Complex Med-Surg Exam 1 QUESTIONS
And Answers
Standards serve as __________ for clinical practice. They _________ _____ for patient care
and provide mechanisms for nurses to _____ the achievement of patient goals - ANS
guidelines; establish goals; assess
The _________ of patients' illness makes their care the top priority of critical care nurses. - ANS
acuteness
What are two issues that critical care nurses face because of the fast-paced environment,
critical nature of illness, and issues surrounding life and death patients? - ANS
Compassion fatigue and Moral distress
3 initiatives that focus on the quality and safety of patient care (preventing errors and harm) -
ANS -Joint Commission National Patient Safety Goals
-Institute for Healthcare Improvement
-Quality and Safety Education for Nurses (QSEN)
What has the Joint Commission identified as necessary to be addressed in hospitals, long-term
care facilities, and other agencies that it accredits? - ANS National Patient Safety Goals
How can critical illnesses and the critical care environment affect the patient's family? - ANS
It can cause the feelings of:
-uncertainty
-loss of control
-stress
-anxiety
What are the basic patient family needs in the critical care environment? - ANS •Receiving
assurance
•Remaining near the patient
•Receiving information
•Being comfortable
•Having support available
what are some nursing interventions that can be implemented to meet family needs and reduce
family members' anxiety and stress? - ANS •Facilitate visitation
•Provide information
,•Encourage family involvement in patient care
•Consider family presence during procedures
(Open visitation is one essential intervention, yet it is controversial.)
What aspects of the critical care environment contribute to sensory overload? - ANS
•Light.
•Noise (PRIMARY).
•Loss of privacy: (Multiple caregivers, Multiple people in and out of unit and room).
•Acutely changing mental status
•Key word: inattention
•Types:
-Hyperactive—agitated, combative, disoriented
-Hypoactive—quiet delirium
-Mixed—fluctuating between the two
•Associated with increased mortality and morbidity - ANS Delirium
Risk factors for delirium - ANS •Older than 70 years
•Transfer from a nursing home
•History of depression, dementia, stroke
•Alcohol or substance abuse
•Electrolyte imbalance
•Hypothermia or fever
•Renal Failure
•Liver disease
•Cardiogenic or septic shock
•Human Immunodeficiency Virus (HIV) Infection
•Rectal or bladder catheters
•Tube feedings
•Central Venous Catheters
•Malnutrition
•Presence of physical restraints
•Visual or hearing impairment
types of assessments, goals, and drug of choice for delirium - ANS •Assessment
-Confusion Assessment Method for the ICU (CAM-ICU)
-Intensive Care Delirium Screening Checklist (ICDSC)
•Goal—keep the patient safe
•Drug of choice—haloperidol
ABCDEF Bundle for Preventing Delirium (" * "= important) - ANS •Awakening
•Breathing Coordination***
•Choice of Sedation****
, •Delirium monitoring
•Early mobility and exercise*****
•Family engagement an empowerment
The nature of critical illness results in a greater frequency of ________ ______. - ANS
ethical issues
What are some ethical issue that critical care nurses confront in everyday practice? - ANS
-Informed consent and confidentiality
-Withholding or withdrawal of treatment
•Know wishes: Living Will, Advanced Directives, Code Status
-Organ and tissue transplantation
-Distribution of healthcare resources
-Appropriate use of technology
what is nurse advocacy? - ANS •Obligation to protect patients
-Serve as patient advocates
Several signs alert the nurse to the potential emergence of ethical issues. What are some
ethical dilemma warning signs? - ANS •Emotionally charged
•Significant change in patient's condition
•Confusion about facts
•Hesitancy about what is right
•Deviation from customary practice
•Need for secrecy regarding proposed actions
The nurse recognizes which statement as a potential ethical issue?
A."The physician explained my mother's poor prognosis."
B."If the breathing machine is helping my mother, why is the doctor asking me about removing
the breathing tube?"
C."My mother has designated my brother to make decisions."
D."Can I assist with some of my mother's care?" - ANS B."If the breathing machine is
helping my mother, why is the doctor asking me about removing the breathing tube?"
**Rationale: This answer indicates some confusion and hesitancy about care, and a possible
deviation from norms.
Autonomy - ANS -Right of self-determination concerning medical care
And Answers
Standards serve as __________ for clinical practice. They _________ _____ for patient care
and provide mechanisms for nurses to _____ the achievement of patient goals - ANS
guidelines; establish goals; assess
The _________ of patients' illness makes their care the top priority of critical care nurses. - ANS
acuteness
What are two issues that critical care nurses face because of the fast-paced environment,
critical nature of illness, and issues surrounding life and death patients? - ANS
Compassion fatigue and Moral distress
3 initiatives that focus on the quality and safety of patient care (preventing errors and harm) -
ANS -Joint Commission National Patient Safety Goals
-Institute for Healthcare Improvement
-Quality and Safety Education for Nurses (QSEN)
What has the Joint Commission identified as necessary to be addressed in hospitals, long-term
care facilities, and other agencies that it accredits? - ANS National Patient Safety Goals
How can critical illnesses and the critical care environment affect the patient's family? - ANS
It can cause the feelings of:
-uncertainty
-loss of control
-stress
-anxiety
What are the basic patient family needs in the critical care environment? - ANS •Receiving
assurance
•Remaining near the patient
•Receiving information
•Being comfortable
•Having support available
what are some nursing interventions that can be implemented to meet family needs and reduce
family members' anxiety and stress? - ANS •Facilitate visitation
•Provide information
,•Encourage family involvement in patient care
•Consider family presence during procedures
(Open visitation is one essential intervention, yet it is controversial.)
What aspects of the critical care environment contribute to sensory overload? - ANS
•Light.
•Noise (PRIMARY).
•Loss of privacy: (Multiple caregivers, Multiple people in and out of unit and room).
•Acutely changing mental status
•Key word: inattention
•Types:
-Hyperactive—agitated, combative, disoriented
-Hypoactive—quiet delirium
-Mixed—fluctuating between the two
•Associated with increased mortality and morbidity - ANS Delirium
Risk factors for delirium - ANS •Older than 70 years
•Transfer from a nursing home
•History of depression, dementia, stroke
•Alcohol or substance abuse
•Electrolyte imbalance
•Hypothermia or fever
•Renal Failure
•Liver disease
•Cardiogenic or septic shock
•Human Immunodeficiency Virus (HIV) Infection
•Rectal or bladder catheters
•Tube feedings
•Central Venous Catheters
•Malnutrition
•Presence of physical restraints
•Visual or hearing impairment
types of assessments, goals, and drug of choice for delirium - ANS •Assessment
-Confusion Assessment Method for the ICU (CAM-ICU)
-Intensive Care Delirium Screening Checklist (ICDSC)
•Goal—keep the patient safe
•Drug of choice—haloperidol
ABCDEF Bundle for Preventing Delirium (" * "= important) - ANS •Awakening
•Breathing Coordination***
•Choice of Sedation****
, •Delirium monitoring
•Early mobility and exercise*****
•Family engagement an empowerment
The nature of critical illness results in a greater frequency of ________ ______. - ANS
ethical issues
What are some ethical issue that critical care nurses confront in everyday practice? - ANS
-Informed consent and confidentiality
-Withholding or withdrawal of treatment
•Know wishes: Living Will, Advanced Directives, Code Status
-Organ and tissue transplantation
-Distribution of healthcare resources
-Appropriate use of technology
what is nurse advocacy? - ANS •Obligation to protect patients
-Serve as patient advocates
Several signs alert the nurse to the potential emergence of ethical issues. What are some
ethical dilemma warning signs? - ANS •Emotionally charged
•Significant change in patient's condition
•Confusion about facts
•Hesitancy about what is right
•Deviation from customary practice
•Need for secrecy regarding proposed actions
The nurse recognizes which statement as a potential ethical issue?
A."The physician explained my mother's poor prognosis."
B."If the breathing machine is helping my mother, why is the doctor asking me about removing
the breathing tube?"
C."My mother has designated my brother to make decisions."
D."Can I assist with some of my mother's care?" - ANS B."If the breathing machine is
helping my mother, why is the doctor asking me about removing the breathing tube?"
**Rationale: This answer indicates some confusion and hesitancy about care, and a possible
deviation from norms.
Autonomy - ANS -Right of self-determination concerning medical care
