1.
A patient has just been admitted to the ICU after being in a severe auto accident and losing one of her legs. Her husband has his hand over his heart and complains of a rapid heart rate. The nurse recognizes his condition as a sign of which stage of the general adaptation syndrome to stress?
A...
, 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 nurse's 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
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,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 patient's 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 girl's
Page 2
, family. According to research, which of the following forms of recognition would
the nurse value the most?
A) A card from the girl's family
B) A plaque from the ICU physicians naming her as “Nurse of the Year”
C) A letter of commendation from the hospital's 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 state's 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?
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