Question

Which of the following statements regarding pain and anxiety are true? (Select all that apply.)

Answer 1

Correct Answers:

Pain and anxiety are often interrelated and may be difficult to differentiate because their physiological and behavioral manifestations are similar.
Pain is defined by each patient; it is whatever the person experiencing the pain says it is.
Anxiety is a state marked by apprehension, agitation, autonomic arousal, and/or fearful withdrawal.

Rationale :

🩺Pain and anxiety frequently occur together, especially in critically ill patients, because both can produce similar manifestations such as increased heart rate, agitation, restlessness, and elevated blood pressure, making differentiation challenging.

🧠Pain assessment is based on the principle that pain is subjective, meaning the patient is the most reliable source for determining its presence and severity.

😟Anxiety is characterized by apprehension, autonomic nervous system activation, fear, agitation, and emotional distress, making the description of anxiety accurate.

🚫Critically ill patients commonly experience both pain and anxiety, so saying they rarely experience pain is incorrect.

💉Neuromuscular blockade only causes paralysis and does not treat underlying pain, discomfort, or anxiety, which means separate analgesia and sedation are still required.

📌Core Message

Pain and anxiety are closely related experiences, pain is patient-defined, and neuromuscular blockade does not eliminate pain or anxiety.

Answer 2

Correct Answers:

20

Rationale :

🧮The concentration is 50 mg in 250 mL, which equals 0.2 mg/mL or 200 mcg/mL.

💉The infusion is running at 6 mL/hr, so multiplying 200 mcg × 6 mL = 1200 mcg/hr.

⏱️Converting hourly dosing to minutes requires dividing by 60 minutes, resulting in 20 mcg/min.

🩺Correct medication calculations are essential because nitroglycerin directly affects cardiac workload and myocardial oxygen demand.

📌Core Message

Accurate IV medication calculations require proper concentration conversion and unit analysis.

Answer 3

Correct Answers:

Breaths should be delivered approximately 10 breaths per minute.

Rationale :

🫁Patients with an advanced airway receive continuous chest compressions during resuscitation.

💨Current guidelines recommend approximately 1 breath every 6 seconds, which equals 10 breaths per minute.

❤️Interrupting compressions unnecessarily reduces perfusion during cardiac arrest.

🚑Proper ventilation timing improves oxygen delivery while maintaining effective circulation.

📌Core Message

Patients with an advanced airway receive continuous compressions with ventilation at approximately 10 breaths per minute.

Answer 4

Correct Answers:

35.0

Rationale :

🧮The concentration is 1000 mg in 100 mL, giving 10 mg/mL.

💉At 14.3 mL/hr, the patient receives 143 mg/hr.

⚖️Converting to micrograms and dividing by 68 kg and 60 minutes gives 35 mcg/kg/min.

🩺Weight-based medication calculations are critical because Propofol dosing directly influences sedation safety.

📌Core Message

Safe weight-based infusion dosing requires careful unit conversion and calculation accuracy.

Answer 5

Correct Answers:

Nursing care
Monitoring devices
Invasive procedures
Inability to communicate

Rationale :

🩺Critically ill patients experience frequent procedures, repositioning, and nursing interventions that contribute to discomfort.

🖥️Monitoring devices and medical equipment may increase stress, discomfort, and anxiety.

💉Invasive procedures commonly trigger both physical pain and emotional distress.

😔An inability to communicate increases anxiety because patients cannot easily express needs or symptoms.

📌Core Message

Critical illness commonly increases pain and anxiety because of procedures, equipment, and communication barriers.

Answer 6

Correct Answers:

Administer sedatives in conjunction with the neuromuscular blocking agent.

Rationale :

💉Neuromuscular blockers produce paralysis but do not provide sedation or pain relief.

🧠Patients receiving paralysis may still experience awareness, anxiety, and pain if sedation is inadequate.

😴Providing appropriate sedation promotes comfort and prevents psychological distress.

🩺Critically ill patients receiving paralytics require continuous monitoring and supportive care.

📌Core Message

Neuromuscular blockade causes paralysis only and must be combined with sedation.

Answer 7

Correct Answers:

Synchronized cardioversion

Rationale :

❤️The patient has atrial fibrillation with rapid ventricular response and evidence of instability with hypotension and diaphoresis.

⚠️Unstable tachydysrhythmias require rapid intervention to restore cardiac output.

⚡Synchronized cardioversion delivers energy coordinated with cardiac rhythm to reduce deterioration risk.

🚨Delayed treatment may worsen tissue perfusion and cardiovascular compromise.

📌Core Message

Unstable tachyarrhythmias often require immediate synchronized cardioversion.

Answer 8

Correct Answers:

A patient with a heart rate of 50, BP 72/48 and complaining of dizziness

Rationale :

❤️Symptomatic bradycardia with hypotension requires urgent intervention.

⚡Transcutaneous pacing supports cardiac output when bradycardia causes instability.

🚨Dizziness and hypotension indicate poor perfusion requiring immediate action.

🩺Stable bradycardia without symptoms generally does not require emergency pacing.

📌Core Message

Symptomatic bradycardia with poor perfusion requires emergent intervention.

Answer 9

Correct Answers:

Administer 2 units of packed red blood cells as ordered by the physician

Rationale :

🩸The patient's hemoglobin of 7 and hematocrit of 22 indicate significant anemia.

❤️Anemia reduces oxygen delivery and may contribute to compensatory sinus tachycardia.

⚠️Replacing blood volume improves oxygen-carrying capacity and tissue perfusion.

🚑Treating the underlying cause is more appropriate than rhythm-focused intervention.

📌Core Message

Significant anemia requires correction to improve oxygen delivery and circulation.

Answer 10

Correct Answers:

The patient must have knowledge and competence to make the decision.

Rationale :

🧠Informed consent requires patient understanding and decision-making ability.

⚖️Competence ensures patients appreciate risks, benefits, and alternatives.

🩺Mechanical ventilation alone does not eliminate decision-making capacity.

📋Valid consent depends on knowledge and voluntary participation.

📌Core Message

Informed consent requires both understanding and decision-making competence.

NR455 Exam-1

No.

1 :
Which of the following statements regarding pain and anxiety are true? (Select all that apply.)

2 :
Mrs. Smith is admitted with ST elevation MI. She is currently on a Nitroglycerin infusion at 6 mL/hr for chest pain. Nitroglycerin 50 mg is supplied in 250 mL of D5W. What dose of Nitroglycerin is Mrs. Smith receiving in mcg/min? (Round to the nearest tenths.)

3 :
A nurse is providing manual ventilations with a bag-valve mask. The patient has been intubated with an advanced airway. Which of the following guidelines would the nurse use?

4 :
Ms. Peters is intubated and on Propofol for sedation. Propofol 1000 mg is supplied in 100 mL of D5W. Ms. Peters weighs 68 kg. The infusion is currently at 14.3 mL/hr. What dose of Propofol is Ms. Peters receiving in mcg/kg/min? (Round to the nearest tenths.)

5 :
Which of the following factors predispose the critically ill patient to pain and anxiety? (Select all that apply.)

6 :
Your patient has been started on intentional hypothermia and is requiring a cisatracurium infusion to prevent shivering. You plan to:

7 :
A patient presents with atrial fibrillation with rapid ventricular response with a rate of 178. The patient is diaphoretic with a BP of 85/50. Which intervention would the nurse anticipate?

8 :
Which of the following patient would require emergent application of a transcutaneous pacemaker?

10 :
The physician identifies the need for a bronchoscopy for a patient who is on mechanical ventilation. The patient is alert and able to give consent. Based on the criteria for informed consent, what specific patient criteria must be demonstrated prior to the procedure?

NR455 Exam-1

No.

1 : Which of the following statements regarding pain and anxiety are true? (Select all that apply.)

2 : Mrs. Smith is admitted with ST elevation MI. She is currently on a Nitroglycerin infusion at 6 mL/hr for chest pain. Nitroglycerin 50 mg is supplied in 250 mL of D5W. What dose of Nitroglycerin is Mrs. Smith receiving in mcg/min? (Round to the nearest tenths.)

3 : A nurse is providing manual ventilations with a bag-valve mask. The patient has been intubated with an advanced airway. Which of the following guidelines would the nurse use?

4 : Ms. Peters is intubated and on Propofol for sedation. Propofol 1000 mg is supplied in 100 mL of D5W. Ms. Peters weighs 68 kg. The infusion is currently at 14.3 mL/hr. What dose of Propofol is Ms. Peters receiving in mcg/kg/min? (Round to the nearest tenths.)

5 : Which of the following factors predispose the critically ill patient to pain and anxiety? (Select all that apply.)

6 : Your patient has been started on intentional hypothermia and is requiring a cisatracurium infusion to prevent shivering. You plan to:

7 : A patient presents with atrial fibrillation with rapid ventricular response with a rate of 178. The patient is diaphoretic with a BP of 85/50. Which intervention would the nurse anticipate?

8 : Which of the following patient would require emergent application of a transcutaneous pacemaker?

10 : The physician identifies the need for a bronchoscopy for a patient who is on mechanical ventilation. The patient is alert and able to give consent. Based on the criteria for informed consent, what specific patient criteria must be demonstrated prior to the procedure?

1 :
Which of the following statements regarding pain and anxiety are true? (Select all that apply.)

2 :
Mrs. Smith is admitted with ST elevation MI. She is currently on a Nitroglycerin infusion at 6 mL/hr for chest pain. Nitroglycerin 50 mg is supplied in 250 mL of D5W. What dose of Nitroglycerin is Mrs. Smith receiving in mcg/min? (Round to the nearest tenths.)

3 :
A nurse is providing manual ventilations with a bag-valve mask. The patient has been intubated with an advanced airway. Which of the following guidelines would the nurse use?

4 :
Ms. Peters is intubated and on Propofol for sedation. Propofol 1000 mg is supplied in 100 mL of D5W. Ms. Peters weighs 68 kg. The infusion is currently at 14.3 mL/hr. What dose of Propofol is Ms. Peters receiving in mcg/kg/min? (Round to the nearest tenths.)

5 :
Which of the following factors predispose the critically ill patient to pain and anxiety? (Select all that apply.)

6 :
Your patient has been started on intentional hypothermia and is requiring a cisatracurium infusion to prevent shivering. You plan to:

7 :
A patient presents with atrial fibrillation with rapid ventricular response with a rate of 178. The patient is diaphoretic with a BP of 85/50. Which intervention would the nurse anticipate?

8 :
Which of the following patient would require emergent application of a transcutaneous pacemaker?

10 :
The physician identifies the need for a bronchoscopy for a patient who is on mechanical ventilation. The patient is alert and able to give consent. Based on the criteria for informed consent, what specific patient criteria must be demonstrated prior to the procedure?