Clinical Competencies
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The process of ventilation has four phases. Which of the following correctly describes the events of Phase III?
delivery of oxygen to the erythrocytes, and the removal of carbon dioxide from the erythrocytes and the bloodstream
movement of ambient air in and out of the respiratory tract
diffusion of oxygen and carbon dioxide in the alveoli
regulation of ventilation
Explanation
The four phases of ventilation are as follows: Phase I is the movement of ambient air in and out of the respiratory tract; Phase II is the diffusion of oxygen and carbon dioxide in the alveoli; Phase III entails the delivery of oxygen to erythrocytes, and the removal of carbon dioxide from the erythrocytes and the bloodstream; Phase IV is the regulation of ventilation.
Direct-acting vasodilators that are smooth muscle relaxants include which of the following medications?
I. Nitroglycerin
II. Furosemide
III. Nitroprusside
I and III only
III only
I and II only
II only
Explanation
Smooth muscle relaxants that are direct-acting vasodilators include nitroprusside and nitroglycerin. These medications, which are used in the treatment of heart failure, work to reduce cardiac filling pressures and dilate coronary arteries. Furosemide is a loop diuretic.
A patient in the ICU presents with an acute disorder of attention, perception, and memory impairment. This is most accurately described as:
delirium
dementia
attention-deficit-hyperactivity-disorder (ADHD)
dysthymic disorder
Explanation
Delirium is an acute disorder characterized by attention, perception, and memory impairment. It is often the symptom of an underlying condition such as dementia, medication overdose, substance intoxication, and electrolyte disorders.
The critical care nurse knows that metabolic acidosis is defined by which of the following parameters?
pH < 7.35; and a \[HCO3-\] < 22 mEq/L
pH > 7.35; and a \[HCO3-\] > 22 mEq/L
pH < 7.45; and a \[HCO3-\] < 26 mEq/L
pH < 7.35; and a \[HCO3-\] > 26 mEq/L
Explanation
Metabolic acidosis is one of the four main acid-base disorders. The disorder is characterized by a bloodstream pH < 7.35 and a \[HCO3-\] < 22 mEq/L. The decrease in bicarbonate ion can be due to an endocrine, gastrointestinal, or renal disorder, as well as a nutritional deficiency.
Direct-acting vasodilators that are smooth muscle relaxants include which of the following medications?
I. Nitroglycerin
II. Furosemide
III. Nitroprusside
I and III only
III only
I and II only
II only
Explanation
Smooth muscle relaxants that are direct-acting vasodilators include nitroprusside and nitroglycerin. These medications, which are used in the treatment of heart failure, work to reduce cardiac filling pressures and dilate coronary arteries. Furosemide is a loop diuretic.
The critical care nurse knows that metabolic acidosis is defined by which of the following parameters?
pH < 7.35; and a \[HCO3-\] < 22 mEq/L
pH > 7.35; and a \[HCO3-\] > 22 mEq/L
pH < 7.45; and a \[HCO3-\] < 26 mEq/L
pH < 7.35; and a \[HCO3-\] > 26 mEq/L
Explanation
Metabolic acidosis is one of the four main acid-base disorders. The disorder is characterized by a bloodstream pH < 7.35 and a \[HCO3-\] < 22 mEq/L. The decrease in bicarbonate ion can be due to an endocrine, gastrointestinal, or renal disorder, as well as a nutritional deficiency.
A patient in the ICU presents with an acute disorder of attention, perception, and memory impairment. This is most accurately described as:
delirium
dementia
attention-deficit-hyperactivity-disorder (ADHD)
dysthymic disorder
Explanation
Delirium is an acute disorder characterized by attention, perception, and memory impairment. It is often the symptom of an underlying condition such as dementia, medication overdose, substance intoxication, and electrolyte disorders.
The process of ventilation has four phases. Which of the following correctly describes the events of Phase III?
delivery of oxygen to the erythrocytes, and the removal of carbon dioxide from the erythrocytes and the bloodstream
movement of ambient air in and out of the respiratory tract
diffusion of oxygen and carbon dioxide in the alveoli
regulation of ventilation
Explanation
The four phases of ventilation are as follows: Phase I is the movement of ambient air in and out of the respiratory tract; Phase II is the diffusion of oxygen and carbon dioxide in the alveoli; Phase III entails the delivery of oxygen to erythrocytes, and the removal of carbon dioxide from the erythrocytes and the bloodstream; Phase IV is the regulation of ventilation.
A patient with renal dysfunction presents with hypernatremia. This is most likely the result of:
an inability of the renal tubules to respond to ADH secretion
an inability of the posterior pituitary to secrete ADH
an inability of the adrenal cortex to secrete aldosterone
an inability of the kidneys to secrete renin
Explanation
Hypernatremia is an electrolyte imbalance characterized via elevated sodium levels in the blood. This condition results in water retention and the development of excess extracellular fluid volume. In patient's with normal renal function, the condition is typically caused by a lack of ADH secretion via the posterior pituitary. In patients with renal dysfunction, the condition is typically the result of an inability of the renal tubules to respond to ADH secretion. The renin-angiotensin-aldosterone system functions to increase sodium reabsorption via the renal tubules, and thus insufficient secretion of either renin or aldosterone would work to produce the opposite effect of hypernatremia.
The two specialized cell types contained within the sinoatrial (SA) node:
border zone cells and specialized pacemaker cells
specialized pacemaker cells and cardiomyocytes
chondrocytes and border zone cells
cardiomyocytes and border zone cells
Explanation
The sinoatrial (SA) node contains two specialized cell types: border zone cells and specialized pacemaker cells. Cardiomyocytes are heart muscle cells, and chondrocytes are cartilage producing cells.