Chapter 66: Nursing Management: Critical Care
Test Bank
MULTIPLE CHOICE
1. A 68-year-old patient has been in the intensive care unit for 4
days and has a nursing diagnosis of disturbed sensory perception
related to sleep deprivation. Which action should the nurse include
in the plan of care?
a. Administer prescribed sedatives or opioids at bedtime to promote sleb. Cluster nursing activities so that the patient has uninterrupted rest pc. Silence the alarms on the cardiac monitors to allow 30- to 40-minuted. Eliminate assessments between 0100 and 0600 to allow uninterruptANS: B
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: Apply (application) REF: 1601
TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity
2. Which hemodynamic parameter is most appropriate for the nurse
to monitor to determine the effectiveness of medications given to a
patient to reduce left ventricular afterload?
a. Mean arterial pressure (MAP)
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: Apply (application) REF: 1604
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
3. While family members are visiting, a patient has a respiratory
arrest and is being resuscitated. Which action by the nurse is best?
a. Tell the family members that watching the resuscitation will be very b. Ask family members if they wish to remain in the room during the re
c. Take the family members quickly out of the patient room and remaind. Assign a staff member to wait with family members just outside the ANS: B
Research indicates that family members want the option of
remaining in the room during procedures such as cardiopulmonary
resuscitation (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: Apply (application) REF: 1602
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. Following surgery for an abdominal aortic aneurysm, a patients
central venous pressure (CVP) monitor indicates low pressures.
Which action is a priority for the nurse to take?
a. Administer IV diuretic medications.
b. Increase the IV fluid infusion per protocol.
c. Document the CVP and continue to monitor.
d. Elevate the head of the patients bed to 45 degrees.
ANS: B
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: Apply (application) REF: 1609
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
5. When caring for a patient with pulmonary hypertension, which
parameter is most appropriate for the nurse to monitor to evaluate
the effectiveness of the treatment?
a. Central venous pressure (CVP)
b. Systemic vascular resistance (SVR)
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: Apply (application) REF: 1603-1604
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