ECCO: Hemodynamic Monitoring
Critically Ill Patients: Part 1 Questions
With Complete Solutions
After a subclavian CVC is inserted and dressed, what should be
the nurse’s next step? – Answer Request order for chest x-ray to
confirm catheter tip is properly placed and lung is intact.
What is the main purpose of quickly activating and releasing the
flush device to bounce the waveform into a “square wave?” –
Answer To evaluate the dynamic response of the system.
A patient with pulmonary hypertension is admitted. Which of
the following CVP readings should the nurse anticipate? –
Answer 22 mm Hg
Which of the following should the nurse include when caring for
a patient with a CVC? – Answer Assess the need for a CVC on
a daily basis
A patient with a radial arterial catheter has a damped waveform.
The nurse is unable to aspirate blood from the line and notes
pallor of the affected hand but no cyanosis. The nurse should: –
Answer Notify provider, and prepare to remove the catheter.
Interpret the result of the square wave test shown. – Answer
Optimally damped
ECCO: Caring for Patients with Hematologic
Disorders Questions with complete solutions
A patient receiving warfarin with an elevated INR….admin of
which reversal agent should nurse anticipate? – Answer – FFP
- PCC
- Vit K
A patient being managed for atrial fibrillation develops sudden
onset of chest pain with dyspnea. CT angio confirms a PE.
Which intervention should the nurse next anticipate? – Answer
Administration of subcutaneous Lovenox
A nurse monitoring a patient who was bleeding and underwent
platelet transfusion 18 hours earlier observes that the initially
increased platelet count is now decreased. What are the nurse’s
initial priorities? – Answer Monitor for bleeding and/or changes
in vital signs.
In a patient with sepsis or trauma, which lab results…provider? –
Answer – elevated.. - peripheral..
- low platelets
A patient post-cardiopulmonary bypass (CPB) procedure is on
VTE prophylaxis with UFH. Baseline postoperative platelet
level is 175,000; on day 5, platelet count is 51,000. Which
should the nurse anticipate? – Answer Discontinue heparin
For which combination of patient conditions and labs should RN
suspect DIC? – Answer – sepsis - viral
- trauma
A patient received 10 units RBCs and 6 units of FFP in the OR.
The patient is dyspneic and remains hypotensive and
hypovolemic. The patient’s H&H is 6.9 and 21 platelets are
148,000, k 3.9, and ionized ca is 0.89. The nurse should
anticipate administration of which treatment? – Answer –
Packed RBCs - Platelets
All heparin products have been stopped in a patient with
HIT…before administering argatroban or bivalirudin? – Answer - assess..
- assess..
- draw..
Which condition puts a pt at greatest risk for developing a
coagulopathy? – Answer Acute hepatic failure
Which are accurate statements about coagulation diagnostic
tests? – Answer – VTE - TEG
- Use FSP
A patient with a history of atrial fibrillation is receiving warfarin
and has limited mobility. For which set of lab results should the
nurse be concerned for risk of developing VTE? – Answer
1.5/25 seconds
ECCO – Neuro 1 Questions With
Complete Solutions
A patient with an EVD in place suddenly develops
disorientation to place, and ICP suddenly increases from 15 to
22 mm Hg. EVD drainage system troubleshooting indicates no
visible blockages and no CSF fluid fluctuation, and the EVD is
no longer draining. Which of the following interventions is the
highest priority? – Answer Inform the provider of the
assessment and EVD status
In assessing an unconscious patient who is noted to have newonset sluggish pupillary light reflex, deficits in what other
cranial nerve reflexes can indicate brainstem compression? –
Answer Corneal, Cough, Gag
A patient with a lumbar drain has zero drainage for the last hour.
Which of the following actions should the nurse implement? –
Answer Assess the tubing for a kink or a clot
A patient with a massive cerebral hemorrhage is admitted. The
patient is comatose. Pupils have become dilated and no longer
react to light. The breathing pattern has become irregular. Vital
signs: BP 170/66 (101), HR 40 and irregular, RR 16 and
irregular. Administration of which of the following should the
nurse anticipate? – Answer Mannitol (Osmitrol)
A nurse finds no CSF in a patient’s EVD collection chamber.
Assessment reveals the drain stopcock is open to drain. What
two other assessment should the nurse perform? – Answer –
Assess for pulsations or fluctuations in the tubing
-Assess drain tubing for presence of visible blockages.
Which of the following should the nurse perform immediately
after insertion of the ICP monitoring device is completed? –
Answer Assess neurologic status and compare to assessment
before insertion.
When a nurse asks a patient’s name, The patient replies with the
name of the town where the hospital is located. When asked
what day it is, he replies “house.” Shown a hairbrush and asked
to name it, he replies “dog.” What other step(s) should the nurse
take to evaluate the patient’s language functioning? – Answer
Ask the patient to raise one arm slowly.
On a patient’s ICP waveform, the P2 wave is higher and more
rounded than the P1 wave. What is the significance of this
finding? – Answer Decreased intracranial compliance; patient
may be unable to compensate for intracranial volume changes.
Which of the following central pain stimuli should the nurse use
to assess motor function in a patient who is unconscious and
who has facial fractures? – Answer Apply Trapezius squeeze
A nurse finds that a patient does not move spontaneously or
follow commands. To assess the patient’s motor function, the
nurse applies a central pain stimulus, without response. What is
the nurse’s next step? – Answer Apply peripheral pain stimulus
ECCO Caring for Patients with Renal Disorders:
Part 1 Questions With Complete Solutions
A patient is receiving IV calcium gluconate, IV insulin, IV D50,
and oral polystyrene sulfonate (Kayexalate). What evidence of
the treatment’s effectiveness should the nurse assess for? –
Answer Resolution of life-threatening hyperkalemia is assessed
by monitoring the ECG rhythm for stability with resolution of
widened QRS, IVC delay, and peaked T waves; and assessing
for decreasing K levels.
A patient with sepsis received vancomycin (Vancocin), had a
CT scan with contrast, and is diagnosed with AKI. Current vitals
on norepinephrine at 0.1 mcg/kg/min: HR 88 sinus rhythm, BP
70/40 (50), UO 0.3 mL/kg/hr; lab values: BUN: creatinine 15:1,
serum Osmo 292 (N) and hematocrit 30%. Which is indicated? –
Answer Titrate vasopressors to maintain MAP greater than 65
mm Hg.
A patient with SIADH has the following lab results: serum
sodium 128 mEq/L (L), serum osmolality 275 mOsm/kg H2O
(L), and hematocrit 32% (L). Which of the following
interventions should the nurse anticipate? – Answer Decrease
of IV fluids to 10 mL/hr
A patient who sustained a prolonged hypotensive episode in the
operating room is admitted on a norepinephrine infusion; MAP
is being maintained >65 mm Hg. Which intervention is
indicated to prevent further kidney injury? – Answer Discuss
with the pharmacist and provider collaborative efforts to avoid
the use of nephrotoxic agents.
A patient with CKD is to have a permanent arteriovenous shunt
placed. Which nursing intervention is indicated after the
procedure? – Answer Check for presence of thrill/bruit.
Assessment of a trauma patient with a spleen injury reveals BP
at 85/54 (64) and varying; HR 135 sinus tachycardia; and UO
0.2 mL/kg/hour for the past three hours. What do these signs
indicate? – Answer Fluid deficit
Assessment of a patient with CKD who is scheduled for dialysis
reveals pitting edema and crackles throughout both lungs. What
other signs should the nurse expect to see in this patient? –
Answer Decreased urine output, and increased BUN, Cr levels
A patient with kidney dysfunction has increasing confusion, BP
102/70 (81) lying, 86/68 (74) sitting, HR 118 sinus tachycardia,
and UO 0.1 mL/kg/hr. What intervention should the nurse
expect first? – Answer Administer IV NS in boluses of 250-500
mL.
What signs and symptoms should alert the nurse to fluid volume
deficit in a patient who has undergone dialysis? – Answer Poor
skin turgor; Decreased pulses in extremities; Cracked lips, dry
skin
A nurse is administering hypertonic saline to a patient with
cerebral salt-wasting syndrome and hyponatremia. Which two
assessments are crucial for patient safety and evaluating
response to this treatment? – Answer Monitor serum NA at
regular intervals; Evaluate neurologic status.
ECCO Cardiovascular Part 1 Questions With
Complete Solutions
A patient awaiting transfer to the catheterization lab for OCI
reports…mild nausea with diaphoresis. Admin of which single
agent… – Answer X – Reopro
X – Aspirin
YES – Plavix
Which of these on a 12-lead ECG tracing indicates ischemia or
infarction? – Answer X – QRS wide, ST elevation
X – All BUT Q waves that are 1mm wide
A patient with an acute inferior wall MI presents with vital signs
of BP 90/60, HR 84, RR 22, clear breath sounds, and Sp)2
95%….which of the following? – Answer Fluid bolus
What information about chest discomfort should a nurse seek
from a patient to identify ACS? – Answer Where,
did the discomfort
how long
The provider has ordered an echocardiogram to evaluate a
patient’s abnormal heart sounds. What are other indications for
assessment by echocardiogram? – Answer All BUT persistent
cough
What criteria indicate it is appropriate to use fibrinolytics in a
patient with acute MI? – Answer X – Symptom onset, STEMI,
non-stemi
YES – system onset, STEMI
**should not be hx of ic hemorrhage, or aortic dissection
After a stress test, a patient with ACS is fatigued with prolonged
dyspnea. The provider orders cardiac cath. What info to you
expect…? – Answer X – Coronary ischemia, infarction
YES – All BUT perfusion
A patient reports fainting and feeling persistent fatigue over the
past month. Which heart sounds likely indicate the patient’s
cardiovascular status is normal? – Answer S1, S2
Administration of which of the following should the nurse
anticipate for the patient? – Answer X – O2
X – Angiography
for a patient with non-STEMI …
morphine 2mg IV is indicated
What action should a nurse perform when a post-PCI patient
bleeds from a radial artery site when the inflatable compression
device is removed? – Answer Apply inflatable compression
device
ECCO global perspectives in critical care: part 2
(PCU) Questions With Complete Solutions
A patient is receiving morphine (Duramorph) and midazolam
(Versed). The patient does not respond to verbal commands and
has a CPOT score of 3 (out of 8). Which should the nurse
anticipate? – Answer A CPOT score of 3 indicates the patient is
experiencing pain, so increasing the morphine infusion rate is
appropriate. Remember to always treat pain before addressing
sedation (analgosedation).
Which action should the nurse implement prior to a patient
undergoing a procedure with moderate sedation in order to
ensure patient safety? – Answer The Universal Protocol
consists of verifying the patients identify, site marking, and a
time-out procedure. this is designed to prevent the rate but
disastrous events of wrong patient, wrong, site, and/or wrong
procedure.
In caring for sedated post-procedure patient, what are the nurse’s
patient care priorities? – Answer Following a patients
procedural sedation, nursing priorities including monitoring vital
signs, sedation level, and oxygenation until the patient returns to
pre-sedation state, as well as monitoring for pain and reorienting
the patient as needed. If necessary, encourage the non-ventilated
patient to take deep breaths.
In addition to using a closed suctioning system, which action
will decrease the likelihood of VAE/VAP in patients? – Answer
Changing the airway humidifies every 5-7 days as indicated may
decrease the likelihood of VAE/VAP. Other measures include
using a closed suctioning system, changing the vent circuit only
when it is soiled, and changing suctioning systems only as
needed.
A patient is being seen by the palliative care team for
management of dyspnea. The SP02 is 90% on RA in addition to
administration of low-dose opioids, which should the nurse
anticipate? – Answer palliative management of dyspnea
includes administration of low-dose opioids, adjusting the
environment, complementary treatments, and psychosocial and
interpersonal treatments such as guided imagery. Oxygen would
be appropriate if the patient is hypoxic.
-guided imagery
which interventions should the nurse anticipate to prevent
delirium? – Answer promote early mobility
in caring for a patient who will undergo procedural sedation,
what are the nurse’s pre-procedure care priorities? – Answer
Verify, mark, perform
In addition to clustering interventions to allow for uninterrupted
sleep time, which strategy should the nurse use to help the
patient receive adequate sleep? – Answer Diurnal light, ensure
treatment of pain and anxiety will help the patient receive
adequate sleep
Which should the nurse employ to decrease a patient’s risk of
hospital acquired pressure ulcers (HAPU) – Answer Turn
patient at 30 degrees
ECCO Global Perspectives in Critical Care:
Part 1 Questions With Complete Solutions
Which should the nurse expect as a cognitive change in older
adults? – Answer Slower reaction time
Which action is indicated to help ensure safety of a critically ill
patient? – Answer Adhere to established policies and protocols.
An older patient with no family is visited by close friends and a
minister. The nurse observes the patient will need help with
medications at discharge. Which strategy should the nurse
consider? – Answer Ask the friends and minister who might
help the patient with medications.
Which strategies should the nurse use to overcome barriers to
implementing a change? – Answer Know how the change is
expected to benefit patient outcomes;
Participate in data reviews to help evaluate the change;
Ask questions to clearly understand the goal of the change.
In preparing to transport a critically ill patient, which primary
task should the nurse perform? – Answer Determine transport
personnel needed based on monitoring and equipment.
According to the IOM, which are core competencies for
interprofessional collaborative practice? – Answer Provide
patient-centered care.
Which strategy should the nurse implement to incorporate
family-centered care into a plan of care? – Answer Ask family
about pre-admission usual state of functioning.
Family-centered care includes engaging the family to provide
needed information about the patient’s prior condition, such as
their usual functional and mental status. They can also
participate in patient care, provide emotional support, and help
with transition planning.
Regulatory reporting of patient outcomes and instances of
healthcare-associated patient harm can result in which of the
following? – Answer influence public confidence in the
institution’s quality of care.
Regulatory reporting of patient outcomes and instances of
healthcare-associated patient harm is expected to motivate
healthcare providers to adhere to EBP, results can influence
public confidence in the institutions quality of care. Compliance
with reporting and achieving target goals will also help the
hospital avoid reimbursement penalties.
A colleague is causing workplace violence. Which is a group
strategy that, if implemented, may manage the situation? –
Answer Offer support to work colleagues and get their support.
Which resources should the nurse use to facilitate evidencebased practice in the unit? – Answer Engage advanced-practice
nurses and educators in evidence-based projects.
AACN ECCO Pulmonary Part 1 |75 questions |
with Complete Solutions
What are the nursing priorities for patient care before, during, or
after thoracentesis? – Answer Position patient sitting on or
lying…
Continually monitor…
Help attach tubes to chest drainage…
A nurse caring for a patient with ARDS on BiPAP observes
rapid progression and tachypnea with RR between 37 and 41.
What intervention should the nurse anticipate? – Answer Call
emergency team for rapid intubation
For which purposes is EtCO2 monitoring indicated? – Answer
WRONG
Determining accurate…
Monitoring patients recovering from general…
Measuring effectiveness of CPR
A patient has the following ABG results: pH 7.25, PaCO2 43,
PaO2 80, SaO2 91%, and HCO3- 18. What is the most likely
underlying cause? – Answer Acute kidney injury
Which patient has an indication for oxygen therapy with a lowflow device? – Answer Who is postoperative…
A patient with respiratory failure following cardiac surgery has
crackles in bilateral posterior lower lobes and is on 4 L/min NC.
Which interventions will promote normal respiratory function? –
Answer Reduce anxiety…
Ensure early progressive mobility…
Administer bronchodilators…
A nurse monitoring a patient undergoing bedside bronchoscopy
notes a decline in a patient’s oxygen saturation. Which should
the nurse anticipate? – Answer Auscultate lung sounds…
Provide supplemental O2…
Monitor EtCO2
The ABG test results for a patient with a spinal cord injury are
pH 7.29, PaCO2 54, and HCO3- 25. Which acid-base disorder is
reflected? – Answer Respiratory acidosis
A patient with COPD on PEEP reports sudden chest pain. The
nurse observes tachycardia and shortness of breath. Which other
conditions should the nurse expected? – Answer Decreased
PaCO2 levels…
Decreased chest excursion on one side…
Decreased SaO2 level
Which are correct statements about a closed-chest drainage
system or component? – Answer To drain, system pressure
must be lower…
Gravity, and sometimes suction…
Wet suction chambers create suction…
A nurse caring for a patient with worsening hypoxia should
anticipate which signs of ARDS? – Answer PaO2/FiO2 below
300…
PEEP requirements of at least 5…
Respiratory failure unexplained…
AACN ECCO Cardiovascular Part 4 Questions
With Complete Solutions
What incision care interventions should a nurse use while
monitoring a post-cardiac surgery patient’s incisions and access
sites? – Answer Elevate donor leg after vein harvesting,
Maintain OR dressings for 24-48 hours, Irrigate
Anesthesia handoff for patient admitted to ICU shows BP 86/52
(63), HR 112, and RAP 4 mm HG. In ICU, CT output is 49 mL
over the first hour. For which condition should you intervene,
and based on what information? – Answer Intravascular
hypovolemia: BP, HR
In caring for a patient who underwent CABG with a saphenous
vein graft, the nurse should anticipate which postop
intervention(s)? – Answer Administer ASA within first six
hours and elevate donor leg
Patient underwent CABG with cardiopulmonary bypass. Which
rhythm disturbance is most likely to occur? – Answer A-fib
Patient is 24 hours post-CABG with a left radial artery graft.
Which is an unexpected finding? – Answer NOT: Chest tub
drainage 1,000 mL in 24 hours
Patient is undergoing CABG using the radial artery. Nurse
should anticipate which? – Answer Performing Allen’s test
Nurse finds dyspnea, bilaterally diminished breath sounds, and
respiratory distress in a patient in the acute recovery phase post-
cardiac surgery. What interventions should the nurse anticipate?
- Answer Progressive mobility,
Incentive spirometry exercises,
Deep breathing
Which findings in a patient in the acute recovery phase postcardiac surgery indicate possible cardiac tamponade? – Answer
Decreased ECG voltage; narrow pulse pressure,
Significant, abrupt ↓ in mediastinal CT output; tachycardia
Muffled heart sounds; ↓ UO and CO
Which additional conditions make it likely that a patient with
severe aortic stenosis will be advised to undergo TAVR instead
of surgical aortic valve replacement? – Answer COPD and
poorly controlled diabetes,
CKD and history of stroke,
Two previous sternotomies for CABG
Patient is admitted post-TAVR with a transfemoral approach.
Which findings related to the procedure leg should cause
concern? – Answer TRY: Pallor, Pain
What are the nurse’s care priorities for a patient who underwent
TAVR via transaxillary approach? – Answer Assess sensory
and motor function on affected side,
Anticipate return to OR for ongoing bleeding or vascular
insufficiency,
Anticipate return to OR for pseudoaneurysm
ECCO Practice Exam Questions With
Complete Solutions
A patient has a transcutaneous pacemaker. Which action should
the nurse implement when a pacemaker spike occurs but is not
followed by ventricular complex?
Assess the heart rate
Increase the mA
Increase the mV
Assess the ECG lead placement – Answer Increase the mA
A patient has a transvenous temporary pacemaker in place.
Pacemaker spikes are noted on the ECG, but they are not
followed by a P wave or QRS complex. Which is initially
indicated?
Reposition patient on the right side
Increase the sensitivity (set mV to a lower number).
Check the connections.
Decrease the mS (output) – Answer Check the connections.
A patient has a epicardial temporary pacemaker in place at a rate
of 70 and mA of 6. The patient’s rhythm is junctional with a rate
of 55. No pacemaker spikes are noted on the ECG. Which is
initially indicated.
Increase the mV on the sensitivity dial
Change the batteries
Increase the pacemaker rate
Increase the mA (output) – Answer Change the batteries
A patient’s ICD defibrillates and the nurse assesses the patient’s
rhythm and vital signs. What should be the nurse’s next step?
Watch to see whether the ICD terminated the dysrhythmia
Place a magnet over the ICD
Turn off the ICD, and insert a new battery
Change the ICD to standby mode – Answer Watch to see
whether the ICD terminated the dysrhythmia
A nurse notes bradycardia in a patient admitted with
subarachnoid hemorrhage and vomiting. What medications may
increase the patient’s risk of sudden cardiac death due to long
QT syndrome?
Anticholinergics or phosphodiesterase inhibitors
Acetaminophen or calcium channel blockers
ACE inhibitors or anticonvulsants
Antibiotics or antidysrhythmics – Answer Antibiotics or
antidysrhythmics
Which patient is at greatest risk for development of torsades de
pointes? A patient with a…
QTc of 0.40 with hypercalcemia
QTc of 0.52 with hypokalemia
QTc of 0.44 with hyperphosphatemia
QTc of 0.36 with hyponatremia – Answer QTc of 0.52 with
hypokalemia
A patient has indication for synchronized cardioversion? A
patient with:
Ventricular tachycardia with BP 100/60 (73)
Supraventricular tachycardia with chest pain
Atrial fibrillation with a history of VTE
Sinus bradycardia with mental status changes – Answer
Supraventricular tachycardia with chest pain
A nurse finds a patient unresponsive and without a palpable
pulse. Which of the following assessments is an indication for
defibrillation?
Ventricular fibrillation
Cyanosis
Pulse oximeter below 80
Asystole – Answer Ventricular fibrillation
Which should the nurse include in preparing a patient for an
electrophysiology study?
“You’ll see yourself in v tach on the screen”
“The study calls for dye to be places in your IV”
“You will be sedated for the procedure”
“Since you will be awake, you can eat a light breakfast” –
Answer “You will be sedated for the procedure”
A patient with a history of cocaine use reports headache, blurred
vision, severe chest pain, nausea, and vomiting. Vital signs are:
BP 214/136, HR 106, RR 24. Which priority is initially
indicated?
Emergent ophthalmology consult
Implement a chest pain protocol
Initiation of anti-emetic therapy
Administration of an antihypertensive – Answer Administration
of an antihypertensive
A patient reports sudden onset of chest pain, and dyspnea.
Which 3 assessment findings would differentiate whether the
cause is ACS or pericarditis?
Pericarditis pain often accompanied by severe headache
ACS pain is not usually accompanied by fever
Pericarditis chest pain increases with inspiration
ACS chest pain doesn’t alter when patient changes position –
Answer ACS pain is not usually accompanied by fever
Pericarditis chest pain increases with inspiration
ACS chest pain doesn’t alter when patient changes position
A patient with a recent MI reports stabbing chest pain that
increases with deep breathing and is relieved by leaning
forward. SpO2 is 94%. Which should the nurse initially
anticipate?
Corticosteroids
NSAIDs/ASA
Pericardiocentesis
Nitroglycerin – Answer NSAIDs/ASA
ECCO – Global Perspectives 1 Questions
With Complete Solutions
Which factor should the nurse consider in determining whether
is to transport a critical care patient? – Answer Stability of the
patient
A postoperative trauma patient is admitted. Which family need
has the highest priority at the time? – Answer Information
Which strategy should the nurse implement to incorporate
family-centered care into a plan of care? – Answer Ask family
about pre-admission usual state of functioning
Older adult patients are at risk of geriatric syndromes which
prolong length of stay and can result in loss of function. Which
of the following should the nurse do to prevent geriatric
syndromes? – Answer Assess sleep patterns and encourage
daily activity
Which example illustrated the impact of team competency on
patient outcomes? – Answer Collaboration for implementation
of evidence-based guidelines
You are caring for a patient with BMI of 48. Which strategy
should you implement? – Answer Assess patient for increased
preload
An older patient with no family is visited by close friends and a
minister. The nurse observes the patient will need help with
medications at discharge. Which strategy should the nurse
ECCO Global Perspectives: Part 1 Questions
With Complete Solutions
a pt w/ sepsis receiving titration of pressors is on mech
ventilation. what equipment should the rn obtain for safe
transport – Answer oxygen, infusion, transport
which should the rn expect as a physical domain change in older
adults – Answer increased risk of falls
which EB intervention should the rn incorporate into the plan of
care of an older adult – Answer observe for decreased stress
which pt characteristics should the rn consider to determine
appropriate to transition to a different level of care – Answer
vulnerability, complexity, stability
which of these signs in a healthcare provider likely signal moral
distress – Answer minimally, avoiding, experiencing
which comorbidities shoudl the rn anticipate may prolong
recovery time in a pt with morbid obesity – Answer
pulmonary, asthma, CAD
which comp should the rn develop in order to make accurate
clinical judgement regaiding a critcally ill pt – Answer
recongize, connect, follow
in preparing to transport a critically ill pt, which primary task
should the nurse perform – Answer check, ensure, determine
pt w/ ARDS on mechanical vent requires transport to CT. What
equipment should the rn obtain for safe pt transport – Answer
oxygen, manual, transport
which factor should the rn consider when determining if it is
safe to transport a pt to another dept for a diagnostic test –
Answer stability, complexity
you are notified that a new procedure change will be
implemented. which strategy helps overcome barriers to
implement change – Answer clarify why
which strategies should the rn use to overcome barriers to
implement a change – Answer participate, ask, know
an older pt with no fam is visited by close friends and minister –
Answer ask the friends
which factor should rn consider toi determine whether is it safe
to transport – Answer coordination, availability, stability
which comps shoudl the rn develop to make accurate clinical
judgements – Answer connect, recognize, follow
should a rn anticipate malnutrition in a morbid obese pt –
Answer yes cant store fat
which strategy shoud rn implement to incorporate familycentered care into a plan of care – Answer Ask
ECCO Global Perspectives in Critical Care: Part
2 Questions With Complete Solutions
A patient is being seen by the palliative care team for
management of dyspnea. SpO2 is 90% on room air. In addition
to administration of low-dose opioids, which should the nurse
anticipate? – Answer Performing guided imagery as needed
Palliative management of dyspnea includes administration of
low-dose opioids, adjusting the environment, complementary
treatments, and psychosocial and interpersonal treatments such
as guided imagery. Oxygen would be appropriate if the patient is
hypoxic.
Which tools should the nurse use to assess delirium in a
critically ill patient? – Answer Confusion Assessment Method
for the ICU (CAM-ICU);
Intensive Care Delirium Screening Checklist (ICDSC)
Which intervention should the nurse implement to help prevent
a CAUTI? – Answer Remove catheter if not indicated.
A patient hospitalized with acute respiratory distress syndrome
(ARDS) is now told he will be discharged soon. Which
statements or actions may indicate PICS? – Answer Patient is
unable to recall medication instructions he was taught yesterday.
In caring for a sedated post-procedure patient, what are the
nurse’s patient care priorities? – Answer Record vital signs,
sedation level, and oxygenation until patient is at pre-sedation
LOC and function until the patient returns to pre-sedation state,
as well as monitoring for pain and reorienting the patient as
needed.
If necessary, encourage the non-ventilated patient to take deep
breaths.
A patient with end-stage kidney disease (ESKD) managed with
hemodialysis is hypotensive. The nephrologist agrees there are
no options. The family agrees the patient is end of life. A DNR
order is signed. Which has the highest priority? – Answer In the
situation described, the patient has a DNR order, and the
provider and family agree the patient is at end of life and that
further hemodialysis is not indicated due to the patient’s
hypotension. The nurse’s next priority is to
explain to the family what to expect the patient’s response and
care to be as hemodialysis is discontinued.
A patient is recovering from moderate sedation with fentanyl
(Sublimaze). The patient’s BP is 30 mm Hg from baseline.
Which should the nurse anticipate? – Answer Monitor vital
signs every five minutes.
What are the care priorities for a patient in the immediate
postoperative period? – Answer Maintaining airway and
normothermia, monitoring vital signs and indications of
recovery from anethesia, managing pain, and recognizing and
intervening for complications.
ECCO Multisystem Disorders Questions
With Complete Solutions
Which of the following are signs and symptoms consistent with
a diagnosis of rhabdo – Answer profound muscle weakness and
pain
A patient was admitted with septic shock due to a urinary tract
infection. The 3 hour bundle has been completed. Norepi and
vasopressin are infusing with MAP trending 55-58 mmHg.
Which of the following should the nurse anticipate being
ordered? – Answer An inotropic agent
A patient with sepsis had blood glucose levels of 185 and an
hour later 191 the nurse implements glucose management
protocol. What is the nurse’s goal for maintenance of glucose
levels in sepsis patients? – Answer Target glucose
A patient who fell down a flight of stairs is admitted with a Ccollar in place. Vital signs are BP 84/32 (49), HR 52 sinus
bradycardia, RR 16, temo 36 C. The patient has warm
extremities but is unable to move the lower extremities. Which
of the following interventions should the nurse initially
anticipate? – Answer – IV fluid bolus
- A vasopressor
A patient with a history of chronic alcohol abuse is admitted for
respiratory failure that required intubation and mechanical
ventilation. For which of the following signs of symptoms
should the nurse observe? – Answer Shaky hands and seizures
A patient who reported being a social drinkers undergoes
surgery and is admitted. Vital signs are BP 156/92 (113), HR
105 ST, RR 22, temp 38.3C, and SPO2 94% on 2L n/c. The
patient is inquiring why voices are coming from the air vent and
is chewing on the IV tubing. Which of the following
interventions is of highest priority? – Answer AWS
management includes maintaining a patent airway. Have suction
set up
A patient with diabetes reports that the site of a resolving
pressure ulcer has now become very painful. The nurse observes
edema at the site. What other signs are likely for a patient
developing necrotizing fasciitis? – Answer – bullae
- erythema
- fatigue
Which of the following is a sign or symptom of necrotizing
fasciitis? – Answer ulcerated ares of blistering
Following a diagnosis of sepsis, a nurse draws the patient’s
blood cultures and lactate level. Broad spectrum IV antibiotics
are started. Which additional step is essential for the nurse to
complete within 3 hours of presentation? – Answer Administer
30 ml/kg crystalloid for hypotension of lactate >/= 4
A patient reports pain after a sports injury, saying it feels like a
muscle has been pulled. The nurse notes that the painful area has
black spots on it and it is expanding rapidly. The provider has
been notified. Which of the following is an anticipated treatment
priority for this patient? – Answer Prepare pt for ct scan