Complex Care Exam 1 Practice

These questions are part of the practice quiz. Start practicing

• Which option is NOT a nonpharmacologic delirium prevention measure?
• What is the purpose of goals-of-care discussions in complex care?
• In left-sided heart failure, which hemodynamic finding would you expect?
• A patient with hyponatremia due to SIADH from a lung cancer has a low serum sodium. Which mechanism primarily causes this hyponatremia?
• What statement about hyponatremia correction carries risk?
• A 64-year-old man with GI hemorrhage who is tense and nervous; the clinician notes anxiety. What action is most important for the critical care nurse to take?
• Protein intake should be adjusted for renal function and catabolic state. Which option correctly reflects this statement?
• In which patients is noninvasive ventilation typically appropriate?
• The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer. The nurse is aware that the patient is at risk for tumor lysis syndrome (TLS) and will monitor for which abnormality associated with this oncologic emergency?
• What is a key safety concern when using neuromuscular blockers in the ICU?
• In the context of complex care, interprofessional rounds primarily aim to coordinate which elements?
• Which finding indicates perfusion improvement during septic shock resuscitation?
• Which of the following represents a common adverse effect of opioids in ICU patients?
• What is the sequence for treating hyperkalemia in an emergency?
• Which observation by the nurse caring for a patient with a radial arterial line would require emergency intervention?
• An ambulance nurse is caring for a 45-year-old patient in acute respiratory distress due to asthma. The absence of inspiratory wheezing indicates what?
• The overall impact of interprofessional rounds on patient care is best described as which of the following?
• In ARDS management, what is the target PaO2 to maintain adequate oxygenation?
• Discharge instructions for a 64-year-old woman with ascites and peripheral edema related to cirrhosis were reviewed. Which statement indicates teaching was effective?
• What acid-base disturbance is commonly seen in kidney failure?
• Which outcome is promoted by interprofessional rounds regarding care plans?
• Which item best explains the pathophysiology of ascites in cirrhosis?
• Discharge teaching after a laparoscopic cholecystectomy should include which information?
• Which order by the physician should the nurse question in a patient with ARDS on PPV who has a low cardiac index?
• How is symptomatic hyponatremia managed?
• Which two inotropes are commonly used for cardiogenic or low-output states, and what are their typical roles?
• In caring for a patient in acute septic shock, which intervention should the nurse anticipate?
• Why is overly tight glycemic control in the ICU discouraged?
• Which sign is associated with pancreatitis?
• What is a practical safety measure when administering vasopressors via IV to minimize complications?
• A patient with a history of lung cancer and hepatitis C has developed liver failure and is considering liver transplantation. After a comprehensive evaluation, which finding may be a contraindication for liver transplantation?
• A dramatic reduction in blood pressure after increasing PEEP indicates which complication?
• Which set of parameters constitutes essential hemodynamic measures for shock assessment?
• A patient with right upper quadrant abdominal pain has cholelithiasis. What is the nurse's priority?
• What pain assessment tool is suitable for nonverbal ICU patients?
• A patient is in acute respiratory distress syndrome (ARDS) as a result of sepsis. Which measure would be implemented to maintain cardiac output?
• In hyperkalemia management, which step acutely stabilizes the myocardium?
• Which statement demonstrates understanding of the disease process in hepatitis C (HCV)?
• When planning care for a patient with cirrhosis, the nurse will give highest priority to which nursing diagnosis?
• The patient has pulmonary fibrosis and experiences hypoxemia during exercise but not at rest. To plan patient care, the nurse should know the patient is experiencing which physiologic mechanism of respiratory failure?
• When is continuous renal replacement therapy favored over intermittent hemodialysis?
• Which statement best describes the signs of fluid overload in the ICU?
• In ARDS, a PaO2/FiO2 ratio less than 200 is used to define ARDS. Which value represents this threshold?
• When are stress-dose steroids indicated in critical illness?
• Which patient is most at risk for developing MODS?
• A 27-year-old man with multiple fractured ribs from a motor vehicle crash develops respiratory failure. Which clinical manifestation, if experienced, is an early indication of respiratory failure?
• What is refeeding syndrome and how can it be prevented?
• What is the purpose of train-of-four monitoring in the ICU?
• What is a safe general caloric target for critically ill adults?
• The nurse is caring for a patient admitted with a barbiturate overdose. The patient is comatose with a blood pressure of 90/60 mm Hg, apical pulse of 110 beats/min, and respiratory rate of 8 breaths/min. Based on the initial assessment findings, the nurse recognizes that the patient is at risk for which type of respiratory failure?
• What ABG pattern is typical of metabolic acidosis due to sepsis?
• What tidal volume is recommended for lung-protective ventilation in ARDS?
• A 50-year-old woman with suspected brain tumor is scheduled for a CT scan with contrast. The patient reports a shellfish allergy. Which physician response should be questioned?
• How does lactate level relate to sepsis prognosis?
• Interprofessional rounds contribute to enhancing patient safety by which of the following?
• What indicates improvement in shock management in terms of perfusion and tissue oxygenation?
• Which statement best describes family engagement in interprofessional rounds?
• Which nonpharmacologic strategies help prevent ICU delirium?
• What is the initial fluid resuscitation target for adult septic shock?
• Which factor indicates that tracheostomy placement would be preferable to endotracheal intubation?
• Acute pancreatitis in this patient is most commonly caused by which factor?
• DNI stands for which of the following?
• Interprofessional rounds support which of the following outcomes related to patient and family involvement?
• Which statement best describes prevention of refeeding syndrome when restarting nutrition?
• Which statement describes an ICU medication safety strategy to reduce errors?
• Which position can improve oxygenation by better perfusion-ventilation matching in ARDS?
• Which laboratory finding is consistent with a medical diagnosis of cardiogenic shock?
• Hepatitis C is transmitted primarily through which exposure?
• Which nursing action is most important for a patient with sepsis who is orally intubated on mechanical ventilation to prevent complications?
• Which statement about ARDS ventilation is correct?
• A patient preparing for cholecystectomy has which assessment as a contraindication?
• Enteral feedings are used for which pancreatitis scenario?
• After initial fluid resuscitation in septic shock, what is the recommended next step?
• What is a key benefit of interprofessional rounds in complex care?
• How is norepinephrine titrated in septic shock?
• During CRRT, which electrolyte consideration is important?
• Which individual should the nurse refer for an immunoglobulin (IG) injection after exposure to hepatitis A?
• Which vasopressor is commonly titrated to restore mean arterial pressure (MAP) in septic shock?
• A patient on a ventilator is being evaluated for readiness to wean. Which finding indicates the patient is NOT a candidate for weaning?
• Which statement regarding diet and bleeding risk is NOT part of a safe plan of care for a patient with cirrhosis?
• CPOT stands for which pain assessment tool?
• Which statement about edema care in cirrhosis is true?
• In the aspiration ARDS case with PaO2 42 mmHg on 80% FiO2, which intervention would be harmful to oxygenation status?
• The nurse is caring for a 37-yr-old female patient with multiple musculoskeletal injuries who has developed acute respiratory distress syndrome (ARDS). Which intervention should the nurse initiate to prevent stress ulcers?
• A 72-year-old man in cardiogenic shock after an acute myocardial infarction. Which finding would be most concerning?
• What combination is a key sign of ventilator-associated pneumonia risk?
• Family asks how to prevent illness from hepatitis A; which response is most appropriate?
• Which value falls within the normal range for pulmonary artery wedge pressure (PAWP)?
• Within what time frame should broad-spectrum antibiotics be started once septic shock is suspected or identified?
• Invasive arterial monitoring requires the arterial pressure bag to be inflated to which pressure?
• In a patient with a localized infection that has become systemic and septic shock is suspected, which medication is expected to treat septic shock refractory to fluids?
• A 34-year-old woman with acute decompensated heart failure has a PA catheter. Which assessment indicates the patient's condition is improving?
• Which statement best captures the relationship between interprofessional rounds and coordination of care?
• A 29-year-old man admitted with sepsis; which information should the nurse include when explaining the early stage of sepsis?
• Which imaging modalities are used to screen for and diagnose liver cancer?
• Which statement describes a NOT recommended delirium prevention strategy?
• Which antiviral is used for severe hepatitis B with liver failure?
• What is the mechanism by which lactulose reduces ammonia levels in hepatic encephalopathy?
• Backrest elevation may be up to how many degrees unless the patient has orthostatic changes?
• Immunoglobulin given after exposure to hepatitis A provides temporary immunity for about how long?
• Which statement about wound drainage after laparoscopic cholecystectomy is correct?
• Which of the following is NOT a typical manifestation of MODS?
• Which approach best minimizes harm when using high-alert medications in the ICU?
• Which hematologic problem significantly increases the risks associated with pulmonary artery catheter insertion?
• In caring for a patient with acute respiratory distress syndrome (ARDS), which finding indicates therapy is appropriate?
• Which clinical manifestation is suggestive of sepsis?
• What is the normal tidal volume range for an adult on mechanical ventilation?
• What is a critical consideration when a patient has reduced consciousness and potential airway compromise?
• During ARDS, which phase is characterized by an increased inflammatory response?
• Which statement correctly describes the early events in the exudative phase of acute respiratory distress syndrome (ARDS)?
• Why are high-alert medications carefully managed in critical care settings?
• Application of positive end-expiratory pressure to the ventilator settings has which therapeutic effect?
• In the initial resuscitation of hypovolemic shock due to GI bleed, which fluid is indicated?
• Which statement indicates the patient needs more teaching?
• What are key practices to prevent central line-associated infections?
• Cullen's sign is a bluish discoloration around the umbilicus associated with which condition?
• Which medication class is used primarily in cardiogenic shock rather than septic shock?
• Which of the following best describes a potential outcome of interprofessional rounds on safety and coordination?
• Which of the following is a potential MODS complication?
• Which finding best indicates hyperchloremic metabolic acidosis or deterioration in renal function?
• A 64-year-old woman presents with bright red vomiting and hypotension. Which order should be completed first?
• What is the minimum mean arterial pressure (MAP) target for patients on vasopressors?
• What is the empiric approach to suspected hospital-acquired pneumonia in the ICU?
• Which signs indicate fluid overload in the ICU?
• Which clinical manifestation would the nurse expect in acute pancreatitis?
• Which activity is a direct reflection of interprofessional rounds improving communication?
• Why is PEEP used in ARDS management?
• Which factor should guide adjustments of caloric targets in critically ill adults?
• What is the principle of autonomy in medical ethics?
• A massive gastrointestinal bleed has resulted in hypovolemic shock. Which nursing diagnosis is the priority?
• How do you calculate predicted body weight for ventilator settings?
• How is lactate used in septic shock management?
• What is the target plateau pressure in lung-protective ventilation?
• What sedation strategy helps minimize delirium risk in mechanically ventilated patients?
• Which statement best describes surrogate decision-making in medical care?
• During care of a critically ill patient on a mechanical ventilator, which clinical manifestation indicates MODS?
• What is the rationale for daily sedation vacations?
• Which hormone is responsible for salt and water retention contributing to ascites in cirrhosis?
• During the initial management of acute pancreatitis, which intervention is used to treat or prevent shock?
• Which statement about using dexmedetomidine for agitation in the ICU is true?
• Which electrolytes are affected in refeeding syndrome?
• What is the normal cardiac output range for a healthy adult?
• In a 70-year-old man with end-stage lung cancer who is confused and has oliguria for 2 days, which finding should the nurse report immediately to the health care provider?
• Why should acetaminophen be used cautiously in patients with cirrhosis and ascites?
• Which assessment tools are commonly used to assess delirium in ICU patients?
• The health care provider orders lactulose for a patient with hepatic encephalopathy. Which finding indicates the medication has been effective?
• If the patient in shock is to receive 1000 mL of normal saline in 2 hours, at what rate should the infusion pump be set?
• Why is rapid correction of hyponatremia dangerous?
• How do you distinguish DNR from DNI?
• In septic shock management, antibiotics should be started within what time frame after obtaining cultures?
• After coronary artery bypass graft surgery, a patient has postoperative bleeding requiring return to surgery for repair. During surgery, the patient experiences MI. After restoring body temperature to normal, which patient parameter is most important for planning nursing care?
• Interprofessional rounds are designed to enhance which relationship in care delivery?
• What is the recommended glucose target range for most critically ill adults?
• In early septic shock, which skin finding is common due to a hyperdynamic state?
• Which diagnostic study would help determine if the patient has developed liver cancer?
• Interprofessional rounds primarily help teams by improving which aspect of team dynamics?
• Arterial blood gas results are reported to the nurse for a 68-yr-old patient admitted with pneumonia: pH 7.31, PaCO2 49 mm Hg, HCO3 26 mEq/L, and PaO2 52 mm Hg. What order should the nurse complete first?
• When caring for a patient with biliary obstruction, which vitamin supplements would you anticipate administering?
• Which circulatory-assist device should be expected for cardiogenic shock after a myocardial infarction?
• What is the normal mean arterial pressure range?
• What is the recommended protein intake for many critically ill patients?
• During the compensated stage of hypovolemic shock, in what order should the pathophysiologic mechanisms occur?
• What analgesia strategy helps minimize delirium risk in ICU patients?
• During resuscitation, what does lactate clearance over time indicate?
• In acute pancreatitis with vomiting, which intervention should be included in the plan of care?
• If hypotension persists after initial fluid bolus in septic shock, what is the recommended next step?
• Serum α-fetoprotein level may be elevated in liver cancer or other liver problems. Which statement is true?
• What fluid type is preferred for initial resuscitation in septic shock when possible?
• When is palliative sedation indicated?
• The nurse in the cardiac care unit is caring for a patient who has developed acute respiratory failure. Which medication is used to decrease patient pulmonary congestion and agitation?
• What considerations are essential when anticoagulating critically ill patients?
• Which patient has the highest risk for developing pancreatic cancer?
• Which PACU patient should receive the least amount of endotracheal suctioning?
• Which patient would most benefit from noninvasive positive pressure ventilation (NIPPV) to promote oxygenation?
• In a 72 kg patient with acute respiratory distress syndrome on pressure support ventilation with FiO2 80% and PEEP 15 cm H2O, which finding would indicate that treatment is effective?
• A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. Which diagnosis does the nurse expect?
• A patient with type 2 diabetes and cirrhosis asks about taking silymarin (milk thistle) to minimize liver damage. The nurse should respond based on knowledge that...
• What is the primary purpose of corticosteroid therapy in MODS?
• Which sequence correctly represents the order of physiological results after administering corticosteroids to a patient with MODS?
• A primary purpose of interprofessional rounds is to...
• Which vasopressor is first-line in septic shock?
• During interprofessional rounds, which activity most directly supports coordinated care?
• Which statement best describes the effect of early mobility on delirium?
• In biliary obstruction, which physiologic principle explains why fat-soluble vitamins must be supplemented?
• Which of the following statements best captures the primary purpose of interprofessional rounds in complex care?
• How is hyperkalemia initially stabilized in an emergency?
• Which suctioning technique is preferred to maintain oxygenation and reduce exposure to secretions?
• When caring for older adult patients with respiratory failure, which intervention should be added to individualize care?
• After corticosteroid response in MODS, what happens to potassium handling?