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NUR 445 EXAM 1 2026 ACTUAL EXAM COMPLETE EXAM QUESTIONS WITH VERIFIED ANSWERS 100% CORRECT ANSWERS ALREADY GRADED A+

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Pass your NUR 445 high-acuity nursing exam with the most current and comprehensive test bank available for the 2026 academic year. This resource features actual exam questions with 100% verified correct answers—already graded A+ by successful critical care nursing students. Covering over 400 high-yield questions, this guide mirrors the exact content domains tested on NUR 445 (High Acuity / Critical Care): Hemodynamics & Cardiovascular Monitoring: Cardiac output (CO), cardiac index (CI), stroke volume (SV), preload (CVP/RAP, PAWP), afterload (SVR/PVR), contractility, MAP, transducer leveling (phlebostatic axis), PA catheter waveforms, and normal hemodynamic values. Cardiac Dysrhythmias & Treatment: Junctional rhythms (accelerated, tachycardia), ventricular dysrhythmias (PVCs—unifocal/multifocal, V-tach, V-fib), asystole, heart blocks (1st degree, Mobitz I/Wenckebach, Mobitz II, 3rd degree complete block), antidysrhythmics (amiodarone), cardioversion vs. defibrillation, pacemakers (failure to sense/capture/fire), and ICDs. Cardiac Conditions: Valvular diseases (stenosis vs. regurgitation—mitral/aortic), infective endocarditis, heart failure (left vs. right, reduced vs. preserved EF), cardiomyopathy (dilated, hypertrophic, restrictive), hypertensive crisis (urgency vs. emergency), aortic aneurysm (thoracic/abdominal—dissection, rupture, EVAR), and CABG post-op care. ABG Interpretation & Acid-Base Disorders: Metabolic acidosis/alkalosis, respiratory acidosis/alkalosis, uncompensated/partially compensated/fully compensated states, causes, and treatments. Neurologic Critical Care: Increased ICP (early vs. late signs, mannitol, furosemide), brain death criteria (3 cardinal signs: coma, absent brainstem reflexes, apnea), CVA/stroke (ischemic vs. hemorrhagic, tPA), spinal cord injury, basilar skull fractures (raccoon eyes, battle sign), diffuse axonal injury, and Glasgow Coma Scale. Respiratory Critical Care: Pneumothorax (tension, open), flail chest, sleep apnea (CPAP), pulmonary embolism/DVT, mechanical ventilation nursing cares (q2h oral care, HOB elevation), and tension pneumothorax (tracheal deviation). Renal & Metabolic Disorders: AKI, renal stones, diabetes insipidus (DI) vs. SIADH (s/s, labs, treatment), hypovolemia vs. hypervolemia, hyperglycemia post-op, and peritoneal/hemodialysis nursing considerations. GI & Abdominal Emergencies: Peptic ulcer disease (PUD), cholecystitis, cholelithiasis, acute/chronic pancreatitis, appendicitis (Rovsing's sign), diverticulitis vs. diverticulosis, abdominal compartment syndrome, hepatic failure, Mallory-Weiss tears, and post-tonsillectomy bleeding precautions. Critical Care Concepts: Alarm fatigue, burnout (symptoms, buffers), TJC National Patient Safety Goals, family presence during CPR, palliative care (FICA spiritual history tool), goals of care, code status (AND), medical futility, organ donation, moral distress, transfer anxiety, and the ABCDEF bundle. Shock & Sepsis: Hypovolemic shock, cardiogenic shock, septic shock (s/s, early fluid resuscitation, vasopressors), MODS (Multiple Organ Dysfunction Syndrome), and lactate acidosis. Medications & Emergency Treatments: Atropine (bradycardia), nitroprusside (hypertensive emergency), tPA (ischemic stroke), lactulose (hepatic encephalopathy), mannitol (increased ICP), amiodarone, beta blockers, ACE inhibitors, ARBs, CCBs, diuretics (furosemide), and anticoagulants (aspirin, Plavix, warfarin, heparin). Nursing Prioritization & Patient Safety: Primary survey (A-B-C-D-E), preoperative consent criteria (18+, competent, informed), PACU discharge criteria (Aldrete score 7-10), post-op assessments, wire cutters for jaw wiring, and suicide risk assessment (CUS method, DESC). Perfect for nursing students in high-acuity, critical care, medical-surgical, or advanced adult health courses. Each answer includes the verified correct response to ensure exam readiness. hyponatremia, sepsis early fluid resuscitation vasopressors, and NUR 445 critical care study guide.

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NUR 445 EXAM 1 2026 ACTUAL EXAM COMPLETE EXAM
QUESTIONS WITH VERIFIED ANSWERS 100% CORRECT
ANSWERS ALREADY GRADED A+




Who must "goals of care" be discussed with? - ANS... -With the patient and their
family, allowing ample time for meaningful discussion

What is a major advantage of having technology available in the high acuity
environment? - ANS... -The patient's status can be monitored continuously

What is a major criticism of nurses who work in high acuity environments? -
ANS... -they are too technologically oriented

What is alarm fatigue? - ANS... -When the number and frequency of alarms
becomes overwhelming, it can result in delayed alarm responses and deliberate
alarm deactivations

What does working in a healthy environment increase? - ANS... -job satisfaction
and provides a buffer against stress and burnout

Which professional organization made a commitment to promote healthy work
environments that support quality patient care and high levels of nurse satisfaction?
- ANS... -American Association of Critical Care Nurses

What are some standards of healthy work environments? - ANS... -Skilled
communication, true collaboration, efficient decision making, appropriate staffing,
meaningful recognition, and authentic leadership

Who are the gatekeepers of patient safety? - ANS... -high acuity nurses

What is burnout? - ANS... -Feelings of personal/professional frustration, job
dissatisfaction, job insecurity, emotion/physical exertion, emotional exhaustion,

,depersonalization, reduced personal accomplishments, lack of control, overworked,
insufficient awards, conflicting values

What are some symptoms of burnout? - ANS... -Withdrawal, risk taking,
ambivalence, decreased productivity, contemplating career change, increased use
of caffeine/alcohol/nicotine, chronic fatigue, frequent minor ailments, sleep
changes, appetite change, sexual difficulty, attempts to blame others, stereotyping
patients, nightmares, depression, hostility, negativism, loss of tolerance, decreased
ability to make decisions, poor judgement, lack of initiative, forgetfulness

What can serve as a buffer against the negative effects of stress? - ANS... -a
positive social climate characterized by strong managerial support and
cohesiveness among the staff

What are critical incident stress debriefings? - ANS... -structured group discussions
occurring within several days following a crisis, designed to address symptoms of
stress, assess the need for follow-up, and provide a sense of closure

What is TJC? - ANS... -The Joint Commission

What is the TJCs mission? - ANS... -to continuously improve the safety and
quality of care provided to the public through the provision of healthcare
accreditation that supports process improvement in healthcare organizations

What are the national patient safety goals? - ANS... -patient identifiers, staff
communication, medication safety, alarm safety, infection prevention, risk
identification, and timeout

What are some factors that inhibit learning and barriers to communication for the
high acuity patient? - ANS... -Fatigue, barriers to communication, pain, drugs

What takes precedence over the need to know and understand? - ANS... -
physiologic needs

What are some of the educational needs of ICU patients and families? - ANS... -
current info about patient progress, informed decision making, acknowledgement
of past, optimal learning environment, orientation to routines and care, motivation

What is transfer anxiety? - ANS... -transferring to a less acute unit creates anxiety
as they move to an unfamiliar environment

,What are some components of ICU patient and family centered care? - ANS... -
Open visitation, inclusion in decision making, education about healthcare, and
inclusion of families in designing comfortable spaces

What is reduced for the ICU patient when the family is at the bedside? - ANS... -
anxiety and hallucinations

How can the family help the ICU patient and nursing staff? - ANS... -they can
comfort patients in ways not open to staff, as well as provide info to help the nurse
individualize care

Historically, why have families been restricted from the ICU? - ANS... -Harmful
physiological consequences, interferes with time nurses need to spend caring for
patients, delays in care

What are some advantages to having family present during CPR? - ANS... -Family
grasps seriousness of condition, sees firsthand everything was done for the patient,
helps with grieving, doubt is removed, less fear and anxiety, a sense of closure,

What is cultural competence? - ANS... -Being mindful of your own beliefs and
attitudes, without letting personal bias influence the care of patients with different
backgrounds

Why is culturally competent care essential? - ANS... -to achieve equitable
outcomes for all patients

Why is it important for nurses to recognize and address barriers to culturally
competent care? - ANS... -to convey respect for the patient's uniqueness,
discussing language preferences, educational material at their level, address
sensitivity

Which senses are involved in sensory output? - ANS... -visual, auditory, olfactory,
gustatory, tactile

What are the 3 sensory perceptual alterations? - ANS... -sensory
overload/deprivation, delirium, sleep deprivation

How can nurses act as an advocate in providing rest and sleep? - ANS... -control
the environment and ensure rest throughout the day/night

, What are a few interventions nurses can do to promote uninterrupted rest periods? -
ANS... -Relaxing music, ear plugs, control pain, silencing pagers and alarms,
lowering lights, limit visitation, help patient mentally prepare for bedtime



What is the difference between a small hospital ICU and a large hospital ICU? -
ANS... -The size, resources available, specialized units, etc.

What must the nurse caring for the high acuity patient be able to do? - ANS... -
Analyze critical situations, make decisions based on their analysis, and rapidly
intervene to ensure optimal outcomes

Who is the only member of the healthcare team who is at the bedside and
frequently coordinates patient care? - ANS... -The nurse

Who detects early signs of an impending complication with the patient? - ANS... -
The nurse

What is one of the primary goals for the acute care nurse? - ANS... -the prevention
of complications

What changes led to decreased job satisfaction and nurses leaving practice in the
high acuity environment? - ANS... -Schedules, staffing, floating outside the
specialty, hospital restructuring, etc.

What really should be considered when making decisions about nursing staffing
patterns? - ANS... -The needs of the patient and the skill mix of the nursing staff

What should the first principle of staffing be? - ANS... -provide safe and effective
patient care

What does the ANCC award hospitals magnet status for? - ANS... -If they are able
to create working environments that are successful in recruiting and retaining
professional nurses

Which patients are often stereotyped as not being candidates for aggressive
treatment? - ANS... -Oncology patients

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