A 56-year-old patient is admitted to the critical care unit with acute respiratory distress syndrome (ARDS)
The patient has been intubated and is mechanically ventilated. The patient is becoming increasingly agitated, and the high-pressure alarm on the ventilator has been frequently triggered. The nurse's first intervention for this patient would be to
a. administer midazolam (Versed) 5 mg by intravenous push immediately.
b. assess the patient to see if a physiologic reason exists for his agitation.
c. obtain a stat arterial blood gas level; his agitation indicates he is becoming increasingly hypoxic.
d. apply soft wrist restraints to keep him from pulling out the endotracheal tube.
Question 2A patient on mechanical ventilation is receiving total parenteral nutrition (TPN). Which of the following is true?
a. Excessive calorie intake can cause an increase in PaCO2 .
b. The patient's head should remain elevated at 45 degrees to avoid aspiration.
c. Lipid intake should be maintained at greater than 2 g/kg/day.
d. TPN is preferred over the use of enteral feeding to avoid the complication of aspiration.
Question 3According to Malcolm Knowles' andragogy, which of the following are characteristics of the adult learner? (Select all that apply.)
a. Autonomy
b. Experience
c. Instructor-driven assessments
d. Peer-directed motivation
e. Individualism
Question 4Which of the following statements about comfort care is accurate?
a. Withholding and withdrawing life-sustaining treatment are distinctly different in the eyes of the legal community.
b. Each procedure should be evaluated for its effect on the patient's comfort before being implemented.
c. Only the patient can determine what constitutes comfort care for him or her.
d. Withdrawing life-sustaining treatments is considered euthanasia in most states.
Question 5A patient has been taking benzodiazepines and suddenly develops respiratory depression and hypotension. After careful assessment, the nurse determines that the patient is experiencing benzodiazepine overdose. What is the nurse's next step?
a. Decrease benzodiazepines to half the prescribed dose.
b. Increase IV fluids to 500 cc/hr for 2 hours.
c. Administer flumazenil (Romazicon).
d. Discontinue benzodiazepine and start propofol.
Question 6Obtaining 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.
Question 7Sources of physiologic stress in the acutely ill include (Select all that apply.)
a. hypotension.
b. hypoxia.
c. fever.
d. neurologic deficits.
e. eupnea.
Question 8An older patient is receiving a nephrotoxic medication. Which of the following would be a priority for the nurse to monitor?
a. Electrocardiogram
b. Lung sounds
c. Blood pressure
d. Level of consciousness
Question 9A patient is admitted to the CCU complaining of pain from a femur fracture and is anxious and agitated. The patient is receiving steroids and theophylline for exacerbation of asthm
a. The nurse should assess the patient for
a. anxiety.
b. low self-esteem.
c. regression.
d. suicidal ideations.
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