Nursing Care of the Critically Ill Question Bank
Course Introduction
This course focuses on the comprehensive nursing care required for critically ill patients across a range of acute care settings, such as intensive care units and emergency departments. Students will explore advanced concepts in pathophysiology, clinical assessment, and evidence-based interventions for life-threatening conditions affecting various body systems. Emphasis is placed on the application of advanced monitoring technologies, effective communication within multidisciplinary teams, prioritization of care, and ethical considerations in end-of-life decision-making. The course aims to equip students with the critical thinking and technical skills necessary to provide high-quality, patient-centered care to those experiencing complex and rapidly changing health challenges.
Recommended Textbook
Introduction to Critical Care Nursing 7th Edition by Sole
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21 Chapters
757 Verified Questions
757 Flashcards
Source URL: https://quizplus.com/study-set/570
Page 2
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 family of your critically ill patient tells you that they have not spoken with the physician in over 24 hours and that they have some questions they want clarified.During morning rounds,you convey this concern to the attending intensivist and arrange a meeting with the family at 4:00 PM.Which competency of critical care nursing does this represent?
A) Advocacy and moral agency in solving ethical issues
B) Clinical judgment and clinical reasoning skills
C) Collaboration with patients, families, and team members
D) Facilitation of learning for patients, families, and team members
Answer: C
Q2) Which of the following assists the critical care nurse in ensuring that care is appropriate and based on research?
A) Clinical practice guidelines
B) Computerized physician order entry
C) Consulting with advanced practice nurses
D) Implementing Joint Commission National Patient Safety Goals
Answer: A
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3
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) It is important for critically ill patients to feel safe.Which nursing strategies help the patient to feel safe in the critical care setting? (Select all that apply.)
A) Allow family members to remain at the bedside.
B) Consult with the charge nurse before making any patient care decisions.
C) Provide informal conversation by discussing your plans for after work.
D) Respond promptly to call bells or other communication for assistance.
E) Inform the patient that you have cared for many similar patients.
Answer: A,D
Q2) The critical care environment is often stressful to a critically ill patient.Identify stressors that are common.(Select all that apply.)
A) Alarms that sound from various devices
B) Bright fluorescent lighting
C) Lack of day-night cues
D) Sounds from the mechanical ventilator
E) Visiting hours tailored to meet individual needs
Answer: A,B,C,D
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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/10615
Sample Questions
Q1) Which statement regarding ethical concepts is true?
A) A living will is the same as a health care proxy.
B) A signed donor card ensures that organ donation will occur in the event of brain death.
C) A surrogate is a competent adult designated by a person to make health care decisions in the event the person is incapacitated.
D) A persistent vegetative state is the same as brain death in most states.
Answer: C
Q2) The nurse is caring for a patient who is not responding to medical treatment.The intensivist holds a conference with the family,and a decision is made to withdraw life support.The nurse's religious beliefs are not in agreement with the withdrawal of life support.However,the nurse assists with the process to avoid confronting the charge nurse.Afterward the nurse feels guilty for "killing the patient." This scenario is likely to cause
A) abandonment.
B) family stress.
C) moral distress.
D) negligence.
Answer: C
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Page 5
Chapter 4: End-of-Life Care and Palliative Care in Critical Care Settings
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/10616
Sample Questions
Q1) Which therapeutic interventions may be withdrawn or withheld from the terminally ill client? (Select all that apply.)
A) Antibiotics
B) Dialysis
C) Nutrition
D) Pain medications
E) Simple nursing interventions such as repositioning and hygiene
Q2) The patient's spouse is very upset because his loved one,who is near death,has dyspnea and restlessness.The nurse explains that there are some ways to decrease this discomfort,including:
A) respiratory therapy treatments.
B) opioid medications given as needed.
C) incentive spirometry.
D) increased hydration.
Q3) 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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Chapter 5: Comfort and Sedation
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33 Verified Questions
33 Flashcards
Source URL: https://quizplus.com/quiz/10617
Sample Questions
Q1) The nurse wishes to assess the quality of a patient's pain.Which of the following questions is appropriate to obtain this assessment if the patient is able to give a verbal response?
A) "Is the pain constant or intermittent?"
B) "Is the pain sharp, dull, or crushing?"
C) "What makes the pain better? Worse?"
D) "When did the pain start?"
Q2) The nurse is concerned about the risk of alcohol withdrawal syndrome in a postoperative patient.Which statement by the nurse indicates understanding of management of this patient?
A) "Alcohol withdrawal is common; we see it all of the time in the trauma unit."
B) "There is no way to assess for alcohol withdrawal."
C) "This patient will require less pain medication."
D) "We have initiated the alcohol withdrawal protocol."
Q3) The primary mode of action for neuromuscular blocking agents used in the management of some ventilated patients is
A) analgesia.
B) anticonvulsant therapy.
C) paralysis.
D) sedation.
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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) A patient is receiving enteral tube feedings and has developed drug-nutrient interactions.The nurse recognizes which drug as having the potential for causing drug-nutrient reactions?
A) Aspirin
B) Enoxaparin
C) Ibuprofen
D) Phenytoin
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) The best nursing approach to prevent feeding tube obstruction is to
A) dilute the feeding to make it flow more easily.
B) flush the tube every 4 hours with 20 to 30 mL of tap water.
C) pass a stylet daily to keep the tubing clear.
D) use a larger bore tube where possible.
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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/10619
Sample Questions
Q1) The patient has a permanent pacemaker in place with a demand rate set at 60 beats/min.The cardiac monitor is showing a heart rate of 44 beats/min with no pacemaker spikes.The nurse recognizes this as:
A) normal pacemaker function.
B) failure to capture.
C) failure to pace.
D) failure to sense.
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 because 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) One of the functions of the atrioventricular (AV)node is to
A) pace the heart if the ventricles fail.
B) slow the impulse arriving from the SA node.
C) send the impulse to the SA node.
D) allow for ventricular filling during systole.
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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 charge nurse has a pulse contour cardiac output monitoring system available for use in the surgical intensive care unit.For which patient is use of this device most appropriate?
A) A patient with a history of aortic insufficiency admitted with a postoperative myocardial infarction
B) A mechanically ventilated patient with cardiogenic shock being treated with an intraaortic balloon pump
C) A patient with a history of atrial fibrillation having frequent episodes of paroxysmal supraventricular tachycardia
D) A mechanically ventilated patient admitted following repair of an acute bowel obstruction
Q2) The provider writes an order to discontinue a patient's left radial arterial line.When discontinuing the patient's invasive line,what is the priority nursing action?
A) Apply an air occlusion dressing to insertion site.
B) Apply pressure to the insertion site for 5 minutes.
C) Elevate the affected limb on pillows for 24 hours.
D) Keep the patient's wrist in a neutral position.
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Page 10
Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/10621
Sample Questions
Q1) A mode of pressure-targeted ventilation that provides positive pressure to decrease the workload of spontaneous breathing through the endotracheal tube is
A) continuous positive airway pressure.
B) positive end-expiratory pressure.
C) pressure support ventilation.
D) T-piece adapter.
Q2) A patient is admitted to the progressive care unit with a diagnosis of community-acquired pneumonia.The patient has a history of chronic obstructive pulmonary disease and diabetes.A set of arterial blood gases obtained on admission without supplemental oxygen shows pH 7.35; PaCO<sub>2</sub> 55 mm Hg; bicarbonate 30 mEq/L; PaO<sub>2</sub> 65 mm Hg.These blood gases reflect:
A) hypoxemia and compensated metabolic alkalosis.
B) hypoxemia and compensated respiratory acidosis.
C) normal oxygenation and partly compensated metabolic alkalosis.
D) normal oxygenation and uncompensated respiratory acidosis.
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11
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) The patient's monitor shows bradycardia (heart rate of 40 beats/min)and frequent premature ventricular contractions (PVCs)with a measured blood pressure of 85/50 mm Hg.The nurse anticipates the use of which drug?
A) Atropine 0.5 to 1 mg intravenous push
B) Dopamine drip-continuous infusion
C) Lidocaine 1 mg/kg intravenous push
D) Transcutaneous pacemaker
Q2) During a code,the nurse would place paddles for anterior defibrillation in what locations?
A) Second intercostal space, left sternal border and fourth intercostal space, left midclavicular line
B) Second intercostal space, right sternal border and fourth intercostal space, left midaxillary line
C) Second intercostal space, right sternal border and fifth intercostal space, left midclavicular line
D) Fourth intercostal space, right sternal border and fifth intercostal space, left midclavicular line
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Page 12
Chapter 11: Organ Donation
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10623
Sample Questions
Q1) A nurse is caring for a patient declared brain dead following a car crash in preparation for the harvesting of organs.The patient's urine output was 1050 mL in the last hour.What medication does the nurse prepare to administer?
A) Vasopressin
B) Methylprednisolone
C) Desmopressin acetate
D) Esmolol
Q2) Which statement best describes the lung allocation score (LAS)used to prioritize lung transplant recipients?
A) The LAS estimates the probability of survival and benefits from transplantation.
B) Lungs from children and adolescents are offered to adults first.
C) The LAS is limited to candidates under the age of 65 years.
D) The score was developed to estimate 5-year survival rates.
Q3) Which clinical scenario best represents hyperacute rejection?
A) A cardiac transplant patient with a 3-month history of shortness of breath
B) A lung transplant patient with small pustules that follow a dermatome
C) A liver transplant patient with several small lumps under the skin
D) An implanted renal transplant that, upon reperfusion, becomes cyanotic
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Page 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) The nurse is administering intravenous norepinephrine at 5 mcg/kg/min via a 20-gauge peripheral intravenous (IV)catheter.Which assessment finding requires immediate action by the nurse?
A) Blood pressure 100/60 mm Hg
B) Swelling at the IV site
C) Heart rate of 110 beats/min
D) Central venous pressure (CVP) of 8 mm Hg
Q2) The nurse has been administering 0.9% normal saline intravenous fluids in a patient with severe sepsis.To evaluate the effectiveness of fluid therapy,which physiological parameters would be most important for the nurse to assess?
A) Breath sounds and capillary refill
B) Blood pressure and oral temperature
C) Oral temperature and capillary refill
D) Right atrial pressure and urine output
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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) A patient has been diagnosed with Marfan syndrome.What information does the nurse plan to teach the patient about this condition?
A) It is an autosomal dominant inherited disorder of connective tissue.
B) It is caused by a random genetic mutation and is not familial.
C) There are no drugs that help control the cardiac symptoms of the disease.
D) Contact sports are permitted if precautions against concussion are taken.
Q2) A 72-year-old woman is brought to the ED by her family.The family states that she's "just not herself." Her respirations are slightly labored,and her heart monitor shows sinus tachycardia (rate 110 beats/min)with frequent premature ventricular contractions (PVCs).She denies any chest pain,jaw pain,back discomfort,or nausea.Her troponin levels are elevated,and her 12-lead electrocardiogram (ECG)shows elevated ST segments in leads II,III,and aVF.The nurse knows that these symptoms are most likely associated with which diagnosis?
A) Hypokalemia
B) Non-Q wave MI
C) Silent myocardial infarction
D) Unstable angina
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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 nurse receives a patient from the emergency department following a closed head injury.After insertion of an ventriculostomy,the nurse assesses the following vital signs: blood pressure 100/60 mm Hg,heart rate 52 beats/min,respiratory rate 24 breaths/min,oxygen saturation (SpO<sub>2</sub>)97% on supplemental oxygen at 45% via Venturi mask,Glasgow Coma Scale score of 4,and intracranial pressure (ICP)of 18 mm Hg.Which provider prescription should the nurse institute first?
A) Mannitol 1 g intravenous
B) Portable chest x-ray
C) Seizure precautions
D) Ancef 1 g intravenous
Q2) The nurse is caring for a patient admitted with new onset of slurred speech,facial droop,and left-sided weakness 8 hours ago.Diagnostic computed tomography scan rules out the presence of an intracranial bleed.Which actions are most important to include in the patient's plan of care? (Select all that apply.)
A) Make frequent neurological assessments.
B) Maintain CO<sub>2</sub> level at 50 mm Hg.
C) Maintain MAP less than 130 mm Hg.
D) Prepare for thrombolytic administration.
E) Restrain affected limb to prevent injury.
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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) 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.
Q2) In assessing a patient,the nurse understands that an early sign of hypoxemia is A) clubbing of nail beds.
B) cyanosis.
C) hypotension.
D) restlessness.
Q3) The nurse is caring for a patient with acute respiratory failure and identifies "Risk for Ineffective Airway Clearance" as a nursing diagnosis.A nursing intervention relevant to this diagnosis is to
A) elevate the head of the bed to 30 degrees.
B) obtain an order for venous thromboembolism prophylaxis.
C) provide adequate sedation.
D) reposition the patient every 2 hours.
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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) Acute kidney injury from postrenal etiology is caused by A) obstruction of the flow of urine.
B) conditions that interfere with renal perfusion.
C) hypovolemia or decreased cardiac output.
D) conditions that act directly on functioning kidney tissue.
Q2) The nurse is caring for an elderly patient who was admitted with renal insufficiency.An expected laboratory finding for this patient may be
A) an increased glomerular filtration rate (GFR).
B) a normal serum creatinine level.
C) increased ability to excrete drugs.
D) hypokalemia.
Q3) 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.
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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) Erythrocytes (RBCs)are flexible biconcave disks without nuclei whose primary component is an oxygen-carrying molecule called A) erythropoietin.
B) a reticulocyte.
C) hemoglobin.
D) 2,3-DPG
Q3) With minor vessel injury,primary hemostasis is achieved
A) after several minutes.
B) with fibrin to solidify the platelet plug.
C) usually within seconds.
D) as a permanent solution.
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Chapter 18: Gastrointestinal Alterations
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/10630
Sample Questions
Q1) In assessing the patient complaining of abdominal pain,it is important for the nurse to understand that
A) pain receptors in the abdomen are more likely to be localized.
B) pain of a peptic ulcer is easily distinguished from that of heart attack.
C) visceral pain often leads to tachycardia and hypertension.
D) increasing intensity of pain is always significant.
Q2) The patient is admitted with generalized fatigue and low hemoglobin and hematocrit levels.The patient denies vomiting and states that the last bowel movement earlier that day was normal in color and consistency.However,because GI blood loss can be a cause of anemia,the nurse should expect to
A) obtain a stool sample for guaiac testing.
B) chart that the patient reports the presence of melena in his stool.
C) inspect the patient's next stool for the presence of coffee-ground contents.
D) obtain guaiac positive stools only if bleeding is current.
Q3) The liver plays a major role in homeostasis by
A) synthesizing factor I but not factor II.
B) synthesizing clotting factors without the need for vitamin K.
C) removing active clotting factors from the circulation.
D) synthesizing factor II but not factor I.
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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) The nurse is caring for a patient with a diagnosis of head trauma.The nurse notes that the patient's urine output has increased tremendously over the past 18 hours.The nurse suspects that the patient may be developing A) diabetes insipidus.
B) diabetic ketoacidosis.
C) hyperosmolar hyperglycemic syndrome.
D) syndrome of inappropriate secretion of antidiuretic hormone.
Q2) Acute adrenal crisis is caused by A) acute renal failure.
B) deficiency of corticosteroids.
C) high doses of corticosteroids.
D) overdose of testosterone.
Q3) The most significant clinical finding of acute adrenal crisis associated with fluid and electrolyte imbalance is A) fluid volume excess.
B) hyperglycemia.
C) hyperkalemia
D) hypernatremia
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21
Chapter 20: Trauma and Surgical Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/10632
Sample Questions
Q1) Which of the following injuries would result in a greater likelihood of internal organ damage and risk for infection?
A) A fall from a 6-foot ladder onto the grass
B) A shotgun wound to the abdomen
C) A knife wound to the right chest
D) A motor vehicle crash in which the driver hits the steering wheel
Q2) The nurse has admitted a patient to the ED following a fall from a first-floor hotel balcony.The patient smells of alcohol and begins to vomit in the ED.Which of the following interventions is most appropriate?
A) Insert an oral airway to prevent aspiration and to protect the airway.
B) Offer the patient an emesis basin so that you can measure the amount of emesis.
C) Prepare to suction the oropharynx while maintaining cervical spine immobilization.
D) Send a specimen of the emesis to the laboratory for analysis of blood alcohol content.
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Chapter 21: Burns
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/10633
Sample Questions
Q1) 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."
Q2) The optimal measurement of intravascular fluid status during the immediate fluid resuscitation phase of burn treatment is
A) blood urea nitrogen.
B) daily weight.
C) hourly intake and urine output.
D) serum potassium.
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