NUR 445 Exam 1 UPDATED ACTUAL
Questions and CORRECT Answers
What is the difference between a small hospital ICU and a large hospital ICU? - CORRECT
ANSWER - The size, resources available, specialized units, etc.
What must the nurse caring for the high acuity patient be able to do? - CORRECT ANSWER -
Analyze critical situations, make decisions based on their analysis, and rapidly intervene to ensure
optimal outcomes
Who is the only member of the healthcare team who is at the bedside and frequently coordinates patient
care? - CORRECT ANSWER - The nurse
Who detects early signs of an impending complication with the patient? - CORRECT ANSWER -
The nurse
What is one of the primary goals for the acute care nurse? - CORRECT ANSWER - the prevention
of complications
What changes led to decreased job satisfaction and nurses leaving practice in the high acuity
environment? - CORRECT ANSWER - Schedules, staffing, floating outside the specialty, hospital
restructuring, etc.
What really should be considered when making decisions about nursing staffing patterns? - CORRECT
ANSWER - The needs of the patient and the skill mix of the nursing staff
What should the first principle of staffing be? - CORRECT ANSWER - provide safe and effective
patient care
What does the ANCC award hospitals magnet status for? - CORRECT ANSWER - If they are able
to create working environments that are successful in recruiting and retaining professional nurses
,Which patients are often stereotyped as not being candidates for aggressive treatment? - CORRECT
ANSWER - Oncology patients
Who must "goals of care" be discussed with? - CORRECT ANSWER - With the patient and their
family, allowing ample time for meaningful discussion
What is a major advantage of having technology available in the high acuity environment? - CORRECT
ANSWER - The patient's status can be monitored continuously
What is a major criticism of nurses who work in high acuity environments? - CORRECT
ANSWER - they are too technologically oriented
What is alarm fatigue? - CORRECT ANSWER - When the number and frequency of alarms
becomes overwhelming, it can result in delayed alarm responses and deliberate alarm deactivations
What does working in a healthy environment increase? - CORRECT ANSWER - job satisfaction
and provides a buffer against stress and burnout
Which professional organization made a commitment to promote healthy work environments that support
quality patient care and high levels of nurse satisfaction? - CORRECT ANSWER - American
Association of Critical Care Nurses
What are some standards of healthy work environments? - CORRECT ANSWER - Skilled
communication, true collaboration, efficient decision making, appropriate staffing, meaningful
recognition, and authentic leadership
Who are the gatekeepers of patient safety? - CORRECT ANSWER - high acuity nurses
What is burnout? - CORRECT ANSWER - Feelings of personal/professional frustration, job
dissatisfaction, job insecurity, emotion/physical exertion, emotional exhaustion, depersonalization,
reduced personal accomplishments, lack of control, overworked, insufficient awards, conflicting values
What are some symptoms of burnout? - CORRECT ANSWER - Withdrawal, risk taking,
ambivalence, decreased productivity, contemplating career change, increased use of
,caffeine/alcohol/nicotine, chronic fatigue, frequent minor ailments, sleep changes, appetite change, sexual
difficulty, attempts to blame others, stereotyping patients, nightmares, depression, hostility, negativism,
loss of tolerance, decreased ability to make decisions, poor judgement, lack of initiative, forgetfulness
What can serve as a buffer against the negative effects of stress? - CORRECT ANSWER - a
positive social climate characterized by strong managerial support and cohesiveness among the staff
What are critical incident stress debriefings? - CORRECT ANSWER - structured group
discussions occurring within several days following a crisis, designed to address symptoms of stress,
assess the need for follow-up, and provide a sense of closure
What is TJC? - CORRECT ANSWER - The Joint Commission
What is the TJCs mission? - CORRECT ANSWER - to continuously improve the safety and
quality of care provided to the public through the provision of healthcare accreditation that supports
process improvement in healthcare organizations
What are the national patient safety goals? - CORRECT ANSWER - patient identifiers, staff
communication, medication safety, alarm safety, infection prevention, risk identification, and timeout
What are some factors that inhibit learning and barriers to communication for the high acuity patient? -
CORRECT ANSWER - Fatigue, barriers to communication, pain, drugs
What takes precedence over the need to know and understand? - CORRECT ANSWER -
physiologic needs
What are some of the educational needs of ICU patients and families? - CORRECT ANSWER -
current info about patient progress, informed decision making, acknowledgement of past, optimal
learning environment, orientation to routines and care, motivation
What is transfer anxiety? - CORRECT ANSWER - transferring to a less acute unit creates anxiety
as they move to an unfamiliar environment
, What are some components of ICU patient and family centered care? - CORRECT ANSWER -
Open visitation, inclusion in decision making, education about healthcare, and inclusion of families in
designing comfortable spaces
What is reduced for the ICU patient when the family is at the bedside? - CORRECT ANSWER -
anxiety and hallucinations
How can the family help the ICU patient and nursing staff? - CORRECT ANSWER - they can
comfort patients in ways not open to staff, as well as provide info to help the nurse individualize care
Historically, why have families been restricted from the ICU? - CORRECT ANSWER - Harmful
physiological consequences, interferes with time nurses need to spend caring for patients, delays in care
What are some advantages to having family present during CPR? - CORRECT ANSWER - Family
grasps seriousness of condition, sees firsthand everything was done for the patient, helps with grieving,
doubt is removed, less fear and anxiety, a sense of closure,
What is cultural competence? - CORRECT ANSWER - Being mindful of your own beliefs and
attitudes, without letting personal bias influence the care of patients with different backgrounds
Why is culturally competent care essential? - CORRECT ANSWER - to achieve equitable
outcomes for all patients
Why is it important for nurses to recognize and address barriers to culturally competent care? -
CORRECT ANSWER - to convey respect for the patient's uniqueness, discussing language
preferences, educational material at their level, address sensitivity
Which senses are involved in sensory output? - CORRECT ANSWER - visual, auditory, olfactory,
gustatory, tactile
What are the 3 sensory perceptual alterations? - CORRECT ANSWER - sensory
overload/deprivation, delirium, sleep deprivation
Questions and CORRECT Answers
What is the difference between a small hospital ICU and a large hospital ICU? - CORRECT
ANSWER - The size, resources available, specialized units, etc.
What must the nurse caring for the high acuity patient be able to do? - CORRECT ANSWER -
Analyze critical situations, make decisions based on their analysis, and rapidly intervene to ensure
optimal outcomes
Who is the only member of the healthcare team who is at the bedside and frequently coordinates patient
care? - CORRECT ANSWER - The nurse
Who detects early signs of an impending complication with the patient? - CORRECT ANSWER -
The nurse
What is one of the primary goals for the acute care nurse? - CORRECT ANSWER - the prevention
of complications
What changes led to decreased job satisfaction and nurses leaving practice in the high acuity
environment? - CORRECT ANSWER - Schedules, staffing, floating outside the specialty, hospital
restructuring, etc.
What really should be considered when making decisions about nursing staffing patterns? - CORRECT
ANSWER - The needs of the patient and the skill mix of the nursing staff
What should the first principle of staffing be? - CORRECT ANSWER - provide safe and effective
patient care
What does the ANCC award hospitals magnet status for? - CORRECT ANSWER - If they are able
to create working environments that are successful in recruiting and retaining professional nurses
,Which patients are often stereotyped as not being candidates for aggressive treatment? - CORRECT
ANSWER - Oncology patients
Who must "goals of care" be discussed with? - CORRECT ANSWER - With the patient and their
family, allowing ample time for meaningful discussion
What is a major advantage of having technology available in the high acuity environment? - CORRECT
ANSWER - The patient's status can be monitored continuously
What is a major criticism of nurses who work in high acuity environments? - CORRECT
ANSWER - they are too technologically oriented
What is alarm fatigue? - CORRECT ANSWER - When the number and frequency of alarms
becomes overwhelming, it can result in delayed alarm responses and deliberate alarm deactivations
What does working in a healthy environment increase? - CORRECT ANSWER - job satisfaction
and provides a buffer against stress and burnout
Which professional organization made a commitment to promote healthy work environments that support
quality patient care and high levels of nurse satisfaction? - CORRECT ANSWER - American
Association of Critical Care Nurses
What are some standards of healthy work environments? - CORRECT ANSWER - Skilled
communication, true collaboration, efficient decision making, appropriate staffing, meaningful
recognition, and authentic leadership
Who are the gatekeepers of patient safety? - CORRECT ANSWER - high acuity nurses
What is burnout? - CORRECT ANSWER - Feelings of personal/professional frustration, job
dissatisfaction, job insecurity, emotion/physical exertion, emotional exhaustion, depersonalization,
reduced personal accomplishments, lack of control, overworked, insufficient awards, conflicting values
What are some symptoms of burnout? - CORRECT ANSWER - Withdrawal, risk taking,
ambivalence, decreased productivity, contemplating career change, increased use of
,caffeine/alcohol/nicotine, chronic fatigue, frequent minor ailments, sleep changes, appetite change, sexual
difficulty, attempts to blame others, stereotyping patients, nightmares, depression, hostility, negativism,
loss of tolerance, decreased ability to make decisions, poor judgement, lack of initiative, forgetfulness
What can serve as a buffer against the negative effects of stress? - CORRECT ANSWER - a
positive social climate characterized by strong managerial support and cohesiveness among the staff
What are critical incident stress debriefings? - CORRECT ANSWER - structured group
discussions occurring within several days following a crisis, designed to address symptoms of stress,
assess the need for follow-up, and provide a sense of closure
What is TJC? - CORRECT ANSWER - The Joint Commission
What is the TJCs mission? - CORRECT ANSWER - to continuously improve the safety and
quality of care provided to the public through the provision of healthcare accreditation that supports
process improvement in healthcare organizations
What are the national patient safety goals? - CORRECT ANSWER - patient identifiers, staff
communication, medication safety, alarm safety, infection prevention, risk identification, and timeout
What are some factors that inhibit learning and barriers to communication for the high acuity patient? -
CORRECT ANSWER - Fatigue, barriers to communication, pain, drugs
What takes precedence over the need to know and understand? - CORRECT ANSWER -
physiologic needs
What are some of the educational needs of ICU patients and families? - CORRECT ANSWER -
current info about patient progress, informed decision making, acknowledgement of past, optimal
learning environment, orientation to routines and care, motivation
What is transfer anxiety? - CORRECT ANSWER - transferring to a less acute unit creates anxiety
as they move to an unfamiliar environment
, What are some components of ICU patient and family centered care? - CORRECT ANSWER -
Open visitation, inclusion in decision making, education about healthcare, and inclusion of families in
designing comfortable spaces
What is reduced for the ICU patient when the family is at the bedside? - CORRECT ANSWER -
anxiety and hallucinations
How can the family help the ICU patient and nursing staff? - CORRECT ANSWER - they can
comfort patients in ways not open to staff, as well as provide info to help the nurse individualize care
Historically, why have families been restricted from the ICU? - CORRECT ANSWER - Harmful
physiological consequences, interferes with time nurses need to spend caring for patients, delays in care
What are some advantages to having family present during CPR? - CORRECT ANSWER - Family
grasps seriousness of condition, sees firsthand everything was done for the patient, helps with grieving,
doubt is removed, less fear and anxiety, a sense of closure,
What is cultural competence? - CORRECT ANSWER - Being mindful of your own beliefs and
attitudes, without letting personal bias influence the care of patients with different backgrounds
Why is culturally competent care essential? - CORRECT ANSWER - to achieve equitable
outcomes for all patients
Why is it important for nurses to recognize and address barriers to culturally competent care? -
CORRECT ANSWER - to convey respect for the patient's uniqueness, discussing language
preferences, educational material at their level, address sensitivity
Which senses are involved in sensory output? - CORRECT ANSWER - visual, auditory, olfactory,
gustatory, tactile
What are the 3 sensory perceptual alterations? - CORRECT ANSWER - sensory
overload/deprivation, delirium, sleep deprivation
