CCRN Pain, Agitation, and Delirium Management 3

Question 1

Which neuromuscular blocking agent is preferred in ICU patients with acute respiratory distress syndrome (ARDS) requiring paralysis?

Accepted Answer

Cisatracurium

Answer

Cisatracurium is preferred in ARDS because it undergoes Hofmann elimination (spontaneous degradation), making it independent of renal and hepatic function.

Question 2

When using a daily spontaneous awakening trial (SAT), which patient condition is an absolute contraindication?

Accepted Answer

Active seizures

Answer

Active seizures are an absolute contraindication to SAT because interrupting sedation could precipitate further neurological deterioration.

Question 3

Which component of the ABCDEF bundle specifically addresses family engagement and empowerment?

Accepted Answer

F — Family engagement and empowerment

Answer

The 'F' in the ABCDEF bundle stands for Family Engagement and Empowerment, recognizing family as partners in care to reduce patient distress and delirium.

Question 4

A patient's ICDSC (Intensive Care Delirium Screening Checklist) score is 5. What does this indicate?

Accepted Answer

Delirium is likely present

Answer

An ICDSC score of 4 or higher indicates the likely presence of delirium; the scale ranges from 0–8 across eight behavioral features.

Question 5

Which medication is used as an adjunct analgesic in the ICU to reduce opioid requirements through its action on NMDA receptors?

Accepted Answer

Ketamine

Answer

Low-dose ketamine acts as an NMDA receptor antagonist and is used as an opioid-sparing adjunct analgesic in ICU patients, reducing total opioid consumption.

CCRN Review Practice Test

CCRN Review Practice Test

CCRN Pain, Agitation, and Delirium Management 3