Test Bank - Introduction to Critical Care Nursing 7e
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(Sole
Table of Contents s s s s
1
Chapter 01: Overview of Critical Care Nursing
s s s s s s s s s s s s 2
Chapter 02: Patient and Family Response to the Critical Care
ss ss ss ss ss ss ss ss ss 14
Experience Chapter 03: Ethical and Legal Issues in Critical Care
ss ss ss ss ss ss ss ss ss ss 30
Nursing
ss 42
Chapter 04: Palliative and End-of-Life
ss ss ss ss 56
Care Chapter 05: Comfort and
ss ss ss 69
Sedation Chapter 06: Nutritional
ss ss ss 83
Therapy
ss 117
Chapter 07: Dysrhythmia Interpretation and Management
ss ss ss ss ss 137
Chapter 08: Hemodynamic Monitoring
ss ss ss ss 156
Chapter 09: Ventilatory Assistance
s s s s s s 171
Chapter 10: Rapid Response Teams and Code Management
ss ss ss ss ss ss ss 189
Chapter 11: Organ Donation
ss ss ss ss 207
Chapter 12: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
ss ss ss ss ss ss ss ss 225
Chapter 13: Cardiovascular Alterations
ss ss ss ss 243
Chapter 14: Nervous System
ss ss ss 260
sAlterations Chapter 15: Acute
s ss ss ss 285
Respiratory Failure Chapter 16: Acute
ss ss ss ss 312
Kidney Injury Chapter 17:
ss ss ss 341
Gastrointestinal Alterations
ss ss 361
Chapter 17: Hematological and Immune Disorders
ss ss ss ss ss 377
Chapter 19: Endocrine Alterations
ss ss ss ss
Chapter 20: Trauma and Surgical Management
ss ss ss ss ss
Chapter 21: Burns
ss ss ss
,Test Bank - Introduction to Critical Care Nursing 7e
ss ss ss ss ss ss ss ss 2
(Sole
Chapter 01: Overview of Critical Care Nursing s s s s s s s s s s s s
MULTIPLE CHOICE s s
1. Which of the following professional s s s s s s s s s s organizations best supports critical care s s s s s s s s s s nursing s s practice?
a. American Association of Critical-Care Nurses
s s s s s s s s
b. American Heart Association s s s s
c. American s s Nurses s s Association
d. Society of Critical Care ss ss ss
Medicine ANS: A s s s s
The American Association of Critical-Care Nurses is the specialty organization that supports
s s s s s s s s s s s s s s s s s s s s s s
and
s s represents critical care nurses. The American Heart Association supports cardiovascular initiatives.
s s ss ss ss ss ss ss ss ss ss ss
The American Nurses Association supports all nurses. The Society of Critical Care Medicine represents the
ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss
multiprofessional critical care team under the direction of an intensivist.
ss s s s s s s s s s s s s s s s s s s
DIF: Cognitive Level:s s s s s s Knowledge s s REF: s s p. 4 s s
OBJ: Discuss the purposes and functions of the professional organizations that support critical care
ss ss ss ss ss ss ss ss ss ss ss ss ss
spractice. TOP: Nursing Process Step: N/A
s s s s s s s s s s s
MSC: NCLEX: Safe and Effective Care
s s s s s s s s s s s s Environment
2. A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and is interested
ss ss ss ss ss ss oo ss ss ss ss ss ss ss oo ss ss ss ss ss
in certification. Which credential would be most applicable for her to seek?
ss ss s s ss s s ss s s ss s s s s ss s s
a. ACNPC
b. CCNS
c. CCRN
d. PCCN
ANS: s s C
The CCRN certification is appropriate for nurses in bedside practice who care for critically
s s s s s s s s s s s s s s s s s s s s s s s s s s
ill patients. The ACNPC certification is for acute care nurse practitioners. The CCNS
s s s s ss s s s s s s ss s s s s s s ss s s ss
certification is for critical care clinical nurse specialists. The PCCN certification is for staff nurses
ss s s s s ss s s ss s s ss s s ss s s s s ss ss ss
working in progressive care, intermediate care, or step-down unit settings.
ss ss ss ss ss ss ss ss s s s s
DIF: s s Cognitive s s Level: Application s s s s REF: s s p. 5 s s
OBJ: Explain certification options for critical care nurses. TOP: Nursing Process Step: N/A
ss ss ss ss ss ss ss ss ss ss ss ss
s s MSC: NCLEX: Safe and Effective Care Environment
s s s s s s s s s s s s
,Test Bank - Introduction to Critical Care Nursing 7e
ss ss ss ss ss ss ss ss 3
(Sole
3. The main purpose of certification
s s s s s s s s s s is to: s s
a. assure the consumer that you will not make a mistake.
s s s s s s s s s s s s s s s s s s
b. prepare for graduate s s s s s s school.
c. promote magnet status for your facility. s s s s s s s s s s
d. validate knowledge of critical s s s s s s s s care nursing. s s
ANS: s s D
Certification assists in validating knowledge of the field, promotes excellence in the
s s s s s s s s s s s s s s s s s s s s s s
profession, and helps nurses to maintain their knowledge of critical care nursing. Certification
s s s s ss s s s s s s s s s s s s s s s s s s s s
helps to assure the consumer that the nurse has a minimum level of knowledge; however,
s s s s s s s s ss s s s s s s s s s s s s s s s s s s s s
it does not ensure that care will be mistake-free.
s s s s s s s s s s s s s s ss ss
Certification does not prepare one for graduate school; however, achieving certification
s s s s s s s s s s s s s s s s s s s s
demonstrates motivation for achievement and professionalism. Magnet facilities are rated on the
s s ss ss ss ss ss ss ss ss ss ss ss
number of certified nurses; however, that is not the purpose of certification.
ss ss ss s s s s s s s s s s s s s s s s s s
DIF: Cognitive s s s s Level: s s Analysis s s REF: pp. 4-5 s s s s
OBJ: Explain certification options for critical care nurses. TOP: Nursing Process Step: N/A
ss ss ss ss ss ss ss ss ss ss ss ss
s s MSC: NCLEX: Safe and Effective Care Environment
s s s s s s s s s s s s
4. The synergy s s s s model s s of practice s s s s focuses on: s s
a. allowing unrestricted visiting for the patient 24 hours each day.
s s s s s s s s s s s s s s s s s s
b. holistic and alternative therapies. s s s s s s
c. needs of patients and their families, which drives nursing competency.
s s s s s s ss s s s s s s s s s s
d. patients needs for energy and support. s s s s s s s s s s
ANS: s s C
The synergy model of practice states that the needs of patients and families influence and
s s s s s s s s s s s s s s s s s s s s s s s s s s s s
drive competencies of nurses. Nursing practice based on the synergy model would involve
s s ss s s s s s s s s s s s s s s s s s s s s s s
tailored visiting to meet the patients and familys needs and application of alternative therapies
s s s s s s ss s s ss ss ss s s s s s s s s ss s s
if desired by the patient, but that is not the primary focus of the model.
ss s s s s ss s s ss ss s s s s s s s s s s s s s s s s
DIF: Cognitive Level: Application
s s s s s s s s REF: p. 5 | Fig. 1-3 s s s s s s s s s s
OBJ: Describe standards of
s s s s s s s s professional practice s s s s for critical care
s s s s s s nursing.
TOP: Nursing Process Step:
s s s s s s s s N/A MSC: NCLEX: Safe and Effective
s s s s s s s s s s s s Care Environment s s
5. The family of your critically ill patient tells you that they have not spoken with the
s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s
physician in over 24 hours and they have some questions that they want clarified. During
s s s s s s s s s s ss ss ss s s s s s s ss ss ss ss
morning rounds, you convey this concern to the attending intensivist and arrange for her to
ss s s ss s s ss ss s s s s s s s s s s s s s s s s
meet with the family at 4:00 PM in the conference room. Which competency of critical
s s s s s s s s s s s s s s s s ss s s s s s s s s s s s s
care nursing does this represent?
s s s s s s s s s s
, Test Bank - Introduction to Critical Care Nursing 7e
ss ss ss ss ss ss ss ss 4
(Sole
a. Advocacy and moral s s s s s s agency in solving ethical issues s s s s s s s s
b. Clinical s s judgment and s s s s clinical reasoning s s s s skills
c. Collaboration with patients, families, and team members s s s s s s s s s s s s
d. Facilitation of learning for patients, families, and team ss ss ss ss ss ss ss
members ANS: C s s s s
Although one might consider that all of these competencies are being addressed, communication and
ss ss ss ss ss ss ss ss ss ss ss ss ss
collaboration with the family and physician best exemplify the competency of
s s s s s s s s s s s s s s s s s s s s s s
collaboration.
s s
DIF: Cognitive s s s s Level: s s Analysis s s REF: p. 9 s s s s
OBJ: Describe standards of
s s s s s s s s professional practice s s s s for critical care s s s s s s nursing.
TOP: Nursing Process Step:
s s s s s s s s N/A MSC: NCLEX: Safe and Effective
s s s s s s s s s s s s Care Environment s s
6. The AACN Standards for Acute and Critical Care Nursing Practice use what framework to
ss ss ss ss ss ss ss ss ss ss ss ss ss
guide critical care nursing practice?
ss ss ss ss ss
a. Evidence-based practice s s
b. Healthy work environment s s s s
c. National Patient s s s s Safety Goals s s
d. Nursing process ss
ANS: D ss
The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing process
s s s s s s s s s s s s s s s s s s s s s s s s s s
as applied to critically ill patients: collect data, determine diagnoses, identify expected
s s s s ss s s s s s s s s s s s s s s s s s s
outcomes, develop a plan of care, implement interventions, and evaluate care. AACN
s s s s s s s s s s ss s s s s s s s s s s s s
s promotes a healthy work environment, but this is not included in the Standards. The Joint
s s s s s s s s s s s s s ss s s s s ss ss ss ss ss
Commission has established National Patient Safety Goals, but these are not the AACN Standards.
s s s s ss s s ss s s ss s s ss ss s s s s s s s s
DIF: Cognitive Level: Analysis
s s s s s s s s REF: p. 5 | Box 1-2 s s s s s s s s s s
OBJ: Describe standards of
s s s s s s s s professional practice s s s s for critical care s s s s s s nursing.
TOP: Nursing Process Step:
s s s s s s s s N/A MSC: NCLEX: Safe and Effective
s s s s s s s s s s s s Care Environment s s
7. The charge nurse is responsible for making the patient assignments on the critical care unit.
s s s s s s s s s s s s s s s s s s s s s s s s s s s s
She assigns the experienced, certified nurse to care for the acutely ill patient with sepsis
s s s s ss s s s s s s s s s s s s s s s s s s s s s s s s
s swho also requires continuous renal replacement therapy and mechanical ventilation. She
s s s s ss s s s s s s s s s s s s s s
assigns the nurse with less than 1 year of experience to two patients who are more stable.
s s s s s s s s s s s s s s ss ss ss ss s s s s s s s s s s s s
This assignment reflects implementation of the:
s s s s s s s s s s s s
a. crew s s resource s s management s s model
ss ss ss ss ss ss ss ss 1
(Sole
Table of Contents s s s s
1
Chapter 01: Overview of Critical Care Nursing
s s s s s s s s s s s s 2
Chapter 02: Patient and Family Response to the Critical Care
ss ss ss ss ss ss ss ss ss 14
Experience Chapter 03: Ethical and Legal Issues in Critical Care
ss ss ss ss ss ss ss ss ss ss 30
Nursing
ss 42
Chapter 04: Palliative and End-of-Life
ss ss ss ss 56
Care Chapter 05: Comfort and
ss ss ss 69
Sedation Chapter 06: Nutritional
ss ss ss 83
Therapy
ss 117
Chapter 07: Dysrhythmia Interpretation and Management
ss ss ss ss ss 137
Chapter 08: Hemodynamic Monitoring
ss ss ss ss 156
Chapter 09: Ventilatory Assistance
s s s s s s 171
Chapter 10: Rapid Response Teams and Code Management
ss ss ss ss ss ss ss 189
Chapter 11: Organ Donation
ss ss ss ss 207
Chapter 12: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
ss ss ss ss ss ss ss ss 225
Chapter 13: Cardiovascular Alterations
ss ss ss ss 243
Chapter 14: Nervous System
ss ss ss 260
sAlterations Chapter 15: Acute
s ss ss ss 285
Respiratory Failure Chapter 16: Acute
ss ss ss ss 312
Kidney Injury Chapter 17:
ss ss ss 341
Gastrointestinal Alterations
ss ss 361
Chapter 17: Hematological and Immune Disorders
ss ss ss ss ss 377
Chapter 19: Endocrine Alterations
ss ss ss ss
Chapter 20: Trauma and Surgical Management
ss ss ss ss ss
Chapter 21: Burns
ss ss ss
,Test Bank - Introduction to Critical Care Nursing 7e
ss ss ss ss ss ss ss ss 2
(Sole
Chapter 01: Overview of Critical Care Nursing s s s s s s s s s s s s
MULTIPLE CHOICE s s
1. Which of the following professional s s s s s s s s s s organizations best supports critical care s s s s s s s s s s nursing s s practice?
a. American Association of Critical-Care Nurses
s s s s s s s s
b. American Heart Association s s s s
c. American s s Nurses s s Association
d. Society of Critical Care ss ss ss
Medicine ANS: A s s s s
The American Association of Critical-Care Nurses is the specialty organization that supports
s s s s s s s s s s s s s s s s s s s s s s
and
s s represents critical care nurses. The American Heart Association supports cardiovascular initiatives.
s s ss ss ss ss ss ss ss ss ss ss
The American Nurses Association supports all nurses. The Society of Critical Care Medicine represents the
ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss
multiprofessional critical care team under the direction of an intensivist.
ss s s s s s s s s s s s s s s s s s s
DIF: Cognitive Level:s s s s s s Knowledge s s REF: s s p. 4 s s
OBJ: Discuss the purposes and functions of the professional organizations that support critical care
ss ss ss ss ss ss ss ss ss ss ss ss ss
spractice. TOP: Nursing Process Step: N/A
s s s s s s s s s s s
MSC: NCLEX: Safe and Effective Care
s s s s s s s s s s s s Environment
2. A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and is interested
ss ss ss ss ss ss oo ss ss ss ss ss ss ss oo ss ss ss ss ss
in certification. Which credential would be most applicable for her to seek?
ss ss s s ss s s ss s s ss s s s s ss s s
a. ACNPC
b. CCNS
c. CCRN
d. PCCN
ANS: s s C
The CCRN certification is appropriate for nurses in bedside practice who care for critically
s s s s s s s s s s s s s s s s s s s s s s s s s s
ill patients. The ACNPC certification is for acute care nurse practitioners. The CCNS
s s s s ss s s s s s s ss s s s s s s ss s s ss
certification is for critical care clinical nurse specialists. The PCCN certification is for staff nurses
ss s s s s ss s s ss s s ss s s ss s s s s ss ss ss
working in progressive care, intermediate care, or step-down unit settings.
ss ss ss ss ss ss ss ss s s s s
DIF: s s Cognitive s s Level: Application s s s s REF: s s p. 5 s s
OBJ: Explain certification options for critical care nurses. TOP: Nursing Process Step: N/A
ss ss ss ss ss ss ss ss ss ss ss ss
s s MSC: NCLEX: Safe and Effective Care Environment
s s s s s s s s s s s s
,Test Bank - Introduction to Critical Care Nursing 7e
ss ss ss ss ss ss ss ss 3
(Sole
3. The main purpose of certification
s s s s s s s s s s is to: s s
a. assure the consumer that you will not make a mistake.
s s s s s s s s s s s s s s s s s s
b. prepare for graduate s s s s s s school.
c. promote magnet status for your facility. s s s s s s s s s s
d. validate knowledge of critical s s s s s s s s care nursing. s s
ANS: s s D
Certification assists in validating knowledge of the field, promotes excellence in the
s s s s s s s s s s s s s s s s s s s s s s
profession, and helps nurses to maintain their knowledge of critical care nursing. Certification
s s s s ss s s s s s s s s s s s s s s s s s s s s
helps to assure the consumer that the nurse has a minimum level of knowledge; however,
s s s s s s s s ss s s s s s s s s s s s s s s s s s s s s
it does not ensure that care will be mistake-free.
s s s s s s s s s s s s s s ss ss
Certification does not prepare one for graduate school; however, achieving certification
s s s s s s s s s s s s s s s s s s s s
demonstrates motivation for achievement and professionalism. Magnet facilities are rated on the
s s ss ss ss ss ss ss ss ss ss ss ss
number of certified nurses; however, that is not the purpose of certification.
ss ss ss s s s s s s s s s s s s s s s s s s
DIF: Cognitive s s s s Level: s s Analysis s s REF: pp. 4-5 s s s s
OBJ: Explain certification options for critical care nurses. TOP: Nursing Process Step: N/A
ss ss ss ss ss ss ss ss ss ss ss ss
s s MSC: NCLEX: Safe and Effective Care Environment
s s s s s s s s s s s s
4. The synergy s s s s model s s of practice s s s s focuses on: s s
a. allowing unrestricted visiting for the patient 24 hours each day.
s s s s s s s s s s s s s s s s s s
b. holistic and alternative therapies. s s s s s s
c. needs of patients and their families, which drives nursing competency.
s s s s s s ss s s s s s s s s s s
d. patients needs for energy and support. s s s s s s s s s s
ANS: s s C
The synergy model of practice states that the needs of patients and families influence and
s s s s s s s s s s s s s s s s s s s s s s s s s s s s
drive competencies of nurses. Nursing practice based on the synergy model would involve
s s ss s s s s s s s s s s s s s s s s s s s s s s
tailored visiting to meet the patients and familys needs and application of alternative therapies
s s s s s s ss s s ss ss ss s s s s s s s s ss s s
if desired by the patient, but that is not the primary focus of the model.
ss s s s s ss s s ss ss s s s s s s s s s s s s s s s s
DIF: Cognitive Level: Application
s s s s s s s s REF: p. 5 | Fig. 1-3 s s s s s s s s s s
OBJ: Describe standards of
s s s s s s s s professional practice s s s s for critical care
s s s s s s nursing.
TOP: Nursing Process Step:
s s s s s s s s N/A MSC: NCLEX: Safe and Effective
s s s s s s s s s s s s Care Environment s s
5. The family of your critically ill patient tells you that they have not spoken with the
s s s s s s s s s s s s s s s s s s s s s s s s s s s s s s
physician in over 24 hours and they have some questions that they want clarified. During
s s s s s s s s s s ss ss ss s s s s s s ss ss ss ss
morning rounds, you convey this concern to the attending intensivist and arrange for her to
ss s s ss s s ss ss s s s s s s s s s s s s s s s s
meet with the family at 4:00 PM in the conference room. Which competency of critical
s s s s s s s s s s s s s s s s ss s s s s s s s s s s s s
care nursing does this represent?
s s s s s s s s s s
, Test Bank - Introduction to Critical Care Nursing 7e
ss ss ss ss ss ss ss ss 4
(Sole
a. Advocacy and moral s s s s s s agency in solving ethical issues s s s s s s s s
b. Clinical s s judgment and s s s s clinical reasoning s s s s skills
c. Collaboration with patients, families, and team members s s s s s s s s s s s s
d. Facilitation of learning for patients, families, and team ss ss ss ss ss ss ss
members ANS: C s s s s
Although one might consider that all of these competencies are being addressed, communication and
ss ss ss ss ss ss ss ss ss ss ss ss ss
collaboration with the family and physician best exemplify the competency of
s s s s s s s s s s s s s s s s s s s s s s
collaboration.
s s
DIF: Cognitive s s s s Level: s s Analysis s s REF: p. 9 s s s s
OBJ: Describe standards of
s s s s s s s s professional practice s s s s for critical care s s s s s s nursing.
TOP: Nursing Process Step:
s s s s s s s s N/A MSC: NCLEX: Safe and Effective
s s s s s s s s s s s s Care Environment s s
6. The AACN Standards for Acute and Critical Care Nursing Practice use what framework to
ss ss ss ss ss ss ss ss ss ss ss ss ss
guide critical care nursing practice?
ss ss ss ss ss
a. Evidence-based practice s s
b. Healthy work environment s s s s
c. National Patient s s s s Safety Goals s s
d. Nursing process ss
ANS: D ss
The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing process
s s s s s s s s s s s s s s s s s s s s s s s s s s
as applied to critically ill patients: collect data, determine diagnoses, identify expected
s s s s ss s s s s s s s s s s s s s s s s s s
outcomes, develop a plan of care, implement interventions, and evaluate care. AACN
s s s s s s s s s s ss s s s s s s s s s s s s
s promotes a healthy work environment, but this is not included in the Standards. The Joint
s s s s s s s s s s s s s ss s s s s ss ss ss ss ss
Commission has established National Patient Safety Goals, but these are not the AACN Standards.
s s s s ss s s ss s s ss s s ss ss s s s s s s s s
DIF: Cognitive Level: Analysis
s s s s s s s s REF: p. 5 | Box 1-2 s s s s s s s s s s
OBJ: Describe standards of
s s s s s s s s professional practice s s s s for critical care s s s s s s nursing.
TOP: Nursing Process Step:
s s s s s s s s N/A MSC: NCLEX: Safe and Effective
s s s s s s s s s s s s Care Environment s s
7. The charge nurse is responsible for making the patient assignments on the critical care unit.
s s s s s s s s s s s s s s s s s s s s s s s s s s s s
She assigns the experienced, certified nurse to care for the acutely ill patient with sepsis
s s s s ss s s s s s s s s s s s s s s s s s s s s s s s s
s swho also requires continuous renal replacement therapy and mechanical ventilation. She
s s s s ss s s s s s s s s s s s s s s
assigns the nurse with less than 1 year of experience to two patients who are more stable.
s s s s s s s s s s s s s s ss ss ss ss s s s s s s s s s s s s
This assignment reflects implementation of the:
s s s s s s s s s s s s
a. crew s s resource s s management s s model
