DOH Nursing Critical Care and Emergency Nursing 1 — Questions and Answers
Question 1: A patient in the ICU is found unresponsive with no pulse. What is the nurse's FIRST priority action?
- Call for the crash cart
- Begin high-quality chest compressions (Correct answer)
- Administer epinephrine 1 mg IV
- Apply defibrillator pads
Correct answer: Begin high-quality chest compressions
High-quality chest compressions are the first intervention in cardiac arrest as they maintain circulation to vital organs until definitive treatment is available.
Question 2: A patient's SpO2 drops suddenly to 87% on room air. What is the nurse's immediate priority action?
- Obtain an arterial blood gas sample
- Apply supplemental oxygen via non-rebreather mask (Correct answer)
- Administer a bronchodilator
- Notify the physician
Correct answer: Apply supplemental oxygen via non-rebreather mask
Applying supplemental oxygen immediately corrects hypoxemia and prevents further deterioration of tissue oxygenation.
Question 3: Which cardiac rhythm requires immediate unsynchronised defibrillation?
- Atrial fibrillation with rapid ventricular response
- Ventricular fibrillation (Correct answer)
- Sustained ventricular tachycardia with a pulse
- Third-degree (complete) heart block
Correct answer: Ventricular fibrillation
Ventricular fibrillation produces no cardiac output and is a shockable rhythm requiring immediate unsynchronised defibrillation.
Question 4: A patient presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea. What is the nurse's priority diagnostic action?
- Administer aspirin 300 mg orally
- Obtain a 12-lead ECG (Correct answer)
- Establish two large-bore IV lines
- Administer sublingual glyceryl trinitrate
Correct answer: Obtain a 12-lead ECG
A 12-lead ECG is the priority to confirm or rule out STEMI and guide time-sensitive reperfusion decisions.
Question 5: In the ABCDE primary trauma survey, what does 'D' assess?
- Dressings and wound care
- Disability — neurological status using GCS and pupils (Correct answer)
- Decontamination of hazardous materials
- Drug administration history
Correct answer: Disability — neurological status using GCS and pupils
'D' in the primary survey stands for Disability, assessed by the Glasgow Coma Scale, pupil size/reactivity, and limb movement.
Question 6: An ICU patient has a central venous pressure (CVP) of 1 mmHg and a mean arterial pressure (MAP) of 52 mmHg. What does this most likely indicate?
- Right heart failure
- Cardiac tamponade
- Hypovolaemia requiring fluid resuscitation (Correct answer)
- Fluid overload
Correct answer: Hypovolaemia requiring fluid resuscitation
Low CVP combined with low MAP indicates insufficient circulating volume, pointing to hypovolaemia that requires prompt fluid resuscitation.
Question 7: Which nursing intervention is MOST appropriate for a patient with raised intracranial pressure (ICP)?
- Position the patient flat to maximise cerebral blood flow
- Elevate the head of bed to 30–45 degrees (Correct answer)
- Administer hypotonic IV fluids to dilute cerebral oedema
- Encourage vigorous coughing to clear airway secretions
Correct answer: Elevate the head of bed to 30–45 degrees
Elevating the head of bed 30–45 degrees promotes venous drainage from the cranial vault, thereby reducing ICP.
DOH Nursing Critical Care and Emergency Nursing 1
A patient in the ICU is found unresponsive with no pulse.
What is the nurse's FIRST priority action?