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Critical Care Exam 1 quizzes Questions &Exam (elaborations) answers 100% satisfaction guarantee Latest update 2024/2025 with complete solution
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  • Introduction to Critical Care Nursing

Critical Care Exam 1 quizzes Questions &Exam (elaborations) answers 100% satisfaction guarantee Latest update 2024/2025 with complete solution

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  • August 9, 2024
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  • 2024/2025
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Critical Care Exam 1 quizzes
"Do you use any over-the-counter (OTC) drugs?"

The patient's symptoms, lack of antibodies for hepatitis, and the abrupt onset of symptoms suggest toxic
hepatitis, which can be caused by commonly used OTC drugs such as acetaminophen (Tylenol). Travel to a
foreign country and a history of IV drug use are risk factors for viral hepatitis. Corticosteroid use does not
cause the symptoms listed. - ✔✔A patient is admitted with an abrupt onset of jaundice, nausea, and abnormal
liver function studies. Serologic testing is negative for viral causes of hepatitis. Which question by the nurse is
most appropriate?

add positive end expiratory pressure
increase FiO2
The pH is up (alkalosis) and the CO2 is decreased but this is due to the patient's PaOa being low. You see
respiratory alkalosis in early ARDS or hypoxemic respiratory failure. This is a ventilation issue to you must
adjust either the FiO2 or add PEEP. To increase PaO2 you may need to increase either or both. - ✔✔Your
patient's ABGs values are: pH 7.48; PaO2 60; PaCO2 30; HCO3 22;

The patient is receiving mechanical ventilation with the SIMV mode. The nurse might expect which of the
following orders after reporting the ABG results to the physician?

Select all that apply.
%


Administering mannitol
Elevate the HOB 45 degrees.
Maintaining the PCO2 within the lower normal range

To decrease intracranial pressure, the patient's HOB is elevated above 30 degrees, head is kept midline,
osmotic diuretics and hypertonic saline infusions are given to decrease cellular fluid along with keeping the
PCO2 low normal to prevent vasodilation.You would not want the SaO2 to be below 90% so waiting until below
80 is much too late. - ✔✔Your patient had a large ischemic stroke and is hospitalized in the neurologic
intensive care unit. What interventions will be provided for this patient to decrease intracranial pressure?

Alanine aminotransferase (ALT)
Gamma-glutamyl transferase (GGT)
Aspartate aminotransferase (AST)

Liver function testing includes GGT, ALT, and AST. CRP and PCT addresse the presence of generalized
inflammation and BNP is relevant to heart failure; neither is included in a liver panel. - ✔✔A client's physician
has ordered a liver panel in response to the client's development of jaundice. When reviewing the results of
this laboratory testing, the nurse should expect to review what blood tests? Select all that apply

Aldosterone release



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Pneumothorax
Aspiration, barotrauma (pneumothorax), decreased cardiac output, and retention of sodium and water due to
decreased renal perfusion are the only correct answers. Mechanical ventilation can increase thoracic pressure
leading to barotrauma of the alveoli and it can decrease venous return which decreases cardiac output which
leads to decrease perfusion to kidneys resulting in the retention of sodium and water. Having an endotracheal
tube or tracheostomy tube will increase risk of aspiration. - ✔✔Which of the following are possible
complications of mechanical ventilation?

ammonia level

Neomycin is given to patients with elevated ammonia levels to decrease the ammonia forming bacteria in the
GI tract when lactulose alone is not effective. - ✔✔The laboratory test that would indicate that the liver of a
patient with cirrhosis is compromised and Neomycin administration might be helpful would be

Ascites
Hyperaldosteronism
Esophageal varices
Hepatic encephalopathy

Complications of heaptic failure include increased risk of bleeding, esophageal varicies, ascites, hepatic
encephalopathy, increased amounts of aldosterone, fluid overload, fever, infection. There is an increase in the
PTT due to loss of clotting factors. - ✔✔You are admitting a patient with hepatic failure. You anticipate the
%


patient may have which of the following complications with hepatic failure? Select all that apply.

at higher altitudes.
At higher altitudes (C), the atmospheric pressure decreases resulting in a lower PaO2. This is why airplane
cabins are pressurized--to help maintain adequate oxygenation at high altitudes. PaO2 is decreased in older
adults, not in children, so option A is incorrect. - ✔✔The partial pressure of oxygen in arterial blood (PaO2) is
normally decreased

Blood flow through some areas of your lungs is decreased even though you are taking adequate breaths.
In this question, the nurse needs to understand whether a ventilation or perfusion problem has caused the
respiratory failure so that patient teaching may be implemented correctly. A pulmonary embolism occludes
perfusion (circulation) to a part of the lungs, causing a V/Q (ventilation/perfusion) mismatch. With a PE,
ventilation or air delivery is usually unaffected. The other options are all ventilation problems and do not
correctly describe the pathophysiology of a PE. - ✔✔A patient is diagnosed with an acute pulmonary
embolism. When explaining to the patient what happened to cause respiratory failure, which information should
the nurse include?

chest trauma and multiple rib fractures.
Hypercapnic failure is a ventilation issue. The only problem listed that would impede ventilation is chest trama
and rib fractures. The other choices would lead to hypoxemic failure - an oxygenation issue. - ✔✔The nurse




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