Critical Care Nursing Study Guide Questions
Course Introduction
Critical Care Nursing is a specialized course designed to equip students with the knowledge and skills necessary to provide high-quality care to critically ill patients in intensive care settings. The course covers the pathophysiology of life-threatening conditions, advanced assessment techniques, and the application of evidence-based interventions for adults experiencing acute organ dysfunction or failure. Emphasis is placed on clinical decision-making, use of advanced technologies, patient and family-centered care, interdisciplinary teamwork, and ethical and legal considerations unique to critical care environments. Students will also develop competence in managing complex therapies and monitoring critically ill patients to optimize outcomes and promote recovery.
Recommended Textbook
Introduction to Critical Care Nursing 6th Edition by Mary Lou Sole
Available Study Resources on Quizplus 21 Chapters
756 Verified Questions
756 Flashcards
Source URL: https://quizplus.com/study-set/2011
Page 2
Chapter 1: Overview of Critical Care Nursing
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Which of the following professional organizations best supports critical care nursing practice?
A) American Association of Critical-Care Nurses
B) American Heart Association
C) American Nurses Association
D) Society of Critical Care Medicine
Answer: A
Q2) A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and is interested in certification.Which credential would be most applicable for her to seek?
A) ACNPC
B) CCNS
C) CCRN
D) PCCN
Answer: C
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Page 3
Chapter 2: Patient and Family Response to the Critical Care Experience
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) The nurse is a member of a committee to design a critical care unit in a new building.Which design trend would best to facilitate family-centered care?
A) Ensure that the patient's room is large enough and has adequate space for a sleeper sofa and storage for family members' personal belongings.
B) Include a diagnostic suite in close proximity to the unit so that the patient does not have to travel far for testing.
C) Incorporate a large waiting room on the top floor of the hospital with a scenic view and amenities such as coffee and tea.
D) Provide access to a scenic garden for meditation.
Answer: A
Q2) Which intervention is appropriate to assist the patient to cope with admission to the critical care unit?
A) Allowing unrestricted visiting by several family members at one time
B) Explaining all procedures in easy-to-understand terms
C) Providing back massage and mouth care
D) Turning down the alarm volume on the cardiac monitor
Answer: B
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Page 4
Chapter 3: Ethical and Legal Issues in Critical Care Nursing
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) The nurse is caring for a patient whose condition has deteriorated and who is not responding to standard treatment.The physician calls for an ethical consultation with the family to discuss potential withdrawal versus aggressive treatment.The nurse understands that applying a model for ethical decision making involves which of the following? (Select all that apply.)
A) Burden versus benefit
B) Family's wishes
C) Patient's wishes
D) Potential outcomes of treatment options
Answer: A,C,D
Q2) A specific request made by a competent person that directs medical care related to life-prolonging procedures if the patient loses capacity to make decisions is called a:
A) do not resuscitate order.
B) healthcare proxy.
C) informed consent.
D) living will.
Answer: D
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Page 5
Chapter 4: End-Of-Life Care in the Critical Care Unit
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) A patient with end-stage heart failure is experiencing considerable dyspnea.Appropriate pharmacological management of this symptom includes:
A) administration of 6 mg of midazolam ( Versed ) and initiation of a continuous midazolam infusion.
B) administration of morphine, 5 mg IV bolus, and initiation of a continuous morphine infusion.
C) hourly increases of the midazolam ( Versed ) infusion by 100% dose increments.
D) hourly increases of the morphine infusion by 100% dose increments.
Q2) The patient's husband is terrified by the prospect of removing life-sustaining treatments from the patient.He asks why anyone would do that.The nurse explains,
A) "It is to save you money so you won't have such a large financial burden."
B) "It will preserve limited resources for the hospital so other patients may benefit from them."
C) "It is to discontinue treatments that are not helping your wife and may be very uncomfortable for her."
D) "We have done all we can for your wife and any more treatment would be futile."
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Chapter 5: Comfort and Sedation
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33 Flashcards
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Sample Questions
Q1) Nociceptors differ from other nerve receptors in the body in that they:
A) adapt very little to continual pain response.
B) inhibit the infiltration of neutrophils and eosinophils.
C) play no role in the inflammatory response.
D) transmit only the thermal stimuli.
Q2) The most important nursing intervention for patients who receive neuromuscular blocking agents is to:
A) administer sedatives in conjunction with the neuromuscular blocking agents.
B) assess neurological status every 30 minutes.
C) avoid interaction with the patient, because he or she won't be able to hear.
D) restrain the patient to avoid self-extubation.
Q3) The nurse wishes to assess the quality of a patient's pain.Which of the following questions is appropriate to obtain this assessment if the patient is able to give a verbal response?
A) "Is the pain constant or intermittent?"
B) "Is the pain sharp, dull, or crushing?"
C) "What makes the pain better? Worse?"
D) "When did the pain start?"
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Chapter 6: Nutritional Support
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) The patient is to start parenteral nutrition.The nurse knows to prepare which site for catheter insertion?
A) Basilic vein
B) Femoral vein
C) Radial artery
D) Subclavian vein
Q2) Calorie-dense feedings: (Select all that apply.)
A) are most useful in heart failure and liver disease.
B) are most useful in malabsorption syndromes.
C) contain 2 kcal/mL and 70 g protein/L.
D) include increased fiber.
Q3) In addition to residual stomach volume,what other evidence suggests feeding intolerance?
A) Abdominal distention
B) Absence of tympany on percussion
C) Active bowel sounds
D) Elevated blood glucose by fingerstick
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Chapter 7: Dysrhythmia Interpretation and Management
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59 Verified Questions
59 Flashcards
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Sample Questions
Q1) The nurse is working on the night shift when she notices sinus bradycardia on the patient's cardiac monitor.The nurse should:
A) give atropine to increase heart rate.
B) begin transcutaneous pacing of the patient.
C) start a dopamine infusion to stimulate heart function.
D) assess for hemodynamic instability.
Q2) The patient is having premature ventricular contractions (PVCs).The nurse's greatest concern should be:
A) the proximity of the R wave of the PVC to the T wave of a normal beat.
B) the fact that PVCs are occurring, because they are so rare.
C) if the number of PVCs are decreasing.
D) if the PVCs are wider than 0.12 seconds.
Q3) The rhythm on the cardiac monitor is showing numerous pacemaker spikes,but no P waves or QRS complexes following the spikes.The nurse realizes this as:
A) normal pacemaker function.
B) failure to capture.
C) failure to pace.
D) failure to sense.
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Chapter 8: Hemodynamic Monitoring
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter.The nurse assesses a blood pressure of 90/60 mm Hg,heart rate 110 beats/min,respirations 36/min,oxygen saturation of 89% on 3 L of oxygen via nasal cannula.Bilateral crackles are audible upon auscultation.Which hemodynamic value requires immediate action by the nurse?
A) Cardiac index (CI) of 1.2 L/min/m<sup>3</sup>
B) Cardiac output (CO) of 4 L/min
C) Pulmonary vascular resistance (PVR) of 80 dynes/sec/cm<sup>-5</sup>
D) Systemic vascular resistance (SVR) of 1800 dynes/sec/cm<sup>-5</sup>
Q2) Upon entering the room of a patient with a right radial arterial line,the nurse assesses the waveform to be slightly dampened and notices blood to be backed up into the pressure tubing.What is the best action by the nurse?
A) Check the inflation volume of the flush system pressure bag.
B) Disconnect the flush system from the arterial line catheter.
C) Zero reference the transducer system at the phlebostatic axis.
D) Reduce the number of stopcocks in the flush system tubing.
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Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
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Sample Questions
Q1) Positive end-expiratory pressure (PEEP)is a mode of ventilatory assistance that produces the following condition:
A) Each time the patient initiates a breath, the ventilator delivers a full preset tidal volume.
B) For each spontaneous breath taken by the patient, the tidal volume is determined by the patient's ability to generate negative pressure.
C) The patient must have a respiratory drive, or no breaths will be delivered.
D) There is pressure remaining in the lungs at the end of expiration that is measured in cm H?O.
Q2) Neuromuscular blocking agents are used in the management of some ventilated patients.Their primary mode of action is:
A) analgesia.
B) anticonvulsant.
C) paralysis.
D) sedation.
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Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) Post-resuscitation goals include which of the following? (Select all that apply.)
A) Control dysrhythmias
B) Maintain airway
C) Maintain blood pressure
D) Wean off oxygen
Q2) The patient has been admitted to a critical care unit with a diagnosis of acute myocardial infarction.Suddenly his monitor alarms and the screen shows a flat line.What action should the nurse take first?
A) Administer epinephrine by intravenous push.
B) Begin chest compressions.
C) Check patient for unresponsiveness.
D) Defibrillate at 360 J.
Q3) Which code drugs can be given safely through an endotracheal tube? (Select all that apply.)
A) Adenosine
B) Atropine
C) Epinephrine
D) Vasopressin
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Chapter 11: Shock, sepsis, and Multiple Organ Dysfunction Syndrome
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34 Verified Questions
34 Flashcards
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Sample Questions
Q1) The nurse is caring for an 18-year-old athlete with a possible cervical spine (C5)injury following a diving accident.The nurse assesses a blood pressure of 70/50 mm Hg,heart rate 45 beats/min,and respirations 26 breaths/min.The patient's skin is warm and flushed.What is the best interpretation of these findings by the nurse?
A) The patient is developing neurogenic shock.
B) The patient is experiencing an allergic reaction.
C) The patient most likely has an elevated temperature.
D) The vital signs are normal for this patient.
Q2) The nurse is caring for a patient with severe sepsis who was resuscitated with 3000 mL of lactated Ringer solution over the past 4 hours.Morning laboratory results show a hemoglobin of 8 g/dL and hematocrit of 28%.What is the best interpretation of these findings by the nurse?
A) Blood transfusion with packed red blood cells is required.
B) Hemoglobin and hematocrit results indicate hemodilution.
C) Fluid resuscitation has resulted in fluid volume overload.
D) Fluid resuscitation has resulted in third spacing of fluid.
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Chapter 12: Cardiovascular Alterations
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37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/40010
Sample Questions
Q1) A patient is admitted with an acute myocardial infarction (AMI).The nurse knows that an angiotensin-converting enzymes (ACE)inhibitor should be started within 24 hours to reduce the incidence of which process?
A) Myocardial stunning
B) Hibernating myocardium
C) Myocardial remodeling
D) Tachycardia
Q2) The patient has been in chronic heart failure for the past 10 years.He has been treated with beta-blockers and angiotensin-converting enzyme inhibitors as well as diuretics.His symptoms have recently worsened,and he presents to the ED with severe shortness of breath and crackles throughout his lung fields.His respirations are labored and arterial blood gases show that he is at risk for respiratory failure.Which of the following therapies may be used for acute,short-term management of the patient? (Select all that apply).
A) Dobutamine
B) Intraaortic balloon pump
C) Nesiritide (Natrecor)
D) Ventricular assist device
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Page 14
Chapter 13: Nervous System Alterations
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) The physician orders fosphenytoin (Cerebyx),1.5 g intravenous (IV)loading dose for a 75-kg patient in status epilepticus.What is the most important action by the nurse?
A) Contact the admitting physician.
B) Administer drug over 10 minutes.
C) Mix medication with 0.9% normal saline.
D) Administer via central line.
Q2) Which patient being cared for in the emergency department should the charge nurse evaluate first?
A) A patient with a complete spinal injury at the C5 dermatome level
B) A patient with a Glasgow Coma Scale score of 15 on 3-L nasal cannula
C) An alert patient with a subdural bleed who is complaining of a headache
D) An ischemic stroke patient with a blood pressure of 190/100 mm Hg
Q3) The nurse admits a patient to the emergency department ( ED )with a suspected cervical spine injury.What is the priority nursing action?
A) Keep the neck in the hyperextended position.
B) Maintain proper head and neck alignment.
C) Prepare for immediate endotracheal intubation.
D) Remove cervical collar upon arrival to the ED.
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Chapter 14: Acute Respiratory Failure
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/40012
Sample Questions
Q1) Which of the following statements is true regarding oral care for the prevention of ventilator-associated pneumonia (VAP)? (Select all that apply.)
A) Tooth brushing is performed every 2 hours for the greatest effect.
B) Implementing a comprehensive oral care program is an intervention for preventing VAP.
C) Oral care protocols should include oral suctioning and brushing teeth.
D) Protocols that include chlorhexidine gluconate have been effective in preventing VAP.
Q2) The nurse is concerned that a patient is at increased risk of developing a pulmonary embolus and develops a plan of care for prevention to include which of the following?
A) Antiseptic oral care
B) Bed rest with head of bed elevated
C) Coughing and deep breathing
D) Mobility
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Chapter 15: Acute Kidney Injury
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Sample Questions
Q1) Conditions that produce acute kidney injury by directly acting on functioning kidney tissue are classified as intrarenal.The most common intrarenal condition is:
A) prolonged ischemia.
B) exposure to nephrotoxic substances.
C) acute tubular necrosis (ATN).
D) hypotension for several hours.
Q2) The patient's potassium level is 7.0 mEq/L.Besides dialysis,which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?
A) Kayexalate
B) Kayexalate with sorbitol
C) Regular insulin
D) Calcium gluconate
Q3) A normal glomerular filtration rate is:
A) less than 80 mL/min.
B) 80 to 125 mL/min
C) 125 to 180 mL/min
D) more than 189 mL/min
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Chapter 16: Hematological and Immune Disorders
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55 Verified Questions
55 Flashcards
Source URL: https://quizplus.com/quiz/40014
Sample Questions
Q1) The process in which antibody and complement proteins attach to the target cell and enhance the phagocyte's ability to engulf the target cell is known as:
A) opsonization.
B) phagocytosis.
C) the lymphoreticular system.
D) the portal circulation.
Q2) Causes of anemia include: (Select all that apply.)
A) hypoxic states.
B) blood loss.
C) impaired production of red blood cells.
D) increased destruction of red blood cells.
E) chronic obstructive pulmonary disease.
Q3) The patient has yellow skin and low hemoglobin and hematocrit levels.The nurse should look for:
A) an elevated bilirubin level.
B) a low reticulocyte count.
C) sickled cells.
D) low white blood cell and platelet counts.
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18
Chapter 17: Gastrointestinal Alterations
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Sample Questions
Q1) After gastric bypass surgery,the patient is getting vitamin B<sub>12</sub> via injection.The patient asks why he can't get the vitamin by mouth.The nurse explains that:
A) the patient may not have enough intrinsic factor for normal absorption.
B) the patient would have to drink water, and the small intestine can't handle water.
C) the vitamin is absorbed in the upper part of the small bowel and would travel too fast.
D) all vitamins are absorbed in the terminal ileum and it would take too long for B<sub>12</sub>.
Q2) The nurse is caring for a patient who is receiving several cardiac medications designed to stimulate the sympathetic nervous system,vitamin B<sub>12</sub>,and an H<sub>2</sub>blocker.The nurse should do which of the following?
A) Assess for signs of peptic ulcer.
B) Be watchful for increased saliva production.
C) Evaluate for a decrease in potassium level.
D) Give the patient medications to prevent anemia.
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Chapter 18: Endocrine Alterations
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) Which of the following is a high-priority nursing diagnosis for both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome?
A) Activity intolerance
B) Fluid volume deficient
C) Hyperthermia
D) Impaired nutrition, more than body requirements
Q2) What psychosocial factors may potentially contribute to the development of diabetic ketoacidosis? (Select all that apply.)
A) Altered sleep/rest patterns
B) Eating disorder
C) Exposure to influenza
D) High levels of stress
E) Lack of financial resources
Q3) Which of the following laboratory values would be more common in patients with diabetic ketoacidosis?
A) Blood glucose >1000 mg/dL
B) Negative ketones in the urine
C) Normal anion gap
D) pH 7.24
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Page 20
Chapter 19: Trauma and Surgical Management
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Sample Questions
Q1) A 36-year-old driver was pulled from a car after it collided with a tree and the gas tank exploded.What assessment data suggest the patient suffered tissue damage consistent with a blast injury?
A) Blood pressure 82/60, heart rate 122, respiratory rate 28.
B) Crackles (rales) on auscultation of bilateral lung fields.
C) Responsive only to painful stimuli.
D) Irregular heart rate and rhythm.
Q2) Patients with musculoskeletal injury are at increased risk for compartment syndrome.What is an initial symptom of a suspected compartment syndrome?
A) Absence of pulse in affected extremity
B) Pallor in the affected area
C) Paresthesia in the affected area
D) Severe, throbbing pain in the affected area
Q3) In the trauma patient,symptoms of decreased cardiac output are most commonly caused by:
A) cardiac contusion.
B) cardiogenic shock.
C) hypovolemia.
D) pericardial tamponade.
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Page 21
Chapter 20: Burns
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Sample Questions
Q1) In patients with extensive burns,edema occurs in both burned and unburned areas because of:
A) catecholamine-induced vasoconstriction.
B) decreased glomerular filtration.
C) increased capillary permeability.
D) loss of integument barrier.
Q2) A patient admitted with severe burns to his face and hands is showing signs of extreme agitation.The nurse should explore the mechanism of burn injury possibly related to:
A) excessive alcohol use.
B) methamphetamine use.
C) posttraumatic stress disorder.
D) subacute delirium.
Q3) The optimal measurement of intravascular fluid status during the immediate fluid resuscitation phase of burn treatment is:
A) blood urea nitrogen.
B) daily weight.
C) hourly intake and urine output.
D) serum potassium.
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Page 22
Chapter 21: Solid Organ Transplantation
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Sample Questions
Q1) The postanesthesia care unit receives handoff communication from the CRNA indicating that the renal transplant recipient received induction therapy in the operating room with antithymocyte globulin (ATG).What is the best understanding of the administration of this drug by the nurse?
A) The drug is administered for recipients of CMV-positive donor organs.
B) Administration of the drug decreases initial postoperative rejection rates.
C) Antiproliferative agents are recommended for routine induction therapy.
D) Antithymocyte globulin (ATG) is given as a single dose in the OR.
Q2) The nurse is caring for a renal transplant patient admitted with an acute rejection episode.The patient asks the nurse how the doctors will know if the kidney has been rejected.What is the best response by the nurse?
A) "Your admission lab results will determine if your kidney is being rejected."
B) "A procedure called a renal biopsy will be the best way to confirm rejection."
C) "Monitoring over the next few days will determine if your kidney is failing."
D) "An ultrasound of your kidney will determine if your kidney has failed."
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