and dyspneic. She begins coughing up blood-streaked sputum and complains of chest pain that worsens on inspiration. The nurse should first 1. Incorrect apply soft restraints to prevent excessive movement. 2. Correct place her in bed in semi-Fowler's position. 3. Incorrect place her in Trendelenburg position on her left side. 4. Incorrect perform a Heimlich maneuver. Answer Rationale: 2. Her symptoms suggest that the client has pulmonary emboli. Her activity should be limited to prevent further embolization and her head should be elevated to promote lung expansion and ease dyspnea. Question 162 of 385 A client is admitted to rule out pulmonary embolism (PE) from a deep vein thrombosis. A Dextran 70 infusion is ordered for the client. The nurse understands the Dextran is administered to 1. Correct decrease platelet adhesion. 2. Incorrect increase the hemoglobin. 3. Incorrect decrease plasma volume. 4. Incorrect increase blood viscosity. Answer Rationale: 1. Dextran coats the platelet surface to decrease adhesion. In doing so, the plasma volume expands, and viscosity is decreased. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. Incorrect remind him that that foot was amputated and therefore cannot have pain. 2. Correct explain to him that this is a common sensation after amputation. 3. Incorrect show him the stump so he will realize his right foot is gone. 4. Incorrect tell him that such pain is a common psychological response to loss of a limb. Answer Rationale: 2. Phantom limb pain is common after amputation. It is a real sensation and needs to be acknowledged by the nurse. Question 166 of 385 Mr. J. has been diagnosed with some type of anemia. The results of his blood tests showed: Decreased WBC, normal RBC, decreased Hct, decreased Hgb. Based on these data, which of the following nursing diagnoses should the nurse prioritize as being the most important? 1. Incorrect Alteration in nutrition. 2. Correct Potential for infection. 3. Incorrect Fluid volume excess. 4. Incorrect Self- care deficit. Answer Rationale: 2. These blood values are consistent with a diagnosis of aplastic anemia in which the nurse's primary goals are to prevent complications from infection and hemorrhage. Whenever WBC blood levels are low, this should cue the nurse to recognize that the client's immune system is weakened and the potential for infection is great. Question 167 of 385 A client has the following blood lab values platelets 50,000/ul RBCs 3.5 (× 106) Hemoglobin 10 g/dl Hematocrit 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 30% WBCs 10,000/ul 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION only. Answer Rationale: 1. Persons with type AB blood, because they are universal blood recipients, are able to receive either type A, B, AB, or O blood. People with any blood type other than AB, are restricted as to the type of blood they can receive. Question 170 of 385 Which nursing intervention is appropriate for the nurse to take when setting up supplies for a client who requires a blood transfusion? 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. Correct Prime tubing of blood administration set with 0.9% NS solution, completely filling filter. 2. Incorrect Use a small-bore catheter to prevent rapid infusion of blood products that may lead to a reaction. 3. Incorrect Obtain blood bag from laboratory and leave at room temperature for at least one hour prior to infusion. 4. Incorrect Add any needed IV medication in the blood bag within one half hour of planned infusion. Answer Rationale: 1. The tubing is primed with 0.9% NS solution. If the filter is not completely primed, debris will coagulate in the filter and the transfusion will be slowed. In addition, saline is prepared to infuse in case a transfusion reaction occurs. Question 171 of 385 A client who is receiving a blood transfusion begins to experience chills, shortness of breath, nausea, excessive perspiration, and a vague sense of uneasiness. The best action for the nurse to initially take is to 1. Correct stop the transfusion. 2. Incorrect assess respiratory status. 3. Incorrect monitor the client's vital signs. 4. Incorrect report the signs and symptoms to the physician. Answer Rationale: 1. The signs and symptoms the client is experiencing are indicative of a transfusion reaction and the transfusion must first be discontinued. Question 172 of 385 A client with iron deficiency anemia is ordered parental iron to be given intramuscularly. Which of the following actions should the nurse take in the preparation/administration of this medication? 1. Correct Use the Z-track technique to administer the medication. 2. Incorrect Use a 1-in needle to administer the medication. 3. Incorrect Massage the site after the injection is given to promote absorption. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. Incorrect administer a fleets enema the evening before the test. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2. Incorrect collect his urine for 12 hours. 3. Correct take nothing by mouth for 12 hours prior to the test. 4. Incorrect empty his bladder immediately before the test. Answer Rationale: 3. The client is to fast for 12 hours prior to the test. No food or drink is permitted. Following administration of the vitamin B12 dose, food is delayed for three hours. Question 176 of 385 A 40-year-old woman with aplastic anemia is prescribed estrogen with progesterone. The nurse can expect that these medications are given for which of the following reasons? 1. Incorrect To promote utilization and storage of fluids. 2. Incorrect To enhance sodium and potassium absorption. 3. Incorrect To regulate fluid balance. 4. Correct To stimulate bone growth. Answer Rationale: 4. In aplastic anemia, the bone marrow elements (erythrocytes, leukocytes, and platelets) are suppressed. Treatments include, but are not limited to, bone marrow transplantation, transfusions to reduce symptomatology, and drugs to stimulate bone marrow function. Drugs like estrogen and progesterone work to stimulate bone growth. Estrogen and progesterone also stop menstruation so there is less blood loss. Question 177 of 385 Which of the following lab value profiles should the nurse know to be consistent with hemolytic anemia? 1. Incorrect Increased RBC, increased bilirubin, increased hemoglobin and hematocrit, decreased reticulocytes. 2. Incorrect Decreased RBC, decreased bilirubin, increased hemoglobin and hematocrit, decreased reticulocytes. 3. Incorrect Increased RBC, decreased bilirubin, decreased hemoglobin and hematocrit, increased reticulocytes. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 4. Correct Decreased RBC, increased bilirubin, decreased hemoglobin and hematocrit, increased reticulocytes. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION Question 180 of 385 The nurse should understand that a heparin order for a client with DIC is given to 1. Incorrect decrease blood flow to target organs. 2. Incorrect increase clot formation. 3. Incorrect increase blood flow to target organs. 4. Correct prevent clot formation. Answer Rationale: 4. In DIC, the paradoxical events of hemorrhage and clotting occur. Although it may seem counterproductive to administer heparin while a client is bleeding, it is necessary to prevent the clotting that is simultaneously occurring in the microcirculation. It is critical that the client be monitored closely. Question 181 of 385 Mr. H. is a 34-year-old client diagnosed with AIDS. His pharmacologic management includes zidovudine (AZT). During a home visit, Mr. H. states, "I don't understand how this medication works. Will it stop the infection?" The nurse's best response is 1. Incorrect "The medication blocks reverse transcriptase, the enzyme required for HIV replication." 2. Correct "The medication helps to slow the disease process, but it won't cure or stop it totally." 3. Incorrect "No, it won't stop the infection. In fact, sometimes the HIV can become immune to the drug itself." 4. Incorrect "Don't you know? There aren't any medications to stop or cure HIV." Answer Rationale: 2. This statement answers Mr. H.'s question in a simple, matter of fact manner that is truthful and to the point. Question 182 of 385 Which statement, from a participant attending a class on AIDS prevention, indicates an understanding of how to reduce 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION transmission of HIV? 1. Incorrect "It's okay to use natural skin condoms since they offer 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION the same protection as the latex condoms." 2. Incorrect "Orgasms are necessary for the heterosexual transmission of the virus." 3. Incorrect "Mothers who are HIV-positive should still be encouraged to breast feed their babies because breast milk is superior to cow's milk." 4. Correct "I think a needle exchange program, where clean needles are exchanged for dirty needles, should be offered in every city." Answer Rationale: 4. Although needle exchange programs are very controversial, it is evident the transmission of HIV can be significantly reduced when needle exchange programs are introduced. Question 183 of 385 What should be included in the teaching plan to young adults about the spread of AIDS? 1. Correct Heterosexual transmission of HIV is on the rise. 2. Incorrect Transmission of HIV by IV drug users is prominent even when sterile equipment is used. 3. Incorrect The greatest increase of HIV infection is by homosexual transmission. 4. Incorrect The increase of HIV in children is primarily attributed to the rise in sexual abuse. Answer Rationale: 1. Heterosexual transmission of HIV is a concern, especially in this age group. It is on the rise and this is often overlooked because the more known transmissions take place among homosexuals and IV drug abusers. Question 184 of 385 In planning care for a client with multiple myeloma, the nurse should be aware that the client may have orders for 1. Incorrect fluid restrictions. 2. Incorrect bedrest. 3. Correct corticosteroid therapy. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION Question 187 of 385 The nurse's assessment of a client with lung cancer reveals the following: copious secretions, dyspnea, and cough. Based on these findings the most appropriate nursing diagnosis is 1. Correct ineffective airway clearance. 2. Incorrect altered tissue perfusion. 3. Incorrect pain. 4. Incorrect impaired gas exchange. Answer Rationale: 1. A patient with lung cancer demonstrating the assessment findings provided would indicate a nursing diagnosis of ineffective airway clearance. The goal for this patient is that the patient will breathe without dyspnea or discomfort and maintain a patent airway. Question 188 of 385 Mr. B. has just had arterial blood gases drawn. When handling the specimen, the nurse's best action is to 1. Incorrect aspirate 0.5 ml of heparin into the syringe. 2. Incorrect place the sample in a syringe of warm water. 3. Incorrect gently shake the syringe. 4. Correct have the specimen analyzed immediately. Answer Rationale: 4. The sample must be analyzed within 20 minutes, or if the patient has leukocytosis immediately, to ensure accurate results. Question 189 of 385 The nurse is to obtain a sputum specimen from a client. Select the correct set of statements instructing the patient in the proper technique for obtaining a sputum specimen. 1. Incorrect "Spit into the container, then add two tablespoons of water." 2. Incorrect "Right after lunch, cough and spit into the container." 3. Incorrect "Collect the specimen right before bed. Spit carefully into the container." 4. Correct "Brush your teeth, then cough into the container. Do this first 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION thing in the morning." 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION E. safely, the nurse should: 1. Incorrect question the order to ambulate Mr. E. 2. Incorrect clamp the chest tube and carefully ambulate Mr. E. a short distance. 3. Correct carefully ambulate Mr. E., keeping the Pleur-evac lower than Mr. E.'s chest. 4. Incorrect disconnect the Pleur-evac from Mr. E.'s chest tube, leave it attached to the bed, ambulate Mr. E., and then reconnect the chest tube when he is returned to bed. Answer Rationale: 3. The Pleur-evac must not be raised above chest level because it can cause back flow of the fluid into the pleural space precipitating collapse of the lung or mediastinal shift. The Pleur- evac must remain upright and the chest tube should not have traction on it. Question 193 of 385 The nurse is assessing a client who has a chest tube to water seal drainage with a one- bottle drainage system. Which statement best indicates proper functioning of the chest drainage system? 1. Incorrect The nurse observes the air vent is clamped off. 2. Incorrect The nurse observes no fluctuations in the straw in the bottle with respiration. 3. Incorrect The nurse observes bubbling from the straw in the bottle when the client coughs. 4. Correct The nurse observes rising and falling of fluid in the bottle's straw with respiration. Answer Rationale: 4. Fluctuations of 5–10 cm during normal breathing are common. These fluctuations provide continuous manometer of pressure changes in the pleural space and are a reliable indicator of overall respiratory effort. Question 194 of 385 The nurse will perform chest physiotherapy (CPT) on Mrs. Y. every four hours. It is important for the nurse to 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. Incorrect plan apical drainage at the beginning of the CPT session. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2. Incorrect use vibration techniques to move secretions from affected lung areas during the inspiration phase. 3. Incorrect gently slap the chest wall. 4. Correct perform CPT at least two hours after meals. Answer Rationale: 4. Chest physiotherapy should be performed at least two hours after meals to reduce the risk of vomiting and aspiration. Question 195 of 385 A client is on a ventilator. The ventilator alarm goes off. The nurse assesses the patient and observes increased respiratory rate, use of accessory muscles, and agitation. The nurse's best initial action is to 1. Correct remove the client from the ventilator and ambu bag the patient, while continuing to assess to determine the cause of the client's distress. 2. Incorrect turn off the alarm. 3. Incorrect notify the physician. 4. Incorrect call respiratory therapy to check the ventilator. Answer Rationale: 1. The nurse's best initial action should be to remove the client from the ventilator, ventilating the client with an ambu bag. Obviously, the client is experiencing respiratory distress and is not receiving adequate ventilation. The nurse should continue to closely assess to determine the cause and determine if the respiratory distress is related to ventilator malfunction or change in patient status. Question 196 of 385 A patient with respiratory failure is on a ventilator. The alarm goes off. The nurse's initial reaction should be to 1. Incorrect disconnect the patient and use the ambu bag to ventilate the patient. 2. Incorrect turn off the alarm. 3. Incorrect notify the physician. 4. Correct assess the patient to determine the 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION Question 199 of 385 An adult is receiving oxygen per face mask at 40%. The nurse should include which of the following in her plan of care? 1. Incorrect Instruct the client's husband to smoke away from the bed. 2. Incorrect Provide water-soluble jelly to the nares. 3. Correct Provide good skin care, making sure the mask fits well. 4. Incorrect Assess for signs and symptoms of oxygen toxicity. Answer Rationale: 3. The mask must fit properly as a poor fitting mask reduces the amount of oxygen delivered. The mask may also cause skin breakdown, so it is very important to provide skin care. Loosen the strap holding the mask frequently and assess the skin. Question 200 of 385 Mr. E. has a new tracheostomy in place. He has a small amount of thin, white secretions. The stoma is pink with no drainage noted. The nurse should expect to provide trach care for Mr. E. every: 1. Incorrect hour. 2. Incorrect 24 hours. 3. Incorrect four hours. 4. Correct eight hours. Answer Rationale: 4. Trach care should be provided once every eight hours. Question 201 of 385 A 64-year-old female is admitted to the hospital. She has smoked two packs per day for 30 years. While providing her history, she becomes breathless, pauses frequently between words, and appears very anxious. She has a cough with thick white sputum production. Her chest is barrel shaped. Based on this data, the nurse will need to develop a plan of care for a client with 1. Incorrect asthma. 2. Incorrect tuberculosis. 3. Incorrect pneumonia. 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 4. Correct chronic obstructive pulmonary 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. Correct place the client in respiratory isolation. 2. Incorrect encourage cough and deep breathing. 3. Incorrect force fluids. 4. Incorrect administer O2. Answer Rationale: 1. The client should be placed in respiratory isolation until active TB is ruled out. TB is spread by droplet infection, thus her sputum should be handled according to respiratory isolation protocol. Question 205 of 385 An adult is being followed in the outpatient clinic for a diagnosis of active TB. She is receiving isoniazid 200 mg po qd, rifampin 500 mg po qd, and streptomycin 1500 mg IM twice weekly. Which statement by the client best indicates she understands her therapeutic regime? 1. Correct "It may work best to take these pills in the evening right before bed." 2. Incorrect "I'm glad I only have to take these drugs for a couple of weeks." 3. Incorrect "I need to take these two drugs every day and come back to the clinic once a week for the shot." 4. Incorrect "I'm glad my birth control pills aren't affected by these drugs--the doctor told me not to get pregnant!" Answer Rationale: 1. These medications frequently cause nausea. The nausea may be decreased if the medications are taken at bedtime. Question 206 of 385 The nurse is counseling the family of Ms. C., 18-years-old, a patient with active TB, about measures to prevent transmission of the disease. Which statement by the family best indicates understanding of these instructions? 1. Correct "We all need to wash our hands carefully, but especially Ms. C." 2. Incorrect "I won't let Ms. C. and her sister share clothes." 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 3. Incorrect "We will have to keep her in her room." 4. Incorrect "We cannot get TB from exposure to Ms. C.'s sputum." Answer Rationale: 1. Handwashing is the best tool for prevention of infection. Ms. C. should wash her hands very carefully after any contact with body 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION substances, masks, or soiled tissues. The family should also use good handwashing techniques. Question 207 of 385 Mrs. P., 86-years-old, has fallen and broken her eighth rib on her left side. the nurse 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 4. Incorrect increased sputum production. Answer Rationale: 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. With pleural effusions, lung expansion may be restricted and the patient will experience dyspnea, primarily on exertion. Question 210 of 385 An 86-year-old female was admitted to the hospital two days ago with pneumonia. She now has an order to be up in the chair as much as possible. The nurse plans to get her up and help her with her morning care. The best plan to accomplish this would be to 1. Correct allow her to eat breakfast in bed, rest for 30 minutes, get up in the chair, and rest for a few minutes. Allow her to wash her hands and face--nurse to complete bath. 2. Incorrect get her up before breakfast. Have her eat in the chair, then bathe while still up. 3. Incorrect Allow her to eat in bed, get her up, and provide her with a pan of water for her to bathe. 4. Incorrect get her up before breakfast, have her bathe before breakfast, eat in the chair, then a rest in the chair. Answer Rationale: 1. This plan allows frequent rest periods for the client. The patient should not rush through morning care activities as rushing will increase hypoxemia, dyspnea, and fatigue. Question 211 of 385 A client has been admitted to the hospital. Lung assessment reveals the following: bronchial breath sounds over (L) lower lobe, diminished breath sounds (L) lower lobe, tactile fremitus present, percussion dulled in this area. Based on the assessment findings the nurse can expect to plan care for a client with 1. Incorrect early left-sided heart failure. 2. Correct pneumonia. 3. Incorrect asthma. 4. Incorrect emphysema. Answer Rationale: 2. In a patient with pneumonia, bronchial breath sounds are heard 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION over areas of density or consolidation. Breath sounds are diminished when the airflow is decreased as is typical with pneumonia. Tactile fremitus is 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION Question 214 of 385 A 52-year-old patient is admitted to the nursing unit from the recovery room following a left pneumonectomy. When planning his care, the nurse can expect this patient to 1. Incorrect have a chest tube to water seal. 2. Incorrect have a chest tube to suction. 3. Incorrect have his left arm maintained in a sling to prevent pain and discomfort. 4. Correct be monitored closely for respiratory and cardiac complications. Answer Rationale: 4. Post-op respiratory insufficiency may result from an altered level of consciousness related to anesthesia, pain medications, decreased respiratory effort secondary to pain, or inadequate airway clearance. So, the client must be monitored very closely with frequent vital sign checks and respiratory assessments. Question 215 of 385 Mr. B. has had a right thoracotomy for a wedge resection of his lung. He repeatedly refuses to do breathing or arm exercises because of the pain. What should the nurse include on Mr. B.'s plan of care? 1. Correct Schedule Mr. B.'s activity 30–45 minutes after his IM injection of pain medication. 2. Incorrect Offer Mr. B. pain medication immediately after arm exercises are completed. 3. Incorrect Offer Mr. B. sips of ice water prior to a deep breathing and coughing session. 4. Incorrect Have Mr. B. hold a pillow against his abdomen for support. Answer Rationale: 1. Thirty or forty-five minutes after the administration of IM pain medication is the time when the pain medication is most effective. Thus, this is the best time to schedule coughing and deep breathing and arm exercises. Question 216 of 385 The nurse may expect a client with suspected early ARDS to exhibit which of the following? 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION 1. Correct Restlessness, suprasternal retractions, PaO2 of 65. 2. Incorrect PaO2 of 90, PCO2 of 45, X-ray showing enlarged heart, bradycardia. 3. Incorrect Thick green sputum production, PaO2 of 75, pH 7.45. 4. Incorrect Wheezes, slow deep respirations, PCO2 of 55, pH of 7.25. Answer Rationale: 1. It is common for the client to have suprasternal and intercostal retractions as the client loses lung capacity. The nurse should anticipate restlessness, apprehension, agitation, sluggishness, disorientation, and tachycardia. Question 217 of 385 The nurse caring for a patient who has had a removal of the larynx and a permanent opening made into the trachea will plan care for a patient who has undergone a 1. Correct total laryngectomy. 2. Incorrect tracheostomy. 3. Incorrect radical neck dissection. 4. Incorrect partial laryngectomy. Answer Rationale: 1. A total laryngectomy is the removal of the larynx and formation of the tracheostomy. The esophagus remains attached to the pharynx. No air will enter through the nose. The patient will breathe through the tracheostomy. The procedure is indicated for large glottic tumors with fixation of vocal cords. Question 218 of 385 An adult will undergo a total laryngectomy tomorrow. She is concerned about communicating post-op. The nurse should plan for her to communicate by which method the first 24–48 hours after surgery? 1. Incorrect Using the artificial larynx. 2. Incorrect Using esophageal speech. 3. Incorrect Using a voice button. 4. Correct Writing or pointing on a communication 2022/2023 NURSING CRITICAL CARE EXAM QUESTIONS WITH ANSWERS 100% VERIFIED LATEST UPDATES EXAM SOLUTION