CRRT and Acute Kidney Injury: Hemodynamic Consequences and Treatment, Exams of Nursing

Download CRRT and Acute Kidney Injury: Hemodynamic Consequences and Treatment and more Exams Nursing in PDF only on Docsity! CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score.  Which of the following ventilator settings is most likely to decrease the work of breathing? A assist- control B pressure support C tidal volume D CPAP {{Ans- Answer: B Pressure support senses the beginning of the patient's spontaneous inspiration and provides a set pressure to assist the inspiratory effort. The primary purpose of the ventilator settings listed in choices (A), (C), and (D) is not to decrease the work of breathing.  A patient with aortic regurgitation will have which of the following upon auscultation? Select single answer choice. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. A a diastolic murmur, loudest at the fifth intercostal space, midclavicular a systolic murmur, loudest at the apex of the heart C a diastolic murmur, loudest at the second intercostal space, right sternal border CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. as long as the hemodynamic criteria are met. A patient who is receiving PRN morphine may be a candidate for a spontaneous breathing trial, but that patient does not require an infusion to be stopped in order to be awakened. The remaining 2 choices do not meet the criteria for performing eithera spontaneous awakening trial or a spontaneous breathing trial. -While the code team is performing resuscitative efforts, many of the patient's family members start to cry and pray, while other family members lie down on the floor in the corner of the room. Which of the following demonstrates the best action forthe nurse to take at this time? Select single answer choice. A Ensure that a member of the code team serves as a family presence facilitator and clearly communicates the treatment strategies to the family. B Call security to escort the family members to the waiting room due to their disruptive behavior. C Encourage the family members to leave the patient care area because they are extremely distressed. D Ask the family members to leave the patient care area because they may suffer anxiety from remaining in the room. {{Ans- Answer: A It is important to offer families the opportunity to witness the efforts of the health care team during a patient's cardiopulmonary resuscitation. Research suggests that allowing family members to stay with a patient during this time may decrease their rates of post-traumatic stress disorder, depression, and anxiety related to the event. If the family interferes with the code team's ability to provide care to the patient, it may be necessary to have security remove the family; however, this scenario does not state that the family members are interfering with the code team's efforts, so choice (B) is incorrect. The remaining 2 choices do not allow the family to grieve in a way that may be natural to them. -Cardiogenic shock secondary to left ventricular failure CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. will generally result in: Select single answer choice. A decreased afterload. B a narrow pulse pressure. C decreased preload. D a widening pulse pressure. {{Ans- Answer: B CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. The systolic pressure decreases due to a drop in the cardiac output; however, the diastolic pressure either stays the same or increases due to a compensatory increase in the systemic vascular resistance. The remaining choices are not found in the presence of cardiogenic shock. -Massive atelectasis occurs in the presence of acute respiratory distress syndrome (ARDS). What are the 2 causes of the atelectasis that is typical of ARDS? Select single answer choice. A a surfactant deficiency and pulmonary edema B increased pulmonary vascular resistance and increased pulmonary compliance C increased pulmonary compliance and pulmonary edema D mucus plugs and bronchospasm {{Ans- Answer: A ARDS destroys Type II alveolar cells, which results in decreased surfactant production. ARDS also results in capillary leak at normal left-sided heart pressures, which results in pulmonary edema. Both a surfactant deficiency and pulmonary edema lead to atelectasis. The remaining choices are not correct because increased pulmonary compliance and mucus plugs are not features of ARDS. -A patient was admitted with an acute inferior wall STEMI. The physician advises the nurse to monitor the patient for signs of right ventricular (RV) infarction. Which of the following are signs of RV infarction? Select single answer choice. A S4 heart sound, lung crackles B hypotension, flat neck veins C hypertension, a systolic CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. choice. A alcohol abuse. B a salicylate overdose. C biliary obstruction. D an acetaminophen overdose. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. {{Ans- Answer: D Alcohol abuse results in chronic, not acute, hepatic failure. A salicylate overdose results in renal failure. Biliary obstruction may lead to pancreatitis or gallbladder disease. -Which of the following is most likely to lead to cardiopulmonary arrest for a patient with status asthmaticus? Select single answer choice. A bronchosp asm. B thick, tenacious secretions. C hypoxe mia. D air trapping. {{Ans- Answer: D Air trapping, due to the inability to effectively exhale, leads to chest hyperinflation, which in turn leads to decreased venous return and a precipitous drop in cardiac output. The remaining choices are seen with status asthmaticus but are not directcauses of cardiopulmonary arrest. -The ECG demonstrates ST elevation in leads II, III, and aVF. The nurse needs to monitor the patient closely forwhich of the following? Select single answer choice. A tachycardia, lung crackles B sinus bradycardia, an acute systolic murmur in the fifth intercostal space, midclavicular C second-degree AV block (Type II), hypotension. D hypoxemia, an acute systolic murmur in the fifth intercostal space, left sternal border. {{Ans- Answer: B CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. Complications that are likely to occur after an acute inferior wall MI include bradycardia secondary to ischemia to the SA node and/or the AV node and papillary muscle rupture or dysfunction due to the anatomical distance between the right coronary artery and the papillary muscle. The remaining choices are not common complications of an inferior wall MI. -Which of the following statements about delirium is accurate? Select single answer choice. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. right atrial pressure (RAP) 12 mmHg; pulmonary artery occlusion pressure (PAOP) 7 mmHg; systemic vascular resistance (SVR) 1400 dynes/sec/cm- 5; cardiacoutput (CO) 5 L/min. {{Ans- Answer: B The hemodynamic profile described in choice (B) is typical of septic shock. The patient described in choice (B) would benefit from the interventions described in the question. The hemodynamic profile described in choice (A) is one of hypovolemia. The hemodynamic profile described in choice (C) is one of cardiogenic pulmonary edema. The hemodynamic profile described in choice (D) is one of right ventricular failure. The treatment plan described in the question would not be appropriate for the patients described in choices (A), (C), and (D). -Pulmonary hypertension may result in which of the following? Select single answer choice. A left-sided heart failure. c B right-sided heart failure. C increased lung compliance D arterial hypertension {{Ans- Answer: B The right ventricular wall is normally thinner than the left because the RV generally ejects into a low- pressure pulmonary system with a mean pulmonary artery pressure of approximately 20 mmHg. An increase in the mean pulmonary artery pressure may result in right-sided heart failure. -A patient received a transfusion for upper GI bleeding 4 hours ago. The patient developed acute tachypnea, and the pulse oximeter read 0.88 on room air. After examining the patient and getting a chest radiograph, the physician diagnosed the patient with transfusion-related acute lung injury (TRALI). The nurse anticipates an order for which of the following? Select single answer choice. A CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. furosemide (Lasix). B diphenhydramine (Benadryl). C subcutaneous epinephrine. D aggressive respiratory support. {{Ans- Answer: D CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. This patient requires titration of FiO2 to maintain an SpO2greater than 0.90. Short-term mechanical ventilation may be needed for select patients who are in a similar situation. There is no indication of fluid overload, which may occur with transfusion-associated circulatory overload (TACO). Therefore, a diuretic, such as furosemide (Lasix), is not needed. Diphenhydramine (Benadryl) and subcutaneous epinephrine are not treatments for TRALI. -A patient with a history of chronic alcohol abuse was admitted in a stuporous state with an extremely elevated serum alcohol level. Which of the following will most likely be a part of the treatment plan for this patient? Select single answer choice. A naloxone, activated charcoal, sodium bicarbonate B flumazenil (Romazicon), lactulose, calcium gluconate. C dialysis, cooling, potassium. D fluids, thiamine, phosphate. {{Ans- Answer: D This patient has signs of acute alcohol poisoning with a history of chronic alcohol abuse. Fluids are needed to prevent hypovolemia. Chronic alcohol abuse leads to a thiamine deficiency. Therefore, thiamine is needed to prevent Wernicke encephalopathy. Hypophosphatemia is commonly seen in patients with chronic alcohol abuse. Therefore, the administration of phosphate is also indicated. The remaining 3 choices are not interventions for alcohol poisoning. -Which of the following is indicative of a mixed acid-base disorder? Select single answer choice. A pH 7.18; PaCO2 25; PaO2 64; HCO3 11. B pH 7.33; PaCO2 29; PaO2 72; HCO3 15. C CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. overdose. C a beta blocker for a cocaine overdose. D warming for a phencyclidine (PCP) overdose. {{Ans- Answer: A Dialysis may be initiated even before abnormal creatinine or GFR develop. The remaining choices are incorrect treatments forthe associated overdoses. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -Which of the following would be LEAST likely to cause hypoglycemia for a patient with Type 1 diabetes? Select single answer choice. A late sepsis. B discontinuation of enteral feeding after a morning insulin dose. C a strenuous exercise session. D stress. {{Ans- Answer: D Stress will result in DKA rather than hypoglycemia. The remaining choices may cause hypoglycemia. -A patient with diastolic heart failure develops supraventricular tachycardia, with a heart rate of 220 beats/minute. The most dangerous hemodynamiceffect is a decrease in: Select single answer choice. A myocardial contractility. B coronary artery perfusion. c ejection fraction. D arterial oxygenation. {{Ans- Answer: B Diastolic heart failure results in a problem with left ventricular filling secondary to ventricular thickening, and myocardial contractility and the ejection fraction are maintained in diastolic heart failure. The rapid heart rate will decrease the filling time and worsen the left ventricular filling. Since coronary artery perfusion occurs during diastole, this arrhythmia may be life-threatening. -A 75-year-old patient develops frequent 6- to 10-second episodes of CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. asystole, interspersed with normal sinus rhythm that is associated with hypotension. The priority intervention is: Select single answer choice. A transcutaneous pacing. B a fluid bolus. C transvenous pacing. . CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. A urine sodium less than 20, the renal tubules' ability to concentrate urine, and a BUN/creatinine ratio of ~ 20:1 indicate that the renal tubular basement membrane remains intact. The remaining 3 choices involve an injury to the renal tubular basement membrane and would not produce the lab results described in the question. -Which of the following statements about the provision of enteral nutrition for a critically ill pati ent is accurate? Select single answer choice. A It is preferred over the parenteral nutrition route. B It should be initiated 48 to 72 hours after the first day of mechanical ventilation. C It should be initiated after the patient has bowel sounds and passing flatus. D Enteral nutrition should be withheld if the gastric residual volume is greater than 100 mL. {{Ans- Answer: A If the gut can be used, that is the preferred nutrition route because it is more natural and has fewer complications than the parenteral nutrition route. The remaining choices are not accurate in regard to enteral nutritional support. -A patient with Type 1 diabetes has been started on metoprolol for heart disease. The nurse needs to inform the patient that the first sign of hypoglycemiamight be which of the following? Select single answer choice. A mental status change. B palpitatio ns. C diaphore sis. D irritability. {{Ans- Answer: A CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. The beta blocker (metoprolol) will mask the early signs of hypoglycemia that are due to sympathetic stimulation (tachycardia, palpitations, irritability, headache, shakiness, and diaphoresis). The presenting signs will be the later signs of hypoglycemia (mental status change, slurred speech, seizure, and coma). -Which of the following are appropriate interventions for the treatment of anaphylaxis? Select single answer choice. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. A vasopressors, inotropes, fluids. B epinephrine SQ, antihistamines, beta-1 blockers. C vasopressors, fluids, antibiotics. D epinephrine IM, antihistamines, corticosteroids. {{Ans- Answer: D Inotropes (choice (A)), beta-1 blockers (choice (B)), and antibiotics (choice (C)) are not appropriate treatmentoptions for anaphylaxis. -Which of the following is most likely to be the etiology of diabetic ketoacidosis (DKA) and to require further investigation? Select single answer choice. A an infection. B Type 2 diabetes. C pancreat itis. D steroid use. {{Ans- Answer: A The physiological stress of an infection may trigger DKA, even when the patient is compliant with the diabetes treatment plan. The remaining 3 choices are more often associated with HHS. -One hemodynamic benefit of intra-aortic balloon pump therapy is that: Select single answer choice. A balloon inflation prevents right- to-left shunt. B balloon deflation increases coronary artery perfusion. C CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. anaphylactic shock; epinephrine IM. {{Ans- Answer: A Volume depletion results in decreased preload. A compensatory response to volume depletion results in an increase in the SVR in an attempt to maintain pressure. Fluids will restore the filling pressure (preload), and the SVR will return to normal as compensatory mechanisms will no longer be needed. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -A patient has right middle and lower lobe pneumonia. Which of the following is an appropriate intervention forthis patient? Select single answer choice. A Provide fluids and expectorants. B Maintain the patient in a supine position. C Withhold enteral nutrition. D Avoid turning the patient to his right side. {{Ans- Answer: D Gravity will increase perfusion to the dependent lung tissue. The "good" lung in this case is the left side. Turning the patient to his right side may precipitate hypoxemia by increasing perfusion to the side with greaterdisease. -A patient was admitted post motor vehicle accident with hypotension and an INR of 8. Which of the following needs to be administered to this patient? Select single answer choice. A protamine sulfate. B vitamin K. C hepari n. D platelets. {{Ans- Answer: B This patient was most likely taking warfarin (Coumadin) prior to admission, which caused an elevated INR. Warfarin works by inhibiting the effects of vitamin K, thereby preventing the conversion of prothrombin to thrombin. A rapid reversal of warfarin with vitamin K is indicated since this patient is hypotensive post MVA and may have internal bleeding. The remaining choices will not decrease the INR. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -A patient with a history of thyroid disease was admitted with elevated TSH and decreased T3 and T4. Based on these lab results and the patient history, which of the following assessments would be expected for this patient? Select single answer choice. A tremor, fever, respiratory alkalosis CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -A patient with oat cell carcinoma has the following clinical findings: low urine output, low serum osmolality, hyponatremia, and elevated urine sodium. The nurse anticipates which of the following as part of the treatment plan? Select single answer choice. A vasopressin, free water B vasopressin, hypertonic saline. C phenytoin (Dilantin), 3% saline. D phenytoin (Dilantin), 0.45 normal saline. {{Ans- Answer: C This patient has signs of SIADH, which results in the production of excessive ADH. Phenytoin (Dilantin) will inhibit ADH secretion, and 3% saline will increase the serum sodium. The remaining choices (vasopressin, free water, 0.45 normal saline) will worsen the problem. -What is an indication for which a patient, who is receiving mechanical ventilation, is placed in the prone position? Select single answer choice. A tachypn ea. B hypoventila tion. C pulmonary hypertension. D refractory hypoxemia. {{Ans- Answer: D The prone position helps alleviate refractory hypoxemia (e.g., ARDS) by allowing for the perfusion of lung units that were not able to be perfused while the patient was in the supine position. P lacing the patient in the prone position is not an intervention that is used for the remaining 3 CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. problems. -Which of the following is NOT needed to calculate the creatinine clearance? Select single answer choice. A serum BUN B CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. the patient's age. C the patient's sex. D ideal body weight. {{Ans- Answer: A The serum BUN is not needed to calculate the creatinine clearance. The remaining 3 values (as well as the serum creatinine) are used for this calculation. The creatinine clearance is the best clinical indicator of the glomerular filtration rate (GFR). -A 70 kg patient required intubation for status asthmaticus. A propofol infusion was started at 40 mcg/kg/min, and the patient appears calm. The ventilator settings are: FiO20.30, assist-control mode 12 breaths/minute, tidal volume 400 mL, and an increased peak flow rate. The patient's respiratory rate is 28 breaths/minute, and the SpO2 is 0.98. Which of the following interventions should the nurse anticipate? Select single answer choice. A Administer vecuronium (Norcuron) PRN. B Decrease the tidal volume. C Increase the assist- control rate. D Increase the FiO2. {{Ans- Answer: A The elevated respiratory rate needs to be immediately addressed since it puts the patient at risk for auto-PEEP. The goal of ventilation for a patient with status asthmaticus is to provide low breath rates, a short inspiratory time, and a longer expiratory time, as well as to prevent auto-PEEP. Although neuromuscular blocking agents should be avoided, if possible, the benefit of administering Norcuron PRN outweighs the risk in this particular situation. The tidal volume is already low, so choice (B) is incorrect. An increase in the assist-control rate would not be beneficial, so choice (C) is incorrect. This patient does not have hypoxemia. Therefore, an increase in the FiO2 is not indicated, which means that choice (D) is also incorrect. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. recruitment, prevent atelectasis, and improve oxygenation. However, the increase in the intrathoracic pressure may lead to a pneumothorax or subcutaneous emphysema. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -A patient's chest X-ray demonstrates a right upper lobe infiltrate. The mean arterial pressure (MAP) is 55 mmHg after fluid resuscitation, and the serum lactate is elevated. At this time, which of the following medications is a priority? Select single answer choice. A dopamine (Intropin) B norepinephrine (Levophed). C hydrocortisone (Solu- Cortef). D dobutamine (Dobutrex). {{Ans- Answer: B This patient has septic shock with organ dysfunction, as evidenced by signs of an infection, hypotension despite fluid resuscitation, and elevated serum lactate. A vasopressor is indicated at this point, and norepinephrine is the vasopressor of choice. There are no indications for the administration of the remaining drugs at this time. -Which of the following clinical findings is typical of compensatory shock? Select single answer choice. A hypotens ion B metabolic acidosis. C blood pressure is maintained. D organ failure. {{Ans- Answer: C During the earliest stage of shock (compensatory shock), the compensatory mechanisms are working to maintain the systemic blood pressure. The remaining 3 choices are seen in the progressive and refractory stages of shock. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -A patient who is status post thoracic surgery has bubbling in the water seal drainage chamber of his chest tube. Which of the following interventions is indicated? Select single answer choice. A Avoid turning the patient onto his side. B CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. than DKA, which results in a higher serum glucose. The higher serum glucose of HHS results in a higher serum osmolality. An additional differentiating finding is that a patient with DKA will have positive ketones. -A patient presented with status asthmaticus and required mechanical ventilation. Which of the following findings would be expected shortly after intubation? Select single answer choice. A peak inspiratory pressure 68 cm H2O pressure; plateau pressure 25 cm H2O pressure. B peak inspiratory pressure 68 cm H2O pressure; plateau pressure 40 cm H2O pressure. C peak inspiratory pressure 28 cm H2O pressure; plateau pressure 22 cm H2O pressure. D peak inspiratory pressure 28 cm H2O pressure; plateau pressure 42 cm H2O pressure. {{Ans- Answer: A Due to bronchospasm, the airway pressure will be elevated (elevated peak inspiratory pressure), but the lung pressure itself (plateau pressure) will not be elevated above 30 cm H2O pressure. -A man is admitted with a gunshot wound to the head. The nurse is told by the trauma surgeon that the patient has cranial nerve III involvement. Which of the following is evidence of cranial nerve III involvement? Select single answer choice. A loss of gag reflex. B right pupil is dilated and nonreactive. C decerebrate posturing. D loss of vision in the right visual field bilaterally. {{Ans- Answer: B Cranial nerve III is the oculomotor nerve, which controls the pupillary CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. response. Compression of this nerve on the side of the injury (ipsilateral) results in pupildilation on that side. -Which of the following is a contraindication to noninvasive ventilation? Select single answer choice. A a need for FiO2 of 0.60. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. B hypoventila tion. c obtunded mental status. D positive blood cultures. {{Ans- Answer: C In order for a patient to derive benefits from noninvasive ventilation, the patient needs a spontaneous ventilatory effort and needs to be able to protect her airway. An obtunded mental status is a contraindication to the safe use of noninvasive ventilation. A patient with any of the other choices may benefit from this treatment option, and those choices do not represent contraindications to that form of treatment. -A patient presents with hypotension refractory to initial treatment, and a pulmonary artery catheter was placed. The hemodynamic profile revealed the following: right atrial (RA) pressure 10 mmHg, pulmonary artery pressure (PAP) 49/25 mmHg, pulmonary artery occlusion pressure (PAOP) 24 mmHg, systemic vascular resistance (SVR) 1,900 dynes/sec/cm-5, and SvO248%. What is most likely the cause of this patient's hypotension and the appropriate treatment for it? Select single answer choice. A hypovolemic shock; fluids. B septic shock; vasopressors. C cardiogenic shock; IABP. D anaphylactic shock; epinephrine IM. {{Ans- Answer: C This patient's hemodynamic profile includes an elevated RA pressure, PAP, PAOP, and SVR. This is reflective of cardiogenic shock. Mechanical support with an IABP is an effective treatment for this patient. The hemodynamic profiles of hypovolemic shock, septic shock, and anaphylactic shock would not include an elevated RA pressure, PAP, and/or PAOP. Also, the hemodynamic profile of a patient with septic shock or anaphylactic shock CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. decreased PaCO2.. C bradycar dia D elevated creatine kinase (CK). {{Ans- Answer: D The destruction of skeletal muscle cells occurs secondary to seizure activity, which results in the release of creatine kinase (CK) into the serum. If skeletal muscle cell destruction is not controlled, the elevated CKs may lead to rhabdomyolysis and acute kidney injury. Neuromuscular blocking agents may be used to CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. stop the skeletal muscle seizing and to prevent skeletal muscle damage. (Note that the patient may still be seizing when clinically paralyzed; therefore, continuous EEG monitoring is indicated to determine whether or not the patient is seizing.) Hyperkalemia, elevated PaCO2, and tachycardia are also associated with status epilepticus, which makes the remaining 3 choices incorrect. -A 19-year-old male was admitted with traumatic injuries secondary to a motor vehicle accident. The ECG demonstrates a sinus rhythm with a short PR interval and the presence of a slow rise of the initial upstroke of the QRS. This patient is at risk for developing which of the following? Select single answer choice. A pre-excited atrial fibrillation. B second-degree AV block, Type II. C third-degree AV block. D atrial flutter {{Ans- Answer: A This patient has Wolff-Parkinson-White (WPW) syndrome, as evidenced by a short PR interval with the presence of a delta wave (a slow rise of the initial upstroke of the QRS). The abnormal conduction pathway of WPW may result in a supraventricular tachycardia (SVT) or cause pre-excited atrial fibrillation (an irregular rhythm, rates of 150 beats/minute or greater, and a wide QRS). WPW does not cause the remaining arrhythmias listed in choices (B), (C), and (D). -A patient has a blood pressure of 78/40, a right atrial (RA) pressure of 1 mmHg, a pulmonary artery occlusion pressure (PAOP) of 4 mmHg, a systemic vascular resistance (SVR) of 1,800 dynes/s/cm-5, and a cardiac output (CO) of 3 L/min. Which of the following statements about this patient is correct? Select single answer choice. A The patient has septic shock; provide CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. vasopressors. B The patient has cardiogenic shock; provide positive inotropes. C The patient has hypovolemic shock; provide fluid resuscitation. D The patient has right ventricular infarct; provide fluids. {{Ans- Answer: C The hemodynamic profile described in the question is that of hypovolemic shock. The SVR would not be elevated in septic shock, so choice (A) is incorrect. In cardiogenic shock, the PAOP would not be CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. Select single answer choice. A papillary muscle rupture. B mitral stenosis. C a pulmonary embolism. D reinfarction. {{Ans- Answer: A This clinical picture describes acute cardiogenic pulmonary edema, and giant V-waves are a sign of acute backflow of blood into the left atrium during systole. A patient with an inferior wall MI is more likely to develop acute mitral valve papillary muscle dysfunction or rupture, leading to mitral valve regurgitation. -A patient with right ventricular infarction would most likely have which of the following hemodynamic pressure findings? Select single answer choice. A right atrial (RA) 4 mmHg, pulmonary artery occlusion pressure (PAOP) 18 mmHg. B right atrial (RA) pressure 14 mmHg, pulmonary artery occlusion pressure (PAOP) 5 mmHg. C right atrial (RA) 14 mmHg, pulmonary artery occlusion pressure (PAOP) 18 mmHg. D right atrial (RA) 0 mmHg, pulmonary artery occlusion pressure (PAOP) 5 mmHg. {{Ans- Answer: B Due to decreased RV ejection, the right atrial pressure increases. Failure of the RV results in decreased left ventricular preload (low PAOP). The lungs will be clear, but the cardiac output and the B/P may decrease. -A patient requires fluid resuscitation and 8 units of PRBCs status post traumatic injury. Which of the following interventions is most appropriate? Select single answer CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. choice. A Warm both blood products and crystalloids. B Monitor for hypercalcemia. C Start norepinephrine for a systolic pressure less than 90 mmHg. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. D Infuse platelets for thrombocytopenia. {{Ans- Answer: A Warming both blood products and fluids that are needed to treat a traumatic injury will prevent hypothermia and its related adverse effects. The remaining 3 choices are not indicated for treating a patient who requires massive fluid/transfusion therapy. -Which of the following patients is a candidate for an internal fecal management system (FMS)? Select single answer choice. A a patient with excoriated skin and frequent, incontinent liquid stool. B a patient with reddened skin and frequent, incontinent soft stools. C a patient who is status post large bowel resection. D a patient with diarrhea who can use the bedside commode. {{Ans- Answer: A An internal fecal management system (FMS) is indicated for a patient with excoriated skin and frequent, incontinent liquid stool. An external device is not an alternative since this type of device should not be applied over excoriated skin. An internal device cannot be used successfully if the stool is soft (since the catheter would clog) or if there has been recent large bowel surgery. For those reasons, choices (B) and (C) are incorrect. A patient who can use the bedside commode and whose stool is not involuntary is not a candidate for an FMS. Therefore, choice (D) is also incorrect. -A patient has been diagnosed with a fat embolism. Which of the following clinical findings is most likely present for this patient? Select single answer choice. A deep vein thrombosis, hypoxemia. B a long bone fracture, petechiae. C CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. Transcranial Doppler, not with a CT scan. -To provide appropriate care for a patient who requires mechanical ventilation, the nurse needs to: Select single answer choice. A instill saline during suctioning. B CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. maintain the patient in a supine position. C hyperoxygenate during suctioning. D deflate the ETT cuff every 4 hours. {{Ans- Answer: C The insertion of a suction catheter into a tracheal tube during a suctioning procedure may decrease the SaO2. Although oxygen desaturation may not occur during every suctioning procedure, it may occur unpredictably. Therefore, it is best practice to increase the FiO2to 1.00 prior to beginning the suctioning procedure. Most ventilators provide the FiO2 of 1.00 that is needed for hyperoxygenation for a predetermined amount of time (for example, 2 minutes). -A post-op patient is undergoing negative-pressure wound therapy. What is an appropriate nursing intervention forthis patient? Select single answer choice. A Contact the physician if there is blocked tubing. B Change the dressing daily. C Maintain the continuous negative pressure at -150 mmHg. D Discontinue negative-pressure wound therapy during the night. {{Ans- Answer: A The physician needs to be notified if it is suspected that the tubing is blocked (as evidenced by an alarm and/or a lack of drainage). The physician will order flushing of the tubing or discontinuation of the therapy and the application of a wet-to-damp dressing until therapy can be resumed. The remaining interventions are not appropriate during negative-pressure wound therapy. -Which of the following arrhythmias typically manifests itself before a person is 30 years old? Select single answer choice. A Wolff-Parkinson-White (WPW) CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. syndrome. B ventricular tachycardia. C second-degree AV block, Type I. D atrial fibrillation. {{Ans- Answer: A WPW is a genetic conduction abnormality in which an abnormal conduction pathway allows a reentrant tachycardia pathway to bypass the normal AV node conduction pathway, resulting in supraventricular tachycardia. WPW is generally first diagnosed in those younger than 30 years old, and it can be cured CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. acute pancreatitis; provide gastric decompression and analgesia. B bowel perforation; provide fluids, prepare for surgery. C small bowel obstruction; provide fluids and gastric decompression D large bowel obstruction; provide antibiotics, prepare for surgery. {{Ans- Answer: B The clinical signs are those of bowel perforation. These clinical signs are not typical of the problems listed in the remaining 3 choices. -A patient with acute ST elevation myocardial infarction received fibrinolytic therapy. Which of the following is a sign of successful coronary artery reperfusion? Select single answer choice. A increased blood pressure. B return of the ST segment to baseline. C resolution of the S4 heart sound. D improved oxygenation. {{Ans- Answer: B Since ST segment elevation is a result of a myocardial infarction (MI) secondary to a lack of perfusion, the return of the ST segment to baseline is a sign of a return of perfusion. The remaining 3 choices are not signs of successful coronary artery reperfusion. -Which of the following is a priority treatment for a patient with DKA who presents with hyperglycemia, ketosis, and normal serum potassium? Select single answer choice. A Reduce serum glucose by 100 to 150 mg/dL/hr. B Administer potassium. C CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. Administer sodium bicarbonate. D Infuse hypertonic saline. {{Ans- Answer: B A patient with DKA will have a low pH and metabolic acidosis. In a state of metabolic acidosis, hydrogen ions (H+) move into the intracellular space. In exchange, potassium leaves the intracellular space. The movement of K+ into the extracellular space results in hyperkalemia (although the total body K+ has not increased). Since this patient presented with acidosis and a normal serum potassium, the total body K+ CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. is deficient, and potassium should be administered immediately. The remaining 3 choices are not indicated for the treatment of DKA. -A patient is receiving mechanical ventilation and is not able to follow commands. What is the preferred strategy for assessing this patient's pain? Select single answer choice. A Assess with the BPS. . B Assess with the RASS. c Assess with the NRS. D Assess with the CAM-ICU. {{Ans- Answer: A This patient cannot follow commands. Therefore, a valid behavioral assessment tool, such as the BPS or the CPOT, needs to be used. The RASS assesses for agitation, so choice (B) is incorrect. The NRS requires the patient to give a number rating to his or her pain, which this patient does not seem capable of doing. For that reason, choice (C) is incorrect. The CAM- ICU assesses the patient for delirium, not pain, so choice (D) is also incorrect. -Which of the following is a systemic effect of targeted temperature management (TTM) during the cooling phase? Select single answer choice. A increased cardiac output secondary to vasodilation. B decreased risk for infection secondary to increased neutrophil production. C hyperkalemia secondary to shivering. D hyperglycemia secondary to insulin resistance. {{Ans- Answer: D During the cooling (induction) phase of TTM, there is typically insulin resistance. Additionally, during this phase, there is vasoconstriction and decreased neutrophil production. During the rewarming phase, rebound CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -Which of the following are the best indicators for a diagnosis of septic shock? Select single answer choice. A an infection and SIRS. B an infection and a fever. C CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. an infection and serum lactate 8. D an infection and a positive blood culture. {{Ans- Answer: C Elevated lactate is evidence of anaerobic metabolism, and it is the best indicator of septic shock of the choices listed. The remaining choices (SIRS, a fever, and a positive blood culture) may be present in sepsis, but they are not specific to a shock state. Additionally, septic shock may be present without signs of a fever ora positive blood culture. -A patient is receiving positive inotropes, vasodilators, and diuretics. This patient most likely has which of the following problems? Select single answer choice. A right ventricular failure. B left ventricular systolic heart failure C papillary muscle rupture. D hypertrophic cardiomyopathy. {{Ans- Answer: B Positive inotropes increase contractility, vasodilators decrease afterload, and diuretics decrease preload. Since a patient with systolic heart failure has decreased contractilityand increased afterload and preload, these agents will be useful forthe treatment of this problem. -A ventricular septal defect is most likely to have which of the following clinical findings? Select single answer choice. A diastolic murmur at the apex of the heart B systolic murmur at the fifth intercostal space, midclavicular C diastolic murmur at the base of the heart D systolic murmur at the fifth intercostal space, left sternal border {{Ans- CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. Answer: D The murmur that is caused by a ventricular septal defect occurs during left ventricular ejection (systole) and is best heard at the fifth intercostal space, left sternal border. -A patient has a fever, and a lumbar puncture is positive for protein and WBCs. This patient most likely has a positive: CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. D anaphylactic shock; epinephrine IM{{Ans- Answer: B The massive vasodilation, loss of vascular tone, and capillary leak caused by endotoxins results in decreased preload and decreased afterload. Endotoxins prevent oxygen utilization, which results in a high SvO2. Vasopressors will restore the vascular tone. None of the remaining choices results in an elevated SvO2. -A patient with right middle lobe pneumonia would be expected to have which of the following assessment findings overthe affected area? Select single answer choice. A inspiratory and expiratory wheezing B expiratory wheezing and fine crackles C bronchial breath sounds and whispered pectoriloquy D absent breath sounds with fremitus {{Ans- Answer: C Over an area of lung consolidation, the breath sounds are louder (bronchial) than over normal lung tissue. Words that are whispered by the patient will be heard clearly through the stethoscope (whispered pectoriloquy) because sound travels faster through liquids or solids than it does through air. -What would increase the risk of developing contrast media nephropathy, and what intervention may prevent it? Select single answer choice. A age less than 18 years old; NSAIDs pre-procedure B edema; using low-osmolar contrast media C calcium channel blockers; diuretics pre-procedure D diabetes; hydration pre-procedure {{Ans- Answer: D CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. Prolonged exposure to elevated serum glucose has an adverse effect on the tubular basement membrane, and exposure to contrast media may trigger renal failure. Pre-procedure hydration causes the release of prostaglandins, which leads to dilation of the efferent arteriole and possible prevention of renal failure. The remaining choices are not known to lead to contrast media nephropathy. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -A patient has a pulmonary embolism with hypotension, hypoxemia (which requires the patient to be on 100% oxygen), and severe tachypnea. Which of the following would provide the quickest resolution of this patient's signs and symptoms? Select single answer choice. A the administration of heparin B intubation with mechanical ventilation C the administration of a fibrinolytic agent D fluid resuscitation {{Ans- Answer: C This patient's signs and symptoms are due to a massive pulmonary embolism. The administration of a fibrinolytic agent would dissolve the clot in a short period of time, with relief from the life-threatening symptoms. Anticoagulation with heparin will be needed, but the therapeutic effects are not immediate, so choice (A) does not represent the quickest resolution of this patient's signs and symptoms. The administration of a fibrinolytic agent as a first step could possibly eliminate the need for mechanical ventilation or fluid resuscitation. For that reason, choices (B) and (D) are incorrect. -A patient presents with left leg pain. The ankle brachial index (ABI) is 0.7. This patient would benefit from which of the following interventions? Select single answer choice. A mechanical compression therapy B putting the legs in the dependent position C the administration of a beta- adrenergic blocker D elevating the leg {{Ans- Answer: B The clinical signs described in the question are indicative of peripheral artery occlusive disease. Putting the legs in the dependent position will aid perfusion. The remaining choices would not be beneficial. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. the patient is at risk for developing anaphylactic shock. B the patient will require treatment for gas gangrene. C hyperbaric oxygen therapy is a priority treatment. D a single surgical debridement intervention will resolve the problem. {{Ans- Answer: B Clostridial myonecrosis is also known as gas gangrene. This patient most likely has necrotizing fasciitis, which may progress to septic shock, not anaphylactic shock, so choice (A) is incorrect. Hyperbaric oxygen therapy is not a priority treatment, but it may be useful for select patients. Since it is not a CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. priority treatment, choice (C) is incorrect. Surgical debridement will be needed, not only initially, but repeatedly until the spread of the necrosis is resolved. -Prerenal failure may be precipitated by which of the following in high-risk patients? Select single answer choice. A acetaminop hen B calcium channel blockers C beta blockers D NSAIDs {{Ans- Answer: D Chronic use of NSAIDs prevents dilation of the efferent renal arteriole, and this dilation may be needed when renal perfusion is stressed by hypovolemiaorother stressors. -A patient has a blood pressure of 78/40, a right atrial (RA) pressure of 13 mmHg, a pulmonary artery occlusion pressure (PAOP) of 5 mmHg, a systemic vascular resistance (SVR) of 1,900 dynes/sec/cm-5, and a cardiac output (CO) of 1.9 L/min. Which of the following statements about this patient is correct? Select single answer choice. A The patient has septic shock; provide vasopressors. B The patient has cardiogenic shock; provide positive inotropes. C The patient has hypovolemic shock; provide fluid resuscitation. D The patient has right ventricular infarct; provide fluids. {{Ans- Answer: D The hemodynamic profile described is that of right ventricular (RV) failure, which may be se condary to acute RV infarct. The elevated SVR is not typical of septic shock, which rules out choice (A). The low PAOP is not seen CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. in cardiogenic shock, which rules out choice (B). The elevated RA pressure is not seen in hypovolemic shock, which rules out choice (C). -A patient has a blood pressure of 78/40, a right atrial (RA) pressure of 8 mmHg, a pulmonary artery occlusion pressure (PAOP) of 19 mmHg, a systemic vascular resistance (SVR) of 1,900 dynes/sec/cm-5, and a cardiac output (CO) of 1.9 L/min. Which of the following statements about this patient is correct? Select single answer choice. A The patient has septic shock; provide vasopressors. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -The physician determines that the patient has ARDS. The patient has developed refractory hypoxemia, bilateral infiltrates, and pulmonary edema, as confirmed by a chest X-ray. Which of the following findings would be expected for apatient with this diagnosis? Select single answer choice. A increased lung compliance B PAOP is normal or low C decreased work of breathing D decreased cardiac output {{Ans- Answer: B The pulmonary edema of ARDS is due to lung capillary leak at a normal or even low left heart pressure (PAOP). This is unlike cardiogenic pulmonary edema, which results in pulmonary edema at a higher than normal left heart pressure (a PAOP of 18 mmHg or greater). -A patient has hepatic encephalopathy and elevated serum ammonia (NH3). Which of the following is a clinical sign of elevated NH3? Select single answer choice. A jaundi ce B asteri xis C ascit es D hyperglycemia {{Ans- Answer: B Asterixis is a motor disorder that is manifested as a tremor of the hand when the wrist is extended. Elevated serum ammonia results in abnormal functioning of the diencephalic motor centers in the brain, and these motor centers regulate the muscles that are involved in maintaining position. The remaining 3 choices are not clinical signs of elevated serum ammonia. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. -Which of the following ABG results (which were obtained from patients with status asthmaticus who were receiving oxygen at 3 L/minute via a nasal cannula) most likely indicates an immediate need for intubation and mechanical ventilation? Select single answer choice. A pH 7.40; PaCO2 39; HCO3 24; PaO2 100 CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. B pH 7.49; PaCO2 28; HCO3 25; PaO2 92 C pH 7.34; PaCO2 47; HCO3 28; PaO2 68 D pH 7.29; PaCO2 50; HCO3 25; PaO2 70 {{Ans- Answer: D The ABG results in choice (D) demonstrate hypoventilation, as evidenced by an uncompensated respiratory acidosis with mild hypoxemia. This patient needs assisted ventilation in order to prevent respiratory arrest. Choice (A) is a normal ABG result (a highly unlikely finding in a tachypneic patient with status asthmaticus). Although not considered normal, the ABG results in choice (B) and choice (C) would not indicate an immediate need for intubation and mechanical ventilation. -A patient presents 1 month status post gastric bypass bariatric surgery with vomiting, a headache, diplopia, and memory loss. These are clinical signs of which of the following? Select single answer choice. A overeati ng. B an infection C malabsorpt ion. D anastomosis leak. {{Ans- Answer: C These signs and symptoms are those of malabsorption, which results in vitamin deficiency and may occur after bariatric surgery. The remaining choices are not manifested by the signs and symptoms described in the question. -Which of the following is a priority treatment for an aortic dissection? Select single answer choice. A fluids and CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. (A) is incorrect. This is not the appropriate time to use the situation to coach the orientee. For that reason, choice (B) is incorrect. Discussing the orientee's rationale for putting the patient in that position would best be done at a later time. For that reason, choice (D) is also incorrect. -The hospital Nursing Practice Committee wants to provide criteria for the maintenance of a central venous catheter in order to decrease the CLABSI rate. Which of the following is a reason to maintain a central venous catheter? Select single answer choice. CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. A The patient requires acute hemodialysis. B The patient requires frequent lab draws. C The patient is receiving mechanical ventilation. D The patient requires peripheral parenteral nutrition. {{Ans- Answer: A A patient who requires emergent hemodialysis (or CRRT) will need a central venous catheter (CVC). Each of the remaining choices alone is not a requirement formaintaining a CVC. -A patient assessment reveals a fever and nuchal rigidity. A lumbar puncture is done, and the cerebrospinal fluid (CSF) results include the following: clear in appearance, glucose 60 mg/dL, mildly elevated protein, mildly elevated WBC count, and opening pressure 150 cm H2O. Treatment for this patient will most likely includewhich of the following? Select single answer choice. A supportive care. B airborne isolation. C antibiotic therapy. D targeted temperature management. {{Ans- Answer: A Treatment for this patient includes supportive care (e.g., fluids, fever management). The clinical signs described indicate that this patient has meningitis, and the results of the lumbar puncture indicate that the meningitis is viral. Antibiotics are indicated for bacterial meningitis, not viral meningitis. Isolation and targeted temperature management are not indicated forviral meningitis. -A patient's bladder pressure has ranged between 15 and 20 mmHg over the past 12 hours. Which of the following interventions is indicated for this patient? Select single answer CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. choice. A Level the pressure transducer at the midaxillary line. B Elevate the head of the bed to 45°. C Withhold analgesic and sedating drugs. D Optimize stool management. {{Ans- Answer: D CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. B The patient is receiving mechanical ventilation, with an SpO2 of 0.94, an FiO2 of 0.40, and a PEEP of 5 cm H2O pressure. C The patient is arousable to vigorous shaking but is not arousable to voice or touch. D The patient is receiving norepinephrine 5 mcg/min and is being weaned off of it. {{Ans- Answer: C The patient described in choice (C) is not ready for weight-bearing if she is not responsive to verbal stimulation. According to the MOVE criteria, the patients described in choices (A), (B), and (D) do not have contraindications to mobility progression. -Which of the following electrolyte abnormalities does NOT result in hyperreflexia? Select single answer choice. A hypocalce mia B hypermagnes emia. C hyperphosphat emia. D hypomagnesemia {{Ans- Answer: B Hypermagnesemia results in decreased deep tendon reflexes (DTRs). The remaining electrolyte abnormalities result in hyperreflexia. -Which of the following patients is NOT at a high risk for a fall? Select single answer choice. A The patient has an indwelling urinary catheter. B The patient requires an antidepressant. C The patient fell at home last month. D CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. The patient is restrained. {{Ans- Answer: B A need for antidepressants has not been shown to increase the risk for falling. The remaining circumstances have been shown to contribute to a patient's risk fora fall. -A patient is status post motor vehicle accident with a large chest bruise. The nurse knows that this patient needs to be assessed for which of the following? CCRN CRITICAL CARE NUR EXAM LATEST QUESTIONS AND 100% CORRECT ANSWERS TEST BANK .Download to score. Select single answer choice. A positive troponin, aortic valve damage. B pain with inspiration, pericardial friction rub. C retroperitoneal bleed, global ST elevation. D atrial fibrillation, mitral valve damage. {{Ans- Answer: A The chest bruise implies that the patient's chest struck the steering wheel. This in turn may have caused aortic valve trauma (trauma to the valve that is lying most anterior in the chest), or it may have caused myocardial traumadamage. -A patient with ST elevation in leads II, III, and aVF is most likely to develop a , whereas a patient with ST elevation in V1, V2, and V3 is most likely to develop . Select single answer choice. A second-degree AV block (Type II), a sinus exit block B second-degree AV block (Type II), a third- degree AV block. C third-degree AV block, a second-degree AV block (Type II). D second-degree AV block (Type II), sinus arrest. {{Ans- Answer: C ST elevation in leads II, III, and aVF is generally secondary to right coronary artery occlusion (an inferior wall MI), and in most of the population, the RCA supplies the AV node, so an occlusion of the RCA would result in complete heart block. ST elevation in V1 through V3 is indicative of left anterior descending artery occlusion. Since the left anterior descending artery supplies the main bundle of His in most of the population, occlusion of that artery would result in a second-degree AV block (Type II). -A patient sustained a crush injury at a construction site. The patient's urine is tea-colored with a urine output of 20 mL/hour. The creatine kinase (CK) is 20,000 U/L. The nurse should anticipate which of the following