NUR 221 (CRITICAL CARE - TEST 1) NCLEX
STYLE PRACTICE QUESTIONS/MULTIPLE
CHOICE /2025-2026
A 75-year-old patient, who suffered a massive stroke 3 weeks ago, has been
unresponsive and has required ventilatory support since the time of the
stroke. The physician has approached the
spouse regarding placement of a permanent feeding tube. The spouse states
that the patient never wanted to be kept alive by tubes and personally didn't
want what was being done. After
holding a family conference with the spouse, the medical team concurs, and
the feeding tube is not placed. This situation is an example of
A. euthanasia
B. palliative care
C. withdrawal of life support
D. withholding life support
**P-4** - ANSWER-D
(withholding life support)
A patient who is undergoing withdrawal of mechanical ventilation appears
anxious and agitated. The patient is on a continuous morphine infusion and
has an additional order for lorazepam (Ativan) 1 to 2 mg IV as needed (prn).
The patient has received no lorazepam (Ativan) during this course of illness.
What is the most appropriate nursing intervention to control agitation?
A. Administer fentanyl (Duragesic) 25 mg IV bolus
,B. Administer lorazepam (Ativan) 1 mg IV now
C. Increase the rate of the morphine infusion by 50%
D. Request an order for a paralytic agent
**P-4** - ANSWER-B
(Administer lorazepam (Ativan) 1 mg IV now)
A statement that provides a legally recognized description of an individual's
desires regarding care at the end of life is
A. advance directive
B. guardianship ad litem
C. health care proxy
D. power of attorney
**P-4** - ANSWER-A
(advance directive)
A patient with metastatic lung carcinoma has been unresponsive to
chemotherapy. The medical team has determined that there are no
additional treatments available that will prolong life or improve the quality of
life in any meaningful way. Despite the poor prognosis, the patient continues
to receive chemotherapy and full nutritional support. This is an example of
which end-of-life concept?
A. Medical futility
B. Palliative care
,C. Terminal weaning
D. Withdrawal of treatment
**P-4** - ANSWER-A
(Medical futility)
Designated health care surrogates should base health care decisions on
A. personal beliefs and values
B. recommendations of family members and friends
C. recommendations of the physician and health care team
D. wishes previously expressed by the patient
**P-4** - ANSWER-D
(wishes previously expressed by the patient)
Which statement made by a staff nurse identifying guidelines for palliative
care would need to be corrected?
A. Basic nursing care is a critical element in palliative care management
B. Common conditions that require palliative management are nausea,
agitation, and sleep disturbance
C. Palliative care practices are reserved for the dying client
D. Palliative care practices relieve symptoms that negatively affect the
quality of life of a patient
, **P-4** - ANSWER-C
(Palliative care practices are reserved for the dying client)
Which statement is true regarding the impact of culture on end-of-life
decision making?
A. Cultural beliefs should not take precedence over health care team
decisions
B. It is easy and common to assess cultural beliefs affecting end-of-life care
in the intensive care unit
C. Culture and religious beliefs may affect end-of-life decision making
D. Perspectives regarding end-of-life care are similar between and within
religious groups
**P-4** - ANSWER-C
(Culture and religious beliefs may affect end-of-life decision making)
The most critical element of effective early end-of-life decision making is
A. Control of distressing symptoms, such as nausea, anxiety, and pain.
B. effective communication among the patient, family, and health care team
throughout the course of the illness
C. organizational support of palliative care principles
D. the relocation of the dying patient from the critical care unit to a lower
level of care
STYLE PRACTICE QUESTIONS/MULTIPLE
CHOICE /2025-2026
A 75-year-old patient, who suffered a massive stroke 3 weeks ago, has been
unresponsive and has required ventilatory support since the time of the
stroke. The physician has approached the
spouse regarding placement of a permanent feeding tube. The spouse states
that the patient never wanted to be kept alive by tubes and personally didn't
want what was being done. After
holding a family conference with the spouse, the medical team concurs, and
the feeding tube is not placed. This situation is an example of
A. euthanasia
B. palliative care
C. withdrawal of life support
D. withholding life support
**P-4** - ANSWER-D
(withholding life support)
A patient who is undergoing withdrawal of mechanical ventilation appears
anxious and agitated. The patient is on a continuous morphine infusion and
has an additional order for lorazepam (Ativan) 1 to 2 mg IV as needed (prn).
The patient has received no lorazepam (Ativan) during this course of illness.
What is the most appropriate nursing intervention to control agitation?
A. Administer fentanyl (Duragesic) 25 mg IV bolus
,B. Administer lorazepam (Ativan) 1 mg IV now
C. Increase the rate of the morphine infusion by 50%
D. Request an order for a paralytic agent
**P-4** - ANSWER-B
(Administer lorazepam (Ativan) 1 mg IV now)
A statement that provides a legally recognized description of an individual's
desires regarding care at the end of life is
A. advance directive
B. guardianship ad litem
C. health care proxy
D. power of attorney
**P-4** - ANSWER-A
(advance directive)
A patient with metastatic lung carcinoma has been unresponsive to
chemotherapy. The medical team has determined that there are no
additional treatments available that will prolong life or improve the quality of
life in any meaningful way. Despite the poor prognosis, the patient continues
to receive chemotherapy and full nutritional support. This is an example of
which end-of-life concept?
A. Medical futility
B. Palliative care
,C. Terminal weaning
D. Withdrawal of treatment
**P-4** - ANSWER-A
(Medical futility)
Designated health care surrogates should base health care decisions on
A. personal beliefs and values
B. recommendations of family members and friends
C. recommendations of the physician and health care team
D. wishes previously expressed by the patient
**P-4** - ANSWER-D
(wishes previously expressed by the patient)
Which statement made by a staff nurse identifying guidelines for palliative
care would need to be corrected?
A. Basic nursing care is a critical element in palliative care management
B. Common conditions that require palliative management are nausea,
agitation, and sleep disturbance
C. Palliative care practices are reserved for the dying client
D. Palliative care practices relieve symptoms that negatively affect the
quality of life of a patient
, **P-4** - ANSWER-C
(Palliative care practices are reserved for the dying client)
Which statement is true regarding the impact of culture on end-of-life
decision making?
A. Cultural beliefs should not take precedence over health care team
decisions
B. It is easy and common to assess cultural beliefs affecting end-of-life care
in the intensive care unit
C. Culture and religious beliefs may affect end-of-life decision making
D. Perspectives regarding end-of-life care are similar between and within
religious groups
**P-4** - ANSWER-C
(Culture and religious beliefs may affect end-of-life decision making)
The most critical element of effective early end-of-life decision making is
A. Control of distressing symptoms, such as nausea, anxiety, and pain.
B. effective communication among the patient, family, and health care team
throughout the course of the illness
C. organizational support of palliative care principles
D. the relocation of the dying patient from the critical care unit to a lower
level of care
