NUR 445 EXAM 1 (2025) COMPLETE EXAM REVIEW QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100% ACCURATE) / FULLY REVIEWED AND APPROVED
What is the difference between a small hospital ICU and a large hospital ICU?
The size, resources available, specialized units, etc.
What must the nurse caring for the high acuity patient be able to do?
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?
The nurse
Which patients are often stereotyped as not being candidates for aggressive
treatment?
Oncology patients
Who must "goals of care" be discussed with?
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?
The patient's status can be monitored continuously
Who detects early signs of an impending complication with the patient?
The nurse
What is one of the primary goals for the acute care nurse?
the prevention of complications
What changes led to decreased job satisfaction and nurses leaving practice in the
high acuity environment?
Schedules, staffing, floating outside the specialty, hospital restructuring, etc.
What really should be considered when making decisions about nursing staffing
patterns?
The needs of the patient and the skill mix of the nursing staff
What should the first principle of staffing be?
provide safe and effective patient care
What does the ANCC award hospitals magnet status for?
If they are able to create working environments that are successful in recruiting and
retaining professional nurses
What is a major criticism of nurses who work in high acuity environments?
they are too technologically oriented
What is alarm fatigue?
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?
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?
American Association of Critical Care Nurses
What are some standards of healthy work environments?
,Skilled communication, true collaboration, efficient decision making, appropriate
staffing, meaningful recognition, and authentic leadership
Who are the gatekeepers of patient safety?
high acuity nurses
What is burnout?
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?
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?
a positive social climate characterized by strong managerial support and cohesiveness
among the staff
What are critical incident stress debriefings?
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?
The Joint Commission
What is the TJCs mission?
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?
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?
Fatigue, barriers to communication, pain, drugs
What takes precedence over the need to know and understand?
physiologic needs
What are some of the educational needs of ICU patients and families?
current info about patient progress, informed decision making, acknowledgement of
past, optimal learning environment, orientation to routines and care, motivation
What is transfer anxiety?
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?
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?
anxiety and hallucinations
, How can the family help the ICU patient and nursing staff?
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?
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?
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?
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?
to achieve equitable outcomes for all patients
Why is it important for nurses to recognize and address barriers to culturally
competent care?
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?
visual, auditory, olfactory, gustatory, tactile
What are the 3 sensory perceptual alterations?
sensory overload/deprivation, delirium, sleep deprivation
How can nurses act as an advocate in providing rest and sleep?
control the environment and ensure rest throughout the day/night
What are a few interventions nurses can do to promote uninterrupted rest
periods?
Relaxing music, ear plugs, control pain, silencing pagers and alarms, lowering lights,
limit visitation, help patient mentally prepare for bedtime
What are some methods of nonverbal communication used by high acuity
patients?
vitals, facial expressions, hand gestures, written messages, computer keyboards,
pointing to letters, coded eye-blink system
What is palliative care?
interdisciplinary approach to relieve suffering and improve QOL
What are common symptoms addressed by the palliative care team?
shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping
What is the goal of palliative care?
to improve quality of life
Who can initiate a consult to the palliative care team?
a nurse, physician, family member, patient, social worker, or case manager
What are the benefits of palliative care in the ICU?
decreased length of stay, decreased use of ineffective treatments, decreased
anxiety/depression, increased family satisfaction and understanding, increased
symptom assessment, increased comfort
Who meets to formulate the palliative care plan?
palliative care team, ICU nurse, other team members
VERIFIED ANSWERS (100% ACCURATE) / FULLY REVIEWED AND APPROVED
What is the difference between a small hospital ICU and a large hospital ICU?
The size, resources available, specialized units, etc.
What must the nurse caring for the high acuity patient be able to do?
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?
The nurse
Which patients are often stereotyped as not being candidates for aggressive
treatment?
Oncology patients
Who must "goals of care" be discussed with?
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?
The patient's status can be monitored continuously
Who detects early signs of an impending complication with the patient?
The nurse
What is one of the primary goals for the acute care nurse?
the prevention of complications
What changes led to decreased job satisfaction and nurses leaving practice in the
high acuity environment?
Schedules, staffing, floating outside the specialty, hospital restructuring, etc.
What really should be considered when making decisions about nursing staffing
patterns?
The needs of the patient and the skill mix of the nursing staff
What should the first principle of staffing be?
provide safe and effective patient care
What does the ANCC award hospitals magnet status for?
If they are able to create working environments that are successful in recruiting and
retaining professional nurses
What is a major criticism of nurses who work in high acuity environments?
they are too technologically oriented
What is alarm fatigue?
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?
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?
American Association of Critical Care Nurses
What are some standards of healthy work environments?
,Skilled communication, true collaboration, efficient decision making, appropriate
staffing, meaningful recognition, and authentic leadership
Who are the gatekeepers of patient safety?
high acuity nurses
What is burnout?
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?
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?
a positive social climate characterized by strong managerial support and cohesiveness
among the staff
What are critical incident stress debriefings?
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?
The Joint Commission
What is the TJCs mission?
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?
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?
Fatigue, barriers to communication, pain, drugs
What takes precedence over the need to know and understand?
physiologic needs
What are some of the educational needs of ICU patients and families?
current info about patient progress, informed decision making, acknowledgement of
past, optimal learning environment, orientation to routines and care, motivation
What is transfer anxiety?
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?
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?
anxiety and hallucinations
, How can the family help the ICU patient and nursing staff?
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?
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?
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?
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?
to achieve equitable outcomes for all patients
Why is it important for nurses to recognize and address barriers to culturally
competent care?
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?
visual, auditory, olfactory, gustatory, tactile
What are the 3 sensory perceptual alterations?
sensory overload/deprivation, delirium, sleep deprivation
How can nurses act as an advocate in providing rest and sleep?
control the environment and ensure rest throughout the day/night
What are a few interventions nurses can do to promote uninterrupted rest
periods?
Relaxing music, ear plugs, control pain, silencing pagers and alarms, lowering lights,
limit visitation, help patient mentally prepare for bedtime
What are some methods of nonverbal communication used by high acuity
patients?
vitals, facial expressions, hand gestures, written messages, computer keyboards,
pointing to letters, coded eye-blink system
What is palliative care?
interdisciplinary approach to relieve suffering and improve QOL
What are common symptoms addressed by the palliative care team?
shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping
What is the goal of palliative care?
to improve quality of life
Who can initiate a consult to the palliative care team?
a nurse, physician, family member, patient, social worker, or case manager
What are the benefits of palliative care in the ICU?
decreased length of stay, decreased use of ineffective treatments, decreased
anxiety/depression, increased family satisfaction and understanding, increased
symptom assessment, increased comfort
Who meets to formulate the palliative care plan?
palliative care team, ICU nurse, other team members
