TEST BANK
High-Acuity Nursing | 7th Edition
by Kathleen Wagner | Melanie Hardin-Pierce |
Darlene Welsh
SC
O
R
EG
U
ID
ES
,Table of Contents
Unit I – Concepts of High Acuity Nursing
1. The High Acuity Setting
2. Physiologic Responses to Stress
SC
3. Shock, Sepsis, and Multiple Organ Dysfunction Syndrome (MODS)
Unit II – Nursing Management of High Acuity Cardiovascular Disorders
4. Acute Coronary Syndromes
5. Heart Failure and Pulmonary Edema
O
6. Cardiac Dysrhythmias and Conduction Disorders
7. Cardiac Surgery and Interventions
R
Unit III – Nursing Management of High Acuity Respiratory Disorders
EG
8. Acute Respiratory Failure
9. Acute Respiratory Distress Syndrome (ARDS)
10. Mechanical Ventilation and Weaning
Unit IV – Nursing Management of Neurologic Disorders
U
11. Acute Intracranial Disorders
12. Traumatic Brain Injury
ID
13. Spinal Cord Injury
Unit V – Nursing Management of Multisystem and Other High Acuity
ES
Problems
14. Burns
15. Renal Failure
16. End-of-Life, Palliative, and Ethical Issues
, Unit I — Concepts of High Acuity Nursing
Chapter 1 — The High Acuity Setting
Q1. Which characteristic best defines a high-acuity patient?
A. Requires minimal nursing intervention
SC
B. Has unstable physiologic parameters requiring continuous monitoring ✅
C. Is ambulatory and independent in activities of daily living
D. Requires only routine oral medications
Answer: B. Has unstable physiologic parameters requiring continuous monitoring
O
Rationale: High-acuity patients have unstable or potentially unstable conditions
(hemodynamic, respiratory, neurologic) that require continuous assessment,
advanced support, and rapid nursing intervention.
R
Q2. A newly admitted patient to the progressive care unit requires telemetry and
EG
frequent neuro checks after surgery. Which nurse assignment is most appropriate?
A. Assign the most novice RN on unit to this patient
B. Assign a nurse with telemetry and neuro assessment experience ✅
C. Assign two LPNs to share the patient’s care
U
D. Place the patient on a floating RN without orientation
Answer: B. Assign a nurse with telemetry and neuro assessment experience
Rationale: Matching complexity of care to nurse competence improves safety and
ID
outcomes; telemetry and neurologic assessments require experienced personnel.
ES
Q3. Which action best reflects the nurse’s role in prioritizing care in a high-acuity
setting?
A. Complete tasks in order of arrival time
B. Attend to the patient with the most complex psychosocial needs first
C. Triage patients by physiologic stability and potential for deterioration ✅
D. Prioritize paperwork before patient assessment
, Answer: C. Triage patients by physiologic stability and potential for deterioration
Rationale: Priority is given to physiologic threats (airway, breathing, circulation)
and those at highest risk of deterioration; this is central to high-acuity nursing.
Q4. During a rapid response, which team action is highest priority for the bedside
SC
nurse?
A. Leaving to call the code team
B. Ensuring airway patency and initiating oxygen ✅
C. Documenting the event before intervention
D. Obtaining family consent for interventions
O
Answer: B. Ensuring airway patency and initiating oxygen
Rationale: Immediate interventions to secure airway and support breathing are
R
lifesaving priorities; calling for help is important, but initial stabilizing actions take
precedence.
EG
Q5. A hospital is implementing a new high-acuity telemetry unit. Which element is
most important to include in staff orientation?
A. Hospital parking procedures
B. Unit emergency response algorithms and equipment use ✅
U
C. Cafeteria hours
D. Vacation scheduling process
ID
Answer: B. Unit emergency response algorithms and equipment use
Rationale: Orientation must focus on clinical competencies and protocols (code
response, alarms, monitors) essential for safe high-acuity care.
ES
Q6. Which of the following best reduces alarm fatigue on a telemetry unit?
A. Turning off all nonessential alarms ✅
B. Setting alarm parameters appropriate for each patient and regular alarm review
C. Having nursing assistants silence alarms routinely
D. Ignoring alarms during shift change
High-Acuity Nursing | 7th Edition
by Kathleen Wagner | Melanie Hardin-Pierce |
Darlene Welsh
SC
O
R
EG
U
ID
ES
,Table of Contents
Unit I – Concepts of High Acuity Nursing
1. The High Acuity Setting
2. Physiologic Responses to Stress
SC
3. Shock, Sepsis, and Multiple Organ Dysfunction Syndrome (MODS)
Unit II – Nursing Management of High Acuity Cardiovascular Disorders
4. Acute Coronary Syndromes
5. Heart Failure and Pulmonary Edema
O
6. Cardiac Dysrhythmias and Conduction Disorders
7. Cardiac Surgery and Interventions
R
Unit III – Nursing Management of High Acuity Respiratory Disorders
EG
8. Acute Respiratory Failure
9. Acute Respiratory Distress Syndrome (ARDS)
10. Mechanical Ventilation and Weaning
Unit IV – Nursing Management of Neurologic Disorders
U
11. Acute Intracranial Disorders
12. Traumatic Brain Injury
ID
13. Spinal Cord Injury
Unit V – Nursing Management of Multisystem and Other High Acuity
ES
Problems
14. Burns
15. Renal Failure
16. End-of-Life, Palliative, and Ethical Issues
, Unit I — Concepts of High Acuity Nursing
Chapter 1 — The High Acuity Setting
Q1. Which characteristic best defines a high-acuity patient?
A. Requires minimal nursing intervention
SC
B. Has unstable physiologic parameters requiring continuous monitoring ✅
C. Is ambulatory and independent in activities of daily living
D. Requires only routine oral medications
Answer: B. Has unstable physiologic parameters requiring continuous monitoring
O
Rationale: High-acuity patients have unstable or potentially unstable conditions
(hemodynamic, respiratory, neurologic) that require continuous assessment,
advanced support, and rapid nursing intervention.
R
Q2. A newly admitted patient to the progressive care unit requires telemetry and
EG
frequent neuro checks after surgery. Which nurse assignment is most appropriate?
A. Assign the most novice RN on unit to this patient
B. Assign a nurse with telemetry and neuro assessment experience ✅
C. Assign two LPNs to share the patient’s care
U
D. Place the patient on a floating RN without orientation
Answer: B. Assign a nurse with telemetry and neuro assessment experience
Rationale: Matching complexity of care to nurse competence improves safety and
ID
outcomes; telemetry and neurologic assessments require experienced personnel.
ES
Q3. Which action best reflects the nurse’s role in prioritizing care in a high-acuity
setting?
A. Complete tasks in order of arrival time
B. Attend to the patient with the most complex psychosocial needs first
C. Triage patients by physiologic stability and potential for deterioration ✅
D. Prioritize paperwork before patient assessment
, Answer: C. Triage patients by physiologic stability and potential for deterioration
Rationale: Priority is given to physiologic threats (airway, breathing, circulation)
and those at highest risk of deterioration; this is central to high-acuity nursing.
Q4. During a rapid response, which team action is highest priority for the bedside
SC
nurse?
A. Leaving to call the code team
B. Ensuring airway patency and initiating oxygen ✅
C. Documenting the event before intervention
D. Obtaining family consent for interventions
O
Answer: B. Ensuring airway patency and initiating oxygen
Rationale: Immediate interventions to secure airway and support breathing are
R
lifesaving priorities; calling for help is important, but initial stabilizing actions take
precedence.
EG
Q5. A hospital is implementing a new high-acuity telemetry unit. Which element is
most important to include in staff orientation?
A. Hospital parking procedures
B. Unit emergency response algorithms and equipment use ✅
U
C. Cafeteria hours
D. Vacation scheduling process
ID
Answer: B. Unit emergency response algorithms and equipment use
Rationale: Orientation must focus on clinical competencies and protocols (code
response, alarms, monitors) essential for safe high-acuity care.
ES
Q6. Which of the following best reduces alarm fatigue on a telemetry unit?
A. Turning off all nonessential alarms ✅
B. Setting alarm parameters appropriate for each patient and regular alarm review
C. Having nursing assistants silence alarms routinely
D. Ignoring alarms during shift change
