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NR 341 Exam #1 - Questions With Correct Answers (100% Accurate)
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NR 341 Exam #1 - Questions With Correct Answers (100% Accurate)
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NR 341 Exam #1 - Questions With Correct Answers(100% Accurate)
As part of nursing management of a critically ill patient, orders are written to
keep the head of the bed elevated at 30 degrees, awaken the patient from
sedation each morning to assess readiness to wean from mechanical
ventilation, and implement oral care protocols every 4 hours. These
interventions are done as a group to reduce the risk of ventilator-associated
pneumonia. This group of evidence-based interventions is often called a:
a. bundle of care.
b. clinical practice guideline.
c. patient safety goal.
d. quality improvement initiative. Right Ans - a
Which of the following statements describes the core concept of the synergy
model of practice?
a. All nurses must be certified in order to have the synergy model
implemented.
b. Family members must be included in daily interdisciplinary rounds.
c. Nurses and physicians must work collaboratively and synergistically to
influence care.
d. Unique needs of patients and their families influence nursing competencies.
Right Ans - d
Which of the following is a National Patient Safety Goal? (Select all that apply.)
a. Accurately identify patients.
b. Eliminate use of patient restraints.
c. Reconcile medications across the continuum of care.
d. Reduce risks of healthcare-acquired infection. Right Ans - a,c,d
Which of the following nursing activities demonstrates implementation of the
AACN Standards of Professional Performance? (Select all that apply.)
a. Attending a meeting of the local chapter of the American Association of
Critical-Care Nurses in which a continuing education program on sepsis is
being taught
b. Collaborating with a pastoral services colleague to assist in meeting
spiritual needs of the patient and family
c. Participating on the unit's nurse practice council
,d. Posting an article from Critical Care Nurse on management of venous
thromboembolism for your colleagues to read
e. Using evidence-based strategies to prevent ventilator-associated
pneumonia Right Ans - a,b,c,d,e
Which scenarios contribute to effective handoff communication at change of
shift? (Select all that apply.)
a. The nephrology consultant physician is making rounds and asks you to
update her on the patient's status and assist in placing a central line for
hemodialysis.
b. The noise level is high because twice as many staff members are present
and everyone is giving report in the nurse's station.
c. The unit has decided to use a standardized checklist/tool for change-of-shift
reports and patient transfers.
d. You and the oncoming nurse conduct a standardized report at the patient's
bedside and review key assessment findings. Right Ans - c,d
Which strategy is important to addressing issues associated with the aging
workforce? (Select all that apply.)
a. Allowing nurses to work flexible shift durations
b. Encouraging older nurses to transfer to an outpatient setting that is less
stressful
c. Hiring nurse technicians that are available to assist with patient care, such
as turning the patient
d. Remodeling patient care rooms to include devices to assist in patient lifting
Right Ans - a,c,d
Which of the following strategies will assist in creating a healthy work
environment for the critical care nurse? (Select all that apply.)
a. Celebrating improved outcomes from a nurse-driven protocol with a pizza
party
b. Implementing a medication safety program designed by pharmacists
c. Modifying the staffing pattern to ensure a 1:1 nurse/patient ratio
d. Offering quarterly joint nurse-physician workshops to discuss unit issues
e. Using the Situation-Background-Assessment-Recommendation (SBAR)
technique for handoff communication Right Ans - a,d,e
The nurse is caring for a patient who is on a cardiac monitor. The nurse
realizes that the sinus node is the pacemaker of the heart because it is:
,a. the fastest pacemaker cell in the heart.
b. the only pacemaker cell in the heart.
c. the only cell that does not affect the cardiac cycle.
d. located in the left side of the heart. Right Ans - A
The cardiac cycle begins with an impulse that is generated from a small
concentrated area of pacemaker cells high in the right atria called the
sinoatrial node (sinus node or SA node). The SA node has the fastest rate of
discharge and thus is the dominant pacemaker of the heart. The AV node has
pacemaker properties and can discharge an impulse if the SA node fails. The
ventricles have pacemaker capabilities if the sinus node or the AV node ceases
to generate impulses.
One of the functions of the atrioventricular (AV) node is to:
a. pace the heart if the ventricles fail.
b. slow the impulse arriving from the SA node.
c. send the impulse to the SA node.
d. allow for ventricular filling during systole. Right Ans - b
The normal rate for the SA node when the patient is at rest is:
a. 40 to 60 beats per minute.
b. 60 to 100 beats per minute.
c. 20 to 40 beats per minute.
d. more than100 beats per minute. Right Ans - b
When assessing the 12-lead electrocardiogram (ECG) or a rhythm strip, it is
helpful to understand that the electrical activity is viewed in relation to the
positive electrode of that particular lead. When an electrical signal is aimed
directly at the positive electrode, the inflection will be:
a. negative.
b. upside down.
c. upright.
d. equally positive and negative. Right Ans - c
The nurse is examining the patient's cardiac rhythm strip in lead II and
notices that all of the P waves are upright and look the same except one that
has a different shape and is inverted. The nurse realizes that the P wave with
the abnormal shape is probably:
a. from the SA node since all P waves come from the SA node.
b. from some area in the atria other than the SA node.
, c. indicative of ventricular depolarization.
d. normal even though it is inverted in lead II. Right Ans - b
Normally a P wave indicates that the SA node initiated the impulse that
depolarized the atrium. However, a change in the shape of the P wave may
indicate that the impulse arose from a site in the atria other than the SA node.
The P wave represents atrial depolarization. It is usually upright in leads I and
II and has a rounded, symmetrical shape. The amplitude of the P wave is
measured at the center of the waveform and normally does not exceed three
boxes, or 3 millimeters, in height.
The QT interval is the total time taken for ventricular depolarization and
repolarization. Prolongation of the QT interval:
a. decreases the risk of lethal dysrhythmias.
b. usually occurs when heart rate increases.
c. increases the risk of lethal dysrhythmias.
d. can only be measured with irregular rhythms. Right Ans - c
The patient has an irregular heart rhythm. To determine an accurate heart
rate, the nurse first:
a. identifies the markers on the ECG paper that indicate a 6-second strip.
b. counts the number of large boxes between two consecutive P waves.
c. counts the number of small boxes between two consecutive QRS complexes.
d. divides the number of complexes in a 6-second strip by 10. Right Ans - A
Six-second method: A quick and easy estimate of heart rate can be
accomplished by counting the number of P waves or QRS waves within a 6-
second strip to obtain atrial and ventricular heart rates per minute. This is the
optimal method for irregular rhythms. Identify the lines above the ECG paper
that represent 6 seconds, and count the number of P waves within the lines;
then add a zero (multiply by 10) to identify the atrial heart rate estimate for 1
minute. Next, identify the number of QRS waves in the 6-second strip and
again add a zero to identify the ventricular rate.
The nurse is calculating the rate for a regular rhythm. There are 20 small
boxes between each P wave and 20 small boxes between each R wave. What is
the ventricular rate?
a. 50 beats/min
b. 75 beats/min
c. 85 beats/min
d. 100 beats/min Right Ans - B
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