CRITICAL CARE NURSING A HOLISTIC
APPROACH 11TH EDITION MORTON
FONTAINE TEST BANK
,Table of Contents
Chapter 1 Critical Care Nursing Practice: Promoting Excellence-Caring,Collaboration ................................... 2
Evidence .............................................................................................................................................................. 2
Chapter 2 The Patient’s Experience With Critical Illness .................................................................................. 8
Chapter 3 The Family’s Experience With Critical Illness ................................................................................ 14
Chapter 4 Patient and Family Education in Critical Care ................................................................................. 19
Chapter 5 Relieving Pain and Providing Comfort ............................................................................................ 24
Chapter 6 Palliative Care and End-of-Life Issues in Critical Care ................................................................... 29
Chapter 7 Ethical Issues in Critical Care Nursing ............................................................................................ 34
Chapter 8 Legal Issues in Critical Care Nursing ............................................................................................... 40
Chapter 9 Building a Professional Practice Model for Excellence in Critical Care Nursing ........................... 45
Chapter 10 The Critically Ill Pediatric Patient .................................................................................................. 50
Chapter 11 The Critically Ill Pregnant Woman ................................................................................................ 56
Chapter 12 The Critically Ill Older Patient ....................................................................................................... 62
Chapter 13 The Postanesthesia Patient ............................................................................................................. 68
Chapter 14 Rapid Response Teams and Transport of the Critically Ill Patient ................................................ 73
Chapter 15 Disaster Management: Implications for the Critical Care Nurse ................................................... 79
Chapter 16 Anatomy and Physiology of the Cardiovascular System ................................................................. 6
Chapter 17 Patient Assessment: Cardiovascular System .................................................................................. 12
Chapter 18 Patient Management: Cardiovascular System ................................................................................ 17
Chapter 19 Common Cardiovascular Disorders ............................................................................................... 24
Chapter 20 Heart Failure ................................................................................................................................... 30
Chapter 21 Acute Myocardial Infarction .......................................................................................................... 37
Chapter 22 Cardiac Surgery .............................................................................................................................. 44
Chapter 23 Anatomy and Physiology of the Respiratory System ..................................................................... 49
Chapter 24 Patient Assessment: Respiratory System ....................................................................................... 54
Chapter 25 Patient Management: Respiratory System ..................................................................................... 60
Chapter 26 Common Respiratory Disorders ..................................................................................................... 68
Chapter 27 Acute Respiratory Distress Syndrome ........................................................................................... 73
Chapter 28 Anatomy and Physiology of the Renal System .............................................................................. 80
Chapter 29 Patient Assessment: Renal System ................................................................................................. 87
Chapter 30 Patient Management: Renal System ............................................................................................... 92
Chapter 31 Acute Kidney Injury and Chronic Kidney Disease ........................................................................ 98
Chapter 32 Anatomy and Physiology of the Nervous System ........................................................................ 104
Chapter 33 Patient Assessment: Nervous System ........................................................................................... 109
Chapter 34 Patient Management: Nervous System ......................................................................................... 115
, Chapter 35 Common Neurosurgical and Neurological Disorders .................................................................. 122
Chapter 36 Traumatic Brain Injury ................................................................................................................. 128
Chapter 37 Spinal Cord Injury ........................................................................................................................ 134
Chapter 38 Anatomy and Physiology of the Gastrointestinal System ............................................................ 139
Chapter 39 Patient Assessment: Gastrointestinal System ............................................................................... 145
Chapter 40 Patient Management: Gastrointestinal System ............................................................................. 151
Chapter 41 Common Gastrointestinal Disorders ............................................................................................ 157
Chapter 42 Anatomy and Physiology of the Endocrine System ..................................................................... 164
Chapter 43 Patient Assessment: Endocrine System ........................................................................................ 170
Chapter 44 Common Endocrine Disorders ..................................................................................................... 175
Chapter 45 Anatomy and Physiology of the Hematological and Immune Systems ....................................... 181
Chapter 46 Patient Assessment: Hematological and Immune Systems .......................................................... 186
Chapter 47 Organ and Hematopoietic Stem Cell Transplantation .................................................................. 192
Chapter 48 Common Immunological Disorders ............................................................................................. 199
Chapter 49 Common Hematological Disorders .............................................................................................. 205
Chapter 50 Anatomy and Physiology of the Integumentary System .............................................................. 210
Chapter 51 Patient Assessment: Integumentary System ................................................................................. 215
Chapter 52 Patient Management: Integumentary System ............................................................................... 222
Chapter 53 Burns and Common Integumentary Disorders ............................................................................. 228
Chapter 54 Shock, Systemic Inflammatory Response Syndrome/Multiple Organ ......................................... 234
Dysfunction ..................................................................................................................................................... 234
Chapter 55 Trauma.......................................................................................................................................... 240
Chapter 56 Drug Overdose and Poisoning ...................................................................................................... 246
Chapter 1 Critical Care Nursing Practice: Promoting Excellence-Caring, Collaboration
Evidence
1. A nurse is the only one in the ICU who has not achieved certification in critical care nursing. She often
will ask her fellow nurses what to do in caring for a patient because she doubts the accuracy of her
knowledge and her intuition. She loves her work but wishes she could do it with a greater level of
competence. What is the most important effect that obtaining certification would likely have on the
nurses practice?
A) Recognition by peers
B) Increase in salary and rank
C) More flexibility in seeking employment
D) Increased confidence in making decisions
, 2. A hospital interviews two different candidates for a position in the ICU. Both candidates have around 10
years of experience working in the ICU. Both have excellent interpersonal skills and highly positive
references. One, however, has certification in critical care nursing. Which of the following is the most
compelling and accurate reason for the hospital to hire the candidate with certification?
A) The certified nurse will have more knowledge and expertise.
B) The certified nurse will behave more ethically.
C) The certified nurse will be more caring toward patients.
D) The certified nurse will work more collaboratively with other nurses.
3. A nurse is caring for an elderly man recently admitted to the ICU following a stroke. She assesses his
cognitive function using a new cognitive assessment test she learned about in a recent article in a nursing
journal. She then brings a cup of water and a straw to the patient because she observes that his lips are
dry. Later, she has the patient sit in a wheelchair and takes him to have some blood tests performed. He
objects at first, saying that he can walk on his own, but the nurse explains that it is hospital policy to use
the wheelchair. That evening, she recognizes signs of an imminent stroke in the patient and immediately
pages the physician. Which action taken by the nurse is the best example of evidence-based practice?
A) Giving the patient a cup of water
B) Transferring the patient in a wheelchair
C) Using the cognitive assessment test
D) Recognizing signs of imminent stroke and paging the physician
4. A nurse is on a committee that is trying to reduce the occurrence of hospital-acquired infections in the
ICU. Her role is to conduct research to find which interventions have been shown to be most effective in
reducing these infections. She consults many different sources and finds conflicting information. Which
of the following sources should she consider the most authoritative?
A) AACN expert panel report
B) A meta-analysis of randomized controlled trials in the American Journal of Nursing
C) A systematic review of qualitative studies in the Journal of Advanced Nursing
D) A single randomized controlled trial in the American Journal of Critical Care
5. A nurse who has been recently hired to manage the nursing staff of the ICU is concerned at the lack of
evidence-based practice she sees among the staff. Which of the following would be the best step for her
to take to promote incorporating evidence into clinical practice?
A) Only hire nurses certified in critical care nursing.
B) Leave copies of several different nursing journals in the nurses lounge.
C) Demonstrate to the staff the best nursing-related search terms to use in Google or Yahoo!
D) Introduce the staff to the PubMed search engine and assign them topics to research on it.
6. A physician visits a patient in the ICU while the nurse is out. The patient complains that the pain
medication is not effective and that he would like to receive an increased dose. The physician has the
nurse paged and consults with him in the hallway regarding the patients request for stronger pain
medication. The nurse explains that patient was started on a morphine drip only 20 minutes ago and that
APPROACH 11TH EDITION MORTON
FONTAINE TEST BANK
,Table of Contents
Chapter 1 Critical Care Nursing Practice: Promoting Excellence-Caring,Collaboration ................................... 2
Evidence .............................................................................................................................................................. 2
Chapter 2 The Patient’s Experience With Critical Illness .................................................................................. 8
Chapter 3 The Family’s Experience With Critical Illness ................................................................................ 14
Chapter 4 Patient and Family Education in Critical Care ................................................................................. 19
Chapter 5 Relieving Pain and Providing Comfort ............................................................................................ 24
Chapter 6 Palliative Care and End-of-Life Issues in Critical Care ................................................................... 29
Chapter 7 Ethical Issues in Critical Care Nursing ............................................................................................ 34
Chapter 8 Legal Issues in Critical Care Nursing ............................................................................................... 40
Chapter 9 Building a Professional Practice Model for Excellence in Critical Care Nursing ........................... 45
Chapter 10 The Critically Ill Pediatric Patient .................................................................................................. 50
Chapter 11 The Critically Ill Pregnant Woman ................................................................................................ 56
Chapter 12 The Critically Ill Older Patient ....................................................................................................... 62
Chapter 13 The Postanesthesia Patient ............................................................................................................. 68
Chapter 14 Rapid Response Teams and Transport of the Critically Ill Patient ................................................ 73
Chapter 15 Disaster Management: Implications for the Critical Care Nurse ................................................... 79
Chapter 16 Anatomy and Physiology of the Cardiovascular System ................................................................. 6
Chapter 17 Patient Assessment: Cardiovascular System .................................................................................. 12
Chapter 18 Patient Management: Cardiovascular System ................................................................................ 17
Chapter 19 Common Cardiovascular Disorders ............................................................................................... 24
Chapter 20 Heart Failure ................................................................................................................................... 30
Chapter 21 Acute Myocardial Infarction .......................................................................................................... 37
Chapter 22 Cardiac Surgery .............................................................................................................................. 44
Chapter 23 Anatomy and Physiology of the Respiratory System ..................................................................... 49
Chapter 24 Patient Assessment: Respiratory System ....................................................................................... 54
Chapter 25 Patient Management: Respiratory System ..................................................................................... 60
Chapter 26 Common Respiratory Disorders ..................................................................................................... 68
Chapter 27 Acute Respiratory Distress Syndrome ........................................................................................... 73
Chapter 28 Anatomy and Physiology of the Renal System .............................................................................. 80
Chapter 29 Patient Assessment: Renal System ................................................................................................. 87
Chapter 30 Patient Management: Renal System ............................................................................................... 92
Chapter 31 Acute Kidney Injury and Chronic Kidney Disease ........................................................................ 98
Chapter 32 Anatomy and Physiology of the Nervous System ........................................................................ 104
Chapter 33 Patient Assessment: Nervous System ........................................................................................... 109
Chapter 34 Patient Management: Nervous System ......................................................................................... 115
, Chapter 35 Common Neurosurgical and Neurological Disorders .................................................................. 122
Chapter 36 Traumatic Brain Injury ................................................................................................................. 128
Chapter 37 Spinal Cord Injury ........................................................................................................................ 134
Chapter 38 Anatomy and Physiology of the Gastrointestinal System ............................................................ 139
Chapter 39 Patient Assessment: Gastrointestinal System ............................................................................... 145
Chapter 40 Patient Management: Gastrointestinal System ............................................................................. 151
Chapter 41 Common Gastrointestinal Disorders ............................................................................................ 157
Chapter 42 Anatomy and Physiology of the Endocrine System ..................................................................... 164
Chapter 43 Patient Assessment: Endocrine System ........................................................................................ 170
Chapter 44 Common Endocrine Disorders ..................................................................................................... 175
Chapter 45 Anatomy and Physiology of the Hematological and Immune Systems ....................................... 181
Chapter 46 Patient Assessment: Hematological and Immune Systems .......................................................... 186
Chapter 47 Organ and Hematopoietic Stem Cell Transplantation .................................................................. 192
Chapter 48 Common Immunological Disorders ............................................................................................. 199
Chapter 49 Common Hematological Disorders .............................................................................................. 205
Chapter 50 Anatomy and Physiology of the Integumentary System .............................................................. 210
Chapter 51 Patient Assessment: Integumentary System ................................................................................. 215
Chapter 52 Patient Management: Integumentary System ............................................................................... 222
Chapter 53 Burns and Common Integumentary Disorders ............................................................................. 228
Chapter 54 Shock, Systemic Inflammatory Response Syndrome/Multiple Organ ......................................... 234
Dysfunction ..................................................................................................................................................... 234
Chapter 55 Trauma.......................................................................................................................................... 240
Chapter 56 Drug Overdose and Poisoning ...................................................................................................... 246
Chapter 1 Critical Care Nursing Practice: Promoting Excellence-Caring, Collaboration
Evidence
1. A nurse is the only one in the ICU who has not achieved certification in critical care nursing. She often
will ask her fellow nurses what to do in caring for a patient because she doubts the accuracy of her
knowledge and her intuition. She loves her work but wishes she could do it with a greater level of
competence. What is the most important effect that obtaining certification would likely have on the
nurses practice?
A) Recognition by peers
B) Increase in salary and rank
C) More flexibility in seeking employment
D) Increased confidence in making decisions
, 2. A hospital interviews two different candidates for a position in the ICU. Both candidates have around 10
years of experience working in the ICU. Both have excellent interpersonal skills and highly positive
references. One, however, has certification in critical care nursing. Which of the following is the most
compelling and accurate reason for the hospital to hire the candidate with certification?
A) The certified nurse will have more knowledge and expertise.
B) The certified nurse will behave more ethically.
C) The certified nurse will be more caring toward patients.
D) The certified nurse will work more collaboratively with other nurses.
3. A nurse is caring for an elderly man recently admitted to the ICU following a stroke. She assesses his
cognitive function using a new cognitive assessment test she learned about in a recent article in a nursing
journal. She then brings a cup of water and a straw to the patient because she observes that his lips are
dry. Later, she has the patient sit in a wheelchair and takes him to have some blood tests performed. He
objects at first, saying that he can walk on his own, but the nurse explains that it is hospital policy to use
the wheelchair. That evening, she recognizes signs of an imminent stroke in the patient and immediately
pages the physician. Which action taken by the nurse is the best example of evidence-based practice?
A) Giving the patient a cup of water
B) Transferring the patient in a wheelchair
C) Using the cognitive assessment test
D) Recognizing signs of imminent stroke and paging the physician
4. A nurse is on a committee that is trying to reduce the occurrence of hospital-acquired infections in the
ICU. Her role is to conduct research to find which interventions have been shown to be most effective in
reducing these infections. She consults many different sources and finds conflicting information. Which
of the following sources should she consider the most authoritative?
A) AACN expert panel report
B) A meta-analysis of randomized controlled trials in the American Journal of Nursing
C) A systematic review of qualitative studies in the Journal of Advanced Nursing
D) A single randomized controlled trial in the American Journal of Critical Care
5. A nurse who has been recently hired to manage the nursing staff of the ICU is concerned at the lack of
evidence-based practice she sees among the staff. Which of the following would be the best step for her
to take to promote incorporating evidence into clinical practice?
A) Only hire nurses certified in critical care nursing.
B) Leave copies of several different nursing journals in the nurses lounge.
C) Demonstrate to the staff the best nursing-related search terms to use in Google or Yahoo!
D) Introduce the staff to the PubMed search engine and assign them topics to research on it.
6. A physician visits a patient in the ICU while the nurse is out. The patient complains that the pain
medication is not effective and that he would like to receive an increased dose. The physician has the
nurse paged and consults with him in the hallway regarding the patients request for stronger pain
medication. The nurse explains that patient was started on a morphine drip only 20 minutes ago and that
