1. 1. A patient who has been in the intensive care unit for 4 days has disturbedsensory perception from sleep deprivation. Which action should the nurse include in the plan of care? a. Administer prescribed sedatives or opioids at bedtime to promote sleep. b. Cluster nursing activities so that the patient hasuninterrupted rest periods. c. Silence the alarms on the cardiac monitors to allow 30- to 40-minute naps. d.Eliminate assessments between 2200 and 0600to allow uninterrupted sleep.: Answer B Clustering nursing activities and providinguninterrupted rest periods will minimize sleepcycle disruption. Sedative and opioidmedications tend to decrease the amount of rapid eye movement (REM) sleep andcan contribute to sleep disturbance and disturbed sensory perception.Silencing thealarms on the cardiac monitors would be unsafe in a critically ill patient, as would discontinuing all assessments during the night. 2. 2. Which hemodynamic parameter best reflects the effectiveness of drugs that the nurse gives to reduce a patient's left ventricular afterload? a. Mean arterial pressure (MAP) b. Systemic vascular resistance (SVR) c. Pulmonary vascular resistance (PVR) d. Pulmonary artery wedge pressure (PAWP): Answer B SVR reflects the resistance to ventricular ejection, or afterload. The other para- meters may be monitored but do not reflect afterload as directly. 3. 3.While close family members are visiting, a patient has a respiratory arrest,and resuscitation is started. Which action by the nurse is best? a. Tell the family members that watching the resuscitation will be very stressful. b. Askfamily members if they wish to remain in the room during the resuscitation. c.Take the family members quickly out ofthe patient roomand remain with them. d. Assign a staff member to wait with family members just outside the patientroom.

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