Critical Care Nursing: Multiple choice questions
ICU nursing is a specialized area of nursing that involves caring for critically ill patients who require close monitoring and specialized medical interventions. ICU nurses play a crucial role in providing comprehensive care to patients with life-threatening conditions, such as severe respiratory distress, cardiac issues, post-operative complications, trauma, and other critical illnesses.
Nurses' responsibilities in critical care areas:
1. Continuous Monitoring: Monitoring patients' vital signs, including heart rate, blood pressure, oxygen saturation, and respiratory rate, to detect any changes or deterioration in their condition.
2. Medication Administration: Administering medications, including intravenous drugs and titrating doses based on patients' responses and conditions.
3. Ventilator Management: Managing mechanical ventilation for patients who cannot breathe adequately on their own.
4. Invasive Procedures: Assisting with and monitoring patients during invasive procedures, such as central line placements, arterial line insertions, and chest tube placements.
5. Assessment and Documentation: Performing thorough assessments, documenting patient data, and communicating changes in the patient's condition to the medical team.
6. Emotional Support: Providing emotional support to patients and their families during stressful and challenging times.
7. Collaboration: Collaborating closely with other healthcare professionals, including physicians, respiratory therapists, and pharmacists, to ensure the best care for patients.
8. Infection Control: Adhering to strict infection control protocols to prevent healthcare-associated infections.
9. Pain Management: Managing pain and discomfort in critically ill patients through appropriate interventions.
10. Family Education: Educating patients' families about their condition, improvement, etc.
MCQs:
1. A patient in the ICU is receiving mechanical ventilation. What nursing intervention is essential to prevent ventilator-associated pneumonia?
(A) Frequent suctioning of the endotracheal tube
(B) Elevating the head of the bed to 30-45 degrees
(C) Administering prophylactic antibiotics
(D) Limiting oral hygiene care
Ans. (B) Elevating the head of the bed to 30-45 degrees
Rationale: Elevating the head of the bed to 30-45 degrees helps prevent aspiration and reduces the risk of ventilator-associated pneumonia.
2. A patient in the ICU has developed sepsis. What is the priority nursing action?
(A) Administering pain medication
(B) Monitoring vital signs frequently
(C) Providing emotional support
(D) Administering a blood transfusion
Ans. (B) Monitoring vital signs frequently
Rationale: In sepsis, frequent monitoring of vital signs, including blood pressure, heart rate, respiratory rate, and temperature, is a priority to assess for deterioration and guide interventions.
3. A patient in the ICU is on a ventilator and requires suctioning. What should the nurse do to minimize the risk of hypoxia during suctioning?
(A) Perform deep suctioning to ensure thorough removal of secretions.
(B) Limit suctioning to no more than 10 seconds at a time.
(C) Use a smaller suction catheter to maximize suctioning efficiency.
(D) Increase the suction pressure to clear secretions quickly.
Ans. (B) Limit suctioning to no more than 10 seconds at a time.
Rationale: Limiting suctioning to no more than 10 seconds at a time helps minimize the risk of hypoxia and oxygen desaturation during the procedure.
4. A patient in the ICU has a central venous catheter in place. The nurse observes redness, warmth, and tenderness at the CVC insertion site. What is the nurse's initial action?
(A) Administer prophylactic antibiotics
(B) Notify the on-duty Doctor
(C) Remove the CVC immediately
(D) Warm compress application to the site
Ans. (B) Notify the on-duty Doctor
Rationale: Redness, warmth, and tenderness at the CVC insertion site may indicate infection or inflammation. The nurse should notify the healthcare provider for further evaluation and potential intervention.
5. A patient in the ICU is receiving a continuous intravenous infusion of a vasoactive medication. What should the nurse monitor closely when administering vasoactive drugs?
(A) Pain level
(B) Urine output
(C) Skin temperature
(D) Oxygen saturation
Ans. (B) Urine output
Rationale: Monitoring urine output is crucial when administering vasoactive medications to assess renal perfusion and the patient's response to the medication.
6. A patient in the ICU has a pulmonary artery catheter (Swan-Ganz catheter) in place. What is the primary purpose of this catheter?
(A) Measurement of central venous pressure
(B) Continuous cardiac output monitoring
(C) Monitoring of arterial blood gases
(D) Administration of intravenous medications
Ans. (B) Continuous cardiac output monitoring
Rationale: The primary purpose of a pulmonary artery catheter is to monitor continuous cardiac output and hemodynamic parameters.
7. A patient in the ICU has a diagnosis of acute respiratory distress syndrome (ARDS). Which ventilator mode is commonly used to manage ARDS?
(A) Assist-control ventilation (ACV)
(B) Pressure support ventilation (PSV)
(C) Synchronized intermittent mandatory ventilation (SIMV)
(D) High-frequency oscillatory ventilation (HFOV)
Ans. (D) High-frequency oscillatory ventilation (HFOV)
Rationale: High-frequency oscillatory ventilation is commonly used to manage ARDS by delivering very high rates of small-volume breaths to minimize barotrauma.
8. A patient in the ICU is receiving total parenteral nutrition (TPN). What is the nurse's priority when caring for a patient on TPN?
(A) Monitoring blood pressure frequently
(B) Administering TPN through a peripheral IV line
(C) Assessing lung sounds for crackles
(D) Checking blood glucose levels regularly
Ans. (D) Checking blood glucose levels regularly
Rationale: The nurse's priority when caring for a patient on TPN is to monitor blood glucose levels regularly to prevent and manage hyperglycemia.
9. A patient in the ICU is experiencing acute renal failure. Which laboratory values should the nurse monitor closely in this patient?
(A) White blood cell count
(B) Platelet count
(C) Serum creatinine
(D) Hemoglobin level
Ans. (C) Serum creatinine
Rationale: Serum creatinine levels are closely monitored in patients with acute renal failure to assess kidney function.
10. A patient in the ICU is on a heparin infusion to prevent deep vein thrombosis (DVT). What should the nurse monitor for as a potential complication of heparin therapy?
(A) Hypertension
(B) Hyperglycemia
(C) Hematuria
(D) Bleeding
Ans. (D) Bleeding
Rationale: Heparin therapy carries a risk of bleeding as a potential complication, so the nurse should monitor for signs of bleeding, such as bruising, hematuria, and decreased hemoglobin levels.