The American Association of Critical-Care Nurses and Critical Care Nursing Practice, Exams of Nursing

Download The American Association of Critical-Care Nurses and Critical Care Nursing Practice and more Exams Nursing in PDF only on Docsity! Chapter 1 Questions CC with Answers 2024. Which of the following professional organizations best supports critical care nursing practice? a. American Association of Critical-Care Nurses b. American Heart Association c. American Nurses Association d. Society of Critical Care Medicine ✔A. The American Association of Critical-Care Nurses is the specialty organization that supports and represents critical care nurses. The American Heart Association supports cardiovascular initiatives. The American Nurses Association supports all nurses. The Society of Critical Care Medicine represents the multiprofessional critical care team under the direction of an intensivist. A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and is interested in certification. Which credential would be most applicable for her to seek? a. ACNPC b. CCNS c. CCRN d. PCCN ✔C. The CCRN certification is appropriate for nurses in bedside practice who care for critically ill patients. The ACNPC certification is for acute care nurse practitioners. The CCNS certification is for critical care clinical nurse specialists. The PCCN certification is for staff nurses working in progressive care, intermediate care, or step-down unit settings. The main purpose of certification is to: a. assure the consumer that you will not make a mistake. b. prepare for graduate school. c. promote magnet status for your facility. d. validate knowledge of critical care nursing. ✔D. Certification assists in validating knowledge of the field, promotes excellence in the profession, and helps nurses to maintain their knowledge of critical care nursing. Certification helps to assure the consumer that the nurse has a minimum level of knowledge; however, it does not ensure that care will be mistake-free. Certification does not prepare one for graduate school; however, achieving certification demonstrates motivation for achievement and professionalism. Magnet facilities are rated on the number of certified nurses; however, that is not the purpose of certification. The synergy model of practice focuses on: a. allowing unrestricted visiting for the patient 24 hours each day. b. holistic and alternative therapies. c. needs of patients and their families, which drives nursing competency. d. patients' needs for energy and support. ✔C. The synergy model of practice states that the needs of patients and families influence and drive competencies of nurses. Nursing practice based on the synergy model would involve tailored visiting to meet the patient's and family's needs and application of alternative therapies if desired by the patient, but that is not the primary focus of the model. The family of your critically ill patient tells you that they have not spoken with the physician in over 24 hours and they have some questions that they want clarified. During morning rounds, you convey this concern to the attending intensivist and arrange for her to meet with the family at 4:00 PM in the conference room. Which competency of critical care nursing does this represent? a. Advocacy and moral agency in solving ethical issues b. Clinical judgment and clinical reasoning skills c. Collaboration with patients, families, and team members d. Facilitation of learning for patients, families, and team members ✔C. Although one might consider that all of these competencies are being addressed, communication and collaboration with the family and physician best exemplify the competency of collaboration. b. Acts ethically on the behalf of the patient and family c. Considers factors related to safe patient care d. Uses clinical inquiry and integrates research findings in practice ✔B. Discussing end-of-life issues is an example of a nurse acting ethically on behalf of the patient and family. The example does not relate to acquiring knowledge, promoting patient safety, or using research in practice. Which of the following assists the critical care nurse in ensuring that care is appropriate and based on research? a. Clinical practice guidelines b. Computerized physician order entry c. Consulting with advanced practice nurses d. Implementing Joint Commission National Patient Safety Goals ✔A. Clinical practice guidelines are being implemented to ensure that care is appropriate and based on research. Some physician order entry pathways, but not all, are based on research recommendations. Some advanced practice nurses, but not all, are well versed in evidence-based practices. The National Patient Safety Goals are recommendations to reduce errors using evidence-based practices. Comparing the patient's current (home) medications with those ordered during hospitalization and communicating a complete list of medications to the next provider when the patient is transferred within an organization or to another setting are strategies to: a. improve accuracy of patient identification. b. prevent errors related to look-alike and sound-alike medications. c. reconcile medications across the continuum of care. d. reduce harms associated with administration of anticoagulants. ✔C. These are steps recommended in the National Patient Safety Goals to reconcile medications across the continuum of care. Improving accuracy of patient identification is another National Patient Safety Goal. Preventing errors related to look-alike and sound- alike medications is done to improve medication safety, not medication reconciliation. Reducing harms associated with administration of anticoagulants is another National Patient Safety Goal. As part of nursing management of a critically ill patient, orders are written to keep the head of the bed elevated at 30 degrees, awaken the patient from sedation each morning to assess readiness to wean from mechanical ventilation, and implement oral care protocols every 4 hours. These interventions are done as a group to reduce the risk of ventilator-associated pneumonia. This group of evidence-based interventions is often called a: a. bundle of care. b. clinical practice guideline. c. patient safety goal. d. quality improvement initiative. ✔A. A group of evidence-based interventions done as a whole to improve outcomes is termed a bundle of care. This is an example of the ventilator bundle. Oftentimes these bundles are derived from clinical practice guidelines and are monitored for compliance as part of quality improvement initiatives. At some point, these may become part of patient safety goals. You work in an intermediate care unit that has experienced high nursing turnover. The nurse manager is often considered to be an autocratic leader by staff members and her leadership style is contributing to turnover. You have asked to be involved in developing new guidelines to prevent pressure ulcers in your patient population. The nurse manager tells you that you do not yet have enough experience to be on the prevention task force. This situation and setting is an example of: a. a barrier to handoff communication. b. a work environment that is unhealthy. c. ineffective decision making. d. nursing practice that is not evidence-based. ✔B. These are examples of an unhealthy work environment. A healthy work environment values communication, collaboration, and effective decision making. It also has authentic leadership. It is not an example of handoff communication, which is communication that occurs to transition patient care from one staff member to another. Neither does it relate to ineffective decision making. As a nurse, you can still implement evidence-based practice, but your influence in the unit is limited by the unhealthy work environment. Which of the following statements describes the core concept of the synergy model of practice? a. All nurses must be certified in order to have the synergy model implemented. b. Family members must be included in daily interdisciplinary rounds. c. Nurses and physicians must work collaboratively and synergistically to influence care. d. Unique needs of patients and their families influence nursing competencies. ✔D. The synergy model of practice is care based on the unique needs and characteristics of the patient and family members. Although critical care certification is based on the synergy model, the model does not specifically address certification. Inclusion of family members into the daily rounds is an example of implementation of the synergy model. With the focus on patients and family members with nurse interaction, the synergy model does not address physician collaboration. A nurse who plans care based on the patient's gender, ethnicity, spirituality, and lifestyle is said to: a. be a moral advocate. b. facilitate learning. c. respond to diversity. d. use clinical judgment. ✔C. Response to diversity considers all of these aspects when planning and implementing care. A moral agent helps resolve ethical and clinical concerns. Consideration of these factors does not necessarily facilitate learning. Clinical judgment uses other factors as well Which of the following is a National Patient Safety Goal? (Select all that apply.) a. Accurately identify patients. b. Eliminate use of patient restraints. c. Reconcile medications across the continuum of care. d. Reduce risks of healthcare-acquired infection. ✔A, C, D Modifying the work environment to reduce physical demands is one strategy to assist the aging workforce. Examples include overhead lifts to prevent back injuries. Twelve- hour shifts can be quite demanding; therefore, allowing nurses flexibility in choosing shifts of shorter duration is a good option as well. Adequate staffing, including non- licensed assistive personnel, to help with nursing and non-nursing tasks is helpful. Encouraging experienced, knowledgeable critical care nurses to leave the critical care unit is not wise as the unit loses the expertise of this group. Which of the following strategies will assist in creating a healthy work environment for the critical care nurse? (Select all that apply.) a. Celebrating improved outcomes from a nurse-driven protocol with a pizza party b. Implementing a medication safety program designed by pharmacists c. Modifying the staffing pattern to ensure a 1:1 nurse/patient ratio d. Offering quarterly joint nurse-physician workshops to discuss unit issues e. Using the Situation-Background-Assessment-Recommendation (SBAR) technique for handoff communication ✔A, D, E Meaningful recognition, true collaboration, and skilled communication are elements of a healthy work environment. Implementing a medication safety program enhances patient safety, and if done without nursing input, could have negative outcomes. Staffing should be adjusted to meet patient needs and nurse competencies, not have predetermined ratios that are unrealistic and possibly not needed. Identify which of the following patients suffers from critical illness? A patient: A. With chronic airflow limitation whose VS are: BP 110/72, P 110, R 16 B. With acute bronchospasm and whose VS are: BP 100/60, P 124, R 32 C. Who was involved in a MVA whose VS are BP 124/74, P 74, R 18. D. On chronic dialysis with no urine output and whose VS are BP 98/50, P 108, R 12 ✔B. Acute bronchospasm can present a life-threatening situation, which can jeopardize a patients survival. 1, 3, 4 are non life threatening. Of the following patients, who should be cared for in a critical care unit? A patient: Select all that apply A. With an acetaminophen overdose B. Suffering from an acute mental illness C. With Chronic Renal Failure D. With acute decompensated heart failure ✔A, D CC are cost efficient units for caring for patients with specific organ system failure. Acetaminophen overdose often suffer liver failure as consequence. 2 and 3 are present patient concerns of noncritical nature. A hospital in a small rural town would be able to provide which level of care in the critical care unit? A. Level 1 B. Level 2 C. Level 3 D. Unlikely hospital would have CC unit ✔C. 1 and 2 are more advanced and inclusive CC units. 4 is not likely because most hospitals have some critical care areas. A nurse employed in an "open" ICU would most likely be working with a: A. Multidisciplinary team with Drs who are also responsible for patients on other units. B. Multi team that include a Dr employed by the hospital . C. Dr in charge of pt care who is a specialist in critical care D. Primary care Dr who must consult a critical care specialist. ✔A. 2, 3, 4 are closed ICUs. According to the Institute of Medicine, technology increases the likelihood of errors in CC units when: A. It relies heavily on human decision making B. Devices are programmed to function without double checks. C. It makes the workload seem overwhelming to health care providers. D. There is uniform equipment throughout each facility. ✔B. 1, 3, 4 not increase likelihood of errors. Which of the following ins a common example of installing forcing functions or system level firewalls in order to prevent errors? A. Prior to admin of insulin, 2 nurses check the dose. B. Prior to obtaining medication, height, weight, and allergies are recorded. C. All meds are checked by 2 nurses prior to admin. D. Undiluted potassium chloride is not available on CC units. ✔D. 1 and 3 are examples of avoiding reliance on vigilance. 2 is an example of utilizing constraints. The increased use of technology in CC units has resulted in which of the following consequences for patient care? A. Decreased risk of errors in patient care. B. Decreased therapeutic nurse-patient communication. C. Improved overall patient satisfaction with care. D. Improved patient safety across the entire spectrum. ✔B. 1, 3, and 4 have not been demonstrated as an outcome. Completion of a preoperative checklist is an operationalized example of which of the following recommendations issued by the Institute of Medicine? A. Utilizing contraints B. Simplifying key processes C. Avoiding reliance on vigilance D. Standardizing key processes ✔C. 1, 2, and 4 are additional recommendations issued by the Institute of Medicine Which of the following actions should the nurse complete first after realizing that an incorrect dose of medication has been administered to a patient? A. Documentation of the error B. Notification of the Dr C. Notification of the patient and family D. Preparation for a root cause analysis ✔B Although they are all correct, 2 should be completed first and a plan developed to ensure that the patient is not harmed. The nurse working within the AACN Synergy Model realizes that optimal patient outcomes are realized when: A. Highly qualified nurses care for patients in highly technical settings. B. Nurses agree to work overtime to cover unit staffing needs. C. Staff nurse competency is matched with patient needs. D. Patient care is delivered within a closed unit model ✔C. The underlying assumption of the synergy model is that the optimal patient outcomes occur when the needs of the patient and family are matched with the competencies of the nurse. The competent critical care nurse demonstrates an understanding of patient advocacy by taking which of the following actions? (Select apply) A. Maintaining attendance at the bedside with the patient during a physical visit B. Assisting and supporting the patient and family as they reveal their needs C. Alerting the Dr to concerns about patient placement after hospitalization D. Encouraging and supporting a patient's spouse in preparing for a family meeting. ✔A. B. C. D All demonstrate understanding of patient advocacy A nurse is preparing to communicate an issue about patient care to a Dr using the SBAR technique. Which of the following phrases is an appropriate initial statement? A. "I am concerned about.." B. "The pts immediate history is.."