Intensive Care Nursing Study Guide Questions
Course Introduction
Intensive Care Nursing is designed to equip students with the advanced knowledge and skills required to provide specialized care for critically ill patients in intensive care settings. The course covers a wide range of topics including hemodynamic monitoring, mechanical ventilation, management of life-threatening conditions, and the use of advanced medical technology. Students will learn to assess rapidly changing patient conditions, interpret complex clinical data, and implement evidence-based interventions. Emphasis is placed on interdisciplinary teamwork, ethical considerations, and family-centered care, preparing students to function effectively within high-pressure environments while ensuring the safety and dignity of patients.
Recommended Textbook
Priorities in Critical Care Nursing 7th Edition by Urden
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27 Chapters
761 Verified Questions
761 Flashcards
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Chapter 1: Caring for the Critically Ill Patient
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Sample Questions
Q1) Which of the following units can provide high quality and cost effective care for patients who are less complex, more stable, and have a decreased need for physiologic monitoring could be placed on?
A) intensive care units
B) triage units
C) progressive care units
D) medical surgical units
Answer: C
Q2) A specific therapy or care that is an option to what is considered conventional treatment of a condition is known as
A) Guided Imagery.
B) holistic care.
C) complementary care.
D) individualized care.
Answer: C
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3
Chapter 2: Ethical and Legal Issues
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Sample Questions
Q1) When deciding whether to withdraw or withhold treatment, it is important to
A) examine one's own beliefs to guide the family to a correct decision.
B) approach the family with honesty and provide clear information.
C) simply follow the advance directive if available.
D) allow the physician to approach the family.
Answer: B
Q2) Which of the following ethical principles is most important when soliciting informed consent from a client?
A) Nonmaleficence
B) Fidelity
C) Beneficence
D) Veracity
Answer: D
Q3) Institutional ethics committees (IECs)review ethical cases that are problematic for the practitioner.Major functions of IECs include
A) consultation with purely binding recommendations.
B) support and education to health care providers.
C) conflict resolution for moral dilemmas.
D) recommendations that are binding in all cases.
Answer: B
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Chapter 3: Patient and Family Education
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Sample Questions
Q1) The content and method of presentation in the critical care unit vary because A) of the different admitting diagnoses.
B) of the uniqueness of each patient's clinical and emotional status.
C) all patients are on ventilators and cannot talk.
D) patients are heavily sedated and may not comprehend teaching.
Answer: B
Q2) A patient has been in the ICU for 20 days with a diagnosis of sepsis and acute respiratory distress syndrome.The patient is ready for transfer to the step-down unit but is apprehensive.The patient has communicated to the nurse that he does not want to leave the ICU because he is afraid that his needs will not be met on the step-down unit.Which educational objective would be best to use in this situation?
A) The patient will state two reasons why he is being transferred by the end of the day.
B) The patient will confront his fears and deal with them within 1 day of transfer.
C) The patient will state the name of his "new" nurse by the end of the day.
D) The patient will be introduced to at least two of his "new" caregivers by the time of transfer.
Answer: D
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Page 5
Chapter 4: Psychosocial and Spiritual Alterations and Management
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Sample Questions
Q1) Which of the following techniques may be used to enhance coping?
A) Encouraging the patient to let the staff have total control of the patient's care
B) Encouraging denial of the illness
C) Letting the patient know everything will be all right
D) Fostering trust in the health care team
Q2) A patient has been admitted to the critical care unit with a severed spinal cord injury at the T2 level.The patient has been in halo traction with immobilization for the past week.The physician explains to the patient that the spinal cord has been severed and that the patient will not be able to walk again.The patient becomes overtly hostile to everyone.The patient is demonstrating
A) regression.
B) loss of autonomy.
C) ineffective coping.
D) hope.
Q3) Anxiety can cause emotional changes in the A) hypothalamus.
B) limbic system.
C) cerebral cortex.
D) pituitary gland.
Page 6
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Chapter 5: Sleep Alterations
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Sample Questions
Q1) A sufficient amount of sleep has been achieved when a person awakens
A) after 8 to 10 hours of uninterrupted sleep.
B) with external stimuli and gets through the day without feeling sleepy.
C) without external stimuli and gets through the day without feeling sleepy.
D) feeling rested in the morning and takes a nap in the afternoon.
Q2) The primary determinant in the efficacy of CPAP in patients with OSA is
A) compliance.
B) weight.
C) tonsil size.
D) respiratory effort.
Q3) REM sleep comprises what percent of the sleep cycle?
A) 70% to 75%
B) 45% to 65%
C) 15% to 20%
D) 20% to 25%
Q4) During a sleep study, which of the following groups of information are gathered?
A) Airflow, snoring, and tonsil size
B) Electroencephalogram, electrocardiogram, and end-tidal carbon dioxide
C) Oxygen saturation, number of arousals, and airflow
D) Frequency of awakenings, REM speed, and apnea-hypopnea index
Page 7
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Chapter 6: Nutritional Alterations
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Sample Questions
Q1) A patient with poorly controlled diabetes mellitus is to be started on enteral tube feeding.What type of formula would be most appropriate?
A) Whole proteins and glucose polymers
B) Concentrated in calories
C) Low sodium
D) High fat, low carbohydrate
Q2) A patient is admitted to the critical care unit with severe malnutrition as a result of hepatic failure.A triple-lumen central venous catheter is placed in the right subclavian vein, and TPN is started.For which of the following complications should the patient be evaluated immediately after insertion of the catheter?
A) Pneumothorax
B) Hypoglycemia
C) Central venous thrombosis
D) Pulmonary aspiration
Q3) Obtaining height and weight measurements for the critically ill patient
A) should be deferred until the medical condition stabilizes.
B) should be measured rather than obtained through patient or family report.
C) requires consistent weights in pounds.
D) requires weight, but height can be deferred.
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Page 8
Chapter 7: Gerontological Alterations
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Sample Questions
Q1) Chemical changes in a drug that renders it active or inactive is known as A) absorption.
B) metabolism.
C) excretion.
D) distribution.
Q2) An older patient is started on amitriptyline to control depression.The nurse knows to monitor for (Select all that apply)
A) impaired psychomotor function.
B) irregular heart rate.
C) polyuria.
D) pulmonary edema.
Q3) Which of the following nonsteroidal anti-inflammatory drugs (NSAIDs)has the side effect of renal failure, HTN, heart failure, and GI bleed in the elderly population?
A) Indomethacin
B) Ketorolac
C) Aspirin greater than 325 mg
D) Naproxen
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Chapter 8: Pain and Pain Management
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Sample Questions
Q1) Acute pain usually corresponds to
A) the healing process but should not exceed 9 months.
B) the healing process but should not exceed 6 months.
C) persistent pain more than 6 months after the healing process.
D) damage to the patient's nervous system unrelated to the initial injury.
Q2) The use of PCA infusion pumps allows the patient to
A) act preemptively by administering a bolus of medication when pain begins.
B) choose between the use of opioids or NSAID medication to control pain.
C) decrease the risk of respiratory depression.
D) control pain medication in 2-hour increments.
Q3) Which of the following combinations of drugs has been found to be effective in managing the pain associated with musculoskeletal and soft tissue inflammation?
A) Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids
B) NSAIDs and antidepressants
C) Opioid agonists and opioid antagonists
D) Adjuvants and partial agonists
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Chapter 9: Sedation, Agitation and Delirium Management
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Sample Questions
Q1) Which of the following drugs is used for sedation in patients experiencing withdrawal syndrome?
A) Dexmedetomidine
B) Hydromorphone
C) Diazepam
D) Clonidine
Q2) A patient was admitted into the critical care unit 3 days ago.She has just been weaned from mechanical ventilation.She suddenly becomes confused, seeing nonexistent animals in her room and pulling at her gown.You suspect this patient is
A) experiencing delirium or "ICU psychosis."
B) experiencing confusion caused by increased hypoxia.
C) hypocalcemic.
D) acting out to receive the attention she was getting while intubated.
Q3) Risk factors for delirium include
A) hypertension, alcohol abuse, and benzodiazepine administration.
B) coma, hypoxemia, and trauma.
C) dementia, hypertension, and pneumonia.
D) coma, alcohol abuse, hyperglycemia
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Chapter 10: End of Life Care
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Sample Questions
Q1) A patient was admitted to the critical care unit several weeks ago with an acute myocardial infarction and subsequently underwent coronary artery bypass grafting surgery.Since a cardiac arrest 5 days ago, the patient has been unresponsive.An electroencephalogram shows no meaningful brain activity.After a family conference, the physician orders a DNR order, and palliative care is begun.This means
A) the patient will continue to receive the same aggressive treatment short of resuscitation if he has another cardiac arrest.
B) all treatment will be stopped, and the patient will be allowed to die.
C) all attempts will be made to keep the patient comfortable without prolonging his life.
D) the patient will be immediately transferred to hospice.
Q2) Organ donation
A) is a choice only the patient can make for him- or herself.
B) is mandated by legal and regulatory agencies.
C) must be requested by the nurse caring for the dying patient.
D) is controlled by individual institutional policies.
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Chapter 11: Cardiovascular Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) A nurse palpates the descending aorta and feels a strong, bounding pulse.The nurse reports the findings to the physician because the results suggest
A) decreased cardiac output.
B) increased cardiac output.
C) an aneurysm.
D) aortic insufficiency.
Q2) The nurse assesses the dorsalis pedis and posterior tibial pulses as weak and thready.Indicate the correct documentation for the pulse volume that the nurse would use.
A) 0
B) 1+
C) 2+
D) 3+
Q3) The most common complication of a central venous catheter (CVC)is
A) air embolus.
B) infection.
C) thrombus formation.
D) pneumothorax.
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Chapter 12: Cardiovascular Disorders
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Sample Questions
Q1) A patient is admitted for palliative care for end-stage heart failure.The nurse's primary goal is
A) to reverse heart failure with the use of diuretics.
B) to increase activity tolerance.
C) symptom management and relief of pain.
D) to increase cardiac output related to alteration of contractility.
Q2) Which of the following clinical manifestations are indicative of left ventricular failure?
A) Cool, pale extremities
B) Jugular venous distention
C) Liver tenderness
D) Weak peripheral pulses
E) Rales
Q3) Dyspnea with wheezing, a nonproductive cough, and pulmonary crackles that progress to the gurgling sounds of pulmonary edema is described as A) dyspnea.
B) orthopnea.
C) paroxysmal nocturnal dyspnea.
D) cardiac asthma.
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Chapter 13: Cardiovascular Therapeutic Management
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Sample Questions
Q1) A patient is admitted to the ICU after a positive exercise treadmill test with a diagnosis of CAD and stable angina.Radiographic test show that the patient has blockage in the left main coronary artery and four other vessels.The nurse anticipates that the patient will be scheduled for
A) medical therapy antianginal medications.
B) PCI.
C) TAVR.
D) CABG.
Q2) The possibility of microshock when handling a temporary pacemaker can be minimized by
A) decreasing the milliamperes.
B) wearing gloves.
C) positioning the patient on the left side.
D) wearing rubber-soled shoes.
Q3) The rationale for administration of a fibrinolytic agent is
A) dilation of the blocked coronary artery.
B) anticoagulation to prevent formation of new emboli.
C) dissolution of atherosclerotic plaque at the site of blockage.
D) restoration of blood flow to the obstructed coronary artery via lysis of the thrombus.
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Page 15
Chapter 14: Pulmonary Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) In a patient who is hemodynamically stable, which procedure can be used to estimate the PaCO<sub>2</sub> levels?
A) PaO<sub>2</sub>/FIO<sub>2</sub> ratio
B) A-a gradient
C) Residual volume (RV)
D) End-tidal CO<sub>2</sub>
Q2) On assessment of a client, you note fremitus over the trachea but not in the lung periphery.You know that this most likely represents
A) bilateral pleural effusion.
B) bronchial obstruction.
C) a normal finding.
D) apical pneumothorax.
Q3) Risk factors that need to be considered with a thoracentesis include A) coagulation defects.
B) intra-aortic balloon pump.
C) pleural effusion.
D) uncooperative patient.
E) empyema.
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Chapter 15: Pulmonary Disorders
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Sample Questions
Q1) Aspiration can best be prevented by
A) observing the amount given in the tube feeding.
B) assessing the patient's level of consciousness.
C) encouraging the patient to cough and to breathe deeply.
D) positioning a patient in a semirecumbent position.
Q2) Which of the following diagnostic criteria is indicative of ARDS?
A) Radiologic evidence of bibasilar atelectasis
B) PaO<sub>2</sub>/FiO<sub>2</sub> ratio less than or equal to 200 mm Hg
C) Pulmonary artery wedge pressure greater than 18 mm Hg
D) Increased static and dynamic compliance
Q3) The most common presenting signs and symptoms associated with PEs are
A) tachycardia and tachypnea.
B) hemoptysis and evidence of deep vein thromboses.
C) apprehension and dyspnea.
D) right ventricular failure and fever
Q4) The major hemodynamic consequence of a massive pulmonary embolus is
A) increased systemic vascular resistance leading to left heart failure.
B) pulmonary hypertension leading to right heart failure.
C) portal vein blockage leading to ascites.
D) embolism to the internal carotids leading to a stroke.
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Chapter 16: Pulmonary Therapeutic Management
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Sample Questions
Q1) Patient safety precautions when working with oxygen involve A) observation for signs of oxygen-introduced hyperventilation.
B) restriction of smoking.
C) removal of all oxygen devices when eating to prevent aspiration.
D) administration of oxygen at the nurse's discretion.
Q2) The ventilator variable that causes inspiration is called the A) cycle.
B) trigger.
C) flow.
D) pressure.
Q3) A patient was admitted to the critical care unit with acute respiratory failure.The patient has been on a ventilator for 3 days and is being considered for weaning.The ventilator high-pressure alarm keeps going off.When you enter the room, the ventilator inoperative alarm sounds.All of the following conditions would set off the high-pressure alarm except
A) a leak in the patient's ET tube cuff
B) a kink in the ET tubing
C) coughing
D) increased secretions in the patient's airway
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Page 18
Chapter 17: Neurologic Clinical Assessment and Diagnostic
Procedures
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Sample Questions
Q1) Which of the following patients may need sedation before having an MRI scan?
A) Claustrophobic patient
B) Comatose patient
C) Elderly patient
D) Patient with a spinal cord injury
Q2) The respiratory pattern with rhythmic increase and decrease of rate and depth of respiration, then brief periods of apnea, is known as
A) central neurogenic hyperventilation.
B) apneustic breathing.
C) ataxic respirations.
D) Cheyne-Stokes respirations.
Q3) An oval pupil is indicative of A) cortical dysfunction.
B) intracranial hypertension.
C) hydrocephalus.
D) metabolic coma.
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Chapter 18: Neurologic Disorders and Therapeutic Management
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Sample Questions
Q1) A patient presents with aphasia, decreased level of consciousness, and right-sided weakness.The patient has a history of heart disease, hyperlipidemia, and transient ischemic attacks.Based on the history, the nurse suspects that the patient has sustained which type of stroke?
A) Hemorrhagic stroke
B) Intracerebral hemorrhages
C) Subarachnoid hemorrhages
D) Ischemic stroke
Q2) A 76-year-old right-handed patient has been admitted to the critical care unit with an intracerebral hemorrhage.A CT of her head reveals a large left parietal area bleed.Patient assessment includes T 98.7°F, P 98 beats/min and thready, R 8 breaths/min, and BP 168/100 mm Hg.The patient's initial treatment plan should involve
A) placing her in the Trendelenburg position.
B) administering an antihypertensive agent.
C) initiating induced hypertensive therapy.
D) intubation to support airway and breathing.
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Page 20
Chapter 19: Kidney Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) A patient is admitted to the critical care unit in congestive heart failure secondary to renal insufficiency.The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites.A diagnosis of renal failure is made.The patient weight upon admission was 176 lb.The patient's weight the next day is 184 lb.What is the approximate amount of fluid retained with this weight gain?
A) 800 mL
B) 2200 mL
C) 3600 mL
D) 8000 mL
Q2) A patient has been on complete bed rest for 3 days.The health care provider has ordered for the patient to sit at the bedside for meals.The patient complains of feeling dizzy and faint while sitting at the bedside.The nurse anticipates that the patient is experiencing
A) orthostatic hypertension.
B) orthostatic hypotension.
C) hypervolemia.
D) electrolyte imbalance.
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Chapter 20: Kidney Disorders and Therapeutic Management
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Sample Questions
Q1) Which of the following IV solutions is contraindicated for patients with kidney or liver disease or in lactic acidosis?
A) D5W
B) 0.9% NaCl
C) Lactated Ringer solution
D) 0.45% NaCl
Q2) To remove fluid during hemodialysis, a positive hydrostatic pressure is applied to the blood and a negative hydrostatic pressure is applied to the dialysate bath.This process is known as
A) ultrafiltration.
B) hemodialysis.
C) reverse osmosis.
D) colloid extraction.
Q3) The most common site for short-term vascular access for immediate hemodialysis is the
A) subclavian artery.
B) subclavian vein.
C) femoral artery.
D) radial vein.
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Chapter 21: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) Upon auscultation, the nurse hears borborygmi.This is a change in the patient's condition.The nurse suspects the patient maybe experiencing A) a complete ileus.
B) early intestinal obstruction.
C) abnormality of blood flow.
D) peritonitis.
Q2) Which radiographic test would be used to identify pseudocysts of the pancreas?
A) Plain film radiography
B) Abdominal ultrasonography
C) CT of abdomen
D) MRI of the abdomen
Q3) Nursing management of the patient undergoing an angiogram includes
A) keeping the patient flat for 24 hours.
B) inserting a nasogastric tube before the procedure.
C) administering tap water enemas until clear.
D) checking the patient's pulse distal to the injection site every 15 minutes.
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23
Chapter 22: Gastrointestinal Disorders and Therapeutic Management
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Q1) Which classification of medication is used to reduce volume and concentration of gastric secretions?
A) Antacids
B) Histamine<sub>2</sub> (H<sub>2</sub>) antagonists
C) Gastric mucosal agents
D) Gastric proton pump inhibitors
Q2) The patient at risk for GI hemorrhage should be monitored for which of the following signs and symptoms?
A) Metabolic acidosis and hypovolemia
B) Decreasing hemoglobin and hematocrit
C) Hyperkalemia and hypernatremia
D) Hematemesis and melena
Q3) Which of the following is a potential cause for acute liver failure?
A) Ischemia
B) Hepatitis A, B, C, D, E, non-A, non-B, non-C
C) Acetaminophen toxicity
D) Wilson disease
E) Reye syndrome
F) Diabetes
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Chapter 23: Endocrine Clinical Assessment and Diagnostic Procedures
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Sample Questions
Q1) The patient weighed 62 kg on admission yesterday.Today the patient weighs 60 kg.The nurse knows this reflects a fluid loss of
A) 1 L.
B) 2 L.
C) 4 L.
D) 10 L.
Q2) A 16-year-old young woman is admitted to the critical care unit with severe hyperglycemia caused by new-onset type 1 diabetes mellitus.The nurse notes a sweet-smelling odor on the patient's exhaled breath.This is a result of A) compensation for metabolic alkalosis.
B) ketoacidosis.
C) prior ingestion of high-calorie foods.
D) decreased serum osmolality.
Q3) Which of the following laboratory studies or diagnostic procedures is most useful in identifying central diabetes insipidus (DI)?
A) Skull radiographs
B) Serum glucose level
C) Water deprivation test
D) Antidiuretic hormone (ADH) stimulation test
Page 25
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Chapter 24: Endocrine Disorders and Therapeutic Management
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Q1) The primary intervention for hyperglycemic hyperosmolar syndrome (HHS)is
A) rapid rehydration.
B) monitoring vital signs.
C) high-dose intravenous (IV) insulin.
D) hourly urine sugar and acetone testing.
Q2) The hallmark of hyperglycemic hyperosmolar syndrome (HHS)is
A) hyperglycemia with low serum osmolality.
B) severe hyperglycemia with minimal or absent ketosis.
C) little or no ketosis in serum with rapidly escalating ketonuria.
D) hyperglycemia and ketosis.
Q3) A patient in diabetic ketoacidosis is comatose with a temperature of 102.2° F.The nurse would suspect
A) head injury.
B) infarct of the hypothalamus.
C) infection.
D) heat stroke.
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Chapter 25: Trauma
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Sample Questions
Q1) The majority of falls accounting for traumatic injury occur in what population?
A) Construction workers
B) Adolescents
C) Older adults
D) Young adults
Q2) A patient is admitted to the ICU with a C5-C6 subluxation fracture.He is able to move his legs better than he can move his arms.Which of the following statements is true about his spinal cord injury?
A) He is likely to be in supraventricular tachycardia.
B) Hyperthermia is common in patients with spinal cord injury.
C) These patients do not usually require mechanical ventilation.
D) The patient has a central cord syndrome.
Q3) Which of the following physiologic changes caused by aging is the most likely contributor to the high mortality rate in older trauma patients compared with younger trauma patients?
A) Deterioration of cerebral and motor skills
B) Poor vision and hearing
C) Diminished pain perception
D) Limited cardiovascular physiologic reserve in the elderly
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Page 27
Chapter 26: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
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Sample Questions
Q1) The gastrointestinal system is a common target organ for MODS related to A) anorexia.
B) limited or absent food ingestion.
C) disruption of the mucosal barrier from hypoperfusion.
D) a decrease in hydrochloric acid secretion.
Q2) A patient is admitted to the intensive care unit after she develops disseminated intravascular coagulation (DIC)after a vaginal delivery.DIC is known to occur in patients with retained placental fragments.What is the result of DIC?
A) Hypersensitive response to an antigen, resulting in anaphylaxis
B) Depletion of clotting factors and excessive fibrinolysis, resulting in simultaneous microvascular clotting and hemorrhage
C) Vasodilatation, resulting in hypotension
D) Septic shock, resulting in vasodilation and decreased perfusion
Q3) With anaphylactic shock, which mechanism results in a decreased cardiac output?
A) Peripheral vasodilation
B) Increased cardiac output
C) Decreased alveolar ventilation
D) Fluid retention resulting in congestive heart failure
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Chapter 27: Hematologic Disorders and Oncologic Emergencies
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Sample Questions
Q1) Common findings in tumor lysis syndrome (TLS)include
A) increased calcium.
B) decreased potassium.
C) dysrhythmias.
D) elevated blood urea nitrogen (BUN) and creatine.
E) edema.
Q2) Medical intervention to prevent metabolic imbalances associated with tumor lysis syndrome includes
A) give Kayexalate for hypokalemia.
B) keep urine pH below 7.0.
C) fluid restriction.
D) dietary restriction of potassium and phosphorus foods.
Q3) Which of the following pathophysiologic events contributes to renal failure associated with tumor lysis syndrome?
A) Hypocalcemia
B) Elevated white blood cell count
C) Metabolic acidosis
D) Crystallization of uric acid in the renal tubules
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