The intra-aortic balloon inflates during diastole, when the aortic valve is closed, which pushes more blood into the coronary arteries.
Missing Word
diastole
Diastole is the relaxation phase of the heart cycle. Inflating the balloon then improves coronary perfusion, and deflating it just before the next contraction reduces the resistance the left ventricle must pump against.
Category: Hemodynamic Monitoring
Question 2
To estimate how far to insert a nasogastric tube, the nurse measures from the tip of the nose to the earlobe and then down to the xiphoid process.
Missing Word
xiphoid
The xiphoid process is the small lower tip of the sternum. Measuring nose to earlobe to this landmark approximates the distance to the stomach, and the length is marked on the tube.
Category: GI and Renal Concerns
Question 3
A critically ill patient with frequent urinary and fecal incontinence scores low in the moisture category of the Braden Scale, which signals a higher risk of pressure injury.
Missing Word
moisture
Moisture is one of the Braden subscales, along with sensory perception, activity, mobility, nutrition, and friction and shear. Skin that stays wet from incontinence softens and breaks down more easily, so the nurse cleans and dries it promptly and protects it with a barrier product.
Category: Skin and Mobility
Question 4
After intubation, a small balloon near the tip of the endotracheal tube, called the cuff, is inflated to seal the trachea so air flows through the tube rather than around it.
Missing Word
cuff
The inflated cuff seals the trachea so ventilated air reaches the lungs and secretions are less likely to be aspirated. Maintaining correct cuff pressure is also part of bundles that prevent ventilator-associated pneumonia.
Category: Respiratory and Ventilator Care
Question 5
A breakdown product of skeletal muscle that is made at a fairly steady rate, so a rising serum level can be an early sign of acute kidney injury, is creatinine.
Missing Word
creatinine
Creatinine is cleared by the kidneys, and because the body produces it at a fairly steady rate, a rising blood level signals reduced kidney clearance, although the rise can lag behind the actual drop in function.
Category: GI and Renal Concerns
Question 6
Suspected acute GI bleeding usually calls for urgent endoscopy, in which a flexible scope passed through the esophagus or the rectum lets the provider see and cauterize the bleeding site.
Missing Word
endoscopy
Endoscopy is the direct viewing of the inside of the GI tract with a flexible scope. It can locate the bleeding source and treat it during the same procedure.
Category: GI and Renal Concerns
Question 7
The team caring for a patient on extracorporeal membrane oxygenation includes a perfusionist, a specialist trained to run the machines that take over the work of the heart and lungs.
Missing Word
perfusionist
A perfusionist operates heart-lung bypass and similar circuits. Care for these patients is interdisciplinary and includes perfusionists, cardiologists and critical care nurses.
Category: Hemodynamic Monitoring
Question 8
The low nurse-to-patient ratio in an intensive care unit reflects the high acuity of its patients, meaning how sick they are and how much nursing care they need.
Missing Word
acuity
Acuity describes the severity of a patient's condition and the intensity of care it requires. Higher acuity calls for more nursing time per patient, so ICU nurses care for fewer patients.
Category: ICU Care and Ethics
Question 9
A patient with a head injury whose CT scan shows enlarged ventricles holding excess cerebrospinal fluid has hydrocephalus, so the nurse watches for rising intracranial pressure and prepares for drainage through a ventriculostomy or a shunt.
Missing Word
hydrocephalus
Hydrocephalus is an excess of cerebrospinal fluid inside the ventricles. Because the skull cannot expand, the added volume raises intracranial pressure, so the nurse watches closely for a falling level of consciousness and other signs of rising pressure.
Category: Neurological Care
Question 10
When turning a critically ill patient, the nurse places a pillow under the calves so the heels, the bony backs of the feet, float free of the mattress.
Missing Word
heels
The heels have little padding over bone and are among the sites most prone to pressure injury in a patient confined to bed. Floating them off the mattress, along with regular turning and pillows for support, relieves that pressure.
Category: Skin and Mobility
Question 11
In acute respiratory distress syndrome, widespread inflammation lets fluid fill the alveoli, the tiny air sacs where gas exchange occurs.
Missing Word
alveoli
The alveoli are where oxygen and carbon dioxide cross between air and blood. When they fill with fluid, gas exchange falls sharply and hypoxemia results.
Category: Respiratory and Ventilator Care
Question 12
Early in an acute GI bleed the hematocrit, the share of blood volume made up of red cells, may still look normal because plasma and red cells are lost together.
Missing Word
hematocrit
The hematocrit falls only after fluid shifts or IV fluids dilute the remaining blood, so a normal early value does not rule out a significant bleed.
Category: GI and Renal Concerns
Question 13
Stroke volume is set by preload, afterload and contractility, and in cardiogenic shock after a large infarction the ventricle is well filled but its squeeze has failed.
Missing Word
contractility
Preload is the filling of the ventricle, afterload the resistance it pumps against, and contractility the strength of the squeeze itself. Infarcted muscle cannot contract well, so stroke volume and cardiac output fall even though filling pressures are high, which is why drugs and devices that support the heart are used.
Category: Hemodynamic Monitoring
Question 14
During transcutaneous pacing, the nurse confirms capture by checking that each pacing spike on the monitor is followed by a QRS complex and by feeling a pulse that matches the paced rate.
Missing Word
capture
Capture means the pacemaker's impulse actually depolarizes the heart: a QRS complex after each spike shows electrical capture, and a pulse at the paced rate shows the ventricles are contracting. Spikes with no QRS after them mean the impulse is not reaching the heart, so the nurse reports it promptly and the output is adjusted as ordered.
Category: Hemodynamic Monitoring
Question 15
While a nasogastric tube is advanced, the alert patient sips water through a straw, because each swallow closes off the airway and guides the tube into the esophagus.
Missing Word
swallow
Swallowing lifts the larynx and folds the epiglottis over it while the upper esophagus opens, so a tube advanced during a swallow tends to pass into the esophagus rather than the trachea. Severe gagging, a hoarse voice or falling oxygen saturation still means the tube must come out.
Category: GI and Renal Concerns