Advanced Nursing Practice
Pre-Test Questions
Course Introduction
Advanced Nursing Practice is designed to equip experienced nurses with the knowledge and skills necessary to provide high-quality, evidence-based care in a variety of clinical settings. This course explores advanced concepts in health assessment, diagnostic reasoning, pharmacology, and patient management, with an emphasis on leadership, interprofessional collaboration, and clinical decision-making. Students will develop competencies in critical thinking, patient advocacy, and holistic care, as well as gain insights into policy, ethics, and advanced practice roles. Through theory and practical application, nurses are prepared to lead innovations in healthcare delivery, respond to complex patient needs, and contribute to improved patient outcomes.
Recommended Textbook
Introduction to Critical Care Nursing 6th Edition by Mary Lou Sole
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21 Chapters
756 Verified Questions
756 Flashcards
Source URL: https://quizplus.com/study-set/2011 Page 2
Chapter 1: Overview of Critical Care Nursing
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/39999
Sample Questions
Q1) The synergy model of practice focuses on:
A) allowing unrestricted visiting for the patient 24 hours each day.
B) holistic and alternative therapies.
C) needs of patients and their families, which drives nursing competency.
D) patients' needs for energy and support.
Answer: C
Q2) The charge nurse is responsible for making the patient assignments on the critical care unit.She assigns the experienced,certified nurse to care for the acutely ill patient with sepsis who also requires continuous renal replacement therapy and mechanical ventilation.She assigns the nurse with less than 1 year of experience to two patients who are more stable.This assignment reflects implementation of the:
A) crew resource management model
B) National Patient Safety Goals
C) Quality and Safety Education for Nurses (QSEN) model
D) synergy model of practice
Answer: D
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3
Chapter 2: Patient and Family Response to the Critical Care Experience
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28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/40000
Sample Questions
Q1) Sleep often is disrupted for critically ill patients.Which nursing intervention is most appropriate to promote sleep and rest?
A) Consult with the pharmacist to adjust 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.
Answer: A
Q2) Patients often have recollections of the critical care experience.Which is likely the most common recollection from a patient who required endotracheal intubation and mechanical ventilation?
A) Difficulty communicating
B) Inability to get comfortable
C) Pain
D) Sleep disruption
Answer: A
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Chapter 3: Ethical and Legal Issues in Critical Care Nursing
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23 Verified Questions
23 Flashcards
Source URL: https://quizplus.com/quiz/40001
Sample Questions
Q1) When addressing an ethical dilemma,contextual,physiological,and personal factors of the situation must be considered.Which of the following is an example of a personal factor?
A) The hospital has a policy that everyone must have an advanced directive on the chart.
B) The patient has lost 20 pounds in the past month and is fatigued all of time.
C) The patient has told you what quality of life means and his or her wishes.
D) The physician considers care to be futile in a given situation.
Answer: C
Q2) The nurse is caring for a patient with severe neurological impairment following a massive stroke.The physician has ordered tests to determine brain death.The nurse understands that criteria for brain death include: (Select all that apply.)
A) absence of cerebral blood flow.
B) absence of brainstem reflexes on neurological examination.
C) Cheyne-Stokes respirations.
D) flat electroencephalogram.
Answer: A,B,D
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Page 5
Chapter 4: End-Of-Life Care in the Critical Care Unit
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/40002
Sample Questions
Q1) All of the patient's children are distressed by the possibility of removing life-support treatments from their mother.The child who is most upset tells the nurse,"This is the same as killing her! I thought you were supposed to help her!" The nurse explains to the family,
A) "This is a process of allowing your mother to die naturally after the injuries that she sustained in a serious accident."
B) "The hospital would never allow us to do that kind of thing."
C) "Let's talk about this calmly, and I will explain why assisted suicide is appropriate in this case."
D) "She's lived a long and productive life."
Q2) Palliation may include: (Select all that apply.)
A) relieving pain.
B) relieving nausea.
C) psychological support.
D) withdrawing life-support interventions.
E) withholding tube feedings.
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Chapter 5: Comfort and Sedation
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33 Verified Questions
33 Flashcards
Source URL: https://quizplus.com/quiz/40003
Sample Questions
Q1) The nurse is concerned about the risk of alcohol withdrawal syndrome in a 45-yearold postoperative patient.Which statement indicates her understanding of management of this patient?
A) "Alcohol withdrawal is common; we see it all of the time in the trauma unit."
B) "There is no way to assess for alcohol withdrawal."
C) "This patient will require less pain medication."
D) "We have initiated the alcohol withdrawal protocol."
Q2) The nurse is assessing the critically ill patient for delirium.The nurse recognizes which characteristics that indicate hyperactive delirium? (Select all that apply.)
A) Agitation
B) Apathy
C) Biting
D) Hitting
E) Restlessness
Q3) Anxiety differs from pain in that: (Select all that apply.)
A) it is confined to neurological processes in the brain.
B) it is linked to reward and punishment centers in the limbic system.
C) it is subjective.
D) there is no actual tissue injury.
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Page 7
Chapter 6: Nutritional Support
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/40004
Sample Questions
Q1) Which statement(s)about total parenteral nutrition is (are)true? (Select all that apply.)
A) Assessing fluid volume status and preventing infection are important nursing considerations.
B) Fingerstick glucose levels are assessed every 6 hours and prn.
C) Total parenteral nutrition is administered through a feeding tube and pump.
D) Total parenteral nutrition, with added lipids, provides adequate levels of protein, carbohydrates, and fats.
Q2) Which statement is true about normal function of the gastrointestinal (GI)tract?
A) Failure of the tight junctions allows bacteria to invade the GI tract.
B) The gut lacks protective mechanisms; thus, infection is always a concern.
C) Water is reabsorbed at the beginning of the colon.
D) Without nutritional stimulation, mucosal villi atrophy.
Q3) In trauma patients,enteral nutrition via nasogastric tube feedings into the small bowel is best initiated within what time frame following the injury?
A) 24 hours
B) 48 hours
C) 7 days
D) 72 hours
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Page 8
Chapter 7: Dysrhythmia Interpretation and Management
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59 Verified Questions
59 Flashcards
Source URL: https://quizplus.com/quiz/40005
Sample Questions
Q1) The patient has a permanent pacemaker in place with a demand rate set at 60 beats/min.The cardiac monitor is showing a heart rate of 44 beats/min with no pacemaker spikes.The nurse realizes this as:
A) normal pacemaker function.
B) failure to capture.
C) failure to pace.
D) failure to sense.
Q2) The patient is having premature ventricular contractions (PVCs).The nurse's greatest concern should be:
A) the proximity of the R wave of the PVC to the T wave of a normal beat.
B) the fact that PVCs are occurring, because they are so rare.
C) if the number of PVCs are decreasing.
D) if the PVCs are wider than 0.12 seconds.
Q3) Sinus bradycardia is a symptom of which of the following? (Select all that apply.)
A) Calcium channel blocker medication
B) Beta-blocker medication
C) Athletic conditioning
D) Hypothermia
E) Hyperthyroidism
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Page 9
Chapter 8: Hemodynamic Monitoring
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40006
Sample Questions
Q1) The nurse is caring for a patient with an arterial monitoring system.The nurse assesses the patient's noninvasive cuff blood pressure to be 70/40 mm Hg.The arterial blood pressure measurement via an intraarterial catheter in the same arm is assessed by the nurse to be 108/70 mm Hg.What is the best action by the nurse?
A) Activate the rapid response system.
B) Place the patient in Trendelenburg position.
C) Assess the cuff for proper arm size.
D) Administer 0.9% normal saline bolus.
Q2) Which of the following situations may result in a low cardiac output and low cardiac index? (Select all that apply.)
A) Exercise
B) Hypovolemia
C) Myocardial infarction
D) Shock
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Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/40007
Sample Questions
Q1) The nurse is assisting with endotracheal intubation of the patient and recognizes that the procedure will be done in what order:
_,_______________? (Put a comma and space between each solve choice.)
A)Assess balloon on endotracheal tube for symmetry and leaks.
B)Assess lung fields for bilateral expansion.
C)Inflate balloon of endotracheal tube.
D)Insert endotracheal tube with laryngoscope and blade.
E)Suction oropharynx.
Q2) Which of the following devices is best suited to deliver 65% oxygen to a patient who is spontaneously breathing?
A) Face mask with non-rebreathing reservoir
B) Low-flow nasal cannula
C) Simple face mask
D) Venturi mask
Q3) One of the early signs of the effect of hypoxemia on the nervous system is:
A) cyanosis.
B) restlessness.
C) tachycardia.
D) tachypnea.
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Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40008
Sample Questions
Q1) A 74-year-old patient is admitted to the coronary care unit with an inferior wall myocardial infarction and develops symptomatic bradycardia with premature ventricular contractions every third beat (trigeminy).The nurse knows to prepare to administer which drug?
A) Amiodarone
B) Atropine
C) Lidocaine
D) Magnesium
Q2) Which of the following are documented as part of the cardiopulmonary arrest record? (Select all that apply.)
A) Medication administration times
B) Defibrillation times, joules, outcomes
C) Rhythm strips of cardiac rhythm(s) noted
D) Signatures of recorder and other personnel
E) None of above
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12
Chapter 11: Shock, sepsis, and Multiple Organ Dysfunction Syndrome
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/40009
Sample Questions
Q1) The nurse is caring for a patient admitted following a motor vehicle crash.Over the past 2 hours,the patient has received 6 units of packed red blood cells and 4 units of fresh frozen plasma by rapid infusion.To prevent complications,what is the priority nursing intervention?
A) Administer pain medication.
B) Turn patient every 2 hours.
C) Assess core body temperature.
D) Apply bilateral heel protectors.
Q2) Fifteen minutes after beginning a transfusion of O negative blood to a patient in shock,the nurse assesses a drop in the patient's blood pressure to 60/40 mm Hg,heart rate 135 beats/min,respirations 40 breaths/min,and a temperature of 102° F.The nurse notes the new onset of hematuria in the patient's Foley catheter.What are the priority nursing actions? (Select all that apply.)
A) Administer acetaminophen (Tylenol).
B) Document the patient's response.
C) Increase the rate of transfusion.
D) Notify the blood bank.
E) Notify the physician.
F) Stop the transfusion.
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Chapter 12: Cardiovascular Alterations
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37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/40010
Sample Questions
Q1) Percutaneous coronary intervention is contraindicated for patients with lesions in which coronary artery?
A) Right coronary artery
B) Left coronary artery
C) Circumflex
D) Left main coronary artery
Q2) Identify the priority interventions for managing symptoms of an acute myocardial infarction (AMI)in the ED.(Select all that apply).
A) Administration of morphine
B) Administration of nitroglycerin (NTG)
C) Dopamine infusion
D) Oxygen therapy
Q3) A patient has elevated blood lipids.The nurse anticipates which classification of drugs to be prescribed for the patient?
A) Bile acid resins
B) Nicotinic acid
C) Nitroglycerin
D) Statins
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14
Chapter 13: Nervous System Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40011
Sample Questions
Q1) While caring for a patient with a closed head injury,the nurse assesses the patient to be alert with a blood pressure 130/90 mm Hg,heart rate 60 beats/min,respirations 18 breaths/min,and a temperature of 102° F.To reduce the risk of increased intracranial pressure (ICP)in this patient,what is (are)the priority nursing action(s)?
A) Ensure adequate periods of rest between nursing interventions.
B) Insert an oral airway and monitor respiratory rate and depth.
C) Maintain neutral head alignment and avoid extreme hip flexion.
D) Reduce ambient room temperature and administer antipyretics.
Q2) The physician has opted to treat a patient with a complete spinal cord injury with glucocorticoids.The physician orders 30 mg/kg over 15 minutes followed in 45 minutes with an infusion of 5.4 mg/kg/min for 23 hours.What is the total 24-hour dose for the 70-kg patient?
A) 2478 mg
B) 5000 mg
C) 10,794 mg
D) 12,750 mg
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Chapter 14: Acute Respiratory Failure
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/40012
Sample Questions
Q1) The nurse is caring for a patient with a diagnosis of pulmonary embolism.The nurse understands that the most common cause of a pulmonary embolus is:
A) amniotic fluid embolus.
B) deep vein thrombosis from lower extremities.
C) fat embolus from a long bone fracture.
D) vegetation that dislodges from an infected central venous catheter.
Q2) The nurse is concerned that a patient is at increased risk of developing a pulmonary embolus and develops a plan of care for prevention to include which of the following?
A) Antiseptic oral care
B) Bed rest with head of bed elevated
C) Coughing and deep breathing
D) Mobility
Q3) The nurse assesses a patient who is admitted for an overdose of sedatives.The nurse expects to find which acid-base alteration?
A) Hyperventilation and respiratory acidosis
B) Hypoventilation and respiratory acidosis
C) Hypoventilation and respiratory alkalosis
D) Respiratory acidosis and normal oxygen levels
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16
Chapter 15: Acute Kidney Injury
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50 Verified Questions
50 Flashcards
Source URL: https://quizplus.com/quiz/40013
Sample Questions
Q1) Acute kidney injury from post renal etiology is caused by:
A) obstruction of the flow of urine.
B) conditions that interfere with renal perfusion.
C) hypovolemia or decreased cardiac output.
D) conditions that act directly on functioning kidney tissue.
Q2) The nurse is caring for a patient who has sustained blunt trauma to the left flank area,and is evaluating the patient's urinalysis results.The nurse should become concerned when
A) creatinine levels in the urine are similar to blood levels of creatinine.
B) sodium and chloride are found in the urine.
C) urine uric acid levels have the same values as serum levels.
D) red blood cells and albumin are found in the urine.
Q3) In calculating the glomerular filtration rate (GFR)results for women,the creatinine clearance is usually:
A) the same as for men.
B) greater than that for men.
C) multiplied by 0.85.
D) multiplied by 1.15.
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17
Chapter 16: Hematological and Immune Disorders
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55 Verified Questions
55 Flashcards
Source URL: https://quizplus.com/quiz/40014
Sample Questions
Q1) Accepted treatments for disseminated intravascular coagulation ( DIC )may require: (Select all that apply.)
A) platelet infusions.
B) administration of fresh frozen plasma.
C) cryoprecipitate.
D) packed RBCs.
E) heparin.
Q2) Exudate formation at the inflammatory site functions to: (Select all that apply.)
A) opsonize bacteria.
B) dilute toxins.
C) deliver proteins.
D) attach to the target cell.
E) carry away toxins.
Q3) Cases of primary immunodeficiency are usually related to: A) aging.
B) nutritional deficiencies.
C) malignancies.
D) a single gene defect.
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18
Chapter 17: Gastrointestinal Alterations
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/40015
Sample Questions
Q1) The nurse is caring for a patient who is passing bright red blood rectally.The nurse should expect to insert a nasogastric tube to:
A) rule out massive upper GI bleeding.
B) detect the presence of melena in the stomach.
C) visually determine the presence of occult bleeding.
D) obtain samples for guaiac to confirm current bleeding.
Q2) Infection by Helicobacter pylori bacteria is a major cause of:
A) duodenal ulcers.
B) Cushing's ulcers.
C) Curling's ulcers.
D) stress ulcers.
Q3) Lactulose is considered the first-line treatment for hepatic encephalopathy and works by:
A) causing ammonia to enter the bloodstream via the colon.
B) trapping ammonia in the bowel for excretion.
C) causing constipation and inhibiting the excretion of ammonia.
D) creating an alkaline environment in the bowel.
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Chapter 18: Endocrine Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40016
Sample Questions
Q1) Which of the following would be seen in a patient with myxedema coma?
A) Decreased reflexes
B) Hyperthermia
C) Hyperventilation
D) Tachycardia
Q2) Which of the following patients is at the highest risk for hyperosmolar hyperglycemic syndrome?
A) An 18-year-old college student with type 1 diabetes who exercises excessively
B) A 45-year-old woman with type 1 diabetes who forgets to take her insulin in the morning
C) A 75-year-old man with type 2 diabetes and coronary artery disease who has recently started on insulin injections
D) An 83-year-old, long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza
Q3) Acute adrenal crisis is caused by:
A) acute renal failure.
B) deficiency of corticosteroids.
C) high doses of corticosteroids.
D) overdose of testosterone.
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Page 20
Chapter 19: Trauma and Surgical Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40017
Sample Questions
Q1) Trauma patients are at high risk for multiple complications not only due to the mechanism of injury but also due to the patients' long-term management.Which of the following statements apply to trauma patients? (Select all that apply.)
A) Indwelling urinary catheters are a source of infection.
B) Patients often develop infection and sepsis secondary to central line catheters.
C) Pneumonia is often an adverse outcome of mechanical ventilation.
D) Wounds require sterile dressings to prevent infection.
Q2) It is important to prevent hypothermia in the trauma patient because hypothermia is associated with which of the following? (Select all that apply.)
A) ARDS
B) Coagulopathies
C) Dysrhythmias
D) Myocardial dysfunction
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Chapter 20: Burns
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40018
Sample Questions
Q1) A patient admitted with severe burns to his face and hands is showing signs of extreme agitation.The nurse should explore the mechanism of burn injury possibly related to:
A) excessive alcohol use.
B) methamphetamine use.
C) posttraumatic stress disorder.
D) subacute delirium.
Q2) A(An)____________________ often produces a superficial cutaneous injury but may cause cardiopulmonary arrest and transient but severe central nervous system deficits.
A) chemical burn
B) electrical burn
C) heat burn
D) infection
Q3) Tissue damage from burn injury activates an inflammatory response that increases the patient's risk for:
A) acute kidney injury.
B) acute respiratory distress syndrome.
C) infection.
D) stress ulcers.
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Chapter 21: Solid Organ Transplantation
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40019
Sample Questions
Q1) The nurse is preparing to admit a patient with heart failure who has been listed on the UNOS transplant list as status 1A.What is the best understanding of this classification by the nurse?
A) The patient can be managed at home with a left ventricular assist device.
B) Hospitalization is required with mechanical support and vasoactive infusions.
C) The patient has advanced heart failure and is being managed with medication.
D) An advanced heart failure patient not successfully managed on medications.
Q2) The nurse is caring for a patient in the critical care unit who,after being declared brain dead,is being managed by the OPO transplant coordinator.Thirty minutes into the shift,assessment by the nurse includes a blood pressure 75/50 mm Hg,heart rate 85 beats/min,and respiratory rate 12 breaths/min via assist/control ventilation.The oxygen saturation (SpO<sub>2</sub>)is 99% and core temperature 93.8° F.Which physician order should the nurse implement first?
A) Apply forced air warming device to keep temperature > 96.8°
B) Obtain basic metabolic panel every 4 hours until surgery
C) Begin phenylephrine (Neo-Synephrine) for systolic BP < 90 mm Hg
D) Draw arterial blood gas every 4 hours until surgery
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