NUR 207 Final Exam with |! |! |! |! |!
verified answers & rationales |! |! |!
The charge nurse is making assignments for the critical care unit and assigns
|! |! |! |! |! |! |! |! |! |! |! |! |!
the experienced nurse to care for two complex patients. The novice nurse is
|! |! |! |! |! |! |! |! |! |! |! |! |!
assigned to care for the less complex patient. The charge nurse is basing
|! |! |! |! |! |! |! |! |! |! |! |! |!
assignments on which model of practice? |! |! |! |! |!
A) Institute for Healthcare Improvement
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B) Universal care
|! |!
C) Quality and Safety Education for Nurses
|! |! |! |! |! |!
D) Synergy model - Correct answer ✔D - The synergy model of care states
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that the needs of patients and families influence and drive competencies of
|! |! |! |! |! |! |! |! |! |! |! |!
nurses, which improves client care. The Institute for Healthcare Improvement
|! |! |! |! |! |! |! |! |!
is an organization aimed at creating a safer health care environment. Quality
|! |! |! |! |! |! |! |! |! |! |! |! |!
and Safety Education for Nurses is an initiative to implement quality and
|! |! |! |! |! |! |! |! |! |! |! |!
safety content in nursing education programs. Universal care is a model of
|! |! |! |! |! |! |! |! |! |! |! |!
delivery in which patients remain on one unit and the level of nursing
|! |! |! |! |! |! |! |! |! |! |! |! |!
assignment changes. |!
Which intervention is most helpful in preventing sensory overload in
|! |! |! |! |! |! |! |! |! |!
critically ill patients? |! |!
A) Encourage family members to assist in the reorientation of the patient.
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B) Move the patient to a semiprivate room with another confused patient.
|! |! |! |! |! |! |! |! |! |! |!
,C) Increase the amount of noise from equipment in the patient's room.
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D) Place the patient nearer to the nurses' station for observation. - Correct
|! |! |! |! |! |! |! |! |! |! |! |! |!
answer ✔A - Family members who reorient the patient help to increase
|! |! |! |! |! |! |! |! |! |! |! |!
pleasant sensory input to counteract the sensory overload. Increasing noise
|! |! |! |! |! |! |! |! |! |!
will add to sensory overload. Exposure to another confused patient may add
|! |! |! |! |! |! |! |! |! |! |! |!
to sensory overload. Increasing stimulation will add to sensory overload.
|! |! |! |! |! |! |! |! |!
The nurse is meeting with family members of a critically ill patient. Which
|! |! |! |! |! |! |! |! |! |! |! |! |!
statement best addresses the psychological needs of the family members?|! |! |! |! |! |! |! |! |!
A) "There are coffee and cookies in the waiting room. Why don't you take a
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
short break?" |!
B) "I'm adjusting the alarms on the monitor to reduce the noise level in the
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
room."
C) "The team has just made rounds on the patient. We are going to begin
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
weaning the patient from the ventilator today since the patient's oxygen is
|! |! |! |! |! |! |! |! |! |! |! |!
improving."
D) "It would help the patient if you can spend the night in the waiting room."
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
- Correct answer ✔C - The need for information is the primary need of
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
family members; providing daily updates is an excellent example of meeting
|! |! |! |! |! |! |! |! |! |! |!
family members' needs. Family members should be encouraged to get
|! |! |! |! |! |! |! |! |! |!
adequate rest; staying all night may increase stress and fatigue. If they do
|! |! |! |! |! |! |! |! |! |! |! |! |!
stay, many hospitals provide in-room sleeping arrangements. Providing food
|! |! |! |! |! |! |! |! |!
and space meets physical needs for family members.
|! |! |! |! |! |! |!
The nurse is on a committee related to family visitation in the critical care
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
unit and discusses evidence to help in the planning. Which statement reflects
|! |! |! |! |! |! |! |! |! |! |! |!
evidence?
,A) Visitation shapes the critical care experience for the family but not the
|! |! |! |! |! |! |! |! |! |! |! |! |!
nurse.
B) Allowing children to visit is stressful for the patient and the child.
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C) Restricted visitation prevents family exhaustion.
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D) Family presence during procedures promotes adaptation. - Correct answer
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✔D - Family presence during procedures has been shown to promote
|! |! |! |! |! |! |! |! |! |! |!
adaptation and reduce fear and anxiety. Allowing children to visit should be
|! |! |! |! |! |! |! |! |! |! |! |!
determined on an individual basis. Research has not shown child visitation to
|! |! |! |! |! |! |! |! |! |! |!
be associated with negative effects. Restricted visitation will not prevent
|! |! |! |! |! |! |! |! |! |! |!
family exhaustion and adds to stress. Visitation shapes the critical care
|! |! |! |! |! |! |! |! |! |! |!
experience for both the family and the nurse. |! |! |! |! |! |! |!
Which strategies should the nurse manager implement to improve
|! |! |! |! |! |! |! |! |!
collaboration in the critical care setting? (Select all that apply.) |! |! |! |! |! |! |! |! |!
A) Exclude family members from rounds.
|! |! |! |! |!
B) Institute morning briefings.
|! |! |!
C) Initiate interdisciplinary rounds.
|! |! |!
D) Create joint programs for continuing education. - Correct answer ✔B, C, D
|! |! |! |! |! |! |! |! |! |! |! |!
- Including family members in rounds fosters collaboration with team
|! |! |! |! |! |! |! |! |! |! |!
members. These might be scheduled family rounds or the daily
|! |! |! |! |! |! |! |! |! |!
multiprofessional rounds. |!
Which stressors should the nurse anticipate the patient to have during the
|! |! |! |! |! |! |! |! |! |! |! |!
critical care experience? (Select all that apply.)
|! |! |! |! |! |!
, A) Feelings of dread
|! |! |!
B) Difficulty sleeping
|! |!
C) Difficult communication
|! |!
D) Pain
|!
E) Thoughts of death and dying - Correct answer ✔A, B, C, D, E - Box 2-1
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
describes many stressors, including difficult communication, pain, feelings of
|! |! |! |! |! |! |! |! |!
dread, and thoughts of death and dying. Most patient's do not report difficulty
|! |! |! |! |! |! |! |! |! |! |! |!
sleeping as a stressor.
|! |! |! |!
The family of a critically ill patient whose care has been deemed futile has
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
decided to withhold treatments. Which action should the nurse take to
|! |! |! |! |! |! |! |! |! |! |!
initiate the family's wishes?
|! |! |!
A) Turn the patient every 2 hours.
|! |! |! |! |! |!
B) Refrain from giving the patient medications.
|! |! |! |! |! |!
C) Slowly wean the patient off the ventilator.
|! |! |! |! |! |! |!
D) Obtain signatures for "do not resuscitate" orders. - Correct answer ✔B - To
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
withhold treatment is a decision not to administer selected treatments in
|! |! |! |! |! |! |! |! |! |! |!
cases in which care is considered futile. Withdrawal is a removal of
|! |! |! |! |! |! |! |! |! |! |! |!
treatments, such as mechanical ventilation. "Do not resuscitate" is a written
|! |! |! |! |! |! |! |! |! |! |!
order not to initiate life-support measures in the event of cardiopulmonary
|! |! |! |! |! |! |! |! |! |! |!
arrest. Turning the patient every two hours is not an example of withholding
|! |! |! |! |! |! |! |! |! |! |! |! |!
treatment.
verified answers & rationales |! |! |!
The charge nurse is making assignments for the critical care unit and assigns
|! |! |! |! |! |! |! |! |! |! |! |! |!
the experienced nurse to care for two complex patients. The novice nurse is
|! |! |! |! |! |! |! |! |! |! |! |! |!
assigned to care for the less complex patient. The charge nurse is basing
|! |! |! |! |! |! |! |! |! |! |! |! |!
assignments on which model of practice? |! |! |! |! |!
A) Institute for Healthcare Improvement
|! |! |! |!
B) Universal care
|! |!
C) Quality and Safety Education for Nurses
|! |! |! |! |! |!
D) Synergy model - Correct answer ✔D - The synergy model of care states
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
that the needs of patients and families influence and drive competencies of
|! |! |! |! |! |! |! |! |! |! |! |!
nurses, which improves client care. The Institute for Healthcare Improvement
|! |! |! |! |! |! |! |! |!
is an organization aimed at creating a safer health care environment. Quality
|! |! |! |! |! |! |! |! |! |! |! |! |!
and Safety Education for Nurses is an initiative to implement quality and
|! |! |! |! |! |! |! |! |! |! |! |!
safety content in nursing education programs. Universal care is a model of
|! |! |! |! |! |! |! |! |! |! |! |!
delivery in which patients remain on one unit and the level of nursing
|! |! |! |! |! |! |! |! |! |! |! |! |!
assignment changes. |!
Which intervention is most helpful in preventing sensory overload in
|! |! |! |! |! |! |! |! |! |!
critically ill patients? |! |!
A) Encourage family members to assist in the reorientation of the patient.
|! |! |! |! |! |! |! |! |! |! |!
B) Move the patient to a semiprivate room with another confused patient.
|! |! |! |! |! |! |! |! |! |! |!
,C) Increase the amount of noise from equipment in the patient's room.
|! |! |! |! |! |! |! |! |! |! |!
D) Place the patient nearer to the nurses' station for observation. - Correct
|! |! |! |! |! |! |! |! |! |! |! |! |!
answer ✔A - Family members who reorient the patient help to increase
|! |! |! |! |! |! |! |! |! |! |! |!
pleasant sensory input to counteract the sensory overload. Increasing noise
|! |! |! |! |! |! |! |! |! |!
will add to sensory overload. Exposure to another confused patient may add
|! |! |! |! |! |! |! |! |! |! |! |!
to sensory overload. Increasing stimulation will add to sensory overload.
|! |! |! |! |! |! |! |! |!
The nurse is meeting with family members of a critically ill patient. Which
|! |! |! |! |! |! |! |! |! |! |! |! |!
statement best addresses the psychological needs of the family members?|! |! |! |! |! |! |! |! |!
A) "There are coffee and cookies in the waiting room. Why don't you take a
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
short break?" |!
B) "I'm adjusting the alarms on the monitor to reduce the noise level in the
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
room."
C) "The team has just made rounds on the patient. We are going to begin
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
weaning the patient from the ventilator today since the patient's oxygen is
|! |! |! |! |! |! |! |! |! |! |! |!
improving."
D) "It would help the patient if you can spend the night in the waiting room."
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
- Correct answer ✔C - The need for information is the primary need of
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
family members; providing daily updates is an excellent example of meeting
|! |! |! |! |! |! |! |! |! |! |!
family members' needs. Family members should be encouraged to get
|! |! |! |! |! |! |! |! |! |!
adequate rest; staying all night may increase stress and fatigue. If they do
|! |! |! |! |! |! |! |! |! |! |! |! |!
stay, many hospitals provide in-room sleeping arrangements. Providing food
|! |! |! |! |! |! |! |! |!
and space meets physical needs for family members.
|! |! |! |! |! |! |!
The nurse is on a committee related to family visitation in the critical care
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
unit and discusses evidence to help in the planning. Which statement reflects
|! |! |! |! |! |! |! |! |! |! |! |!
evidence?
,A) Visitation shapes the critical care experience for the family but not the
|! |! |! |! |! |! |! |! |! |! |! |! |!
nurse.
B) Allowing children to visit is stressful for the patient and the child.
|! |! |! |! |! |! |! |! |! |! |! |!
C) Restricted visitation prevents family exhaustion.
|! |! |! |! |!
D) Family presence during procedures promotes adaptation. - Correct answer
|! |! |! |! |! |! |! |! |! |!
✔D - Family presence during procedures has been shown to promote
|! |! |! |! |! |! |! |! |! |! |!
adaptation and reduce fear and anxiety. Allowing children to visit should be
|! |! |! |! |! |! |! |! |! |! |! |!
determined on an individual basis. Research has not shown child visitation to
|! |! |! |! |! |! |! |! |! |! |!
be associated with negative effects. Restricted visitation will not prevent
|! |! |! |! |! |! |! |! |! |! |!
family exhaustion and adds to stress. Visitation shapes the critical care
|! |! |! |! |! |! |! |! |! |! |!
experience for both the family and the nurse. |! |! |! |! |! |! |!
Which strategies should the nurse manager implement to improve
|! |! |! |! |! |! |! |! |!
collaboration in the critical care setting? (Select all that apply.) |! |! |! |! |! |! |! |! |!
A) Exclude family members from rounds.
|! |! |! |! |!
B) Institute morning briefings.
|! |! |!
C) Initiate interdisciplinary rounds.
|! |! |!
D) Create joint programs for continuing education. - Correct answer ✔B, C, D
|! |! |! |! |! |! |! |! |! |! |! |!
- Including family members in rounds fosters collaboration with team
|! |! |! |! |! |! |! |! |! |! |!
members. These might be scheduled family rounds or the daily
|! |! |! |! |! |! |! |! |! |!
multiprofessional rounds. |!
Which stressors should the nurse anticipate the patient to have during the
|! |! |! |! |! |! |! |! |! |! |! |!
critical care experience? (Select all that apply.)
|! |! |! |! |! |!
, A) Feelings of dread
|! |! |!
B) Difficulty sleeping
|! |!
C) Difficult communication
|! |!
D) Pain
|!
E) Thoughts of death and dying - Correct answer ✔A, B, C, D, E - Box 2-1
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
describes many stressors, including difficult communication, pain, feelings of
|! |! |! |! |! |! |! |! |!
dread, and thoughts of death and dying. Most patient's do not report difficulty
|! |! |! |! |! |! |! |! |! |! |! |!
sleeping as a stressor.
|! |! |! |!
The family of a critically ill patient whose care has been deemed futile has
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
decided to withhold treatments. Which action should the nurse take to
|! |! |! |! |! |! |! |! |! |! |!
initiate the family's wishes?
|! |! |!
A) Turn the patient every 2 hours.
|! |! |! |! |! |!
B) Refrain from giving the patient medications.
|! |! |! |! |! |!
C) Slowly wean the patient off the ventilator.
|! |! |! |! |! |! |!
D) Obtain signatures for "do not resuscitate" orders. - Correct answer ✔B - To
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
withhold treatment is a decision not to administer selected treatments in
|! |! |! |! |! |! |! |! |! |! |!
cases in which care is considered futile. Withdrawal is a removal of
|! |! |! |! |! |! |! |! |! |! |! |!
treatments, such as mechanical ventilation. "Do not resuscitate" is a written
|! |! |! |! |! |! |! |! |! |! |!
order not to initiate life-support measures in the event of cardiopulmonary
|! |! |! |! |! |! |! |! |! |! |!
arrest. Turning the patient every two hours is not an example of withholding
|! |! |! |! |! |! |! |! |! |! |! |! |!
treatment.
