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TEST BANK FOR INTRODUCTION TO CRITICAL CARE NURSIN2
TEST BANK FOR INTRODUCTION TO CRITICAL CARE NURSIN2
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TEST BANK FOR INTRODUCTION TO CRITICALCARE 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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