Clinical Practice in Critical Care Study Guide Questions
Course Introduction
This course offers an in-depth exploration of clinical practice within critical care settings, focusing on the management of critically ill patients. Students will develop advanced assessment, diagnostic, and intervention skills needed to provide optimal care in intensive care units. Emphasis is placed on collaborative decision-making, multidisciplinary care strategies, use of life-support technologies, and the ethical considerations unique to critical care environments. Through case studies, simulations, and supervised clinical experiences, students integrate theoretical knowledge with hands-on practice, preparing them to respond effectively to complex and rapidly evolving patient needs.
Recommended Textbook
Introduction to Critical Care Nursing 7th Edition by Sole
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21 Chapters
757 Verified Questions
757 Flashcards
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Chapter 1: Overview of Critical Care Nursing
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/10613
Sample Questions
Q1) The main purpose of certification is to
A) assure the consumer that you will not make a mistake.
B) prepare for graduate school.
C) promote magnet status for your facility.
D) validate knowledge of critical care nursing.
Answer: D
Q2) You are caring for a critically ill patient whose urine output has been low for 2 consecutive hours.After a thorough patient assessment,you call the intensivist with report.Which information do you convey regarding background?
A) Urine output of 40 mL/2 hours
B) Current vital signs and history of aortic aneurysm repair 4 hours ago
C) A statement that the patient is possibly hypovolemic
D) A request for IV fluids
Answer: B
Q3) The most important outcome of effective communication is to
A) demonstrate caring practices to family members.
B) ensure that patient teaching is done.
C) meet the diversity needs of patients.
D) reduce patient errors.
Answer: D
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Chapter 2: Patient and Family Response to the Critical Care Experience
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28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/10614
Sample Questions
Q1) Open visitation policies are expected by many professional organizations.Which statement reflects adherence to current recommendations?
A) Allow animals on the unit; however, these can only be "therapy" animals through the hospital's pet therapy program.
B) Allow family visitation throughout the day except at change of shift and during rounds.
C) Determine, in collaboration with the patient and family, who can visit and when.Facilitate open visitation policies.
D) Permit open visitation by adults 18 years of age and older; limit visits of children to 1 hour.
Answer: C
Q2) Which intervention is appropriate to assist the patient in coping 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 who has been declared brain dead.The patient is considered a potential organ donor.To proceed with donation,the nurse understands that
A) a signed donor card mandates that organs be retrieved in the event of brain death.
B) after brain death has been determined, perfusion and oxygenation of organs is maintained until organs can be removed in the operating room.
C) the health care proxy does not need to give consent for the retrieval of organs.
D) once a patient has been established as brain dead, life support is withdrawn and organs are retrieved.
Answer: B
Q2) Ideally,an advance directive should be developed by the A) family if the patient is in critical condition.
B) patient as part of the hospital admission process.
C) patient before hospitalization.
D) patient's health care surrogate.
Answer: C
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5
Chapter 4: End-of-Life Care and Palliative Care in Critical Care Settings
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) The family is considering the withdrawal of life-sustaining measures from the patient.The nurse knows that ethical principles for withholding or withdrawing life-sustaining treatments include which of the following?
A) Any treatment may be withdrawn and withheld, including nutrition, antibiotics, and blood products.
B) Doses of analgesic and anxiolytic medications must be adjusted carefully and should not exceed usual recommended limits.
C) Life-sustaining treatments may be withdrawn while a patient is receiving paralytic agents.
D) The goal of withdrawal and withholding of treatments is to hasten death and thus relieve suffering.
Q2) Palliation may include (Select all that apply.)
A) relieving pain.
B) relieving nausea.
C) psychological support.
D) withdrawing life-support interventions.
E) withholding tube feedings.
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6
Chapter 5: Comfort and Sedation
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33 Verified Questions
33 Flashcards
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Sample Questions
Q1) The best way to monitor agitation and effectiveness of treating it in the critically ill patient is to use a/the:
A) Confusion Assessment Method (CAM-ICU).
B) FACES assessment tool.
C) Glasgow Coma Scale.
D) Richmond Agitation Sedation Scale.
Q2) 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.
Q3) Both the electroencephalogram (EEG)monitor and the Bispectral Index Score (BIS)or Patient State Index (PSI)analyzer monitors are used to assess patient sedation levels in critically ill patients.The BIS and PSI monitors are simpler to use because they A) can be used only on heavily sedated patients.
B) can be used only on pediatric patients.
C) provide raw EEG data and a numeric value.
D) require only five leads.
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Chapter 6: Nutritional Support
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/10618
Sample Questions
Q1) Objective data designating that the nutrition goals are not being met include
A) hyperglycemia, normovolemia, and increased protein level.
B) overhydration, hypoglycemia, and weight gain.
C) weight gain, inconsistent glucose, and normovolemia.
D) weight loss, elevated glucose, and dehydration.
Q2) A patient is being ventilated and has been started on enteral feedings with a nasogastric small-bore feeding tube.What is the primary reason the nurse must frequently assess tube placement?
A) To assess for paralytic ileus
B) To maintain the patency of the feeding tube
C) To monitor for skin breakdown on the nose
D) To prevent aspiration of the feedings
Q3) An important nutritional consideration in the elderly population is
A) a decrease in protein requirements.
B) an increase in caloric requirements with age.
C) the potential for drug-nutrient interaction related to polypharmacy.
D) the presence of other diseases that decrease caloric needs.
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Chapter 7: Dysrhythmia Interpretation and Management
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59 Verified Questions
59 Flashcards
Source URL: https://quizplus.com/quiz/10619
Sample Questions
Q1) The nurse understands that in a third-degree AV block
A) every P wave is conducted to the ventricles.
B) some P waves are conducted to the ventricles.
C) none of the P waves are conducted to the ventricles.
D) the PR interval is prolonged.
Q2) The patient's heart rate is 165 beats per minute.The cardiac monitor shows a rapid rate with narrow QRS complexes.The P waves cannot be seen,but the rhythm is regular.The patient's blood pressure has dropped from 124/62 mm Hg to 78/30 mm Hg.The patient's skin is cold and diaphoretic,and the patient is complaining of nausea.The nurse prepares the patient for
A) administration of beta blockers.
B) administration of atropine.
C) transcutaneous pacemaker insertion.
D) emergent cardioversion.
Q3) Which of the following is true about a patient diagnosed with sinus arrhythmia?
A) The heart rate varies, dependent on vagal tone and respiratory pattern.
B) Immediate treatment is essential to prevent death.
C) Sinus arrhythmia is not well tolerated by most patients.
D) PR and QRS interval measurements are prolonged.
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Page 9
Chapter 8: Hemodynamic Monitoring
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10620
Sample Questions
Q1) The nurse is caring for a patient with a left radial arterial line and a pulmonary artery catheter inserted into the right subclavian vein.Which action by the nurse best ensures the safety of the patient being monitored with invasive hemodynamic monitoring lines?
A) Document all waveform values.
B) Limit the pressure tubing length.
C) Zero reference the system daily.
D) Ensure alarm limits are turned on.
Q2) When performing an initial pulmonary artery occlusion pressure (PAOP),what are the best nursing actions? (Select all that apply.)
A) Inflate the balloon for no more than 8 to 10 seconds while noting the waveform change.
B) Inflate the balloon with air, recording the volume necessary to obtain a reading.
C) Maintain the balloon in the inflated position for 8 hours following insertion.
D) Zero reference and level the air-fluid interface of the transducer at the level of the phlebostatic axis.
E) Inflate and deflate the balloon on an hourly schedule
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Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/10621
Sample Questions
Q1) Select all of the factors that may predispose the patient to respiratory acidosis.(Select all that apply.)
A) Anxiety and fear
B) Central nervous system depression
C) Diabetic ketoacidosis
D) Nasogastric suctioning
E) Overdose of sedatives
Q2) When assessing the patient for hypoxemia,the nurse recognizes that an early sign of the effect of hypoxemia on the cardiovascular system is A) heart block.
B) restlessness.
C) tachycardia.
D) tachypnea.
Q3) A PaCO<sub>2 </sub>of 48 mm Hg is associated with A) hyperventilation.
B) hypoventilation.
C) increased absorption of O<sub>2</sub>.
D) increased excretion of HCO<sub>3</sub>.
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Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/10622
Sample Questions
Q1) Which code drugs can be given safely through an endotracheal tube? (Select all that apply)
A) Adenosine
B) Atropine
C) Epinephrine
D) Vasopressin
E) Amiodarone
Q2) The patient has a transcutaneous pacemaker in place.Pacemaker spikes followed by QRS complexes are noted on the cardiac rhythm strip.To determine if the pacemaker is working,the nurse must do which of the following?
A) Obtain a 12-lead electrocardiogram (ECG).
B) Call for a pacemaker interrogation.
C) Palpate the pulse.
D) Run a 2-minute monitor strip for analysis.
Q3) The nurse needs to evaluate arterial blood gases before the administration of which drug?
A) Calcium chloride
B) Magnesium sulfate
C) Potassium
D) Sodium bicarbonate
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Chapter 11: Organ Donation
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10623
Sample Questions
Q1) The nurse assesses morning lab results for a postoperative day 1 liver transplant recipient.Lab results noted by the nurse include aspartate transaminase (AST)365 U/L; alanine aminotransferase (ALT)400 U/L; and serum glucose of 85 mg/dL.What is the best action by the nurse?
A) Notify the provider of liver enzyme results.
B) Treat hypoglycemia with 50 mL 5% dextrose.
C) Repeat the liver enzyme results in 4 hours.
D) Prepare to administer IV insulin infusion.
Q2) The nurse obtains initial vital signs on a patient 2 weeks post-liver transplant who presents for follow-up monitoring to the outpatient transplant clinic.Which assessment finding by the nurse requires immediate action?
A) Blood pressure of 100/60 mm Hg
B) Serum creatinine of 1.5 mg/dL
C) Hemoglobin of 9.2 gm/dL
D) Tenderness over graft site
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13
Chapter 12: Shock,Sepsis,and Multiple Organ Dysfunction Syndrome
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/10624
Sample Questions
Q1) A patient is admitted to the cardiac care unit with an acute anterior myocardial infarction.The nurse assesses the patient to be diaphoretic and tachypneic,with bilateral crackles throughout both lung fields.Following insertion of a pulmonary artery catheter by the physician,which hemodynamic values is the nurse most likely to assess?
A) High pulmonary artery diastolic pressure and low cardiac output
B) Low pulmonary artery occlusive pressure and low cardiac output
C) Low systemic vascular resistance and high cardiac output
D) Normal cardiac output and low systemic vascular resistance
Q2) The nurse is starting to administer a unit of packed red blood cells (PRBCs)to a patient admitted in hypovolemic shock secondary to hemorrhage.Vital signs include blood pressure 60/40 mm Hg,heart rate 150 beats/min,respirations 42 breaths/min,and temperature 100.6° F.What is the best action by the nurse?
A) Administer blood transfusion over at least 4 hours.
B) Notify the physician of the elevated temperature.
C) Titrate rate of blood administration to patient response.
D) Notify the physician of the patient's heart rate.
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Chapter 13: Cardiovascular Alterations
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37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/10625
Sample Questions
Q1) While instructing a patient on what occurs with a myocardial infarction,the nurse plans to explain which process?
A) Coronary artery spasm.
B) Decreased blood flow ( ischemia ).
C) Death of cardiac muscle from lack of oxygen ( tissue necrosis ).
D) Sporadic decrease in oxygen to the heart ( transient oxygen imbalance ).
Q2) A patient has elevated blood lipids.The nurse anticipates which classification of drugs to be prescribed for the patient?
A) Bile acid resins
B) Nicotinic acid
C) Nitroglycerin
D) Statins
Q3) A patient has been prescribed nitroglycerin (NTG)in the ED for chest pain.In taking the health history,the nurse will be sure to verify whether the patient has taken medications before admission for:
A) erectile dysfunction.
B) prostate enlargement.
C) asthma.
D) peripheral vascular disease.
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Page 15
Chapter 14: Nervous System Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10626
Sample Questions
Q1) The provider prescribes fosphenytoin,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 the drug over 10 minutes.
C) Mix medication with 0.9% normal saline.
D) Administer via central line.
Q2) A patient with a head injury has an intracranial pressure (ICP)of 18 mm Hg.The blood pressure is 144/90 mm Hg,and mean arterial pressure (MAP)is 108 mm Hg.What is the cerebral perfusion pressure (CPP)?
A) 54 mm Hg
B) 72 mm Hg
C) 90 mm Hg
D) 126 mm Hg
Q3) Which patient being cared for in the emergency department should the charge nurse evaluate first?
A) A patient with a complete spinal cord 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
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Page 16
Chapter 15: Acute Respiratory Failure
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/10627
Sample Questions
Q1) Which of the following are components of the Institute for Healthcare Improvement's (IHI's)ventilator bundle? (Select all that apply.)
A) Interrupt sedation each day to assess readiness to extubate.
B) Maintain head of bed at least 30 degrees of elevation.
C) Provide deep vein thrombosis prophylaxis.
D) Provide prophylaxis for peptic ulcer disease.
E) Swab the mouth with foam swabs every 2 hours.
Q2) The nurse calculates the PaO<sub>2</sub>/FiO<sub>2</sub> ratio for the following values: PaO<sub>2</sub> is 78 mm Hg; FiO<sub>2</sub> is 0.6 (60%).
A) 46.8; meets criteria for ARDS
B) 130; meets criteria for ARDS
C) 468; normal lung function
D) Not enough data to compute the ratio
Q3) A definitive diagnosis of pulmonary embolism can be made by A) arterial blood gas (ABG) analysis.
B) chest x-ray examination.
C) pulmonary angiogram.
D) ventilation-perfusion scanning.
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Chapter 16: Acute Kidney Injury
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50 Verified Questions
50 Flashcards
Source URL: https://quizplus.com/quiz/10628
Sample Questions
Q1) The patient is on intake and output (I&O),as well as daily weights.The nurse notes that output is considerably less than intake over the last shift,and daily weight is 1 kg more than yesterday.The nurse should
A) draw a trough level after the next dose of antibiotic.
B) obtain an order to place the patient on fluid restriction.
C) assess the patient's lungs.
D) insert an indwelling catheter.
Q2) The nurse is caring for a patient who has sustained blunt trauma to the left flank area,and is evaluating the patient's urinalysis results.The nurse should become concerned when
A) creatinine levels in the urine are similar to blood levels of creatinine.
B) sodium and chloride are found in the urine.
C) urine uric acid levels have the same values as serum levels.
D) red blood cells and albumin are found in the urine.
Q3) The patient's serum creatinine level is 0.7 mg/dL.The expected BUN level should be
A) 1 to 2 mg/dL.
B) 7 to 14 mg/dL.
C) 10 to 20 mg/dL.
D) 20 to 30 mg/dL.
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Page 18
Chapter 17: Hematological and Immune Disorders
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56 Verified Questions
56 Flashcards
Source URL: https://quizplus.com/quiz/10629
Sample Questions
Q1) Desired patient outcomes for immunocompromised patient related to medical and nursing interventions include absence of infection,negative cultures,and an absolute neutrophil count of
A) less than 500 cells/microliter.
B) 500 to 1000 cells/microliter.
C) 1000 to 1500 cells/microliter.
D) 1500 cells/microliter or higher.
Q2) The patient's platelet count is 35,000/microliter.The provider prescribes administration of 10 units of single-donor platelets.After transfusion,the nurse can expect the patient's platelet count to be
A) between 85,000/microliter and 135,000/microliter.
B) between 50,000/microliter and 75,000/microliter.
C) greater than 150,000/microliter.
D) between 150,000/microliter and 185,000/microliter.
Q3) Lymphocytes are made up of B cells and T cells.B cells
A) mature in lymphoid tissue.
B) mediate humoral immunity.
C) migrate to the thymus gland.
D) destroy virus-infected cells.
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Page 19
Chapter 18: Gastrointestinal Alterations
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/10630
Sample Questions
Q1) The nurse is caring for a patient with a heart rate of 140 beats/min.The provider orders parasympathetic medications to slow down the heart rate.With this type of medication,the nurse should
A) evaluate the patient for symptoms of constipation.
B) observe for diarrhea.
C) assess mucous membranes for signs of dryness.
D) expect decreased bowel sounds.
Q2) The nurse is to assist the provider in performing bedside endoscopy on a patient.To prevent respiratory complications,the nurse places the patient
A) supine in Trendelenburg position.
B) in a left lateral reverse Trendelenburg position.
C) flat with the feet elevated.
D) in a semi-Fowler's position.
Q3) The nurse is assessing a patient who is admitted with abdominal pain.To detect abdominal masses,the nurse
A) observes for skin pigmentation and discolorations.
B) looks for pulsations originating from the vena cava.
C) has the patient take a deep breath.
D) watches for signs of pain and distension.
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Page 20
Chapter 19: Endocrine Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10631
Sample Questions
Q1) Which of the following are appropriate nursing interventions for the patient in myxedema coma? (Select all that apply.)
A) Administer levothyroxine as prescribed.
B) Encourage the intake of foods high in sodium.
C) Initiate passive rewarming interventions.
D) Monitor airway and respiratory effort.
E) Monitor urine osmolality.
Q2) The nurse is assigned to care for a patient who presented to the emergency department with diabetic ketoacidosis.A continuous insulin intravenous infusion is started,and hourly bedside glucose monitoring is ordered.The targeted blood glucose value after the first hour of therapy is
A) 70 to 120 mg/dL.
B) a decrease of 25 to 50 mg/dL compared with admitting values.
C) a decrease of 35 to 90 mg/dL compared with admitting values.
D) less than 200 mg/dL.
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21
Chapter 20: Trauma and Surgical Management
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) Which of the following patients would require greater amounts of fluid resuscitation to prevent acute kidney injury associated with rhabdomyolysis? (Select all that apply.)
A) Crush injury to right arm
B) Gunshot wound to the abdomen
C) Lightning strike of the left arm and chest
D) Pulmonary contusion and rib fracture
E) Penetrating wound to both legs
Q2) The nurse is caring for a patient who sustained rib fractures after hitting the steering wheel of the car during a motor vehicle crash.The patient is spontaneously breathing and receiving oxygen via a face mask; the oxygen saturation is 95%.During the nurse's assessment,the oxygen saturation drops to 80%.The patient's blood pressure has dropped from 128/76 mm Hg to 84/60 mm Hg.The nurse assesses that breath sounds are absent throughout the left lung fields.The nurse notifies the provider and anticipates
A) administration of lactated Ringer's solution (1 L) wide open.
B) chest x-ray study to determine the etiology of the symptoms.
C) endotracheal intubation and mechanical ventilation.
D) needle thoracostomy and chest tube insertion.
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Chapter 21: Burns
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Sample Questions
Q1) The nurse is caring for a patient with burns to the hands,feet,and major joints.The nurse plans care to include which of the following? (Select all that apply.)
A) Applying splints that maintain the extremity in an extended position
B) Implementing passive or active range-of-motion exercises
C) Keeping the limbs as immobile as possible
D) Wrapping fingers and toes individually with bandages
E) Administering muscle relaxants around the clock
Q2) A burn patient in the rehabilitation phase of injury is increasingly anxious and unable to sleep.The nurse should consult with the provider to further assess the patient for A) acute delirium.
B) posttraumatic stress disorder.
C) suicidal intentions.
D) bipolar disorder.
Q3) Silver is used as an ingredient in many burn dressings because it A) stimulates tissue granulation.
B) is effective against a wide spectrum of wound pathogens.
C) provides topical pain relief.
D) stimulates wound healing.
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