Critical Care Study Guide Q & A(questions and answers) verified 100%
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Course
Critical Care
Institution
Critical Care
Critical Care Study Guide Q & A(questions and answers) verified 100%
Critical Care Study Guide Q & A(questions and answers) verified 100%
1. Which emergency department (ED) patient represents an issue that has been addressed by the Core Measure Sets for the ED that are established by the Join...
Critical o Care o Study o Guide o Q o & o A(questions o and o answers) o verified o 100% 1. o Which o emergency o department o (ED) o patient o represents o an o issue o that o has o been o addressed o by o the o Core o Measure o Sets o for o the o ED o that o are o established o by o the o Joint o Commission? a. o Patient o has o no o health o insurance o & o no o steady o source o of o income. b. o Patient o has o waited o 7 o hours o to o be o transferred o to o the o medical -surgical o unit. c. o Patient o has o a o history o of o falls o & o sustains o a o fall o in o the o ED o waiting o room. d. o Patient o has o respiratory o arrest o & o requires o emergency o intubation. o - o correct o answers -ANSWER: o b. o Patient o has o waited o 7 o hours o to o be o transferred o to o the o medical -
surgical o unit. 2. o The o ED o nurse o is o preparing o a o report o on o a o patient o being o admitted o for o bacterial o meningitis. o Which o points o are o included o in o the o ED o nurse's o report o to o the o medical -
surgical o nurse? o (SATA) a. o "Patient o reports o severe o headache o with o high o fever o that o started o 4 o days o ago." b. o "Patient o currently o alert o & o oriented o x o 2; o speech o clear, o but o rambling." c. o "Patient o is o divorced o & o currently o does o not o have o any o health o insurance." d. o "IV o normal o saline o into o left o anterior o forearm; o received o first o dose o of o IV o ceftriaxone o (Rocephin) o at o 0700." e. o "Lumbar o puncture o results o are o pending, o but o meningococcal o meningitis o is o suspected." f. o "Received o 1000 o mg o acetaminophen o (Tylenol) o (for o pain o (9/10) o & o fever o 103° o F o at o 0400; o pain o continues o (7/10), o temperature o now o 100.9° o F." o - o correct o answers -
ANSWERS: o a. o "Patient o reports o severe o headache o with o high o fever o that o started o 4 o days o ago." o b. o "Patient o currently o alert o & o oriented o x o 2; o speech o clear, o but o rambling." o d. o "IV o normal o saline o into o left o anterior o forearm; o received o first o dose o of o IV o ceftriaxone o (Rocephin) o at o 0700." o e. o "Lumbar o puncture o results o are o pending, o but o meningococcal o meningitis o is o suspected." o f. o "Received o 1000 o mg o acetaminophen o (Tylenol) o (for o pain o (9/10) o & o fever o 103° o F o at o 0400; o pain o continues o (7/10), o temperature o now o 100.9° o F." 3. o The o ED o nurse o is o attempting o to o transfer o a o patient o to o the o medical -surgical o unit. o When o the o receiving o nurse o answers o the o phone, o he o says, o "You o people o always o dump o these o admissions o on o us o during o shift o change." o Which o response o by o the o ED o nurse o represents o the o best o attempt o at o respectful o negotiation o & o collaboration? a. o "I o am o sorry. o I o realize o you o are o busy, o but o we o are o busy o too." b. o "When o would o you o be o willing o to o take o our o patients?" c. o "I o apologize o for o the o timing. o I o will o call o back o in o 30 o minutes." d. o "I o apologize. o We o just o received o the o bed o assignment." o - o correct o answers -ANSWER: o c. o "I o apologize o for o the o timing. o I o will o call o back o in o 30 o minutes." 4. o The o nurse o is o interviewing o a o psychiatric o patient o who o has o been o verbally o aggressive o for o the o past o several o hours o according o to o the o family. o The o family o states, o "He o won't o hurt o anybody." o However, o the o patient o is o pacing o & o appears o suspicious & o angry. o Which o strategy o does o the o nurse o use o to o conduct o the o interview? a. o Sit o at o eye o level o with o the o patient o in o a o quiet, o secluded o room. b. o Conduct o the o interview o standing o near o the o door o in o a o quiet o room. c. o Bring o the o entire o family o in o & o have o everyone o sit o in o comfortable o chairs. d. o Have o the o security o guard o stand o by o the o patient o during o the o interview. o - o correct o answers -ANSWER: o b. o Conduct o the o interview o standing o near o the o door o in o a o quiet o room. 5. o The o nurse o is o working o alone o in o triage. o It o is o a o busy o night o & o the o waiting o room o is o full o of o people o who o are o restless o & o unhappy o about o having o to o wait. o Which o situation o warrants o the o nurse o to o activate o the o panic o button o under o the o triage o desk? a. o The o line o for o patients o waiting o to o be o triaged o becomes o overwhelmingly o long. b. o EMS o calls o to o announce o they o are o en o route o with o a o patient o in o full o arrest. c. o Several o patients o in o the o waiting o room o start o to o complain o very o loudly. d. o A o person o walks o in o & o starts o threatening o the o registration o staff o with o a o weapon. o - o correct o answers -ANSWER: o d. o A o person o walks o in o & o starts o threatening o the o registration o staff o with o a o weapon. 6. o The o ED o nurse o is o caring o for o a o patient o who o was o found o in o an o alley o with o no o identification o & o no o known o family. o The o nurse o must o give o medication o to o the o patient. o What o is o the o correct o procedure? a. o Emergent o conditions o prevent o identification, o so o the o nurse o gives o the o medication o as o ordered. b. o The o patient o is o designated o as o John o Doe o & o the o nurse o uses o two o unique o identifiers. c. o The o nurse o validates o the o order o with o another o nurse o & o both o verify o that o the o patient o is o unidentified. d. o The o nurse o gives o the o medication o & o identification o is o made o as o soon o as o possible. o - o correct o answers -ANSWER: o b. o The o patient o is o designated o as o John o Doe o & o the o nurse o uses o two o unique o identifiers. 7. o The o nurse o is o using o the o SBAR o method o to o give o a o handoff o report o to o the o nurse o who o will o assume o care o of o the o patient. o What o would o the o nurse o say o first? a. o "CAT o scan o results o are o negative o & o neurology o consult o is o pending." b. o "Mr. o S. o has o a o history o of o high o blood o pressure, o but o stopped o taking o medication o 3 months o ago." c. o "Current o vital o signs: o temperature o 98.6° o F, o pulse o 80/min, o respiratory o rate o 16/min o & o blood o pressure o 160/80." d. o "Mr. o S. o is o a o 65-year-old o male o who o came o to o the o ED o for o a o severe o headache." o - o correct o answers -ANSWER: o d. o "Mr. o S. o is o a o 65-year-old o male o who o came o to o the o ED o for o a o severe o headache." 8. o An o older o adult o is o in o the o ED o for o over o 48 o hours o awaiting o transfer o to o an o inpatient o bed. o The o charge o nurse o delegates o turning o the o patient o every o 2 o hours o to o the o unlicensed o assistive o personnel o (UAP) o for o Risk o for o impaired o skin o integrity. o The o ED o is o busy; o the o patient o is o not o turned o & o begins o to o develop o a o pressure o ulcer. o What o does o the o charge o nurse o do o to o prevent o a o recurrence o of o this o type o of o problem o for o future o patients? o (SATA) a. o Nothing; o in o the o overall o priorities o of o the o ED, o the o situation o is o inevitable. b. o Make o anecdotal o notes o & o counsel o all o the o involved o UAPs. c. o Delegate o the o duty o of o turning o & o repositioning o to o the o physical o therapist. d. o File o an o incident o report o & o seek o resolution o at o the o systems o level. e. o Reeducate o staff o on o the o need o to o turn o patients o at o risk o for o skin o breakdown. o - o correct o answers -ANSWERS: o b. o Make o anecdotal o notes o & o counsel o all o the o involved o UAPs. o d. o File o an o incident o report o & o seek o resolution o at o the o systems o level. o e. o Reeducate o staff o on o the o need o to o turn o patients o at o risk o for o skin o breakdown. 9. o An o older o couple o on o vacation o comes o to o the o ED. o The o man o appears o to o be o having o a o stroke o & o is o unable o to o speak o clearly o or o coherently. o His o wife o is o very o distraught o & o states, o "He o has o many o allergies o & o takes o many o medications, o but o I o can't remember o anything o right o now o - o correct o answers -" o What o should o the o nurse o do o first o to o quickly o obtain o drug o & o allergy o information? a. o Call o the o patient's o family o health o care o provider o for o a o phone o report o about o his o drugs o & o allergies. b. o Remind o the o wife o to o keep o a o list o of o the o patient's o drugs o & o allergies o in o her o purse. c. o Call o the o pharmacy o where o the o patient o obtains o his o medications. d. o Check o for o a o medical o alert o bracelet o & o help o the o wife o to o look o in o the o patient's o suitcase. ! o ANSWER: o d. o Check o for o a o medical o alert o bracelet o & o help o the o wife o to o look o in o the o patient's o suitcase. 10. o A o patient o is o brought o to o the o ED o by o friends o who o report o "he o probably o overdosed o on o downers." o The o patient o has o a o decreased o level o of o consciousness o & o a o decreased o gag o reflex; o his o face o & o chest o are o covered o with o emesis; o he o demonstrates o spontaneous o sonorous o respirations; o & o pulse o oximetry o is o 87% o on o room o air. o What o type o of o airway o management o does o the o nurse o expect o this o patient o to o receive? a. o Supplemental o oxygen o per o nasal o cannula o at o 4-6 o L/min b. o Bag-valve -mask o & o 100% o oxygen o to o assist o with o ventilator o effort c. o Non-rebreather o mask o with o high-flow o oxygen d. o Endotracheal o intubation o with o initial o high o concentration o oxygen o - o correct o answers -
ANSWER: o d. o Endotracheal o intubation o with o initial o high o concentration o oxygen 11. o The o ED o nurse o is o caring o for o several o patients, o all o of o whom o are o currently o lying o on o stretchers o either o pending o discharge o or o awaiting o transfer o to o a o hospital o bed. o Which o patients o have o the o greatest o risk o for o falls? o (SATA) a. o Patient o with o chronic o pain o who o received o 10 o mg o PO o oxycodone o for o myalgia b. o Opioid -naive o teenager o with o a o fracture o who o received o 3 o mg o IV o morphine o for o pain c. o Middle -aged o woman o with o severe o vomiting o & o frequent o watery o stools o for o 3 o days d. o Child o with o a o fever o of o 102° o F, o crying, o with o an o ear o infection e. o Older o adult o patient o with o acute o dementia o secondary o to o infection o - o correct o answers -
ANSWERS: o o b. o Opioid -naive o teenager o with o a o fracture o who o received o 3 o mg o IV o morphine o for o pain o c. o Middle -aged o woman o with o severe o vomiting o & o frequent o watery o stools o for o 3 o days o e. o Older o adult o patient o with o acute o dementia o secondary o to o infection 12. o For o which o circumstance o would o the o use o of o Standard o Precautions o be o adequate o to o ensure o the o safety o of o the o nurse, o staff, o & o other o patients? a. o Performing o hygienic o care o for o a o patient o with o copious o watery o diarrhea b. o Assisting o with o intubation o of o a o patient o with o symptoms o of o tuberculosis c. o Initiating o a o peripheral o intravenous o access o attached o to o a o saline o lock d. o Assessing o a o child o with o a o fever o & o rash o & o known o exposure o to o chickenpox o - o correct o answers -ANSWER: o c. o Initiating o a o peripheral o intravenous o access o attached o to o a o saline o lock 13. o A o patient o is o brought o to o the o ED o by o the o family o because o he o has o verbally o threatened o others o & o attempted o to o stab o the o neighbor's o dog. o What o does o the o nurse o do o in o order o to o ensure o the o safety o of o the o patient o & o others? o (SATA) a. o Search o the o patient's o belongings o & o secure o personal o effects. b. o Instruct o the o patient's o family o to o stay o with o him o & o call o for o help o as o necessary. c. o Remove o dangerous o equipment o from o the o room, o such o as o sharps o containers o or o portable o instruments. d. o Escort o the o patient o to o the o waiting o area o where o he o can o readily o be o observed o by o the triage o nurse. e. o Use o a o metal o detector o to o search o for o objects o that o could o be o used o as o weapons. f. o Instruct o nursing o students o to o avoid o wearing o a o stethoscope o around o their o necks. o - o correct o answers -ANSWERS: o o a. o Search o the o patient's o belongings o & o secure o personal o effects. o c. o Remove o dangerous o equipment o from o the o room, o such o as o sharps o containers o or o portable o instruments. o e. o Use o a o metal o detector o to o search o for o objects o that o could o be o used o as o weapons. o f. o Instruct o nursing o students o to o avoid o wearing o a o stethoscope o around o their o necks. 14. o For o which o patients o would o the o nurse o advocate o for o a o social o services o consult? o (SATA) a. o Toddler o who o bumped o her o head o on o a o table; o observation o for o 24 o hours o is o required. b. o Homeless o woman o who o will o be o discharged o with o a o splint o to o the o lower o leg o & o crutches. c. o Woman o who o was o punched o & o beaten o by o her o husband o & o sustained o a o broken o jaw. d. o Man o who o drove o himself o to o the o ED o for o a o dressing o change o of o an o infected o wound o on o his o back. e. o Preteen o admitted o for o vaginal o bleeding o & o sexually o transmitted o infection. o - o correct o answers -ANSWERS: o o b. o Homeless o woman o who o will o be o discharged o with o a o splint o to o the o lower o leg o & o crutches. o c. o Woman o who o was o punched o & o beaten o by o her o husband o & o sustained o a o broken o jaw. o e. o Preteen o admitted o for o vaginal o bleeding o & o sexually o transmitted o infection 15. o Which o function o represents o an o appropriate o referral o to o the o case o manager? a. o Check o with o the o admissions o office o to o get o a o count o of o available o intensive o care o beds. b. o Contact o the o peripherally o inserted o central o catheter o (PICC) o nurse, o because o the o patient o has o bad o veins. c. o Investigate o whether o the o patient o is o abusing o & o overusing o ED o services.
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