NU 431 EXAM QUESTIONS AND
ANSWERS
First Person Authorization - Answer-A person's legally binding decision to become an
organ and/or tissue donor after their death
Age at which someone may authorize an FPA for organ donation - Answer-15.5 Can be
overturned by a legal guardian until 18
Chain of command for consent for OPO - Answer-MPOA
Spouse
Oldest adult child
Parent
Oldest living sibling
Percentage of ICU patients with moderate to severe unrelieved pain? - Answer-70%
Sedation Vacation - Answer-Daily weaning of sedation medications to see how patient
tolerates
Delirium - Answer-State of temporary but acute mental confusion
Percentage of patients in the ICU that experience delirium? - Answer-80%
Conditions that may increase the likelihood of a patient experiencing delirium - Answer-
Advanced age
Preexisting cognitive impairment
Sensory impairment
Drug/ETOH abuse
Sleep deprivation
Sensory Overload
Hemodynamic instability
Management of delirium in critically ill older adults - Answer-Frequent assessments
Remove cause
Avoid malnutrition
Avoid physical restraints
D/C all unnecessary lines
Management of sleep disruption in the ICU - Answer-Structure activities and rest
periods
Dim lights at night
Limit noise
Time medications/PRNS
,Locked in Syndrome - Answer-Individual is aware and capable of thinking but is
paralyzed and cannot communicate
Guiding principles when interacting with the crucially ill adult's family - Answer-Offer
realistic hope
Give honest answers and information
Give reassurance
How many lives one organ donation may save - Answer-eight
Two automatic organ procurement rule outs - Answer-Systemic infection
Active cancer
Religions that do not support organ donation - Answer-buddhism
Some sects of Islam
HOPE Act - Answer-Signed in 2015
Allows individuals with hepatitis C infection to donate
Clinical triggers to contact OPO - Answer-GCS less than 5
Evaluation for brain death
Plan to withdraw care
Severe neurologic injury is confirmed
> obvious head trauma, poor neurodiagnostics, MD determination of brain stem reflexes
Organ Procurement Organization (OPO) - Answer-Facilitate the organ donation process
by assessing in-hospital deaths for donor eligibility
Consulting with families of potential donors; and retrieving, preserving and transporting
organs for transplantation
What is a living donation? - Answer-Organ donor is alive
1 kidney
1 lobe of liver
1 lung
part of pancreas/intestines
Tissue
Donation after circulatory death - Answer-Patient does not meet criteria for brain death,
but has poor prognosis for meaningful existence
Typically withdrawn from life support
, How long must a heart be stopped after extubation for OPO process to begin? -
Answer-5 consecutive minutes
Timeframe within a patient must pass after extubation following cardiac death to qualify
for OPO? - Answer-2 hours
What is donation after brain death? - Answer-Patient is determined to be brain dead
with all other possibilities ruled out
CNS depressants, tox screen clear, euthermic
What are the initial assessments done by neurosurgeon/neurologist or other qualified
physician to determine brain death? - Answer-Pupils fixed to light
No central pain response
Doll's eyes
Cold ocular caloric response
No cough/gag reflex
Tests that may be performed to confrim brain death - Answer-Cerebral blood flow
Apnea Testing
EEG monitoring
How long can tissue donation occur after cardiac arrest? - Answer-24 hours
Requirements for patient advocates in an advanced directive - Answer-18 years or older
Willing to discuss goals
Able to make decisions in difficult situations
Palliative care - Answer-Any form of care or treatment that focuses on reducing the
severity of disease symptoms. Rather than trying to reverse the progression of disease
itself
Hospice - Answer-Provides support and care for persons in the last phase of a terminal
disease so they might live as fully and as comfortable as possible
End of Life - Answer-Final phase of the patients illness when death is imminent
Advanced directives - Answer-written documents that provide information about the
patients wishes and his or her designated spokesperson
When is it appropriate to withdraw life support? - Answer-When patient is ready
Family/DPOA decides patient would not want further support
Care is determined to be futile
What are nursing duties in comfort care? - Answer-Care for family as well as patient
Remove all appropriate lines (leave IV in)
ANSWERS
First Person Authorization - Answer-A person's legally binding decision to become an
organ and/or tissue donor after their death
Age at which someone may authorize an FPA for organ donation - Answer-15.5 Can be
overturned by a legal guardian until 18
Chain of command for consent for OPO - Answer-MPOA
Spouse
Oldest adult child
Parent
Oldest living sibling
Percentage of ICU patients with moderate to severe unrelieved pain? - Answer-70%
Sedation Vacation - Answer-Daily weaning of sedation medications to see how patient
tolerates
Delirium - Answer-State of temporary but acute mental confusion
Percentage of patients in the ICU that experience delirium? - Answer-80%
Conditions that may increase the likelihood of a patient experiencing delirium - Answer-
Advanced age
Preexisting cognitive impairment
Sensory impairment
Drug/ETOH abuse
Sleep deprivation
Sensory Overload
Hemodynamic instability
Management of delirium in critically ill older adults - Answer-Frequent assessments
Remove cause
Avoid malnutrition
Avoid physical restraints
D/C all unnecessary lines
Management of sleep disruption in the ICU - Answer-Structure activities and rest
periods
Dim lights at night
Limit noise
Time medications/PRNS
,Locked in Syndrome - Answer-Individual is aware and capable of thinking but is
paralyzed and cannot communicate
Guiding principles when interacting with the crucially ill adult's family - Answer-Offer
realistic hope
Give honest answers and information
Give reassurance
How many lives one organ donation may save - Answer-eight
Two automatic organ procurement rule outs - Answer-Systemic infection
Active cancer
Religions that do not support organ donation - Answer-buddhism
Some sects of Islam
HOPE Act - Answer-Signed in 2015
Allows individuals with hepatitis C infection to donate
Clinical triggers to contact OPO - Answer-GCS less than 5
Evaluation for brain death
Plan to withdraw care
Severe neurologic injury is confirmed
> obvious head trauma, poor neurodiagnostics, MD determination of brain stem reflexes
Organ Procurement Organization (OPO) - Answer-Facilitate the organ donation process
by assessing in-hospital deaths for donor eligibility
Consulting with families of potential donors; and retrieving, preserving and transporting
organs for transplantation
What is a living donation? - Answer-Organ donor is alive
1 kidney
1 lobe of liver
1 lung
part of pancreas/intestines
Tissue
Donation after circulatory death - Answer-Patient does not meet criteria for brain death,
but has poor prognosis for meaningful existence
Typically withdrawn from life support
, How long must a heart be stopped after extubation for OPO process to begin? -
Answer-5 consecutive minutes
Timeframe within a patient must pass after extubation following cardiac death to qualify
for OPO? - Answer-2 hours
What is donation after brain death? - Answer-Patient is determined to be brain dead
with all other possibilities ruled out
CNS depressants, tox screen clear, euthermic
What are the initial assessments done by neurosurgeon/neurologist or other qualified
physician to determine brain death? - Answer-Pupils fixed to light
No central pain response
Doll's eyes
Cold ocular caloric response
No cough/gag reflex
Tests that may be performed to confrim brain death - Answer-Cerebral blood flow
Apnea Testing
EEG monitoring
How long can tissue donation occur after cardiac arrest? - Answer-24 hours
Requirements for patient advocates in an advanced directive - Answer-18 years or older
Willing to discuss goals
Able to make decisions in difficult situations
Palliative care - Answer-Any form of care or treatment that focuses on reducing the
severity of disease symptoms. Rather than trying to reverse the progression of disease
itself
Hospice - Answer-Provides support and care for persons in the last phase of a terminal
disease so they might live as fully and as comfortable as possible
End of Life - Answer-Final phase of the patients illness when death is imminent
Advanced directives - Answer-written documents that provide information about the
patients wishes and his or her designated spokesperson
When is it appropriate to withdraw life support? - Answer-When patient is ready
Family/DPOA decides patient would not want further support
Care is determined to be futile
What are nursing duties in comfort care? - Answer-Care for family as well as patient
Remove all appropriate lines (leave IV in)
