Test Bank For Critical Care Nursing- A Holistic Approach
12th Edition Morton Fontaine
Chapters 1 - 56
,Table of Contents
Part 1 The Concept of Holism Applied to Critical Care Nursing Practice
Chapter 1. Critical Care Nursing Practice: Promoting Excellence Through Caring, Collaboration, and Evidence
Chapter 2. The Patient’s Experience With Critical Illness
Chapter 3. The Family’s Experience With Critical Illness
Chapter 4. Patient and Family Education in Critical Care
Chapter 5. Relieving Pain and Providing Comfort
Chapter 6. Palliative Care and End-of-Life Issues in Critical Care
Part 2 Professional Practice Issues in Critical Care
Chapter 7. Ethical Issues in Critical Care Nursing
Chapter 8. Legal Issues in Critical Care Nursing
Chapter 9. Building a Professional Practice Model for Excellence in Critical Care Nursing
Part 3 Special Populations in Critical Care
Chapter 10. The Critically Ill Pediatric Patient
Chapter 11. The Critically Ill Pregnant Woman
Chapter 12. The Critically Ill Older Patient
Chapter 13. The Postanesthesia Patient
Part 4 Special Situations in Critical Care
Chapter 14. Rapid Response Teams and Transport of the Critically Ill Patient
Chapter 15. Disaster Management: Implications for the Critical Care Nurse
Part 5 Cardiovascular System
Chapter 16. Anatomy and Physiology of the Cardiovascular System
Chapter 17. Patient Assessment: Cardiovascular System
Chapter 18. Patient Management: Cardiovascular System
Chapter 19. Common Cardiovascular Disorders
Chapter 20. Heart Failure
Chapter 21. Acute Myocardial Infarction
Chapter 22. Cardiac Surgery
Part 6 Respiratory System
Chapter 23. Anatomy and Physiology of the Respiratory System
Chapter 24. Patient Assessment: Respiratory System
,Chapter 25. Patient Management: Respiratory System
Chapter 26. Common Respiratory Disorders
Chapter 27. Acute Respiratory Distress Syndrome
Part 7 Renal System
Chapter 28. Anatomy and Physiology of the Renal System
Chapter 29. Patient Assessment: Renal System
Chapter 30. Patient Management: Renal System
Chapter 31. Acute Kidney Injury and Chronic Kidney Disease
Part 8 Nervous System
Chapter 32. Anatomy and Physiology of the Nervous System
Chapter 33. Patient Assessment: Nervous System
Chapter 34. Patient Management: Nervous System
Chapter 35. Common Neurosurgical and Neurological Disorders
Chapter 36. Traumatic Brain Injury
Chapter 37. Spinal Cord Injury
Part 9 Gastrointestinal System
Chapter 38. Anatomy and Physiology of the Gastrointestinal System
Chapter 39. Patient Assessment: Gastrointestinal System
Chapter 40. Patient Management: Gastrointestinal System
Chapter 41. Common Gastrointestinal Disorders
Part 10 Endocrine System
Chapter 42. Anatomy and Physiology of the Endocrine System
Chapter 43. Patient Assessment: Endocrine System
Chapter 44. Common Endocrine Disorders
Part 11 Hematological and Immune Systems
Chapter 45. Anatomy and Physiology of the Hematological and Immune Systems
Chapter 46. Patient Assessment: Hematological and Immune Systems
Chapter 47. Organ and Hematopoietic Stem Cell Transplantation
Chapter 48. Common Immunological Disorders
Chapter 49. Common Hematological Disorders
Part 12 Integumentary System
,Chapter 50. Anatomy and Physiology of the Integumentary System
Chapter 51. Patient Assessment: Integumentary System
Chapter 52. Patient Management: Integumentary System
Chapter 53. Burns and Common Integumentary Disorders
Part 13 Multisystem Dysfunction
Chapter 54. Shock, Systemic Inflammatory Response Syndrome, and Multiple Organ Dysfunction Syndrome
Chapter 55. Trauma
Chapter 56. Drug Overdose and Poisoning
,Chapter 1 Critical Care Nursing Practice: Promoting Excellence-Caring,Collaboration
Evidence
Multiple Choice
1. A nurse is the only one in the ICU who has not achieved certification in critical care
nursing. She often will ask her fellow nurses what to do in caring for a patient because
she doubts the accuracy of her knowledge and her intuition. She loves her work but
wishes she could do it with a greater level of competence. What is the most important
effect that obtaining certification would likely have on the nurses practice?
A) Recognition by peers
B) Increase in salary and rank
C) More flexibility in seeking employment
D) Increased confidence in making decisions
2. A hospital interviews two different candidates for a position in the ICU. Both candidates
have around 10 years of experience working in the ICU. Both have excellent
interpersonal skills and highly positive references. One, however, has certification in
critical care nursing. Which of the following is the most compelling and accurate reason
for the hospital to hire the candidate with certification?
A) The certified nurse will have more knowledge and expertise.
B) The certified nurse will behave more ethically.
C) The certified nurse will be more caring toward patients.
D) The certified nurse will work more collaboratively with other nurses.
3. A nurse is caring for an elderly man recently admitted to the ICU following a stroke. She
assesses his cognitive function using a new cognitive assessment test she learned about in
a recent article in a nursing journal. She then brings a cup of water and a straw to the
patient because she observes that his lips are dry. Later, she has the patient sit in a
wheelchair and takes him to have some blood tests performed. He objects at first, saying
that he can walk on his own, but the nurse explains that it is hospital policy to use the
wheelchair. That evening, she recognizes signs of an imminent stroke in the patient and
immediately pages the physician. Which action taken by the nurse is the best example of
evidence-based practice?
A) Giving the patient a cup of water
B) Transferring the patient in a wheelchair
C) Using the cognitive assessment test
D) Recognizing signs of imminent stroke and paging the physician
, 4. A nurse is on a committee that is trying to reduce the occurrence of hospital-acquired
infections in the ICU. Her role is to conduct research to find which interventions have
been shown to be most effective in reducing these infections. She consults many different
sources and finds conflicting information. Which of the following sources should she
consider the most authoritative?
A) AACN expert panel report
B) A meta-analysis of randomized controlled trials in the American Journal of Nursing
C) A systematic review of qualitative studies in the Journal of Advanced Nursing
D) A single randomized controlled trial in the American Journal of Critical Care
5. A nurse who has been recently hired to manage the nursing staff of the ICU is concerned
at the lack of evidence-based practice she sees among the staff. Which of the following
would be the best step for her to take to promote incorporating evidence into clinical
practice?
A) Only hire nurses certified in critical care nursing.
B) Leave copies of several different nursing journals in the nurses lounge.
C) Demonstrate to the staff the best nursing-related search terms to use in Google or
Yahoo!
D) Introduce the staff to the PubMed search engine and assign them topics to research
on it.
6. A physician visits a patient in the ICU while the nurse is out. The patient complains that
the pain medication is not effective and that he would like to receive an increased dose.
The physician has the nurse paged and consults with him in the hallway regarding the
patients request for stronger pain medication. The nurse explains that patient was started
on a morphine drip only 20 minutes ago and that the drug has not had time to take effect
yet. The physician agrees and tells the patient to give it just a bit more time. Which
component of a healthy work environment is most evident in this scenario?
A) Skilled communication
B) Appropriate staffing
C) True collaboration
D) Meaningful recognition
7. A nurse in the ICU is responding to a patient who has just gone into cardiac arrest. A
moment later, the nurse is notified that another patient has just gone into anaphylactic
shock due to a drug allergy. She is conflicted as to what to do, as she is the only nurse
available at the moment to tend to both patients. Which component of a healthy work
environment is lacking in this scenario?
A) Effective decision making
,B) Appropriate staffing
C) Authentic leadership
D) Meaningful recognition
8. An ICU nurse has provided excellent care for a 6-year-old girl who had been admitted to
the ICU for a head injury. The nurse was attentive not only to the needs of the patient but
also went out of her way to care for the needs of the girls family. According to research,
which of the following forms of recognition would the nurse value the most?
A) A card from the girls family
B) A plaque from the ICU physicians naming her as Nurse of the Year
C) A letter of commendation from the hospitals administration
D) A bouquet of flowers from her supervisor
9. A patient in the ICU has recently been diagnosed with diabetes mellitus. Before being
discharged, this patient will require detailed instructions on how to manage her diet, how
to self-inject insulin, and how to handle future diabetic emergencies. Which nurse
competency is most needed in this situation?
A) Clinical judgment
B) Advocacy and moral agency
C) Caring practices
D) Facilitation of learning
10. An elderly patient is admitted to the ICU with stage IV lung cancer, diabetes mellitus, and
congestive heart failure. The health care team assembled to care for her is large and
diverse, including an oncologist, a pulmonologist, an endocrinologist, a cardiologist, and
others. The patient is not expected to survive more than a few weeks, and her husband is
overwhelmed with stress and grief. Which nurse competency or competencies are most
needed in this situation? Select all that apply.
A) Clinical judgment
B) Caring practices
C) Collaboration
D) Response to diversity
11. An Ethiopian man with AIDS has recently been admitted to the ICU with a case of
pneumonia. The man is new to the U.S. and has no health insurance. He would likely be
eligible for the states Medicaid coverage, but does not understand how to access this
coverage. Which competency or competencies are most needed in this situation? Select
all that apply.
,A) Clinical judgment
B) Advocacy and moral agency
C) Collaboration
D) Systems thinking
E) Response to diversity
F) Clinical inquiry
12. A nurse decides to seek certification in critical care nursing. What is the most important
benefit for the individual nurse in becoming certified in a specialty?
A) It will result in a salary increase.
B) It is required to work in critical care.
C) It demonstrates the nurses personal expertise.
D) It is mandated by employers.
13. The American Association of Critical-Care Nurses (AACN) sponsors certification in
critical care nursing for several critical care subspecialties. What is the most important
benefit of such certification for the profession of nursing?
A) Provides positive publicity for nursing
B) Validates nurses expert knowledge and practice
C) Mandated by government regulations
D) Demonstrates basic knowledge in the field
14. A nurse has achieved certification in critical care nursing. What is the most important
effect that this certification will have on the nurses practice?
A) Recognition by peers
B) Increase in salary and rank
C) More flexibility in seeking employment
D) Increased confidence in critical thinking
15. The nurse cites evidence-based practice as a rationale for a patient care decision. What is
the best description of evidence-based practice?
A) Decisions based on expert legal testimony
B) Use of best available research data
C) Evolution of nursing practice over time
D) Individual optimization of patient outcomes
,16. The nurse caring for a critically ill patient implements several components of care. What
component is an example of the use of evidence-based practice?
A) Use of a protocol for admission of a patient to the unit
B) Application of an insulin sliding scale method from research
C) Checking the patients armband before giving a medication
D) Limiting visits to immediate family only for 2 hours a day
17. The nurse wishes to increase the use of evidence-based practice in the critical care unit
where he works. What is a significant barrier to the implementation of evidence-based
practice?
A) Use of computerized records by the hospital
B) Health Information Privacy and Portability Act (HIPPA)
C) Lack of knowledge about literature searches
D) Strong collaborative relationships in the work setting
18. The nurse has identified an increase in medication errors in the critical care unit over the
past several months. What aspect of medication procedures should be evaluated first?
A) Adherence to procedures by nursing staff
B) Clarity of interdisciplinary communication
C) Number of new employees on the unit
D) Changes in administration procedures
19. A critical care unit has decided to implement several measures designed to improve
intradisciplinary and interdisciplinary collaboration. In addition to an expected
improvement in patient outcomes, what is the most important effect that should result
from these measures?
A) Identification of incompetent practitioners
B) Improvement in manners on the unit
C) Increased staff retention
D) Less discussion in front of patients and families
20. A nurse wishes to practice using the Synergy Model developed by the American
Association of Critical-Care Nurses (AACN). What nursing behavior best supports use of
this model?
A) Attending mandatory hospital-wide in-service programs
B) Self-directed study of best practice for the patients she cares for
, C) Gathering demographic data on the patients admitted to the unit
D) Participating in a research study as a data collector
21. As part of the Synergy Model, the nurse has identified a patient characteristic of
resiliency. What patient behavior demonstrates resiliency?
A) Dysfunctional grieving behaviors after receiving bad news
B) Developing a list of questions for the physician
C) Denial of any possible negative outcomes for a procedure
D) Assigning blame to others for undesired outcomes of illness
22. A patient is admitted to the critical care unit after receiving a mechanical heart
implantation. In making a nursing assignment, the charge nurse best demonstrates
application of the Synergy Model by assigning which nurse to care for this patient?
A) A newly hired new graduate nurse, for the experience
B) A nurse with a patient in the next room, for proximity
C) The most senior nurse on the unit, for political reasons
D) The nurse with most experience with this device, for expertise
23. A Muslim patient has been admitted to the critical care unit with complications after
childbirth. Based on the Synergy Model, which nurse would be the most inappropriate to
assign to care for this patient?
A) New graduate female nurse
B) Most experienced female nurse
C) New graduate male nurse
D) Female nurse with postpartum experience
24. Todays critical care nursing environment is constantly changing. What nursing behavior
best illustrates awareness of current events affecting critical care nursing?
A) Participating in the hospitals efforts to recruit new nurses
B) Volunteering to serve on a disaster response planning committee
C) Adhering to content taught in basic nursing program
D) Attending hospital-mandated in-services without other education
Answer Key
1. D
