NUR 221 (CRITICAL CARE - TEST 1) NCLEX STYLE PRACTICE QUESTIONS AND ANSWERS
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Course
NUR 221
Institution
NUR 221
NUR 221 (CRITICAL CARE - TEST 1) NCLEX STYLE PRACTICE QUESTIONS AND ANSWERSNUR 221 (CRITICAL CARE - TEST 1) NCLEX STYLE PRACTICE QUESTIONS AND ANSWERSNUR 221 (CRITICAL CARE - TEST 1) NCLEX STYLE PRACTICE QUESTIONS AND ANSWERS
A 75-year-old patient, who suffered a massive stroke 3 weeks ago, has be...
NUR 221 (CRITICAL CARE - TEST 1)
NCLEX STYLE PRACTICE QUESTIONS
AND ANSWERS
A 75-year-old patient, who suffered a massive stroke 3 weeks ago, has been
unresponsive and has required ventilatory support since the time of the stroke. The
physician has approached the
spouse regarding placement of a permanent feeding tube. The spouse states that the
patient never wanted to be kept alive by tubes and personally didn't want what was
being done. After
holding a family conference with the spouse, the medical team concurs, and the feeding
tube is not placed. This situation is an example of
A. euthanasia
B. palliative care
C. withdrawal of life support
D. withholding life support
**P-4** - ANSWER-D
(withholding life support)
A patient who is undergoing withdrawal of mechanical ventilation appears anxious and
agitated. The patient is on a continuous morphine infusion and has an additional order
for lorazepam (Ativan) 1 to 2 mg IV as needed (prn). The patient has received no
lorazepam (Ativan) during this course of illness. What is the most appropriate nursing
intervention to control agitation?
A. Administer fentanyl (Duragesic) 25 mg IV bolus
B. Administer lorazepam (Ativan) 1 mg IV now
C. Increase the rate of the morphine infusion by 50%
D. Request an order for a paralytic agent
**P-4** - ANSWER-B
(Administer lorazepam (Ativan) 1 mg IV now)
The patient's spouse is very upset because his loved one, who is near death, has
dyspnea and restlessness. The nurse explains that there are some ways to decrease
this discomfort, including:
A. respiratory therapy treatments
,B. opioid medications given as needed
C. incentive spirometry
D. increased hydration
**P-4** - ANSWER-B
(opioid medications given as needed)
The patient's spouse tells the nurse that there is no point in continuing to visit at the
bedside because the patient is unresponsive. The best response by the nurse is
A. "You're right. Your loved one is not aware of anything now."
B. "This seems to be very difficult for you."
C. "I'll call you if she starts responding again."
D. "Why don't you check to see if any other family member would like to visit?"
**P-4** - ANSWER-B
("This seems to be very difficult for you.")
Which of the following statements about palliative care is accurate?
A. Withholding and withdrawing life-sustaining treatment are distinctly different in the
eyes of the legal community
B. Reducing distressing symptoms is the primary goal of palliative care
C. Only the patient can determine what constitutes palliative care for him or her
D. Withdrawing life-sustaining treatments is considered euthanasia in most states
**P-4** - ANSWER-B
(Reducing distressing symptoms is the primary goal of palliative care)
A statement that provides a legally recognized description of an individual's desires
regarding care at the end of life is
A. advance directive
B. guardianship ad litem
C. health care proxy
D. power of attorney
**P-4** - ANSWER-A
(advance directive)
A patient with metastatic lung carcinoma has been unresponsive to chemotherapy. The
medical team has determined that there are no additional treatments available that will
,prolong life or improve the quality of life in any meaningful way. Despite the poor
prognosis, the patient continues to receive chemotherapy and full nutritional support.
This is an example of which end-of-life concept?
A. Medical futility
B. Palliative care
C. Terminal weaning
D. Withdrawal of treatment
**P-4** - ANSWER-A
(Medical futility)
Designated health care surrogates should base health care decisions on
A. personal beliefs and values
B. recommendations of family members and friends
C. recommendations of the physician and health care team
D. wishes previously expressed by the patient
**P-4** - ANSWER-D
(wishes previously expressed by the patient)
Which statement made by a staff nurse identifying guidelines for palliative care would
need to be corrected?
A. Basic nursing care is a critical element in palliative care management
B. Common conditions that require palliative management are nausea, agitation, and
sleep disturbance
C. Palliative care practices are reserved for the dying client
D. Palliative care practices relieve symptoms that negatively affect the quality of life of a
patient
**P-4** - ANSWER-C
(Palliative care practices are reserved for the dying client)
Which statement is true regarding the impact of culture on end-of-life decision making?
A. Cultural beliefs should not take precedence over health care team decisions
B. It is easy and common to assess cultural beliefs affecting end-of-life care in the
intensive care unit
C. Culture and religious beliefs may affect end-of-life decision making
D. Perspectives regarding end-of-life care are similar between and within religious
groups
, **P-4** - ANSWER-C
(Culture and religious beliefs may affect end-of-life decision making)
The most critical element of effective early end-of-life decision making is
A. Control of distressing symptoms, such as nausea, anxiety, and pain.
B. effective communication among the patient, family, and health care team
throughout the course of the illness
C. organizational support of palliative care principles
D. the relocation of the dying patient from the critical care unit to a lower level of care
**P-4** - ANSWER-B
(effective communication among the patient, family, and health care team
throughout the course of the illness)
A patient with end-stage heart failure is experiencing considerable dyspnea. Appropriate
palliative management of this symptom includes:
A. administration of midazolam (Versed)
B. administration of morphine
C. an increase in the amount of oxygen being delivered to the patient
D. aggressive use of inotropic and vasoactive medications to improve heart function
**P-4** - ANSWER-B
(administration of morphine)
Which nursing intervention would need to be corrected on a care plan for a patient in
order to be consistent with the principles of effective end-of-life care?
A. Control of distressing symptoms such as dyspnea, nausea, and pain through the use
of pharmacological and nonpharmacological interventions
B. Limitation of visitation to reduce the emotional distress experienced by family
members
C. Patient and family education on anticipated patient responses to withdrawal of
therapy
D. Provision of spiritual care resources as desired by the patient and family
**P-4** - ANSWER-B
(Limitation of visitation to reduce the emotional distress experienced by family
members)
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