Chapter 66: Nursing Management: Critical Care

Chapter 66: Nursing Management: Critical Care

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. A patient has a nursing diagnosis of disturbed sensory perception related to sleep
deprivation. Which action will the nurse include in the plan of care?
a. Discontinue assessments during the night to allow uninterrupted sleep.
b. Administer prescribed sedatives or opioids at bedtime to promote sleep.
c. Silence the alarms on the cardiac monitors to allow 30- to 40-minute naps.
d. Cluster nursing activities so that the patient has uninterrupted rest periods.
ANS: D
Clustering nursing activities and providing uninterrupted rest periods will minimize
sleep-cycle disruption. Sedative and opioid medications tend to decrease the amount of
rapid eye movement (REM) sleep and can contribute to sleep disturbance and disturbed
sensory perception. Silencing the alarms on the cardiac monitors would be unsafe in a
critically ill patient, as would discontinuing assessments during the night.
DIF: Cognitive Level: Application REF: 1686 TOP: Nursing Process:
Planning
MSC: NCLEX: Psychosocial Integrity
2. To determine the effectiveness of medications that a patient has received to reduce left
ventricular afterload, which hemodynamic parameter will the nurse monitor?
a. Central venous pressure (CVP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
ANS: B
Systemic vascular resistance reflects the resistance to ventricular ejection, or afterload.
The other parameters will be monitored, but do not reflect afterload as directly.
DIF: Cognitive Level: Application REF: 1687-1689 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity
3. While family members are visiting, a patient has a cardiac arrest and is being
resuscitated. Which action by the nurse is best?
a. Ask family members if they wish to remain in the room during the resuscitation.
b. Explain to family members that watching the resuscitation will be very stressful.
c. Assign a staff member to wait with family members just outside the patient room.
d. Escort family members quickly out of the patient room and then remain with them.
ANS: A
Test Bank 66-2
Research indicates that family members want the option of remaining in the room during
procedures such as CPR and that this decreases anxiety and facilitates grieving. The other
options may be appropriate if the family decides not to remain with the patient.
DIF: Cognitive Level: Application REF: 1687
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. Following surgery, a patient’s central venous pressure (CVP) monitor indicates low
pressures. Which action will the nurse anticipate taking?
a. Increase the IV fluid infusion rate.
b. Administer IV diuretic medications.
c. Elevate the head of the patient’s bed to 45 degrees.
d. Document the CVP and continue to monitor.
ANS: A
A low CVP indicates hypovolemia and a need for an increase in the infusion rate.
Diuretic administration will contribute to hypovolemia and elevation of the head may
decrease cerebral perfusion. Documentation and continued monitoring is an inadequate
response to the low CVP.
DIF: Cognitive Level: Application REF: 1693-1695 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
5. When caring for a patient with pulmonary hypertension, which parameter will the nurse
monitor to evaluate whether treatment has been effective?
a. Mean arterial pressure (MAP)
b. Central venous pressure (CVP)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
ANS: C
PVR is a major contributor to pulmonary hypertension, and a decrease would indicate
that pulmonary hypertension was improving. The other parameters also may be
monitored, but do not directly assess for pulmonary hypertension.
DIF: Cognitive Level: Application REF: 1687-1689 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity