Test
ritica
CNursing n
nkkl ar
Fo e
Holist
Approach r cA
BaC
i 12 th
Edition
Chapter 1 Critical Care Nursing Practice: Promoting Excellence-Caring,Collaboration
Evidence
• 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
• 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.
• 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
, • 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
• 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.
• 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 the drug has not
had time to take effect yet. The physician agrees and tells the patient to give it just a
bit more time. Which component of a healthy work environment is most evident in
this scenario?
A. Skilled communication
B. Appropriate staffing
C. True collaboration
D. Meaningful recognition
• A nurse in the ICU is responding to a patient who has just gone into cardiac arrest.
A moment later, the nurse is notified that another patient has just gone into
anaphylactic shock due to a drug allergy. She is conflicted as to what to do, as she is
the only nurse available at the moment to tend to both patients. Which component
of a healthy work environment is lacking in this scenario?
A. Effective decision making
B. Appropriate staffing
C. Authentic leadership
D. Meaningful recognition
, • An ICU nurse has provided excellent care for a 6-year-old girl who had been admitted
to the ICU for a head injury. The nurse was attentive not only to the needs of the
patient but also went out of her way to care for the needs of the girls family. According
to research, which of the following forms of recognition would the nurse value the
most?
A. A card from the girls family
B. A plaque from the ICU physicians naming her as Nurse of the Year
C. A letter of commendation from the hospitals administration
D. A bouquet of flowers from her supervisor
• A patient in the ICU has recently been diagnosed with diabetes mellitus. Before being
discharged, this patient will require detailed instructions on how to manage her diet,
how to self-inject insulin, and how to handle future diabetic emergencies. Which
nurse competency is most needed in this situation?
A. Clinical judgment
B. Advocacy and moral agency
C. Caring practices
D. Facilitation of learning
• An elderly patient is admitted to the ICU with stage IV lung cancer, diabetes mellitus,
and congestive heart failure. The health care team assembled to care for her is large and
diverse, including an oncologist, a pulmonologist, an endocrinologist, a cardiologist,
and others. The patient is not expected to survive more than a few weeks, and her
husband is overwhelmed with stress and grief. Which nurse competency or
competencies are most needed in this situation? Select all that apply.
A. Clinical judgment
B. Caring practices
C. Collaboration
D. Response to diversity
• An Ethiopian man with AIDS has recently been admitted to the ICU with a case of
pneumonia. The man is new to the U.S. and has no health insurance. He would
likely be eligible for the states Medicaid coverage, but does not understand how to
access this coverage. Which competency or competencies are most needed in this
situation? Select all that apply.
A. Clinical judgment
B. Advocacy and moral agency
C. Collaboration
D. Systems thinking
E. Response to diversity
F. Clinical inquiry
• A nurse decides to seek certification in critical care nursing. What is the most
, important benefit for the individual nurse in becoming certified in a specialty?
A. It will result in a salary increase.
B. It is required to work in critical care.
C. It demonstrates the nurses personal expertise.
D. It is mandated by employers.
• The American Association of Critical-Care Nurses (AACN) sponsors certification
in critical care nursing for several critical care subspecialties. What is the most
important benefit of such certification for the profession of nursing?
A. Provides positive publicity for nursing
B. Validates nurses expert knowledge and practice
C. Mandated by government regulations
D. Demonstrates basic knowledge in the field
• A nurse has achieved certification in critical care nursing. What is the
most important effect that this certification will 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 critical thinking
• The nurse cites evidence-based practice as a rationale for a patient care decision.
What is the best description of evidence-based practice?
A. Decisions based on expert legal testimony
B. Use of best available research data
C. Evolution of nursing practice over time
D. Individual optimization of patient outcomes
• The nurse caring for a critically ill patient implements several components of care.
What component is an example of the use of evidence-based practice?
A. Use of a protocol for admission of a patient to the unit
B. Application of an insulin sliding scale method from research
C. Checking the patients armband before giving a medication
D. Limiting visits to immediate family only for 2 hours a day
• The nurse wishes to increase the use of evidence-based practice in the critical care
unit where he works. What is a significant barrier to the implementation of evidence-
based practice?
A. Use of computerized records by the hospital
ritica
CNursing n
nkkl ar
Fo e
Holist
Approach r cA
BaC
i 12 th
Edition
Chapter 1 Critical Care Nursing Practice: Promoting Excellence-Caring,Collaboration
Evidence
• 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
• 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.
• 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
, • 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
• 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.
• 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 the drug has not
had time to take effect yet. The physician agrees and tells the patient to give it just a
bit more time. Which component of a healthy work environment is most evident in
this scenario?
A. Skilled communication
B. Appropriate staffing
C. True collaboration
D. Meaningful recognition
• A nurse in the ICU is responding to a patient who has just gone into cardiac arrest.
A moment later, the nurse is notified that another patient has just gone into
anaphylactic shock due to a drug allergy. She is conflicted as to what to do, as she is
the only nurse available at the moment to tend to both patients. Which component
of a healthy work environment is lacking in this scenario?
A. Effective decision making
B. Appropriate staffing
C. Authentic leadership
D. Meaningful recognition
, • An ICU nurse has provided excellent care for a 6-year-old girl who had been admitted
to the ICU for a head injury. The nurse was attentive not only to the needs of the
patient but also went out of her way to care for the needs of the girls family. According
to research, which of the following forms of recognition would the nurse value the
most?
A. A card from the girls family
B. A plaque from the ICU physicians naming her as Nurse of the Year
C. A letter of commendation from the hospitals administration
D. A bouquet of flowers from her supervisor
• A patient in the ICU has recently been diagnosed with diabetes mellitus. Before being
discharged, this patient will require detailed instructions on how to manage her diet,
how to self-inject insulin, and how to handle future diabetic emergencies. Which
nurse competency is most needed in this situation?
A. Clinical judgment
B. Advocacy and moral agency
C. Caring practices
D. Facilitation of learning
• An elderly patient is admitted to the ICU with stage IV lung cancer, diabetes mellitus,
and congestive heart failure. The health care team assembled to care for her is large and
diverse, including an oncologist, a pulmonologist, an endocrinologist, a cardiologist,
and others. The patient is not expected to survive more than a few weeks, and her
husband is overwhelmed with stress and grief. Which nurse competency or
competencies are most needed in this situation? Select all that apply.
A. Clinical judgment
B. Caring practices
C. Collaboration
D. Response to diversity
• An Ethiopian man with AIDS has recently been admitted to the ICU with a case of
pneumonia. The man is new to the U.S. and has no health insurance. He would
likely be eligible for the states Medicaid coverage, but does not understand how to
access this coverage. Which competency or competencies are most needed in this
situation? Select all that apply.
A. Clinical judgment
B. Advocacy and moral agency
C. Collaboration
D. Systems thinking
E. Response to diversity
F. Clinical inquiry
• A nurse decides to seek certification in critical care nursing. What is the most
, important benefit for the individual nurse in becoming certified in a specialty?
A. It will result in a salary increase.
B. It is required to work in critical care.
C. It demonstrates the nurses personal expertise.
D. It is mandated by employers.
• The American Association of Critical-Care Nurses (AACN) sponsors certification
in critical care nursing for several critical care subspecialties. What is the most
important benefit of such certification for the profession of nursing?
A. Provides positive publicity for nursing
B. Validates nurses expert knowledge and practice
C. Mandated by government regulations
D. Demonstrates basic knowledge in the field
• A nurse has achieved certification in critical care nursing. What is the
most important effect that this certification will 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 critical thinking
• The nurse cites evidence-based practice as a rationale for a patient care decision.
What is the best description of evidence-based practice?
A. Decisions based on expert legal testimony
B. Use of best available research data
C. Evolution of nursing practice over time
D. Individual optimization of patient outcomes
• The nurse caring for a critically ill patient implements several components of care.
What component is an example of the use of evidence-based practice?
A. Use of a protocol for admission of a patient to the unit
B. Application of an insulin sliding scale method from research
C. Checking the patients armband before giving a medication
D. Limiting visits to immediate family only for 2 hours a day
• The nurse wishes to increase the use of evidence-based practice in the critical care
unit where he works. What is a significant barrier to the implementation of evidence-
based practice?
A. Use of computerized records by the hospital
