(Test Bank) Introduction To Critical Care Nursing

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Nursing

Test Bank

7th Edition

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Test Bank for Introduction To Critical Care Nursing, The downloadable file consists of 782 pages, and the total size of the file is 4.22 MB. Purchase now only for highly discounted price.

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TEST BANK FOR INTRODUCTION TO CRITICAL CARE NURSING 7TH EDITION 1 Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 1 Table of Contents Table of Contents 1 Chapter 01: Overview of Critical Care Nursing 1 Chapter 02: Patient and Family Response to the Critical Care Experience 1 Chapter 03: Ethical and Legal Issues in Critical Care Nur sing 37 Chapter 04: Palliative and End -of-Life Care 62 Chapter 05: Comfort and Sedation 91 Chapter 06: Nutritional Therapy 120 Chapter 07: Dysrhythmia Interpretation and Management 144 Chapter 08: Hemodynamic Monitoring 213 Chapter 09: Ventilatory Assistance 256 Chapter 10: Rapid Response Teams and Code Management 294 Chapter 11: Organ Donation 321 Chapter 12: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome 358 Chapter 13: Cardiovascular Alterations 400 Chapter 14: Nervous System Alterations 435 Chapter 15: Acute Respiratory Failure 472 Chapter 16: Acute Kidney Injury 503 Chapter 17: Gastrointestinal Alterations 556 Chapter 17: Hematological and Immune Disorders 613 Chapter 19: Endocrine A lterations 674 Chapter 20: Trauma and Surgical Management 715 Chapter 21: Burns 748 Chapter 01: Overview of Critical Care Nursing Chapter 02: Patient and Family Response to the Critical Care Experience MULTIPLE CHOICE 1. Family members have a need for information. Which interventions best assist in meeting this need? Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 2 a. Handing family members a pamphlet that explains all of the critical care equipment b. Providing a daily update of the patients progress and facilitating communication with the intensivist c. Telling them that you are not permitted to give them a status report but that they can be present at 4:00 PM for family rounds with the intensivist d. Writing down a list of all new medications and doses and giving the list to family members during visitation ANS: B The nurse can give a status report related to the patients condition and current treatment plan as well as ensure that the family has daily meeting time with the intensivist for an update on diagnoses, prognoses, and the like. Pamphlets are helpful; howeve r, the nurse should also explain the equipment that is at this patients bedside and not assume that everyone can read and understand written material. Limiting the information to that provided by the physician is unnecessary and will not meet the familys information needs. Most family members are concerned about the patients general condition and treatment plan. They do not want or need a detailed list of medications, doses, or other treatments. DIF: Cognitive Level: Analysis REF: p. 20 Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 3 OBJ: Describe common family needs and family -centered nursing interventions. TOP: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 2. The nurse is a member of a committee to design a critical care unit in a new building. Which design trend would best to facilitate family -centered care? a. Ensure that the patients room is large enough and has adequate space for a sleeper sofa and storage for family members personal belongings. b. Include a diagnostic suite in close proximity to the unit so that the patient does not have to travel far for testing. c. Incorporate a large waiting room on the top floor of the hospital with a scenic view and amenities such as coffee and tea. d. Provide access to a scenic garden for meditation. ANS: A New unit design trends to promote famil y-centered care include larger patient rooms that include a larger family space and comfortable furniture and storage to promote open visitation, including overnight stays in the patients room. Ready access Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 4 to diagnostic testing, including portable equipme nt, is an important trend; however, the purpose for this is to prevent the need for transport, not to foster family -centered care. A waiting room in close proximity to the unit with amenities is a nice feature; however, it does not need to be large if adeq uate space is incorporated into the patients room. A scenic garden for medication may assist in reducing family members stress, but proximity to the patient is the greatest need. DIF: Cognitive Level: Analysis REF: Table 2-2 OBJ: Describe common family needs and family -centered nursing interventions. TOP: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity 3. The nurse is caring for a patient who sustained a head injury and is unresponsive to painful stimuli. Which intervention is most appropr iate while bathing the patient? a. Ask a family member to help you bathe the patient, and discuss the family structure with the family member during the procedure. b. Because she is unconscious, complete care as quickly and quietly as possible. c. Tell the patient the day and time, and that you are bathing her. Reassure her that you are there. Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 5 d. Turn the television on to the evening news so that you and the patient can be updated to current events. ANS: C Although unconscious, many patients can hear, understand, and respond to stimuli. Therefore, it is important to converse with the patient and reorient her to the environment. Some, but not all, family members may want to get involved in direct care; it is not known if this individual is a willing participant, and talking about whos who in the family is not appropriate while providing direct care to the patient. Although she is unconscious, communication and simple conversations remain important interventions. Use of the television to provide sensory input that the patient regularly enjoys is a nursing intervention, but turning on the news for the sake of the nurse is not appropriate. DIF: Cognitive Level: Application REF: p. 16 OBJ: Describe stressors in the critical care environment and strategies to reduce them. TOP: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 4. Sleep often is disrupted for critically ill patients. Which nursing intervention is most appropriate to promote sleep and rest? Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 6 a. Consult with the pharmacist to adjus t medication times to allow periods of sleep or rest between intervals. b. Encourage family members to talk with the patient whenever they are present in the room. c. Keep the television on to provide white noise and distraction. d. Leave the lights on in the room so that the patient is not frightened of his or her surroundings. ANS: A Planning care to promote periods of uninterrupted rest is important. Consulting with the pharmacist to adjust a medication schedule is an excellent example of this intervention. It is important for family members to communicate with the patient; however, rest periods must be scheduled. Family members can be present in the room while remaining quiet during these scheduled times. The television may be useful if it is part of the patients normal routine for sleep; however, it does not consistently provide white noise or distraction. Lights should be dimmed during scheduled rest periods and at night to facilitate sleep and rest. DIF: Cognitive Level: Analysis REF: p. 16 OBJ: Discuss the impact of critical care hospitalization on the patient and family. TOP: Nursing Process Step: Implementation Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 7 MSC: NCLEX: Psychosocial Integrity 5. Family assessment is essential in order to meet family needs. Which of the following must be assessed first to assist the nurse in providing family -centered care? a. Assessment of patient and familys developmental stages and needs b. Description of the patients home environment c. Identification of immediate family, extended family, and decision makers d. Observation and assessment of how family members function with each other ANS: C Assessment of the family structure is the first step and is essential before specific interventions can be designed. It identifies immediate family, extended family, and decis ion makers in the family. Structural assessment also includes ethnicity and religion. The developmental assessment is done after the structural assessment and includes the developmental stages of the patient and family. Functional assessment is also import ant to assess how family members function with each other; however, it is not done first. Assessment of the home environment is important when identifying discharge planning needs. Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 8 DIF: Cognitive Level: Analysis REF: pp. 17-18 OBJ: Discuss the impact of critical care hospitalization on the patient and family. TOP: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity 6. Critical illness often results in family conflicts. Which scenario is most likely to result in the greatest conflict? a. A 21-year-old college student of divorced parents hospitalized with multiple trauma. She resides with her mother. The parents are amicable with each other and have similar values. The father blames the daughters boyfriend for causing the accident. b. A 36-year -old male admitted for a ruptured cerebral aneurysm. He has been living with his 34- year -old girlfriend for 8 years, and they have a 4-year - old daughter. He does not have written advance directives. His parents arrive from out-of-state and are asked to make decisions about his health care. He has not seen them in over a year. c. A 58-year -old male admitted for coronary artery bypass surgery. He has been living with his samesex partner for 20 years in a committed relationship. He has designated his sister, a registered nurse, as his healthcare proxy in a written advance directive. Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 9 d. A 78-year -old female admitted with gastrointestinal bleeding. Her hemoglobin is decreasing to a critical level. She is a Jehovahs Witness and refuses the treatment of a blood transfusion. She is capable of making her own decisions and has a clearly written advance directive declining any transfusions. Her son is upset with her and tells her she is committing suicide. ANS: B Each of these situations may result in family conflict. The situation with the unmarried couple without written advance directives resu lts in the distant parents being legally responsible for his healthcare decisions. Because of his long -standing commitment with his partner, and lack of recent contact with his parents, this scenario is likely to cause the most conflict. The parents may make decisions based on their wishes, as they may not be knowledgeable of the patients wishes. The supportive parents of the college student may create conflict with the boyfriend, but their ongoing friendship and shared values will assist in reducing confli ct. The male admitted for bypass surgery, although in a same -sex relationship, has clearly identified who he wants to make healthcare decisions for him. The elderly female may have conflict with her son; however, she is capable of making her own decisions and has written advance directives to support her decisions. DIF: Cognitive Level: Analysis REF: pp. 17-18 Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 10 OBJ: Discuss the impact of critical care hospitalization on the patient and family. TOP: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity 7. Which nursing interventions would best support the family of a critically ill patient? a. Encourage family members to stay all night in case the patient needs them. b. Give a condition update each morning and whenever changes occur. c. Limit visitation from children into the critical care unit. d. Provide beverages and snacks in the waiting room. ANS: B The need for information is one of the highest identified by family members of critically ill patients. New room designs provide space for family members to spend the night if desired; however, if the patient is stable, family members should be encouraged to sleep at home to ensure that they are well rested and can support the patient. Restriction of children in the critical care unit is not supported by resea rch evidence. Child visitation should be individualized based on the needs and wishes of the patient and family. Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 11 Beverages and snacks are important but not as important as information. DIF: Cognitive Level: Analysis REF: Box 2-2 OBJ: Describe common family needs and family -centered nursing interventions. TOP: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 8. Which intervention is appropriate to assist the patient to cope with admission to the critical care unit? a. Allowing unrestricted visiting by several family members at one time b. Explaining all procedures in easy -to-understand terms c. Providing back massage and mouth care d. Turning down the alarm volume on the cardiac monitor ANS: B Communication and explanations of procedures are priority interventions to help patients cope with admission. Comfort is an important intervention but not the priority. Noise control is an important intervention but not the priority. Open visitation is recommended; however, the number of family members may need to be limited to promote rest and sleep. Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 12 DIF: Cognitive Level: Analysis REF: pp. 20-21 OBJ: Describe stressors in the critical care environment and strategies to reduce them. TOP: Nursing Process Step: Implementation MSC: NCLEX: Psych osocial Integrity 9. The constant noise of a ventilator, monitor alarms, and infusion pumps predisposes the patient to: a. anxiety. b. pain. c. powerlessness. d. sensory overload. ANS: D Constant noise is a source of sensory overload. Pain and lack of information cont ribute to anxiety. Noise does not cause physical pain. Lack of involvement in care causes powerlessness. DIF: Cognitive Level: Application REF: pp. 14-15 OBJ: Describe stressors in the critical care environment and strategies to reduce them. TOP: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity Test Bank - Introduction to Critical Care Nursing 7e (Sole 2016) 13 10. Which of the following statements about family assessment is false? a. Assessment of structure (who comprises the family) is the last step in assessment. b. Interaction among family mem bers is assessed. c. It is important to assess communication among family members to understand roles. d. Ongoing assessment is important, because family functioning may change during the course of illness. ANS: A Assessment of structure should be done first so that the nurse can identify such things as who comprises the family and who assumes leadership and decision -making responsibilities. This assessment also assists in identifying which individuals are most important to the patient and how many people may be seeking information. Family member interaction must be assessed, so this answer is true. Family member communication must be assessed, so this answer is true. Ongoing assessment of family is necessary as functions may change, so this answer is true. DIF: Cognitive Level: Application REF: pp. 16-17 OBJ: Describe common family needs and family -centered nursing interventions.