Nursing in Critical Care: Identifying Critically Ill Patients and Providing Care, Exams of Nursing

Download Nursing in Critical Care: Identifying Critically Ill Patients and Providing Care and more Exams Nursing in PDF only on Docsity! Essentials of Critical Care Nursing Chapter 1 Introduction exam test 2024 1. Which patient would the nurse identify as experiencing a critical illness? The patient: 1. With chronic airflow limitation whose VS are BP 110/72, P 110, R 16 2. With acute bronchospasm and whose VS are BP 100/60, P 124, R 32 3. Who was involved in a motor vehicle crash whose VS are BP 124/74, P 74, R 18 4. On hemodialysis for chronic renal failure with no urine output and whose VS are BP 98/50, P 108, R 12 - answers>Correct Answer: 2 2. Rationale 1: The blood pressure and respiratory rate are considered within normal limits. The heart rate is slightly elevated. Based upon these vital signs, this patient is not critically ill. 3. Rationale 2: Acute bronchospasm can present a life-threatening situation, which can jeopardize a patient's survival. The patient's pulse and respiratory rate are elevated, which could indicate a critical illness. 4. Rationale 3: According to the vital signs, this patient is not critically ill despite being in a motor vehicle crash. 5. Rationale 4: The patient on receiving hemodialysis for chronic renal failure is not considered critically ill unless another disease process or health issue develops. The patient's vital signs are consistent with someone with chronic renal failure. 6. Of the following patients, which will the nurse expect to be transferred to a critical care unit? The patient: 7. Note: Credit will be given only if all correct choices and no incorrect choices are selected. 8. Standard Text: Select all that apply. 1. With an acetaminophen overdose 2. Suffering from acute mental illness 3. With chronic renal failure 4. With acute decompensated heart failure 5. With bacteremia from an infected foot wound - answers>Correct Answer: 1,4,5 9. Rationale 1: Critical care units are cost-efficient units for caring for patients with specific organ system failure. Patients with acetaminophen overdose often suffer liver failure as a consequence. 10.Rationale 2: A patient with acute mental illness would not receive care in a critical care unit. This health problem would be considered noncritical. 11.Rationale 3: Even though critical care units are cost-efficient units for caring for patients with specific organ system failure, chronic renal failure is not a disease process necessitating the critical care environment. 12.Rationale 4: The patient with acute decompensated heart failure would receive care in a critical care unit. This patient has a specific organ that has failed. 13.Rationale 5: Bacteremia can affect many organs and lead to multisystem organ failure. This patient would receive care in a critical care unit. 14.The nurse, employed in a hospital in a small rural town, would expect to provide which level of care in the critical care unit? 1. Level I 2. Level II 3. Level III 4. It is unlikely that the hospital would have a critical care unit. - answers>Correct Answer: 3 15.Rationale 1: This level of care is provided most likely within teaching hospitals and not in a rural facility. 16.Rationale 2: This level is able to provide comprehensive critical care for most disorders but the unit may not be able to care for specific types of patients. It is unlikely that this level of care would be available in a small rural facility. 17.Rationale 3: Level III facilities provide initial stabilization of critically ill patients but limited ability to provide comprehensive critical care. A limited number of patients who require routine care may remain in the facility but written policies should be in place determining which patients require transfer and where they ought to be transferred. This level of care is most likely provided in a small rural facility. 18.Rationale 4: Most hospitals have some level of critical care area. 19.The nurse, providing patient care in an "open" ICU, would most likely be working with a: 1. Multidisciplinary team with physicians who are also responsible for patients on other units 2. Multidisciplinary team that includes a physician employed by the hospital 3. Physician in charge of patient care who is a specialist in critical care 4. Primary care physician who must consult a critical care specialist - answers>Correct Answer: 1 20.Rationale 1: In an open ICU, nurses, pharmacists, and respiratory therapists are ICU based but the physicians directing patient care may have other obligations. These physicians may or may not choose to consult an intensivist to assist with the management of their ICU patients. 21.The nurse, providing care to patients in a critical care unit, realizes that technology increases the likelihood of errors when: 1. It relies heavily on human decision making. 2. Devices are programmed to function without double checks. 3. It makes the workload seem overwhelming to health care providers. 4. There is uniform equipment throughout each facility. - answers>Correct Answer: 2 22.Rationale 1: This is not identified as increasing the likelihood of errors in the critical care unit. 5. Willing to take responsibility for failures - answers>Correct Answer: 1,2,3,5 42.Which informal power bases will the nurse use in the health care setting? 43.Note: Credit will be given only if all correct choices and no incorrect choices are selected. 44.Standard Text: Select all that apply. 1. Expertise 2. Goodwill 3. Information 4. Observation 5. Collaboration - answers>Correct Answer: 1,2,3 45.The nurse caring for a patient would ensure that the patient has consented to care by providing what to the patient? 1. A consent form to sign to receive medications 2. A consent form to sign to have dressings changed 3. A consent form to sign to be turned in bed 4. An explanation of a dressing to be changed - answers>Correct Answer: 4 46. If a nurse forcibly inserts a nasogastric tube against a patient's wishes, the nurse can be held liable for: 1. Negligence 2. Malpractice 3. Damages 4. Battery - answers>Correct Answer: 4 47.Rationale 1: Forcibly inserting a nasogastric tube against a patient's wishes is not negligence. 48.Rationale 2: Forcibly inserting a nasogastric tube against a patient's wishes is not malpractice. 49.Rationale 3: It cannot be determined if forcibly inserting a nasogastric tube against a patient's wishes will result in damages. 50.Rationale 4: When the nurse treats or touches a patient without consent, it is battery. 51.The nurse is aware that decision-making capacity is likely to be impaired for a patient who: 52.Note: Credit will be given only if all correct choices and no incorrect choices are selected. 53.Standard Text: Select all that apply. 1. Is being medicated for severe pain 2. Does not understand the medical condition 3. Has been diagnosed with septic shock 4. Is depressed 5. Asks questions about identified treatments - answers>Correct Answer: 1,2,3,4 54.The nurse is aware that restraining a patient is most likely to result in the patient: 1. Pulling out an endotracheal tube 2. Pulling out an intravenous line 3. Disconnecting ventilator tubing 4. Developing a nosocomial infection - answers>Correct Answer: 4 55.For a nurse to be found guilty of negligence, it must be demonstrated that the patient: 1. Was assaulted 2. Incurred damages 3. Suffered a wrongful death 4. Was not consulted before being touched - answers>Correct Answer: 2 56.Moral distress among critical care nurses is associated with: 57.Note: Credit will be given only if all correct choices and no incorrect choices are selected. 58.Standard Text: Select all that apply. 1. Having no voice in clinical decision making 2. Providing aggressive care to patients who cannot benefit 3. Realizing that nurses maintain power in bedside decision making 4. Knowing the right thing to do but not being able to do it 5. Leaving employment as a critical care nurse - answers>Correct Answer: 1,2,4,5 59.When a nurse employs conscientious refusal to participate, the nurse should be aware that: 60.Note: Credit will be given only if all correct choices and no incorrect choices are selected. 61.Standard Text: Select all that apply. 1. It may lead to dismissal from a nursing position. 2. Consequences may involve employer sanction. 3. Nursing administrators are largely supportive. 4. State boards of nursing protect the nurse in this situation. 5. The patient will support the nurse's decision. - answers>Correct Answer: 1,2 62.Which symptoms seen in a nurse would suggest compassion fatigue? 63.Note: Credit will be given only if all correct choices and no incorrect choices are selected. 64.Standard Text: Select all that apply. 1. Difficulty separating work from personal life 2. Excessive high tolerance for frustration 3. Having a completely laissez-faire attitude 4. Decreased functioning in nonprofessional situations 5. Dreads working with certain types of patients - answers>Correct Answer: 1,4,5 65.The nurse is providing care to patients in a Level II general critical care unit. For which types of patient problems will this nurse most likely provide care? 66.Note: Credit will be given only if all correct choices and no incorrect choices are selected. 67.Standard Text: Select all that apply. 1. Exacerbation of heart failure 2. Wound infection 3. Burns over 50% of total body surface 4. Kidney transplant 5. Reattachment of a traumatic amputation of the left leg - answers>Correct Answer: 1,2 68.A patient is admitted to an "open" intensive care unit. In addition to the nurse, which health care providers will assist in the care of this patient? 69.Note: Credit will be given only if all correct choices and no incorrect choices are selected. 70.Standard Text: Select all that apply. 1. Pharmacist 2. Respiratory therapist 3. Attending physician 4. Dietician 5. Social worker - answers>Correct Answer: 1,2,3 71.The critical care nurse is identifying patients at risk for safety and medical errors. Which patients would the nurse identify as being at risk for these issues? 72.Note: Credit will be given only if all correct choices and no incorrect choices are selected. 73.Standard Text: Select all that apply. 1. Patient in isolation with MRSA 2. Patient who does not understand English 3. Patient with end stage renal disease and a respiratory rate of 8 per minute 4. Patient recovering from pacemaker insertion 5. Patient with pulmonary edema - answers>Correct Answer: 1,2,3 74.The nurse manager of a critical care unit is explaining the AACN Synergy Model to the critical care nurses. What will the manager include as basic parts of this model? 75.Note: Credit will be given only if all correct choices and no incorrect choices are selected. 76.Standard Text: Select all that apply. 1. Based on the patients' characteristics 2. Based on the competencies of the nurses 3. Patient outcomes will be measured 4. The nurses' assessment of patient outcomes will be measured 5. Reduction of cost to provide critical care services to patients - answers>Correct Answer: 1,2,3,4