TEST BANK
Critical Care Nursing: A Holistic Approach
Patricia Gonce Morton, and Dorrie K. Fontaine
11th Edition
,Table of Contents
Chapter 01 Critical Care Nursing Practice 1
Chapter 02 The Patient's Experience With Critical Illness 9
Chapter 03 The Family's Experience With Critical Illness 16
Chapter 04 Patient and Family Education in Critical Care 23
Chapter 05 Relieving Pain and Providing Comfort 30
Chapter 06 Palliative Care and End-of-Life Issues 37
Chapter 07 Ethical Issues in Critical Care Nursing 44
Chapter 08 Legal Issues in Critical Care Nursing 52
Chapter 09 Building a Professional Practice 60
Chapter 10 The Critically Ill Pediatric Patient 67
Chapter 11 The Critically Ill Pregnant Woman 74
Chapter 12 The Critically Ill Older Patient 81
Chapter 13 The Postanesthesia Patient 88
Chapter 14 Rapid Response Teams and Transport 95
Chapter 15 Disaster Management 102
Chapter 16 Anatomy and Physiology 110
Chapter 17 Patient Assessment-Cardiovascular System 116
Chapter 18 Patient Management 123
Chapter 19 Common Cardiovascular Disorders 130
Chapter 20 Heart Failure 137
Chapter 21 Acute Myocardial Infarction 144
Chapter 22 Cardiac Surgery 151
Chapter 23 Anatomy and Physiology of the Respiratory System 158
Chapter 24 Patient Assessment-Respiratory System 164
Chapter 25 Patient Management-Respiratory System 171
Chapter 26 Common Respiratory Disorders 179
Chapter 27 Acute Respiratory Distress Syndrome 186
Chapter 28 Anatomy and Physiology of the Renal System 193
Chapter 29 Patient Assessment-Renal System 200
Chapter 30 Patient Management-Renal System 206
Chapter 31 Acute Kidney Injury and Chronic Kidney Disease 213
Chapter 32 Anatomy and Physiology of the Nervous System 220
Chapter 33 Patient Assessment-Nervous System 227
Chapter 34 Patient Management-Nervous System 234
Chapter 35 Common Neurosurgical and Neurologic Disorders 241
Chapter 36 Traumatic Brain Injury 247
Chapter 37 Spinal Cord Injury 254
Chapter 38 Anatomy and Physiology 261
Chapter 39 Patient Assessment-Gastrointestinal System 267
Chapter 40 Patient Management-Gastrointestinal System 274
Chapter 41 Common Gastrointestinal Disorders 280
,Chapter 42 Anatomy and Physiology of the Endocrine System 287
Chapter 43 Patient Assessment-Endocrine System 293
Chapter 44 Common Endocrine Disorders 300
Chapter 45 Anatomy and Physiology of the Hematologic 307
Chapter 46 Patient Assessment 313
Chapter 47 Organ and Hematopoietic Stem Cell Transplantation 319
Chapter 48 Common Immunologic Disorders 326
Chapter 49 Common Hematologic Disorders 332
Chapter 50 Anatomy and Physiology of the Integumentary 339
Chapter 51 Patient Assessment-Integumentary System 346
Chapter 52 Patient Management-Integumentary System 353
Chapter 53 Burns and Common Integumentary Disorders 360
Chapter 54 Shock Systemic Inflammatory Response 367
Chapter 55 Trauma 374
Chapter 56 Drug Overdose and Poisoning 382
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Test Bank - Critical Care Nursing-A Holistic Approach, 11th Edition (Morton, 2018)
Chapter 1, Critical Care Nursing Practice
1. A nurse has recently been transferred to the ICU and is excited about the new
challenges. Which action will best improve his skills and confidence to care for his
clients?
A) Obtaining certification in critical care nursing
B) Seeking a mentor from the current staff
C) Subscribing to current critical care nursing journals
D) Volunteering for extra hours
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 clients.
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 client because she observes that his lips are dry. Later, she has the client 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 client and
immediately pages the physician. Which action taken by the nurse is the best example of
evidence-based practice?
A) Giving the client a cup of water
B) Transferring the client in a wheelchair
C) Using the cognitive assessment test
D) Recognizing signs of imminent stroke and paging the physician
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Test Bank - Critical Care Nursing-A Holistic Approach, 11th Edition (Morton, 2018)
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 recently been 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 various 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 client in the ICU while the nurse is out. The client complains that
the pain medication is not effective and that he would like to receive an increased dose.
The physician pages the nurse and consults with him in the hallway regarding the
client's request for stronger pain medication. The nurse explains that client 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 client 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
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Test Bank - Critical Care Nursing-A Holistic Approach, 11th Edition (Morton, 2018)
7. A nurse in the ICU is responding to a client who has just gone into cardiac arrest. A
moment later, the nurse is notified that another client has just gone into anaphylactic
shock because of 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 clients. 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. Not only was the nurse attentive to the needs of the client,
but she also went out of her way to care for the needs of the girl's 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 client in the ICU has recently been diagnosed with diabetes mellitus. Before being
discharged, this client 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 client 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 client 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
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Test Bank - Critical Care Nursing-A Holistic Approach, 11th Edition (Morton, 2018)
11. An Ethiopian man with AIDS has recently been admitted to the ICU with a case of
pneumonia. The man is new to the United States 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. The critical care nurse recognizes that the ability to provide quality nursing care requires
prioritizing many activities to ensure the client remains the main focus. What must the
nurse guard against becoming a potential distraction?
A) Increasing family demands
B) Evidence-based practice information from questionable sources
C) The presence of nuisance alarms
D) Requests and suggestions from client's family members
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 is preparing to hand her clients to the next nurse when several alarms go off.
What is the most appropriate action for the nurse to take?
A) Asking the incoming nurse to help check the clients
B) Starting with the closest client first until all alarms are addressed
C) Starting with the client furthest away first until all alarms are addressed
D) Responding to the alarm according to the intensity until all clients are cared for
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Test Bank - Critical Care Nursing-A Holistic Approach, 11th Edition (Morton, 2018)
15. The nurse is recommending a change in the way the staff performs dressing changes.
What is the best rationale to use to convince the other nurses that a change is warranted?
A) Participate in research to investigate the suggested change.
B) A recent evidence-based practice project validated the effectiveness of the new
method.
C) Other facilities are already doing it with success.
D) It is proven to be more cost-effective.
16. The nurse caring for a critically ill client 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 client to the unit
B) Application of an insulin sliding scale method from research
C) Checking the client's 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 Portability and Accountability Act (HIPAA)
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 client 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 clients and families
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Test Bank - Critical Care Nursing-A Holistic Approach, 11th Edition (Morton, 2018)
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 clients she cares for
C) Gathering demographic data on the clients 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 client characteristic of
resiliency. What client 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. Rising costs and availability of adequate health care will continue to impact the health
of a community. Which action by the nurse can help ensure that future clients will
receive the health care they need?
A) Advise clients of available health insurance options.
B) Conduct information classes in the community about health insurance.
C) Advocate for the client and family with the insurance company to obtain coverage
for necessary care.
D) Become a member of a nursing organization that can influence legislative activity.
23. A Muslim client has been admitted to the critical care unit with complications after
birth. Based on the Synergy Model, which nurse would be the most inappropriate to
assign to care for this client?
A) New graduate female nurse
B) Most experienced female nurse
C) New graduate male nurse
D) Female nurse with postpartum experience
24. Today's critical care nursing environment is constantly changing. What nursing behavior
best illustrates awareness of current events affecting critical care nursing?
A) Participating in the hospital's 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
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Test Bank - Critical Care Nursing-A Holistic Approach, 11th Edition (Morton, 2018)
25. A supervisor has noticed that a nurse appears to be resetting various alarms to
preventing them from working correctly. Which action would be best for this supervisor
to take?
A) Talk to the nurse in private about the situation.
B) Verify the situation with other senior staff nurses.
C) Reset the alarms to the appropriate setting.
D) Assign a mentor to work with this nurse.
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