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AACN Critical Care Nursing Exam Sample Questions (Q147-Q152):

NEW QUESTION # 147
A patient exhibits acute hypervigilance, refusal of treatment, impulsive acts, and hallucinations alternating with lucidity. Family members argue about the hallucinations. The nurse should:

A. Reassure the family this behavior is expected in ICU
B. Encourage the family to go home until the behavior is resolved
C. Role-model patient support and reassurance
D. Validate the hallucinations and use distraction therapy

Answer: C

Explanation:
These are classic symptoms ofICU delirium, especially in pediatric or neurologically impaired patients. The nurse shouldmodel supportive, calm behavior,reorient the patient, andeducate familyabout what they are witnessing. This helpsde-escalate tensionand provides therapeutic support.
"In managing ICU delirium, the nurse should support the patient, reduce stimuli, and help families understand and cope with the patient's altered mental status." (Referenced from CCRN Pediatric - Direct Care: Neurological, Delirium and Cognitive Dysfunction)

NEW QUESTION # 148
When assessing a newborn for developmental dysplasia of the hip, the nurse would expect to assess which of the following:

A. Symmetrical gluteal folds
B. Characteristic limp
C. Ortolani's sign
D. Trendelemburg sign

Answer: C

Explanation:
Explanation: It is the abnormal clicking sound when the hips are abducted. The sound is produced when the femoral head enters the acetabulum. Letter A is wrong because it should be "asymmetrical gluteal fold". Letter B and C are not applicable for newborns because they are seen in older children.

NEW QUESTION # 149
While assessing a male neonate whose mother desires him to be circumcised, the nurse observes that the neonate's urinary meatus appears to be located on the ventral surface of the penis. The physician is notified because the nurse would suspect which of the following:

A. Phimosis
B. Hydrocele
C. Hypospadias
D. Epispadias

Answer: C

Explanation:
Explanation: Hypospadias is a condition in which the urethral opening is located below the glans penis or anywhere along the ventral surface of the penile shaft. Epispadias, the urethral meatus is located at the dorsal surface of the penile shaft.

NEW QUESTION # 150
One hour after starting a continuous IV insulin, a patient's glucose drops by 145 mg/dL. What should the nurse monitor for?

A. Bradycardia, irregular respirations, and widened pulse pressure
B. Tachycardia, widened pulse pressure, and oliguria
C. Tachycardia, irregular respirations, and polyuria
D. Bradycardia, widened pulse pressure, and doll's eyes reflex

Answer: A

Explanation:
Arapid drop in blood glucose, especially duringDKA treatment, can result incerebral edema-a life- threatening complication. Symptoms includebradycardia, irregular respirations, altered mental status, and widened pulse pressuredue to increased intracranial pressure.
"A drop in serum glucose >100 mg/dL/hr in DKA increases risk for cerebral edema. Monitor for bradycardia, abnormal breathing, and neurologic decline." (Referenced from CCRN Pediatric - Direct Care: Endocrine, DKA and Cerebral Edema Monitoring)

NEW QUESTION # 151
Angela, a school age girl, was bitten by a rabid dog. She is scheduled to receive antirabies vaccine/inoculations. The nurse is aware that rabies is a:

A. bacterial infection that causes encephalopathy
B. a bacterial infection characterized by Opisthotonus
C. a viral infection characterized by Opisthotonus
D. viral infection characterized by difficulty in swallowing and seizure

Answer: D

Explanation:
Explanation: These are characteristics of rabies infection that affects the nervous system. It is not a bacterial infection

NEW QUESTION # 152
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