NURS 471: QUIZ 1 QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT RATED A+
Complex Patient
✔✔ Refers to individuals with multiple, interrelated health and social challenges,
such as:
Comorbidity (two or more chronic medical conditions)
Multimorbidity (multiple long-term illnesses)
Substance use disorders
Mental health concerns
Social and environmental stressors
Frequent use of health services
Complex / Critical Care
✔✔ Direct, hands-on care provided to patients with life-threatening illnesses or
injuries.
The condition must acutely impair one or more vital organ systems
The patient’s survival is at immediate risk
Definition of Critical Care Nursing
✔✔ A specialized field of nursing focused on managing human responses to life-
threatening conditions.
Critical care nurses are licensed professionals who provide expert care to
acutely and critically ill patients and support their families through
complex situations.
,Core Elements of Critical Illness or Injury
✔✔
Patient’s life is in danger
Conditions are unstable, complex, and often irreversible
One or more vital organs are impaired
Care is usually delivered in specialized hospital units (e.g., ICU)
Requires highly trained personnel and advanced technology
Levels of Critical Care – Example: Level I ICU
✔✔
Highest level of intensive care
Found in teaching hospitals or academic medical centers
Includes a full team: critical care physicians, specialized nurses,
pharmacists, nutritionists, and other support staff
Equipped with advanced life-support technologies
Example facilities: Stanford Medical Center, UCSF Medical Center
II: comprehensive care for specific population, example: would be open heart
surgery but not heart transplant = transfer
III: able to stabilize critical patient but limited = transfer - ANSWERS✔✔Open &
Closed Units ICU
Open: nursing, resp therapist, etc. but provider has patients throughout hospital,
they rotate every month, have patients in ICU and elsewhere
Closed: care is provided by dedicated team and doctor = cardiologist or
pulmonologist, only patients are in ICU, intensivist
Complex care: one or more vital organ
,Closed unit: intensivist
A lot of errors, pump errors - ANSWERS✔✔Increasing Safety
Utilize patient constraints, weight, allergies
Install forcing functions or system level firewalls, scan wristbands, meds = force us
to do the right thing
Avoid reliance of vigilance, checklists, standing orders
Organizational culture of safety: everyone on the same page for safety
Simplify & standardize key processes: checklists
Develop multidisciplinary approach: all a team, working together
Adequate appropriate competent staffing
Limit work hours - ANSWERS✔✔Safety training: "Keep Me Safe: Universal
Skills"
pay attention to detail, avoid errors = STAR
practice and accept a questioning attitude
communicate clearly
be accountable team member
Powerplans: evidence based
Protocols/guidelines
Clinical pathway (COVID) - ANSWERS✔✔Methods
SBAR: used to handoff report
Two challenge rule: assertive communication
Speak Up
Collaboration
, Collaborative Care MDR rounds ICU: everyone = nurse, doctor, dietitian, family
discusses plan for shift, day, and stay - ANSWERS✔✔Synergy Care Model
Critical care nursing should be defined more by the needs of patients and those of
their families than by the environment in which care is delivered or the diagnosis
of the patients
Patient/family needs + Nurse competencies = Optimal patient outcomes
Patient characteristics, nurse competencies, patient and family outcomes, unit
outcomes, system outcomes - ANSWERS✔✔Patient Needs: laughter
Stress & Worry from Patients
Being thirsty
Being in pain
Having tubes & lines in their body
Being unable to communicate
Being restricted by tubes/lines
Being unable to sleep
Being unable to be in control
Nurses response:
Communication = boards with pictures - ANSWERS✔✔Comfort
Pain assessment and management
Sedation
Delirium assessment and prevention
Sleep
Nutrition
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT RATED A+
Complex Patient
✔✔ Refers to individuals with multiple, interrelated health and social challenges,
such as:
Comorbidity (two or more chronic medical conditions)
Multimorbidity (multiple long-term illnesses)
Substance use disorders
Mental health concerns
Social and environmental stressors
Frequent use of health services
Complex / Critical Care
✔✔ Direct, hands-on care provided to patients with life-threatening illnesses or
injuries.
The condition must acutely impair one or more vital organ systems
The patient’s survival is at immediate risk
Definition of Critical Care Nursing
✔✔ A specialized field of nursing focused on managing human responses to life-
threatening conditions.
Critical care nurses are licensed professionals who provide expert care to
acutely and critically ill patients and support their families through
complex situations.
,Core Elements of Critical Illness or Injury
✔✔
Patient’s life is in danger
Conditions are unstable, complex, and often irreversible
One or more vital organs are impaired
Care is usually delivered in specialized hospital units (e.g., ICU)
Requires highly trained personnel and advanced technology
Levels of Critical Care – Example: Level I ICU
✔✔
Highest level of intensive care
Found in teaching hospitals or academic medical centers
Includes a full team: critical care physicians, specialized nurses,
pharmacists, nutritionists, and other support staff
Equipped with advanced life-support technologies
Example facilities: Stanford Medical Center, UCSF Medical Center
II: comprehensive care for specific population, example: would be open heart
surgery but not heart transplant = transfer
III: able to stabilize critical patient but limited = transfer - ANSWERS✔✔Open &
Closed Units ICU
Open: nursing, resp therapist, etc. but provider has patients throughout hospital,
they rotate every month, have patients in ICU and elsewhere
Closed: care is provided by dedicated team and doctor = cardiologist or
pulmonologist, only patients are in ICU, intensivist
Complex care: one or more vital organ
,Closed unit: intensivist
A lot of errors, pump errors - ANSWERS✔✔Increasing Safety
Utilize patient constraints, weight, allergies
Install forcing functions or system level firewalls, scan wristbands, meds = force us
to do the right thing
Avoid reliance of vigilance, checklists, standing orders
Organizational culture of safety: everyone on the same page for safety
Simplify & standardize key processes: checklists
Develop multidisciplinary approach: all a team, working together
Adequate appropriate competent staffing
Limit work hours - ANSWERS✔✔Safety training: "Keep Me Safe: Universal
Skills"
pay attention to detail, avoid errors = STAR
practice and accept a questioning attitude
communicate clearly
be accountable team member
Powerplans: evidence based
Protocols/guidelines
Clinical pathway (COVID) - ANSWERS✔✔Methods
SBAR: used to handoff report
Two challenge rule: assertive communication
Speak Up
Collaboration
, Collaborative Care MDR rounds ICU: everyone = nurse, doctor, dietitian, family
discusses plan for shift, day, and stay - ANSWERS✔✔Synergy Care Model
Critical care nursing should be defined more by the needs of patients and those of
their families than by the environment in which care is delivered or the diagnosis
of the patients
Patient/family needs + Nurse competencies = Optimal patient outcomes
Patient characteristics, nurse competencies, patient and family outcomes, unit
outcomes, system outcomes - ANSWERS✔✔Patient Needs: laughter
Stress & Worry from Patients
Being thirsty
Being in pain
Having tubes & lines in their body
Being unable to communicate
Being restricted by tubes/lines
Being unable to sleep
Being unable to be in control
Nurses response:
Communication = boards with pictures - ANSWERS✔✔Comfort
Pain assessment and management
Sedation
Delirium assessment and prevention
Sleep
Nutrition
