NUR 221 (Critical Care - Test 1) Study Notes Questions with Correct
Answers (Grade A+)
Question 1: Medical futility
Answer: A situation in which therapy or interventions will not provide a foreseeable possibility of
improvement in the patient's health condition, or a lack of attainable goals of care **Is this
treatment/surgery what is best for the patient if it is not going to help them?
Question 2: Nursing care in the critical care setting at the end-of life is focused on what 5 dimensions?
Answer: 1. Alleviation of distressing symptoms (pallation) 2. Communication and conflict resolution 3.
Withdrawing, limiting, or withholding therapy 4. Emotional and psychological care of the patient and
family 5. Caregiver organizational support
Question 3: Palliation
Answer: Provision of care interventions that are designed to relieve symptoms of illness or injury that
negatively affect the quality of life
Question 4: Palliative care
Answer: Care designed not to treat an illness but to provide physical and emotional comfort to the patient
and support and guidance to his or her family
Question 5: Hospice care
Answer: Treatment of the terminally ill in their own homes, or in special hospital units or other facilities,
with the goal of helping them to die comfortably, without pain
Question 6: T/F: Palliative care should be implemented with ALL patients, not just the dying
Answer: TRUE
Question 7: What 10 symptoms are commonly seen at end of life in patients?
Answer: 1. Pain 2. Anxiety 3. Hunger 4. Thirst 5. Dyspnea 6. Diarrhea 7. Nausea 8. Confusion 9. Agitation
10. Sleep disturbance
Question 8: An important part of palliative care consists of "simple" nursing interventions which
include:
Answer: 1. Frequent repositioning 2. Good hygiene 3. Skin care 4. Creation of a peaceful environment (to
extent possible) 5. Pain relief
Page 1
,Question 9: Elements of palliative care include:
Answer: 1. Early identification of end-of-life patients 2. Pain management 3. Pharmacological and
nonpharmacological interventions
Question 10: What is a key factor in improving the quality of care for the dying patient in the critical
care unit?
Answer: Clear, ongoing, and honest communication among the members of the healthcare team, the patient,
and the family
Question 11: What are 4 guidelines for effective communication to facilitate end-of-life care includes:
Answer: 1. Present a clear and consistent message to the family 2. Allow ample time for family members to
express themselves during family conferences 3. Emphasize that the patient will not be abandoned if the
goals of care shift from aggressive therapy to "comfort" care (palliation) only 4. Facilitate continuity of care
Question 12: Most deaths in the critical care unit are preceded by what?
Answer: Some manner of withholding, withdrawing, or limiting medical treatments, with significant
variation among different patient populations but does not constitute euthanasia or assisted suicide
Question 13: Withdrawal of treatment
Answer: Discontinuation of life-sustaining therapies in a terminally ill or persistently vegetative patient
Question 14: Withholding of treatment
Answer: Failure to initiate life-sustaining therapies in a terminally ill or persistently vegetative patient
Question 15: What is the most commonly withheld or withdrawn medical intervention in the critical
care setting?
Answer: Mechanical ventilation (AKA: terminal weaning)
Question 16: Terminal weaning
Answer: The gradual withdrawal of mechanical ventilation from a patient with a terminal illness or an
irreversible condition with a poor prognosis that could include titration of ventilator support to minimal
levels, removal of the ventilator but not the artificial airway or extubation
Question 17: During terminal weaning of ventilatory support, patient may exhibit symptoms of
respiratory distress which includes:
Answer: 1. Tachycardia 2. Dyspnea 3. Use of accessory muscles
Page 2
, Question 18: What is the nurse's role during ventilator withdrawal/terminal weaning?
Answer: Titrate pain medications and sedation as needed to relieve symptoms of respiratory distress
Question 19: T/F: Life-sustaining treatments should can be withdrawn on patients on paralytic agents
Answer: FALSE **should NOT be withdrawn on these patients
Question 20: Other than mechanical ventilation what are some other commonly withheld therapies
during palliative care?
Answer: 1. Vasopressors 2. Antibiotics 3. Blood and blood products 4. Nutritional support 5. Possible
deactivation of implanted devices (ICDs)
Question 21: Nursing interventions during withdrawal or withholding of treating include:
Answer: 1. Provide anticipatory guidance to patient and family 2. Anticipate distressing symptoms and
medicate to relieve symptoms 3. Titrate therapy to relieve emotional and physical distress
Question 22: Hospice is a model of care based on what concept?
Answer: Comfort measures
Question 23: Nursing interventions to support care at the end-of-life include:
Answer: 1. Assess patient's and family members' understanding of the condition and prognosis to address
educational needs 2. Educate family members about what will happen when life support is withdrawn to
decrease their fear of the unknown 3. Assure family members that the patient will not suffer 4. Assure
family members that the patient will not be abandoned 4. Provide for any needed emotional support and
spiritual care resources, such as grief counselors and spiritual care providers 5. Facilitate physician
communication with the family 6. Provide for visitation and presence of family and extended family; most
family members do not want the patient to die alone
Question 24: What is the usual drug of choice for patients during end-of-life care for dyspnea and pain?
Answer: Morphine
Question 25: What is the usual drug of choice for patients during end-of-life care for anxiety?
Answer: Benzodiazepines
Question 26: Organ donation
Answer: Donating or giving one's organs and/or tissues after death; one may designate specific organs or
may donate any needed organs
Page 3
Answers (Grade A+)
Question 1: Medical futility
Answer: A situation in which therapy or interventions will not provide a foreseeable possibility of
improvement in the patient's health condition, or a lack of attainable goals of care **Is this
treatment/surgery what is best for the patient if it is not going to help them?
Question 2: Nursing care in the critical care setting at the end-of life is focused on what 5 dimensions?
Answer: 1. Alleviation of distressing symptoms (pallation) 2. Communication and conflict resolution 3.
Withdrawing, limiting, or withholding therapy 4. Emotional and psychological care of the patient and
family 5. Caregiver organizational support
Question 3: Palliation
Answer: Provision of care interventions that are designed to relieve symptoms of illness or injury that
negatively affect the quality of life
Question 4: Palliative care
Answer: Care designed not to treat an illness but to provide physical and emotional comfort to the patient
and support and guidance to his or her family
Question 5: Hospice care
Answer: Treatment of the terminally ill in their own homes, or in special hospital units or other facilities,
with the goal of helping them to die comfortably, without pain
Question 6: T/F: Palliative care should be implemented with ALL patients, not just the dying
Answer: TRUE
Question 7: What 10 symptoms are commonly seen at end of life in patients?
Answer: 1. Pain 2. Anxiety 3. Hunger 4. Thirst 5. Dyspnea 6. Diarrhea 7. Nausea 8. Confusion 9. Agitation
10. Sleep disturbance
Question 8: An important part of palliative care consists of "simple" nursing interventions which
include:
Answer: 1. Frequent repositioning 2. Good hygiene 3. Skin care 4. Creation of a peaceful environment (to
extent possible) 5. Pain relief
Page 1
,Question 9: Elements of palliative care include:
Answer: 1. Early identification of end-of-life patients 2. Pain management 3. Pharmacological and
nonpharmacological interventions
Question 10: What is a key factor in improving the quality of care for the dying patient in the critical
care unit?
Answer: Clear, ongoing, and honest communication among the members of the healthcare team, the patient,
and the family
Question 11: What are 4 guidelines for effective communication to facilitate end-of-life care includes:
Answer: 1. Present a clear and consistent message to the family 2. Allow ample time for family members to
express themselves during family conferences 3. Emphasize that the patient will not be abandoned if the
goals of care shift from aggressive therapy to "comfort" care (palliation) only 4. Facilitate continuity of care
Question 12: Most deaths in the critical care unit are preceded by what?
Answer: Some manner of withholding, withdrawing, or limiting medical treatments, with significant
variation among different patient populations but does not constitute euthanasia or assisted suicide
Question 13: Withdrawal of treatment
Answer: Discontinuation of life-sustaining therapies in a terminally ill or persistently vegetative patient
Question 14: Withholding of treatment
Answer: Failure to initiate life-sustaining therapies in a terminally ill or persistently vegetative patient
Question 15: What is the most commonly withheld or withdrawn medical intervention in the critical
care setting?
Answer: Mechanical ventilation (AKA: terminal weaning)
Question 16: Terminal weaning
Answer: The gradual withdrawal of mechanical ventilation from a patient with a terminal illness or an
irreversible condition with a poor prognosis that could include titration of ventilator support to minimal
levels, removal of the ventilator but not the artificial airway or extubation
Question 17: During terminal weaning of ventilatory support, patient may exhibit symptoms of
respiratory distress which includes:
Answer: 1. Tachycardia 2. Dyspnea 3. Use of accessory muscles
Page 2
, Question 18: What is the nurse's role during ventilator withdrawal/terminal weaning?
Answer: Titrate pain medications and sedation as needed to relieve symptoms of respiratory distress
Question 19: T/F: Life-sustaining treatments should can be withdrawn on patients on paralytic agents
Answer: FALSE **should NOT be withdrawn on these patients
Question 20: Other than mechanical ventilation what are some other commonly withheld therapies
during palliative care?
Answer: 1. Vasopressors 2. Antibiotics 3. Blood and blood products 4. Nutritional support 5. Possible
deactivation of implanted devices (ICDs)
Question 21: Nursing interventions during withdrawal or withholding of treating include:
Answer: 1. Provide anticipatory guidance to patient and family 2. Anticipate distressing symptoms and
medicate to relieve symptoms 3. Titrate therapy to relieve emotional and physical distress
Question 22: Hospice is a model of care based on what concept?
Answer: Comfort measures
Question 23: Nursing interventions to support care at the end-of-life include:
Answer: 1. Assess patient's and family members' understanding of the condition and prognosis to address
educational needs 2. Educate family members about what will happen when life support is withdrawn to
decrease their fear of the unknown 3. Assure family members that the patient will not suffer 4. Assure
family members that the patient will not be abandoned 4. Provide for any needed emotional support and
spiritual care resources, such as grief counselors and spiritual care providers 5. Facilitate physician
communication with the family 6. Provide for visitation and presence of family and extended family; most
family members do not want the patient to die alone
Question 24: What is the usual drug of choice for patients during end-of-life care for dyspnea and pain?
Answer: Morphine
Question 25: What is the usual drug of choice for patients during end-of-life care for anxiety?
Answer: Benzodiazepines
Question 26: Organ donation
Answer: Donating or giving one's organs and/or tissues after death; one may designate specific organs or
may donate any needed organs
Page 3
