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CHAPTER 65: CRITICAL CARE LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION, ADULT HEALTH II MODULE 2 REVIEW NEWEST ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT VERIFIED ANSWERS (DETAILED ANSWERS) ALREADY GRADED A+ 100% GUARANTEED TO PASS CONCEPTS!!!$17.99
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CHAPTER 65: CRITICAL CARE LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION, ADULT HEALTH II MODULE 2 REVIEW NEWEST ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT VERIFIED ANSWERS (DETAILED ANSWERS) ALREADY GRADED A+ 100% GUARANTEED TO PASS CONCEPTS!!!
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CHAPTER 65: CRITICAL CARE LEWIS: MEDICAL-SURGICAL
Institution
CHAPTER 65: CRITICAL CARE LEWIS: MEDICAL-SURGICAL
CHAPTER 65: CRITICAL CARE LEWIS: MEDICAL-SURGICAL NURSING, 10TH
EDITION, ADULT HEALTH II MODULE 2 REVIEW NEWEST ACTUAL
EXAM WITH COMPLETE QUESTIONS AND CORRECT VERIFIED
ANSWERS (DETAILED ANSWERS) ALREADY GRADED A+ 100%
GUARANTEED TO PASS CONCEPTS!!!
CHAPTER 65: CRITICAL CARE LEWIS: MEDICAL-SURGICAL NURSING, 10TH
EDITION, ADULT HEALTH II MODULE 2 REVIEW NEWEST ACTUAL
EXAM WITH COMPLETE QUESTIONS AND CORRECT VERIFIED
ANSWERS (DETAILED ANSWERS) ALREADY GRADED A+ 100%
GUARANTEED TO PASS CONCEPTS!!!
The patient has a homocysteine level ordered. What aspects of this test should inform
the nurses care? Select all that apply.
A) A 12-hour fast is necessary before drawing the blood sample.
B) Recent inactivity can depress homocysteine levels.
C) Genetic factors can elevate homocysteine levels.
D) A diet low in folic acid elevates homocysteine levels.
E) An ECG should be performed immediately before drawing a sample. -
<<ANSWER>>A, C, D
A patient with a complex cardiac history is scheduled for transthoracic
echocardiography. What should the nurse teach the patient in anticipation of this
diagnostic procedure?
A) The test is noninvasive, and nothing will be inserted into the patients body.
B) The patients pain will be managed aggressively during the procedure.
C) The test will provide a detailed profile of the hearts electrical activity.
D) The patient will remain on bed rest for 1 to 2 hours after the test. - <<ANSWER>>A
A critical care nurse is caring for a patient with a hemodynamic monitoring system in
place. For what complications should the nurse assess? Select all that apply.
A) Pneumothorax
B) Infection
C) Atelectasis
D) Bronchospasm
E) Air embolism - <<ANSWER>>A, B, E
,The nurse is caring for a patient who has central venous pressure (CVP) monitoring in
place. The nurses most recent assessment reveals that CVP is 7 mm Hg. What is the
nurses most appropriate action?
A) Arrange for continuous cardiac monitoring and reposition the patient.
B) Remove the CVP catheter and apply an occlusive dressing.
C) Assess the patient for fluid overload and inform the physician.
D) Raise the head of the patients bed and have the patient perform deep breathing
exercise, if possible. - <<ANSWER>>C
A critical care nurse is caring for a patient with a pulmonary artery catheter in place.
What does this catheter measure that is particularly important in critically ill patients?
A) Pulmonary artery systolic pressure
B) Right ventricular afterload
C) Pulmonary artery pressure
D) Left ventricular preload - <<ANSWER>>D
A patients declining cardiac status has been attributed to decreased cardiac action
potential. Interventions will be aimed at restoring what aspect of cardiac physiology?
A) The cycle of depolarization and repolarization
B) The time it takes from the firing of the SA node to the contraction of the ventricles
C) The time between the contraction of the atria and the contraction of the ventricles
D) The cycle of the firing of the AV node and the contraction of the myocardium -
<<ANSWER>>A
A patient has been scheduled for cardiovascular computed tomography (CT) with
contrast. To prepare the patient for this test, what action should the nurse perform?
A) Keep the patient NPO for at least 6 hours prior to the test.
B) Establish peripheral IV access.
C) Limit the patients activity for 2 hours before the test.
D) Teach the patient to perform incentive spirometry. - <<ANSWER>>B
The student nurse is preparing a teaching plan for a patient being discharged status
post MI. What should the student include in the teaching plan? (Mark all that apply.)
A) Need for careful monitoring for cardiac symptoms
B) Need for carefully regulated exercise
C) Need for dietary modifications
D) Need for early resumption of prediagnosis activity
E) Need for increased fluid intake - <<ANSWER>>A, B, C
The nurse is caring for a patient who is undergoing an exercise stress test. Prior to
reaching the target heart rate, the patient develops chest pain. What is the nurses most
appropriate response?
A) Administer sublingual nitroglycerin to allow the patient to finish the test.
B) Initiate cardiopulmonary resuscitation.
C) Administer analgesia and slow the test.
D) Stop the test and monitor the patient closely. - <<ANSWER>>D
,What is the normal cardiac output (CO) in an adult? - <<ANSWER>>4-6L/min
What is the difference between cardiac output and stroke volume? -
<<ANSWER>>Cardiac output measure amount of blood ejected per MINUTE, stroke
volume measures amount of blood ejected per BEAT
Which hemodynamic parameter best reflects the effectiveness of drugs that the nurse
gives to reduce a patient's left ventricular afterload?
a. Mean arterial pressure (MAP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP) - <<ANSWER>>ANS: B
SVR reflects the resistance to ventricular ejection, or afterload. The other parameters
may be monitored but do not reflect afterload as directly.
DIF: Cognitive Level: Apply (application)
After surgery for an abdominal aortic aneurysm, a patient's central venous pressure
(CVP) monitor indicates low pressures. Which action should the nurse take?
a. Administer IV diuretic medications.
b. Increase the IV fluid infusion per protocol.
c. Increase the infusion rate of IV vasodilators.
d. Elevate the head of the patient's bed to 45 degrees. - <<ANSWER>>ANS: B
A low CVP indicates hypovolemia and a need for an increase in the infusion rate.
Diuretic administration will contribute to hypovolemia and elevation of the head or
increasing vasodilators may decrease cerebral perfusion.
DIF: Cognitive Level: Apply (application)
When caring for a patient with pulmonary hypertension, which parameter will the nurse
use to directly evaluate the effectiveness of the treatment?
a. Central venous pressure (CVP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP) - <<ANSWER>>ANS: C
PVR is a major contributor to pulmonary hypertension, and a decrease would indicate
that pulmonary hypertension was improving. The other parameters may also be
monitored but do not directly assess for pulmonary hypertension.
DIF: Cognitive Level: Apply (application)
, The intensive care unit (ICU) nurse educator determines that teaching a new staff nurse
about arterial pressure monitoring has been effective when the nurse
a. balances and calibrates the monitoring equipment every 2 hours.
b. positions the zero-reference stopcock line level with the phlebostatic axis.
c. ensures that the patient is supine with the head of the bed flat for all readings.
d. rechecks the location of the phlebostatic axis with changes in the patient's position. -
<<ANSWER>>ANS: B
For accurate measurement of pressures, the zero-reference level should be at the
phlebostatic axis. There is no need to rebalance and recalibrate monitoring equipment
every 2 hours. Accurate hemodynamic readings are possible with the patient's head
raised to 45 degrees or in the prone position. The anatomic position of the phlebostatic
axis does not change when patients are repositioned.
DIF: Cognitive Level: Apply (application)
When monitoring the effectiveness of treatment for a patient with a large anterior wall
myocardial infarction, the most pertinent measurement for the nurse to obtain is
a. central venous pressure (CVP).
b. systemic vascular resistance (SVR).
c. pulmonary vascular resistance (PVR).
d. pulmonary artery wedge pressure (PAWP). - <<ANSWER>>ANS: D
PAWP reflects left ventricular end diastolic pressure (or left ventricular preload) and is a
sensitive indicator of cardiac function. Because the patient is high risk for left ventricular
failure, the PAWP must be monitored. An increase will indicate left ventricular failure.
The other values would also provide useful information, but the most definitive
measurement of changes in cardiac function is the PAWP.
DIF: Cognitive Level: Apply (application)
Which action should the nurse take when the low pressure alarm sounds for a patient
who has an arterial line in the left radial artery?
a. Fast flush the arterial line.
b. Check the left hand for pallor.
c. Assess for cardiac dysrhythmias.
d. Re-zero the monitoring equipment. - <<ANSWER>>ANS: C
The low pressure alarm indicates a drop in the patient's blood pressure, which may be
caused by cardiac dysrhythmias. There is no indication to re-zero the equipment. Pallor
of the left hand would be caused by occlusion of the radial artery by the arterial
catheter, not by low pressure. There is no indication of a need for flushing the line.
DIF: Cognitive Level: Apply (application)
Which nursing action is needed when preparing to assist with the insertion of a
pulmonary artery catheter?
a. Determine if the cardiac troponin level is elevated.
b. Auscultate heart sounds before and during insertion.
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