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TEST BANK FOR INTRODUCTION TO CRITICAL CARE NURSIN2

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  • INTRODUCTION TO CRITICAL CARE NURSIN

TEST BANK FOR INTRODUCTION TO CRITICAL CARE NURSIN2

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  • August 19, 2024
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  • 2024/2025
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  • INTRODUCTION TO CRITICAL CARE NURSIN
  • INTRODUCTION TO CRITICAL CARE NURSIN
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leonardmuriithi061
TEST BANK FOR INTRODUCTION TO CRITICAL
CARE NURSING, 8TH EDITION, MARY LOU SOLE,
DEBORAH KLEIN, MARTHE MOSELEY,

1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Becauseent
eraltubefeedingsarenotpossible,thedecisionistoinitiateparenteralfeedings.Whatarethe
majorcomplicationsforthistherapy - ANSWER b.
Fluidandelectrolyteimbalancesandsepsis

.Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastricsmal
l-
borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacem
ent? - ANSWER d. Topreventaspirationofthefeedings

3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcathete
rinsertion? - ANSWER d. Subclavianvein

4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallowstudy
,thepatientisplacedonenteralfeedings.Followingplacementofanasogastrictubefortubef
eeding,whatisthenextcriticalstep? - ANSWER c. Obtainachestradiograph.

5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinuousf
lowtubefeeding.Thenurseknowsthatthisapproachwaschosenbecause: - ANSWER c.
theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves

6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewouldcar
ryoutwhichinterventiontominimizeaspirationrisk? - ANSWER
Elevatetheheadofthebed30degrees.

7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilkygree
nfluid.Thisisaconcernbecausethismostlikelydemonstratesthatthepatienthas: -
ANSWER d. tube feeding intolerance.

8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.The
nurseholdsthetubefeeding,whichhadbeeninfusingat100mL/
hr.Thenurseknowsthatthenextactionshouldbe: - ANSWER d. recheck the residual in
2hours

9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolerance
? - ANSWER a. Abdominal distention

10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrhea.A
stoolspecimeniscollectedtocheckforwhichpossiblecause? - ANSWER a. Clostridium
difficile

,11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurselisted
possibleinterventionsforthispatient.Whichinterventionneedscorrectionbeforefinalizingt
heplanofcare? - ANSWER b. Infuseantibioticsthroughtheintravenousline.

12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemostsen
sitiveindicatorofproteinsynthesisandcatabolism? - ANSWER c. Prealbumin

13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug-
nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdru
g-nutrientreactions? - ANSWER d. Phenytoin

14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract? -
ANSWER d. Without nutritional stimulation, mucosal villi atrophy.

15.An important nutritional consideration in the elderly population is: - ANSWER c.
potential for drug-nutrient interaction related to polypharmacy.

16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude: - ANSWER
d. weight loss, elevated glucose, and dehydration

17.In trauma patients ,enteral nutrition via nasogastric tube feedings into the small
bowel is best initiated within what time frame following the injury? - ANSWER a.
24hours

18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalcareu
nitonaventilator.Thenutritionassessmentnotesthatthepatienthasaproteinandvitaminde
ficiencyandisunderweight.Whichformulafornutritionalassessmentismostappropriate? -
ANSWER b. Fiber-addedformula

19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceofnutri
tionaltherapy - ANSWER d. Gut mucosa is preserved.

20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein? -
ANSWER b. The patient with ileitis

21.Thebestnursingapproachtopreventfeedingtubeobstructionis: - ANSWER b.
flushthetubeevery4hourswith20to30mLoftapwater.

22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequirement
sto: - ANSWER c. 35kcal/kg/day

23.Malnutritioncontributestoinfectionriskby - ANSWER b. impairing immune function

24.Apatient,whohasatubefeeding,requiresachestx-
raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse: - ANSWER d.
stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph.

1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?(Selectallthatapply.) -
ANSWER a.

, Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsideration
s.b. Fingerstickglucoselevelsareassessedevery6hoursandprn.
d.
Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydra
tes,andfats.

2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration?
(Selectallthatapply). - ANSWER b. Changethetubingevery24hours.
d. Monitortriglyceridelevels.

3.Calorie-densefeedings:(Selectallthatapply.) - ANSWER a. are most useful in heart
failure and liver disease.

4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.) - ANSWER b.
elevatedbloodsugar.
c. infectionatthecathetersite.
d. volumeoverload.

5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition?
(Selectallthatapply.) - ANSWER a.
Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues.
b. Insulinmaybeaddedtoaparenteralnutritionsolution.
c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition.

Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__ -
ANSWER A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency.
D.Obtainchestradiograph. E.Assessresiduals. ANS: B,D,C,A,E

1.Apatienthascoronaryarterybypassgraftsurgeryandistransportedtothesurgicalintensiv
ecareunitatnoon.Heisplacedonmechanicalventilation.Interprethisinitialarterialbloodga
slevels:
pH7.31
PaCO248mmHg
Bicarbonate22mEq/L
PaO2115mmHg
O2saturation99% - ANSWER d. Uncompensated
respiratory
acidosis;
hyperoxygenated

2.Thephysicianordersthefollowingmechanicalventilationsettingsforapatientwhoweighs
75kg.Thepatientsspontaneousrespiratoryrateis22breaths/
min.Whatarterialbloodgasabnormalitymayoccurifthepatientcontinuestobetachypneicat
theseventilatorsettings?
Settings:
Tidalvolume:600mL(8mLperkg)
FiO2:0.5
Respiratoryrate:14breaths/min
Modeassist/ control - ANSWER d. Respiratoryalkalosis

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