TEST BANK
UNDERSTANDING THE ESSENTIALS OF CRITICAL CARE NURSING
3RD EDITION BY KATHLEEN PERRIN, CARRIE MACLEOD
TABLE OF CONTENT
1. What is Critical Care?
2. Care of the Critical Ill Patient
3. Care of the Patient with Respiratory Failure
4. Interpretation and Management of Basic Dysrhythmias
5. Cardiodynamics and Hemodynamic Regulation
6. Care of the Patient Experiencing Shock
7. Care of the Patient Experiencing Heart Failure
8. Care of the Patient Experiencing Acute Coronary Syndrome
9. Care of the Patient Following Traumatic Injury
10. Care of the Patient Experiencing an Intracranial Dysfunction
11. Care of the Patient With a Cerebral or Cerbrovascular Disorder
12. Care of the Critically Ill Patient Experiencing Alcohol Withdrawal and/or Liver
Failure
13. Care of the Patient With an Acute Gastrointestinal Bleed or Pancreatitis
14. Care of the Patient with Problems in Glucose Metabolism
15. Care of the Patient with Acute Kidney Injury
16. Care of the Organ Donor and Transplant Recipient
17. Care of the Acutely Ill Burn Patient
18. Care of the Patient with Sepsis
19. Care of the ICU Patient at the End of Life
, 1. What is Critical Care?
1. Which patient would the nurse identify as experiencing a critical illness? The
patient:
1. With chronic airflow limitation whose VS are BP 110/72, P 110, R 16
2. With acute bronchospasm and whose VS are BP 100/60, P 124, R 32
3. Who was involved in a motor vehicle crash whose VS are BP 124/74, P 74, R 18
4. On hemodialysis for chronic renal failure with no urine output and whose VS are
BP 98/50, P 108, R 12
ANS: 2
Acute bronchospasm can present a life-threatening situation, which can jeopardize a
patient's survival. The patient's pulse and respiratory rate are elevated, which could
indicate a critical illness.
2. Of the following patients, which will the nurse expect to be transferred to a
critical care unit? The patient:
Standard Text: Select all that apply.
1. With an acetaminophen overdose
2. Suffering from acute mental illness
3. With chronic renal failure
4. With acute decompensated heart failure
5. With bacteremia from an infected foot wound
ANS: 1, 4, 5
Rationale 1: Critical care units are cost-efficient units for caring for patients with
specific organ system failure. Patients with acetaminophen overdose often suffer liver
failure as a consequence.
Rationale 4: The patient with acute decompensated heart failure would receive care
in a critical care unit. This patient has a specific organ that has failed.
,Rationale 5: Bacteremia can affect many organs and lead to multisystem organ
failure. This patient would receive care in a critical care unit.
3. The nurse, employed in a hospital in a small rural town, would expect to provide
which level of care in the critical care unit?
1. Level I
2. Level II
3. Level III
4. It is unlikely that the hospital would have a critical care unit.
ANS: 3
Level III facilities provide initial stabilization of critically ill patients but limited ability
to provide comprehensive critical care. A limited number of patients who require
routine care may remain in the facility but written policies should be in place
determining which patients require transfer and where they ought to be transferred.
This level of care is most likely provided in a small rural facility.
4. The nurse, providing patient care in an "open" ICU, would most likely be working
with a:
1. Multidisciplinary team with physicians who are also responsible for patients on
other units
2. Multidisciplinary team that includes a physician employed by the hospital
3. Physician in charge of patient care who is a specialist in critical care
4. Primary care physician who must consult a critical care specialist
ANS: 1
In an open ICU, nurses, pharmacists, and respiratory therapists are ICU based but the
physicians directing patient care may have other obligations. These physicians may or
,may not choose to consult an intensivist to assist with the management of their ICU
patients.
5.The nurse, providing care to patients in a critical care unit, realizes that
technology increases the likelihood of errors when:
1. It relies heavily on human decision making.
2. Devices are programmed to function without double checks.
3. It makes the workload seem overwhelming to health care providers.
4. There is uniform equipment throughout each facility.
ANS: 2
Technology changes the tasks people do by shifting the workload and eliminating
human decision making.
6. What will the nurse identify as an example of an installed forcing functions or a
system level firewall to prevent errors when providing patient care?
1. Prior to administration of insulin, two nurses check the dose.
2. Prior to obtaining a medication, height, weight, and allergies are recorded.
3. All medications are checked by two nurses prior to administration.
4. Undiluted potassium chloride is not available on critical care units.
ANS: 4
This is an example of an installed forcing function or a system level firewall.
7. The nurse realizes that the increased use of technology in critical care units has
resulted in which consequence for patient care?
1. Decreased risk of errors in patient care
,2. Decreased therapeutic nurse-patient communication
3. Improved overall patient satisfaction with care
4. Improved patient safety across the entire spectrum
ANS: 2
This has been demonstrated as an outcome resulting from an increased use of
technology in critical care units.
8. The nurse in the critical care area is completing a preoperative checklist before
sending a patient for surgery. This nurse’s activity is an example of which
recommendation issued by the Institute of Medicine?
1. Utilizing constraints
2. Simplifying key processes
3. Avoiding reliance on vigilance
4. Standardizing key processes
ANS: 3
Completing a preoperative checklist is an example of avoiding reliance on vigilance.
9. Which actions should the nurse complete after realizing that an incorrect dose of
medication has been administered to a patient?
Standard Text: Select all that apply.
1. Notify the patient and family
2. Notify the physician
3. Document the error
4. Prepare for an analysis of the error
5. Keep the notification of the error silent
ANS: 1, 2, 3, 4
,Rationale 1: In a critical care unit that has embraced a culture of safety, practitioners
have a responsibility to their patients to make their errors known, have them
corrected, and share them with the patient and family.
Rationale 2: In a critical care unit that has embraced a culture of safety, practitioners
have a responsibility to their patients to make their errors known, have them
corrected, and share them with other practitioners.
Rationale 3: In a critical care unit that has embraced a culture of safety and practice,
improvement is a goal rather than punishment. The reporting of errors results in the
examination of the factors that contributed to the error and changes practice
patterns.
Rationale 4: In a critical care unit that has embraced a culture of safety and practice,
improvement is a goal rather than punishment. The reporting of errors results in the
examination of the factors that contributed to the error and changes practice
patterns.
10. The nurse working within the AACN Synergy Model realizes that optimal patient
outcomes are realized when:
1. Highly qualified nurses care for patients in highly technical settings.
2. Nurses agree to work overtime to cover unit staffing needs.
3. Staff nurse competency is matched with patient needs.
4. Patient care is delivered within a "closed unit" model.
ANS: 3
The underlying assumption of the Synergy Model is that optimal patient outcomes
occur when the needs of the patient and family are matched with the competencies
of the nurse.
11. The competent critical care nurse demonstrates an understanding of patient
advocacy by taking which actions?
Standard Text: Select all that apply.
,1. Maintaining attendance at the bedside with the patient during a physician visit
2. Assisting and supporting the patient and family as they reveal their needs
3. Alerting the physician to concerns about client placement after hospitalization
4. Encouraging and supporting a patient's spouse in preparing for a family meeting
5. Seeing the big picture when planning patient care
ANS: 1, 2, 3, 4
Rationale 1: The nurse realizes that the patient may be vulnerable and need support
to obtain what is needed from the health care system.
Rationale 2: The nurse realizes that the patient may be vulnerable and need support
to obtain what is needed from the health care system.
Rationale 3: The nurse realizes that the patient may be vulnerable and need support
to obtain what is needed from the health care system.
Rationale 4: The nurse realizes that the patient may be vulnerable and need support
to obtain what is needed from the health care system.
12. A nurse is preparing to communicate an issue about patient care to a physician
using the SBAR technique. Which phrase is an appropriate initial statement?
1. "I am concerned about…"
2. "The patient's immediate history is…"
3. "I think the problem is…"
4. "I would like you to …"
ANS: 1
This is an appropriate initial statement using the SBAR technique.
13. The nurse includes which statement for "A - Assessment" in the SBAR technique
for communication?
1. "I think the problem is…"
,2. "The patient's vital signs are…"
3. "The patient's treatments are…"
4. "I would like you to…"
ANS: 1
This is an appropriate statement for assessment using the SBAR technique for
communication.
14. When concluding SBAR communication about a patient issue, the nurse will use
which statement?
1. "The patient's immediate history is…"
2. "The patient's physical findings are…"
3. "I am requesting that you…"
4. "I have assessed the patient personally."
ANS: 3
This statement would be used when concluding SBAR communication.
15. In order to collaborate with other members of the health care team to effect
optimal outcomes in patient care, the nurse utilizes the characteristics of emotional
maturity which include:
Standard Text: Select all that apply.
1. Maintaining current skills
2. Being a lifelong learner
3. Actively identifying best practices
4. Overlooking one's own shortcomings
5. Willing to take responsibility for failures
ANS: 1, 2, 3, 5
,Rationale 1: This is an attribute of emotional maturity in nursing.
Rationale 2: This is an attribute of emotional maturity in nursing.
Rationale 3: This is an attribute of emotional maturity in nursing.
Rationale 5: This is an attribute of emotional maturity in nursing.
16. Which informal power bases will the nurse use in the health care setting?
Standard Text: Select all that apply.
1. Expertise
2. Goodwill
3. Information
4. Observation
5. Collaboration
ANS: 1, 2, 3
Rationale 1: Expertise is an informal power base.
Rationale 2: Goodwill is an informal power base.
Rationale 3: Information is an informal power base.
17. The nurse caring for a patient would ensure that the patient has consented to
care by providing what to the patient?
1. A consent form to sign to receive medications
2. A consent form to sign to have dressings changed
3. A consent form to sign to be turned in bed
4. An explanation of a dressing to be changed
, ANS: 4
If the nurse does not ask the patient for consent, the nurse should explain the
procedure.
18. If a nurse forcibly inserts a nasogastric tube against a patient's wishes, the nurse
can be held liable for:
1. Negligence
2. Malpractice
3. Damages
4. Battery
ANS: 4
When the nurse treats or touches a patient without consent, it is battery.
19. The nurse is aware that decision-making capacity is likely to be impaired for a
patient who:
Standard Text: Select all that apply.
1. Is being medicated for severe pain
2. Does not understand the medical condition
3. Has been diagnosed with septic shock
4. Is depressed
5. Asks questions about identified treatments
ANS: 1, 2, 3, 4
Rationale 1: The patient must be capable of rational thought and be able to
recognize what the prospective treatment involves.
UNDERSTANDING THE ESSENTIALS OF CRITICAL CARE NURSING
3RD EDITION BY KATHLEEN PERRIN, CARRIE MACLEOD
TABLE OF CONTENT
1. What is Critical Care?
2. Care of the Critical Ill Patient
3. Care of the Patient with Respiratory Failure
4. Interpretation and Management of Basic Dysrhythmias
5. Cardiodynamics and Hemodynamic Regulation
6. Care of the Patient Experiencing Shock
7. Care of the Patient Experiencing Heart Failure
8. Care of the Patient Experiencing Acute Coronary Syndrome
9. Care of the Patient Following Traumatic Injury
10. Care of the Patient Experiencing an Intracranial Dysfunction
11. Care of the Patient With a Cerebral or Cerbrovascular Disorder
12. Care of the Critically Ill Patient Experiencing Alcohol Withdrawal and/or Liver
Failure
13. Care of the Patient With an Acute Gastrointestinal Bleed or Pancreatitis
14. Care of the Patient with Problems in Glucose Metabolism
15. Care of the Patient with Acute Kidney Injury
16. Care of the Organ Donor and Transplant Recipient
17. Care of the Acutely Ill Burn Patient
18. Care of the Patient with Sepsis
19. Care of the ICU Patient at the End of Life
, 1. What is Critical Care?
1. Which patient would the nurse identify as experiencing a critical illness? The
patient:
1. With chronic airflow limitation whose VS are BP 110/72, P 110, R 16
2. With acute bronchospasm and whose VS are BP 100/60, P 124, R 32
3. Who was involved in a motor vehicle crash whose VS are BP 124/74, P 74, R 18
4. On hemodialysis for chronic renal failure with no urine output and whose VS are
BP 98/50, P 108, R 12
ANS: 2
Acute bronchospasm can present a life-threatening situation, which can jeopardize a
patient's survival. The patient's pulse and respiratory rate are elevated, which could
indicate a critical illness.
2. Of the following patients, which will the nurse expect to be transferred to a
critical care unit? The patient:
Standard Text: Select all that apply.
1. With an acetaminophen overdose
2. Suffering from acute mental illness
3. With chronic renal failure
4. With acute decompensated heart failure
5. With bacteremia from an infected foot wound
ANS: 1, 4, 5
Rationale 1: Critical care units are cost-efficient units for caring for patients with
specific organ system failure. Patients with acetaminophen overdose often suffer liver
failure as a consequence.
Rationale 4: The patient with acute decompensated heart failure would receive care
in a critical care unit. This patient has a specific organ that has failed.
,Rationale 5: Bacteremia can affect many organs and lead to multisystem organ
failure. This patient would receive care in a critical care unit.
3. The nurse, employed in a hospital in a small rural town, would expect to provide
which level of care in the critical care unit?
1. Level I
2. Level II
3. Level III
4. It is unlikely that the hospital would have a critical care unit.
ANS: 3
Level III facilities provide initial stabilization of critically ill patients but limited ability
to provide comprehensive critical care. A limited number of patients who require
routine care may remain in the facility but written policies should be in place
determining which patients require transfer and where they ought to be transferred.
This level of care is most likely provided in a small rural facility.
4. The nurse, providing patient care in an "open" ICU, would most likely be working
with a:
1. Multidisciplinary team with physicians who are also responsible for patients on
other units
2. Multidisciplinary team that includes a physician employed by the hospital
3. Physician in charge of patient care who is a specialist in critical care
4. Primary care physician who must consult a critical care specialist
ANS: 1
In an open ICU, nurses, pharmacists, and respiratory therapists are ICU based but the
physicians directing patient care may have other obligations. These physicians may or
,may not choose to consult an intensivist to assist with the management of their ICU
patients.
5.The nurse, providing care to patients in a critical care unit, realizes that
technology increases the likelihood of errors when:
1. It relies heavily on human decision making.
2. Devices are programmed to function without double checks.
3. It makes the workload seem overwhelming to health care providers.
4. There is uniform equipment throughout each facility.
ANS: 2
Technology changes the tasks people do by shifting the workload and eliminating
human decision making.
6. What will the nurse identify as an example of an installed forcing functions or a
system level firewall to prevent errors when providing patient care?
1. Prior to administration of insulin, two nurses check the dose.
2. Prior to obtaining a medication, height, weight, and allergies are recorded.
3. All medications are checked by two nurses prior to administration.
4. Undiluted potassium chloride is not available on critical care units.
ANS: 4
This is an example of an installed forcing function or a system level firewall.
7. The nurse realizes that the increased use of technology in critical care units has
resulted in which consequence for patient care?
1. Decreased risk of errors in patient care
,2. Decreased therapeutic nurse-patient communication
3. Improved overall patient satisfaction with care
4. Improved patient safety across the entire spectrum
ANS: 2
This has been demonstrated as an outcome resulting from an increased use of
technology in critical care units.
8. The nurse in the critical care area is completing a preoperative checklist before
sending a patient for surgery. This nurse’s activity is an example of which
recommendation issued by the Institute of Medicine?
1. Utilizing constraints
2. Simplifying key processes
3. Avoiding reliance on vigilance
4. Standardizing key processes
ANS: 3
Completing a preoperative checklist is an example of avoiding reliance on vigilance.
9. Which actions should the nurse complete after realizing that an incorrect dose of
medication has been administered to a patient?
Standard Text: Select all that apply.
1. Notify the patient and family
2. Notify the physician
3. Document the error
4. Prepare for an analysis of the error
5. Keep the notification of the error silent
ANS: 1, 2, 3, 4
,Rationale 1: In a critical care unit that has embraced a culture of safety, practitioners
have a responsibility to their patients to make their errors known, have them
corrected, and share them with the patient and family.
Rationale 2: In a critical care unit that has embraced a culture of safety, practitioners
have a responsibility to their patients to make their errors known, have them
corrected, and share them with other practitioners.
Rationale 3: In a critical care unit that has embraced a culture of safety and practice,
improvement is a goal rather than punishment. The reporting of errors results in the
examination of the factors that contributed to the error and changes practice
patterns.
Rationale 4: In a critical care unit that has embraced a culture of safety and practice,
improvement is a goal rather than punishment. The reporting of errors results in the
examination of the factors that contributed to the error and changes practice
patterns.
10. The nurse working within the AACN Synergy Model realizes that optimal patient
outcomes are realized when:
1. Highly qualified nurses care for patients in highly technical settings.
2. Nurses agree to work overtime to cover unit staffing needs.
3. Staff nurse competency is matched with patient needs.
4. Patient care is delivered within a "closed unit" model.
ANS: 3
The underlying assumption of the Synergy Model is that optimal patient outcomes
occur when the needs of the patient and family are matched with the competencies
of the nurse.
11. The competent critical care nurse demonstrates an understanding of patient
advocacy by taking which actions?
Standard Text: Select all that apply.
,1. Maintaining attendance at the bedside with the patient during a physician visit
2. Assisting and supporting the patient and family as they reveal their needs
3. Alerting the physician to concerns about client placement after hospitalization
4. Encouraging and supporting a patient's spouse in preparing for a family meeting
5. Seeing the big picture when planning patient care
ANS: 1, 2, 3, 4
Rationale 1: The nurse realizes that the patient may be vulnerable and need support
to obtain what is needed from the health care system.
Rationale 2: The nurse realizes that the patient may be vulnerable and need support
to obtain what is needed from the health care system.
Rationale 3: The nurse realizes that the patient may be vulnerable and need support
to obtain what is needed from the health care system.
Rationale 4: The nurse realizes that the patient may be vulnerable and need support
to obtain what is needed from the health care system.
12. A nurse is preparing to communicate an issue about patient care to a physician
using the SBAR technique. Which phrase is an appropriate initial statement?
1. "I am concerned about…"
2. "The patient's immediate history is…"
3. "I think the problem is…"
4. "I would like you to …"
ANS: 1
This is an appropriate initial statement using the SBAR technique.
13. The nurse includes which statement for "A - Assessment" in the SBAR technique
for communication?
1. "I think the problem is…"
,2. "The patient's vital signs are…"
3. "The patient's treatments are…"
4. "I would like you to…"
ANS: 1
This is an appropriate statement for assessment using the SBAR technique for
communication.
14. When concluding SBAR communication about a patient issue, the nurse will use
which statement?
1. "The patient's immediate history is…"
2. "The patient's physical findings are…"
3. "I am requesting that you…"
4. "I have assessed the patient personally."
ANS: 3
This statement would be used when concluding SBAR communication.
15. In order to collaborate with other members of the health care team to effect
optimal outcomes in patient care, the nurse utilizes the characteristics of emotional
maturity which include:
Standard Text: Select all that apply.
1. Maintaining current skills
2. Being a lifelong learner
3. Actively identifying best practices
4. Overlooking one's own shortcomings
5. Willing to take responsibility for failures
ANS: 1, 2, 3, 5
,Rationale 1: This is an attribute of emotional maturity in nursing.
Rationale 2: This is an attribute of emotional maturity in nursing.
Rationale 3: This is an attribute of emotional maturity in nursing.
Rationale 5: This is an attribute of emotional maturity in nursing.
16. Which informal power bases will the nurse use in the health care setting?
Standard Text: Select all that apply.
1. Expertise
2. Goodwill
3. Information
4. Observation
5. Collaboration
ANS: 1, 2, 3
Rationale 1: Expertise is an informal power base.
Rationale 2: Goodwill is an informal power base.
Rationale 3: Information is an informal power base.
17. The nurse caring for a patient would ensure that the patient has consented to
care by providing what to the patient?
1. A consent form to sign to receive medications
2. A consent form to sign to have dressings changed
3. A consent form to sign to be turned in bed
4. An explanation of a dressing to be changed
, ANS: 4
If the nurse does not ask the patient for consent, the nurse should explain the
procedure.
18. If a nurse forcibly inserts a nasogastric tube against a patient's wishes, the nurse
can be held liable for:
1. Negligence
2. Malpractice
3. Damages
4. Battery
ANS: 4
When the nurse treats or touches a patient without consent, it is battery.
19. The nurse is aware that decision-making capacity is likely to be impaired for a
patient who:
Standard Text: Select all that apply.
1. Is being medicated for severe pain
2. Does not understand the medical condition
3. Has been diagnosed with septic shock
4. Is depressed
5. Asks questions about identified treatments
ANS: 1, 2, 3, 4
Rationale 1: The patient must be capable of rational thought and be able to
recognize what the prospective treatment involves.
