Clinical Practicum in Critical Care Exam Solutions
Course Introduction
This course offers hands-on clinical experience in a critical care setting, allowing students to apply theoretical knowledge to the assessment, planning, implementation, and evaluation of care for critically ill patients. Emphasizing interdisciplinary collaboration, students will develop advanced competencies in monitoring, interventions, and use of specialized equipment under the supervision of experienced clinicians. The practicum focuses on critical thinking, clinical judgment, effective communication, and ethical decision-making in managing complex patient scenarios, preparing participants for a professional role in critical care environments.
Recommended Textbook
Introduction to Critical Care Nursing 6th Edition by Mary Lou Sole
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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
Source URL: https://quizplus.com/quiz/39999
Sample Questions
Q1) 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 the following report.Dr.Smith,I'm calling about Mrs.P.,your 65-year-old patient in CCU 10.Her urine output for the past 2 hours totaled only 40 mL.She arrived from surgery to repair an aortic aneurysm 4 hours ago and remains on mechanical ventilation.In the past 2 hours,her heart rate has increased from 80 to 100 beats per minute and her blood pressure has decreased from 128/82 to 100/70 mm Hg.She is being given an infusion of normal saline at 100 mL per hour.Her right atrial pressure through the subclavian central line is low at 3 mm Hg.Her urine is concentrated.Her BUN and creatinine levels have been stable and in normal range.Her abdominal dressing is dry with no indication of bleeding.My assessment suggests that Mrs.P.is hypovolemic and I would like you to consider increasing her fluids or giving her a fluid challenge.Using the SBAR model for communication,the information the nurse gives about the patient's history and vital signs is:
A) Situation
B) Background
C) Assessment
D) Recommendation
Answer: B
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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/40000
Sample Questions
Q1) Which intervention about visitation in the critical care unit is true?
A) The majority of critical care nurses implement restricted visiting hours to allow the patient to rest.
B) Children should never be permitted to visit a critically ill family member.
C) Visitation that is individualized to the needs of patients and family members is ideal.
D) Visiting hours should always be unrestricted.
Answer: C
Q2) Sleep often is disrupted for critically ill patients.Which nursing intervention is most appropriate to promote sleep and rest?
A) Consult with the pharmacist to adjust medication times to allow periods of sleep or rest between intervals.
B) Encourage family members to talk with the patient whenever they are present in the room.
C) Keep the television on to provide "white" noise and distraction.
D) Leave the lights on in the room so that the patient is not frightened of his or her surroundings.
Answer: A
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4
Chapter 3: Ethical and Legal Issues in Critical Care Nursing
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23 Verified Questions
23 Flashcards
Source URL: https://quizplus.com/quiz/40001
Sample Questions
Q1) The critical care nurse wants a better understanding of when to initiate an ethics consult.After attending an educational program,she understands that the following situation would require an ethics consultation:
A) Conflict has occurred between the physician and family regarding treatment decisions. A family conference is held, and the family and physician agree to a treatment plan that includes aggressive treatment for 24 hours followed by re-evaluation.
B) Family members disagree as to a patient's course of treatment. The patient has designated a healthcare proxy and has a written advance directive.
C) Patient postoperative coronary artery bypass surgery who sustained a cardiopulmonary arrest in the operating room. He was successfully resuscitated, but now is not responding to treatment. He has a written advance directive and his wife is present.
D) Patient with multiple trauma and is not responding to treatment. No family members are known, and care is considered futile.
Answer: D
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Chapter 4: End-Of-Life Care in the Critical Care Unit
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/40002
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) Which of the following statements about comfort care is accurate?
A) Withholding and withdrawing life-sustaining treatment are distinctly different in the eyes of the legal community.
B) Each procedure should be evaluated for its effect on the patient's comfort before being implemented.
C) Only the patient can determine what constitutes comfort care for him or her.
D) Withdrawing life-sustaining treatments is considered euthanasia in most states.
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6
Chapter 5: Comfort and Sedation
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33 Verified Questions
33 Flashcards
Source URL: https://quizplus.com/quiz/40003
Sample Questions
Q1) The assessment of pain and anxiety is a continuous process.When critically ill patients exhibit signs of anxiety,the nurse's first priority is to:
A) administer antianxiety medications as ordered.
B) administer pain medication as ordered.
C) identify and treat the underlying cause.
D) reassess the patient hourly to determine whether symptoms resolve on their own.
Q2) The patient is receiving neuromuscular blockade.Which nursing assessment indicates a target level of paralysis?
A) Glasgow Coma Scale score of 3
B) Train-of-four yields two twitches
C) Bispectral index of 60
D) CAM-ICU positive
Q3) The nurse is concerned that the patient will pull out the endotracheal tube.As part of the nursing management,the nurse obtains an order for:
A) a Posey-type vest.
B) a higher dosage of lorazepam.
C) propofol.
D) soft wrist restraints.
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Chapter 6: Nutritional Support
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/40004
Sample Questions
Q1) Which statement is true about normal function of the gastrointestinal (GI)tract?
A) Failure of the tight junctions allows bacteria to invade the GI tract.
B) The gut lacks protective mechanisms; thus, infection is always a concern.
C) Water is reabsorbed at the beginning of the colon.
D) Without nutritional stimulation, mucosal villi atrophy.
Q2) A patient's feeding tube has been successfully placed in the small intestine with continuous flow tube feeding.The nurse knows that this approach was chosen because:
A) intermittent feedings cause increased nausea and vomiting.
B) the increased filling of the stomach increases absorption.
C) the intestinal mucosa normally receives nutrients from the stomach in peristaltic waves.
D) this will prevent malabsorption syndrome.
Q3) A patient who is receiving continuous enteral feedings has just vomited 250 mL of milky green fluid.This is a concern because this most likely demonstrates that the patient has:
A) a bowel obstruction.
B) developed an ileus.
C) gastrointestinal bleeding.
D) tube feeding intolerance.
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Page 8
Chapter 7: Dysrhythmia Interpretation and Management
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59 Verified Questions
59 Flashcards
Source URL: https://quizplus.com/quiz/40005
Sample Questions
Q1) The nurse is talking with the patient when the monitor alarms and shows a wavy baseline without a PQRST complex.The nurse should:
A) defibrillate the patient immediately.
B) initiate basic life support.
C) initiate advanced life support.
D) assess the patient and the electrical leads.
Q2) The nurse is examining the patient's cardiac rhythm strip in lead II and notices that all of the P waves are upright and look the same except one that has a different shape and is inverted.The nurse realizes that the P wave with the abnormal shape is probably:
A) from the SA node since all P waves come from the SA node.
B) from some area in the atria other than the SA node.
C) indicative of ventricular depolarization.
D) normal even though it is inverted in lead II.
Q3) 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.
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Chapter 8: Hemodynamic Monitoring
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40006
Sample Questions
Q1) The nurse is caring for a patient following insertion of a left subclavian central venous catheter ( CVC ).Which assessment finding 2 hours after insertion by the nurse warrants immediate action?
A) Diminished breath sounds over left lung field
B) Localized pain at catheter insertion site
C) Measured central venous pressure of 5 mm Hg
D) Slight bloody drainage around insertion site
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.
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Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/40007
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) A patient presents to the emergency department demonstrating agitation and complaining of numbness and tingling in his fingers.His arterial blood gas levels reveal the following: pH 7.51,PaCO<sub>2</sub> 25,HCO<sub>3</sub> 25.The nurse interprets these blood gas values as:
A) compensated metabolic alkalosis.
B) normal values.
C) uncompensated respiratory acidosis.
D) uncompensated respiratory alkalosis.
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Page 11
Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40008
Sample Questions
Q1) A patient has been successfully converted from ventricular tachycardia with a pulse to a sinus rhythm.Upon further assessment,it is noted that she is hypotensive.The appropriate treatment for her hypotension may include: (Select all that apply.)
A) adenosine.
B) dopamine infusion.
C) magnesium.
D) normal saline infusion.
E) sodium bicarbonate.
Q2) The patient is diagnosed with abrupt onset of supraventricular tachycardia (SVT).The nurse prepares which medication that has a short half-life and is recommended to treat symptomatic SVT?
A) Adenosine
B) Amiodarone
C) Diltiazem
D) Procainamide
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12
Chapter 11: Shock, sepsis, and Multiple Organ Dysfunction Syndrome
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/40009
Sample Questions
Q1) A patient is admitted after collapsing at the end of a summer marathon.She is lethargic,with a heart rate of 110 beats/min,respiratory rate of 30 breaths/min,and a blood pressure of 78/46 mm Hg.The nurse anticipates administering which therapeutic intervention?
A) Human albumin infusion
B) Hypotonic saline solution
C) Lactated Ringer's bolus
D) Packed red blood cells
Q2) The emergency department nurse admits a patient following a motor vehicle collision.Vital signs include blood pressure 70/50 mm Hg,heart rate 140 beats/min,respiratory rate 36 breaths/min,temperature 101° F and oxygen saturation (SpO<sub>2</sub>)95% on 3 L of oxygen per nasal cannula.Laboratory results include hemoglobin 6.0 g/dL,hematocrit 20%,and potassium 4.0 mEq/L.Based on this assessment,what is most important for the nurse to include in the patient's plan of care?
A) Insertion of an 18-gauge peripheral intravenous line
B) Application of cushioned heel protectors
C) Implementation of fall precautions
D) Implementation of universal precautions
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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 was admitted in terminal heart failure and is not eligible for transplant.The family wants everything possible done to maintain life.Which procedure might be offered to the patient for this condition to increase the patient's quality of life?
A) Intraaortic balloon pump ( IABP )
B) Left ventricular assist device ( LVAD )
C) Nothing, because the patient is in terminal heart failure
D) Nothing additional; medical management is the only option
Q2) The patient is admitted with an acute myocardial infarction (AMI).Three days later the nurse is concerned that the patient may have a papillary muscle rupture.Which assessment data may indicate a papillary muscle rupture?
A) Gallop rhythm
B) Murmur
C) S1 heart sound
D) S3 heart sound
Q3) An essential aspect of teaching that may prevent recurrence of heart failure is:
A) notifying the physician if a 2-lb weight gain occurs in 24 hours.
B) compliance with diuretic therapy.
C) taking nitroglycerin if chest pain occurs.
D) assessment of an apical pulse.
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Page 14
Chapter 13: Nervous System Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40011
Sample Questions
Q1) The nurse is preparing to administer a routine dose of phenytoin (Dilantin).The physician orders phenytoin (Dilantin)500 mg intravenous every 6 hours.What is the best action by the nurse?
A) Administer over 2 minutes.
B) Administer with 0.9% normal saline intravenous.
C) Contact the physician.
D) Assess cardiac rhythm.
Q2) The nurse is preparing to administer 100 mg of phenytoin (Dilantin)to a patient in status epilepticus.To prevent patient complications,what is the best action by the nurse?
A) Ensure patency of intravenous (IV) line.
B) Mix drug with 0.9% normal saline.
C) Evaluate serum K+ level.
D) Obtain an IV infusion pump.
Q3) 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
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Page 15
Chapter 14: Acute Respiratory Failure
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/40012
Sample Questions
Q1) The nurse is discharging a patient with asthma.As part of the discharge instruction,the nurse instructs the patient to prevent exacerbation by:
A) obtaining an appointment for follow-up pulmonary function studies 1 week after discharge.
B) limiting activity until patient is able to climb two flights of stairs.
C) taking all asthma medications as prescribed.
D) taking medications on a "prn" basis according to symptoms.
Q2) The nurse is caring for a patient in acute respiratory failure and understands that the patient should be positioned: (Select all that apply.)
A) high Fowler's.
B) side lying with head of bed elevated.
C) sitting in a chair.
D) supine with the bed flat.
Q3) A strategy for preventing thromboembolism in patients at risk who cannot take anticoagulants is:
A) administration of two aspirin tablets every 4 hours.
B) infusion of thrombolytics.
C) insertion of a vena cava filter.
D) subcutaneous heparin administration every 12 hours.
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Page 16
Chapter 15: Acute Kidney Injury
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50 Verified Questions
50 Flashcards
Source URL: https://quizplus.com/quiz/40013
Sample Questions
Q1) The patient has elevated blood urea nitrogen (BUN)and serum creatinine levels with a normal BUN/creatinine ratio.These levels most likely indicate:
A) increased nitrogen intake.
B) acute kidney injury, such as acute tubular necrosis (ATN).
C) hypovolemia.
D) fluid resuscitation.
Q2) 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.
Q3) An advantage of peritoneal dialysis is that:
A) peritoneal dialysis is time intensive.
B) a decreased risk of peritonitis exists.
C) biochemical disturbances are corrected rapidly.
D) the danger of hemorrhage is minimal.
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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 nurse is evaluating the patient's laboratory values and notes an IgG level of 240 mg/dL.The nurse realizes that this patient is a candidate for:
A) no change in therapy because the level is normal.
B) an immunoglobulin infusion.
C) gene replacement therapy.
D) increased doses of immunosuppressive medications.
Q2) In vivo,the primary activator of the coagulation cascade occurs via the:
A) intrinsic pathway.
B) extrinsic pathway.
C) common pathway.
D) either intrinsic or extrinsic pathway.
Q3) Exudate formation at the inflammatory site functions to: (Select all that apply.)
A) opsonize bacteria.
B) dilute toxins.
C) deliver proteins.
D) attach to the target cell.
E) carry away toxins.
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18
Chapter 17: Gastrointestinal Alterations
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/40015
Sample Questions
Q1) The patient is admitted for GI bleeding,but the source is not known.Before ordering endoscopy,the provider orders Sandostatin (octreotide)to be given intravenously.The purpose of this medication is to:
A) increase portal pressure and improve liver function.
B) decrease splanchnic blood flow and portal pressure.
C) vasodilate the splanchnic arteriolar bed.
D) increase blood flow in the liver's collateral circulation.
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.
Q3) The patient is admitted with acute pancreatitis.The nurse should:
A) assess pain level because pancreatic pain is unique in character.
B) examine laboratory values for low amylase levels.
C) expect lipase levels to decrease within 24 hours.
D) evaluate C-reactive protein as a gauge of severity.
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Page 19
Chapter 18: Endocrine Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40016
Sample Questions
Q1) The nurse is providing insulin education for an elderly patient with longstanding diabetes.An order has been written for the patient to take 20 units of insulin glargine (Lantus)at 10 PM nightly.The nurse should instruct the patient that the peak of the insulin action for this agent is:
A) 0200.
B) 0400.
C) 0800.
D) peakless.
Q2) A patient presents to the emergency department with suspected thyroid storm.The nurse should be alert to which of the following cardiac rhythms while providing care to this patient?
A) Atrial fibrillation
B) Idioventricular rhythm
C) Junctional rhythm
D) Sinus bradycardia
Q3) Acute adrenal crisis is caused by:
A) acute renal failure.
B) deficiency of corticosteroids.
C) high doses of corticosteroids.
D) overdose of testosterone.
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Chapter 19: Trauma and Surgical Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40017
Sample Questions
Q1) Treatment and/or prevention of rhabdomyolysis in at-risk patients includes aggressive fluid resuscitation to achieve urine output of:
A) 30 mL/hr.
B) 50 mL/hr.
C) 100 mL/hr.
D) 300 mL/hr.
Q2) Which of the following patients have the greatest risk of developing acute respiratory distress syndrome (ARDS)after traumatic injury?
A) A patient who has a closed head injury with a decreased level of consciousness
B) A patient who has a fractured femur and is currently in traction
C) A patient who has received large volumes of fluid and/or blood replacement
D) A patient who has underlying chronic obstructive pulmonary disease
Q3) A near-infrared spectroscopy (NIRS)probe is placed in a trauma patient during the resuscitation phase to:
A) assess severity of metabolic acidosis.
B) determine intraperitoneal bleeding.
C) determine tissue oxygenation.
D) prevent complications of over-resuscitation.
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21
Chapter 20: Burns
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40018
Sample Questions
Q1) Which of the following factors increase the burn patient's risk for venous thromboembolism? (Select all that apply.)
A) Burn injury less than 10%
B) Bedrest
C) Burns to lower extremities
D) Electrical burn injury
E) Delayed fluid resuscitation
Q2) The patient asks the nurse if the placement of the autograft over his full-thickness burn will be the only surgical intervention needed to close his wound.The nurse's best response would be:
A) "Unfortunately, an autograft skin is a temporary graft and a second surgery will be needed to close the wound."
B) "An autograft is a biological dressing that will eventually be replaced by your body generating new tissue."
C) "Yes, an autograft will transfer your own skin from one area of your body to cover the burn wound."
D) "Unfortunately, autografts frequently do not adhere well to burn wounds and a xenograft will be necessary to close the wound."
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Chapter 21: Solid Organ Transplantation
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40019
Sample Questions
Q1) The nurse is working for a hospital that holds an agreement with a local organ procurement organization (OPO).The patient has a Glasgow Coma Scale (GCS)score of 3 and discussions have been held with the family about withdrawing life support.Which statement by the nurse best describes requirements that must be met to sustain Centers for Medicare and Medicaid Services (CMS)Conditions of Participation?
A) "I need to notify TransLife (OPO) of my patient's impending death."
B) "I will contact the physician to obtain informed consent for organ donation."
C) "The charge nurse will notify TransLife (OPO) once the patient has been pronounced brain dead."
D) "I need the physician to evaluate my patient's suitability for organ donation."
Q2) While following up on a postoperative renal transplant recipient,the nurse discovers that the donor tested positive for cytomegalovirus (CMV).What is the priority action by the nurse?
A) Notify the OPO transplant coordinator.
B) Verify results with the lab technician.
C) Repeat all pre-procedure viral studies.
D) Continue to monitor for signs of rejection.
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Page 23