Critical Care Nursing 8th Edition Urden Test Bank | Complete

Critical Care Nursing 8th Edition Urden Test Bank | Complete . The patient is asked to complete an admission form. The patient hands the form to his spouse and asks her to complete the form, stating, “I forgot my glasses.” What might be inferred from the patient’s actions? a. Patient has functional health literacy. b. Patient needs a word recognition test. c. Patient has low health literacy. d. Patient needs a reading comprehension test. ANS: C Critical Care Nursing 8th Edition Urden Test Bank NU RS IN GT B.CO M Behaviors such as handing a form to a family member to complete, claiming to be too tired, or “forgetting” one’s glasses are a few behaviors that may be used by individuals to hide their limitations or low health literacy. Word recognition tests consist of lists of health care terms that patients are asked to read. Reading comprehension tests assess understanding of health care information presented but do not demonstrate the individual’s ability to apply this information. Functional health literacy tests assess the individual’s level of comprehension and ability to put into action what he or she has learned. PTS: 1 DIF: Cognitive Level: Applying REF: p. 61|pp. 64-65|Box 5-2 OBJ: Nursing Process Step: Assessment TOP: Patient and Family Education MSC: NCLEX: Psychosocial Integrity 12. What are the three learning domains to be considered when developing an individualized education plan? a. Knowledge, ability, and willingness to learn b. Psychologic, skills, and knowledge c. Knowledge, skills, and attitude d. Skills, attitude, and psychologic ANS: C Three learning domains are considered when developing an individualized education plan: knowledge, attitude, and skills. PTS: 1 DIF: Cognitive Level: Remembering REF: p. 65 OBJ: Nursing Process Step: N/A TOP: Patient and Family Education MSC: NCLEX: Safe and Effective Care Environment 13. Information on what topic should be included in the educational plan of a patient who is unconscious? a. Sensations b. Pathophysiology c. Rehabilitation d. Attitudes ANS: A Providing information regarding environment, procedures, sensations, and time of day is benevolent and may help decrease immediate physiologic stress. PTS: 1 DIF: Cognitive Level: Applying REF: p. 70 OBJ: Nursing Process Step: Intervention TOP: Patient and Family Education MSC: NCLEX: Safe and Effective Care Environment 14. What topic should be included in the education of a patient’s family members during their first visit? a. When to call the practitioner b. Availability of support groups c. Expectations about self-care d. What the patient may look like ANS: D Critical Care Nursing 8th Edition Urden Test Bank NU RS IN GT B.CO M The focus of the any education during the first visit should include what the patient may look like. When to call the practitioner, availability of support groups, and expectation for self-care should be included into later teaching sessions. PTS: 1 DIF: Cognitive Level: Understanding REF: p. 64|Table 5-2 OBJ: Nursing Process Step: Assessment TOP: Patient and Family Education MSC: NCLEX: Psychosocial Integrity 15. A patient has been in the critical care unit for 20 days with a diagnosis of sepsis and acute respiratory distress syndrome. The patient is ready for transfer to the step-down unit but is apprehensive. The patient has communicated to the nurse that he does not want to leave the ICU because he is afraid that his needs will not be met on the step-down unit. Which educational objective would be best to use in this situation? a. The patient will state two reasons why he is being transferred by the end of the day. b. The patient will confront his fears and deal with them within 1 day of transfer. c. The patient will state the name of his “new” nurse by the end of the day. d. The patient will be introduced to at least two of his “new” caregivers by the time of transfer. ANS: D The patient needs to trust the new caregivers on the step-down unit. Introducing the new caregivers will help decrease his anxiety about an unfamiliar environment. Objectives must be realistic in expectation and timeline. Anxiety and fear of change will decrease the patient’s cognitive level. PTS: 1 DIF: Cognitive Level: Applying REF: p. 64|Table 5-2 OBJ: Nursing Process Step: Planning TOP: Patient and Family Education MSC: NCLEX: Health Promotion and Maintenance 16. A 79-year-old patient received a liver transplant 3 days ago. The patient is extubated and hemodynamically stable. His spouse is coming for a visit, and the nurse has some time to discuss immune suppression drug therapy with both of them. The patient is hearing and sight impaired. The spouse brought the patient’s hearing aids 2 days ago and will bring the patient’s glasses today. Which of the following teaching strategies would be least effective in the critical care unit setting? a. Patient education channel b. Written materials c. Lecture d. Discussion ANS: C Lecture is not the strategy of choice for this situation; it does not work well in the critical care unit. Teaching must be done at the bedside by using as many of the senses as possible. Written material, discussion, demonstration, and use of media are common teaching strategies used in the critical care unit. PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 60 OBJ: Nursing Process Step: Intervention TOP: Patient and Family Education MSC: NCLEX: Safe and Effective Care Environment Critical Care Nursing 8th Edition Urden Test Bank NU RS IN GT B.CO M 17. During which phase do Health Insurance Portability and Accountability Act (HIPAA), advance directives, and visitation policies occur for the patient or family members? a. Transfer to a different level of care b. End-of-life care c. Initial contact or first visit d. Continuous care ANS: C During preparation for the first visit, the nurse would instruct the patient or family on Health Insurance Portability and Accountability Act (HIPAA), advance directives, and visitation policy. Transfer to a different level of care includes orientation to the receiving unit. Continuous care includes discussion of day-to-day routines, procedures, and treatment process. End-of-life care includes discussion of palliative care or hospice. PTS: 1 DIF: Cognitive Level: Remembering REF: p. 64|Table 5-2 OBJ: Nursing Process Step: Assessment TOP: Patient and Family Education MSC: NCLEX: Safe and Effective Care Environment 18. Which of the following statements best describes the teaching–learning process? a. It follows the distinct order of the nursing process, with each step of the process separate and without repetition. b. It requires formal blocks of learning time that are planned during the shift. c. It is a continuous activity that occurs during hospitalization and beyond. d. It ends at the point of discharge. ANS: C In the teaching–learning process, the steps of the nursing process (assessment, diagnosis, goals, interventions, and evaluation) may occur simultaneously and repetitively. The teaching–learning process is a dynamic, continuous activity that occurs throughout the entire hospitalization and may continue after the patient has been discharged. PTS: 1 DIF: Cognitive Level: Applying REF: p. 59 OBJ: Nursing Process Step: N/A TOP: Patient and Family Education MSC: NCLEX: Psychosocial Integrity 19. Which statement best describes the efficacy of group discussion as a patient teaching strategy for educating both a patient newly diagnosed with diabetes and a patient who has had the disease for years? a. It is an efficient use of the nurse’s time. b. It is an efficient use of the patient’s time. c. It is an effective strategy as both patients have identical goals. d. It is not an appropriate teaching strategy. ANS: D Educational needs between the two patients will differ. Group discussion is only effective when the goals of the education plan are the same for all patients involved. A patient newly diagnosed with diabetes will require education on topics that are potentially well known to a patient diagnosed years ago. PTS: 1 DIF: Cognitive Level: Remembering REF: p. 63 OBJ: Nursing Process Step: Assessment TOP: Patient and Family Education MSC: NCLEX: Health Promotion and Maintenance Critical Care Nursing 8th Edition Urden Test Bank NU RS IN GT B.CO M 20. A mechanically ventilated patient is being weaned off sedation. The patient begins to wake up and becomes increasingly agitated, pulling at the gown, kicking, and grimacing. What action should the nurse take next? a. Administer additional sedation until the patient stops kicking b. Initiate wrist restraints to prevent the patient from pulling c. Tell the patient to stop moving around to avoid accidental extubation d. Provide the patient with simple facts to assist with understanding of the situation ANS: D The need for oxygen and survival predominates over all other human needs. According to Maslow’s hierarchy of human needs, lower-level, physiologic needs must be satisfied before an individual can move on to higher-level issues. Experiencing a significant physiologic stressor may completely consume all the patient’s available energy and thoughts, affecting his or her ability to interact, comprehend, and respond. PTS: 1 DIF: Cognitive Level: Applying REF: p. 65 OBJ: Nursing Process Step: Implementation TOP: Patient and Family Education MSC: NCLEX: Safe and Effective Care Environment 21. A lack of true understanding can often be misread by the nurse as noncompliance. Which of the following statements demonstrate effective questioning methods to assess a patient’s understanding? a. “Do you take your heart medication every morning?” b. “Can you tell me what you know about your different heart medications?” c. “Do you take all of your medications?” d. “Do you ever miss taking your medication?” ANS: B Open-ended questions provide the nurse an opportunity to assess actual knowledge gaps rather than assume knowledge by obtaining a “yes” or “no” response. These types of questions also assist the patient and family to tell their story of the illness and communicate their perceptions of the experience. Questions that elicit only a “yes” or “no” response close off communication and do not provide for an interactive teaching–learning session. PTS: 1 DIF: Cognitive Level: Applying REF: p. 70 OBJ: Nursing Process Step: Assessment TOP: Patient and Family Education MSC: NCLEX: Health Promotion and Maintenance MULTIPLE RESPONSE 1. Acute illness disrupts the patient’s and family’s normal routines and is extremely stressful. What coping mechanisms might the nurse expect the patient and/or family to display? (Select all that apply.) a. Denial b. Adaptation c. Values d. Anger e. Disbelief ANS: A, D, E Critical Care Nursing 8th Edition Urden Test Bank NU RS IN GT B.CO M Denial, disbelief, and anger are all examples of coping mechanisms that patients use to help in stressful situations. Adaptation is the ability to break down emotional barriers that affect willingness and readiness for learning. Values are considered sociocultural factors for coping with stress. PTS: 1 DIF: Cognitive Level: Remembering REF: p. 60 OBJ: Nursing Process Step: Assessment TOP: Patient and Family Education MSC: NCLEX: Health Promotion and Maintenance 2. What are sources of physiologic stress in the acutely ill patient? (Select all that apply.) a. Hypotension b. Hypoxemia c. Fever d. Neurologic deficits e. Eupnea ANS: A, B, C, D Physiologic alterations in heart rate and blood pressure can be measured and taken into consideration during the teaching–learning encounter. Sources of physiologic stress in acutely ill patients include medications, pain, hypoxemia, decreased cerebral and peripheral perfusion, hypotension, fluid and electrolyte imbalances, infection, sensory alterations, fever, and neurologic deficits. PTS: 1 DIF: Cognitive Level: Understanding REF: p. 61 OBJ: Nursing Process Step: Assessment TOP: Patient and Family Education MSC: NCLEX: Health Promotion and Maintenance 3. According to Malcolm Knowles’ andragogy, what are characteristics of the adult learner? (Select all that apply.) a. Autonomy b. Experience c. Instructor-driven assessments d. Peer-directed motivation e. Individualism ANS: A, B, E Malcolm Knowles described these principles of adult learning in a model known as andragogy. Adult learning theory stresses concepts of individu