Critical Care Exam 1 Questions
You have just received change of shift report. Which patient should you assess first?
a. 62 year-old man who is scheduled for a cardiac cath, and is ready to be transported now
b. 58 year-old woman with COPD with an O2 saturation of 92% on 2 liters of O2, who is sc...
Critical Care Exam 1 Questions
You have just received change of shift report. Which patient should you assess first?
a. 62 year-old man who is scheduled for a cardiac cath, and is ready to be transported now
b. 58 year-old woman with COPD with an O2 saturation of 92% on 2 liters of O2, who is scheduled to be
discharged home on O2
c. 36 year-old man admitted with an exacerbation of asthma with RR 36 at rest, and whose wheezing
has diminished
d. 72 year-old woman with history of asthma with HR 90 and is due for her beta-blocker Ans- C
RR 36 and diminished wheezing indicative of respiratory distress and needs prompt attention
You are about to handover patient care to your on-coming nurse colleague. Which patient requires the
most immediate attention?
1.) 62 year-old man with COPD who has just completed his scheduled bronchodilator
2.) 68 year-old woman with type 2 diabetes who had CVA 2 days ago
3.) 72 year-old woman with history of asthma with HR 90 and is due for her beta-blocker
4.) 48 year-old man admitted with cellulitis of his right hand after a construction accident, currently on
IV antibiotics, with a temperature of 101.8 Ans- 4
Cellulitis is serious infection, involving swelling of subcutaneous tissue, fluid displacement due to 3rd
spacing. What else would you assess?
You are assigned to care for a 58 year-old man who is scheduled for a cardiac angiogram during your
shift. What actions should you take? Check all that apply.
1-Explain that the patient will receive short-acting anesthesia
2-Review the patient's allergies, specifically checking to see if he has an allergy to contrast dye
3-Inform the patient that his wife should stay at home until the procedure is finished, as family
members often distract the team in the cath lab
4-Review and reconcile his medications. Confirm that he did not take his warfarin
5-Check the patient's most recent labs paying particular attention to the PT INR Ans- 2, 4, 5
Contrast dyes contain iodine and allergy could lead to anaphylactic response; might receive light
sedation but needs to be awake and able to follow directions
,A 62 year-old man, who is s/p coronary artery bypass surgery, is about to be transferred from the ICU to
the cardiac stepdown unit. What is the most effective way for the ICU (reporting) nurse and cardiac
stepdown (receiving) nurse to ensure that essential patient information is conveyed?
1- A face-to-face verbal report with both nurses present in a quiet room
2- The ICU nurse will provide an audio-recorded report for future reference and documentation
3- The ICU nurse will document essential transfer information in the patient's medical record
4- The ICU nurse will accompany the patient to the stepdown unit and provide a face-to-face report,
using a unit-approved, standardized guide Ans- 4
What is the most common outcome associated with poorly managed hospital discharge? Ans- Adverse
Drug events
The nurse is tracking data on a group of patients with heart failure, who have been discharged from the
unit where you work and are now being followed in clinic. What is the best indicator that the nursing
interventions of monitoring and teaching have been effective?
1- Eighty-five percent of patients have not gained weight
2- Seventy-five percent of family caregivers have reported watching an educational DVD
3- Five percent of patients have been readmitted to the hospital in the last 90 days
4- Eighty percent report that they are taking their medications Ans- 3
All are important but lower resource utilization is best indicator and one used by accrediting agencies,
payors, etc.
You are the nurse preparing to discharge a 46 year-old man with hypertension who was started on
chlorothiazide. You ask the patient to share with you his understanding of his new medication. Which of
the following statements indicates your teaching has been effective? Select all that apply.
1- I will weigh myself every day at the same time.
2- I will notify Charles, the nurse practitioner in my primary care doctor's office if I gain 3 pounds or
more, have increased swelling in my feet and ankles, or feel more tired than usual.
3- I will reduce my medication if I feel very thirsty or dizzy.
4- I will wear sunscreen if I will be out in the sun for a long period of time.
5- If I want to drink alcohol, I will wait and take my medication right before I go to bed. Ans- 1, 2, 4
, The following should NOT be used to reduce pressure, as it may increase friction injuries:
A) rolled towels
B) convoluted foam mattress overlay
C) foam pads
D) viscoelastic overlay Ans- A
Rolled towels and sheets should not be used and may negate pressure-reducing function of other pads
The MOST common cause of delayed surgical wound healing is:
A) diabetes
B) surgical site infection
C) malnutrition
D) impaired circulation Ans- B
Purlent discharge, signs of infection, open wound. Can occur <30 days up to 1 year post op
An adult Jehovah's' Witness patient is hemorrhaging and might die without transfusions, but he refused
blood products prior to surgery. The correct procedure is?
A) use volume replacement and fractionated blood cells only, as permitted by the religion
B) contact family and ask permission
C) ask legal authorities to grant permission
D) give transfusions because the patient may die Ans- ANSWER: A
This patients religion only permits fractions from red cells, white cells, platelets, and plasma. Some JW
request no blood products at all
The nurse is taking care of Ms. Smith. She is a 85 year old with severe congestive heart failure and has
history of severe dementia and CVA. She has had multiple admissions for CHF exacerbation. Despite
aggressive treatment, she remains dyspneic and is requiring high flow oxygen at 10L. During rounds, the
team discusses sending the patient to the ICU due to her probable need for mechanical ventilation. As
the nurse you are concerned that this plan of care is inappropriate, what is the best action?
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