NR 340 Critical Care Nursing Exam 1 Review, Exams of Clinical Medicine

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NR 340 Critical Care

Nursing Exam 1

(Chapter 1, 2, 9, 14,

5, 7, 14) AANC

CCRN 2024 Exam

Review Questions

and Answers 100%

Pass

NR 340 Critical Care Nursing Exam 1 (Chapter 1,

2, 9, 14, 5, 7, 14) AANC CCRN 2024 Exam Review

Questions and Answers 100% Pass

American Association of Critical-Care Nurses (AACN) - Answer>> Founded in 1969 Largest specialty organization in world Mission Assist nurses to attain knowledge and influence Healthy work environment initiative Web site: www.aacn.org AACN's vision: Create a healthcare system driven by patient's and family's needs in which critical care nurses make their optimum contributions AACN Membership Benefits: Professional journals and continuing education offerings Critical Care Nurse American Journal of Critical Care AACN Advanced Critical Care (reduced rate) Practice Alerts Evidence-based interventions Continuing education National Teaching Institute (NTI) Support from local chapters Scholarships Research grants Student rate for membership Discounted rate for certification exams Society of Critical Care Medicine (SCCM) - Answer>> Founded in 1970 Multiprofessional membership Physicians

Cardiac surgery Standards: Guide clinical practice Establish goals for patient care Provide assessment of outcomes AACN Standards for Acute and Critical Care Nursing Practice Process of nursing practice Expectation of the nurse Harms Targeted for Reduction - Answer>> Adverse drug events Infections Catheter-associated urinary tract infections (CAUTI) Central line-associated bloodstream infections (CLABSI) Surgical site infections Ventilator-associated pneumonia (VAP) Injuries from falls and immobility Obstetric adverse events Pressure ulcers Venous thromboembolism (VTE) Importance of Evidence-Based Practice - Answer>> Implement practice based on evidence Evaluate research Hierarchy of evidence Nurses are encouraged to implement care that is evidence based and to challenge practices that have "always been done" but are not supported by clinical evidence. Research studies are graded by the quality of evidence, with many different schemes used. Meta-analysis and systematic reviews are considered the highest level of evidence. This book uses AACN's grading scheme.

During report using SBAR, the nurse states, "Since we have just initiated a potassium replacement protocol, the patient will need a potassium level drawn at 1300." This depicts: A. Situation B. Background C. Assessment D. Recommendation - Answer>> D. Recommendation. Which of the following is a component of a healthy work environment? A. Collaboration B. Use of many agency nurses C. Crew-resource training D. Evidence-based practice - Answer>> A. Collaboration. Process of gas exchange - Answer>> Ventilation - movement of gases in and out of the alveoli Diffusion at pulmonary capillaries (oxygen and carbon dioxide @ the alveolar-capillary membrane) Perfusion Diffusion to the cells Regulation of Breathing - Answer>> Respiration stimulated by elevated CO Not true for COPD: stimulus is hypoxia rationale for low oxygen in patients with COPD Work of Breathing - Answer>> Amount of effort required to maintain ventilation Respiratory pattern changes automatically WOB increases, more energy needed WOB high, respiratory failure

Functional Residual Capacity (FRC) - Answer>> volume of gas remaining in the lungs at normal resting expiration average: 2300 mL Vital Capacity (VC) - Answer>> maximum volume of gas forcefully expired after maximum inspiration average: 4600 mL Respiratory Assessment - Answer>> Health History: oral and inhalant respiratory medications, OTC drugs, allergies (medication and environmental), last chest x-ray and tuberculosis screen, tobacco pack per year history, occupational history, sputum production, shortness of breath, dyspnea, cough, anorexia, weight loss, and chest pain Physical Examination: Inspection - head, neck, fingers, and chest. accessory muscles, sternal retractions, nasal flaring, asymmetrical chest movements, open-mouth breathing, and gasping breaths Respiratory Rate - tachypnea: rate > 20, bradypnea: rate < 10, assess rate and depth and altered patterns Abnormal Breathing Patterns: Cheyne-Stokes: cyclical with apneic periods Biot's: cluster breathing Kussmaul's: deep, regular, and rapid Apneustic: gasping inspirationsd Palpation: evaluate chest wall excursion, tracheal deviation, chest wall tenderness, subcutaneous crepitus, tactile fremitus Percussion: Resonance - normal lung sound Dullness - denser than normal tissue Flatness - air is absent

Hyperresonance - increased amount of air Tympany - air-filled area Auscultation: assess breath sounds, presence of adventitious lung sounds, voice sounds. quiet environment. systematic approach. Breath Sounds: Normal - bronchial, bronchovesicular, vesicular Adventitious sounds - crackles, rhonchi, wheezes, pleural friction rub, stridor Arterial Blood Gases (ABGs) - Answer>> adequacy of oxygenation and ventilation acid-base status interpret in conjunction with: clinical history, physical assessment ABG normal range: pH: 7.35 - 7. PaO2: 80 - 100 PaCO2: 35 - 45 HCO3: 22 - 26 SaO2: 93%-100% Oxygenation PaO SaO2 - Answer>> PaO2 - partial pressure of oxygen dissolved in arterial blood normal value 80 - 100 mm Hg decreased in elderly value < 60 mm Hg treated SaO2 - amount of oxygen bound to hemoglobin normal value 92%-99% frequently measured via pulse oximetry (SpO2)