Priorities in Critical Care Nursing 8th edition Urden Stacy Lough Test Bank

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Priorities in Critical Care Nursing 8th edition Chapter 1: Caring for the Critically Ill Patient

O M

MULTIPLE CHOICE

.C

1. Which of the following units can provide high quality and cost effective care for patients who

LD

are less complex, more stable, and have a decreased need for physiologic monitoring could be

O R

placed on? a. intensive care units

W

b. triage units

KS

c. progressive care units

BA

N

d. medical surgical units

ST

ANS: C

A growing trend in acute care settings is the designation of progressive care units, considered to

TE

be part of the continuum of critical care. In past years, patients who are placed on these units would have been exclusively in critical care units. However, with the use of additional

G

technology and monitoring capabilities, newer care delivery models, and additional nurse

N

education, these units are considered the best environment. The patients are less complex, more

SI

stable, have a decreased need for physiologic monitoring, and more self-care capabilities. They

R

can serve as a bridge between critical care units and medical-surgical units, while providing high

.N

U

quality and cost effective care at the same time.

W W W

2. _____ have a broad depth of knowledge and expertise in their specialty area and manage complex clinical and system issues. a. SCCMs b. APNs c. CNSs d. AACNs

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ANS: B APNs have a broad depth of knowledge and expertise in their specialty area and manage complex clinical and systems issues. CNSs serve in specialty roles that use their clinical,

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teaching, research, leadership, and consultative abilities. SCCM stands for the Society of Critical

.C

Care Medicine. AACN is the American Association of Critical-Care Nurses.

LD

3. _____ are instrumental in ensuring care that is evidence based and that safety programs are in

O R

place. a. CNSs

W

b. APNs

KS

c. SCCMs

N

d. AACNs

BA

ANS: A

ST

CNSs serve in specialty roles that use their clinical, teaching, research, leadership, and

TE

consultative abilities. They are instrumental in ensuring that care is evidence based and that safety programs are in place. APNs have a broad depth of knowledge and expertise in their

G

specialty area and manage complex clinical and systems issues. SCCM stands for the Society of

SI

N

Critical Care Medicine. AACN is the American Association of Critical-Care Nurses.

U

.N

a. CNS

R

4. The _____ administers many critical care certifications exams for registered nurses.

b. APN

W W W

c. SCCM

d. AACN

ANS: D

AACN is the American Association of Critical-Care Nurses. CNSs serve in specialty roles that use their clinical, teaching, research, leadership, and consultative abilities. They are instrumental

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in ensuring that care is evidence based and that safety programs are in place. APNs have a broad depth of knowledge and expertise in their specialty area and manage complex clinical and systems issues. SCCM stands for the Society of Critical Care Medicine.

.C

interdependent and inseparable. This statement describes which methodology of care?

O M

5. Emphasis is on human integrity and stresses the theory that the body, mind, and spirit are

LD

a. Holistic care b. Individualized care

O R

c. Cultural care

W

d. Interdisciplinary care

KS

ANS: A

N

Holistic care focuses on human integrity and stresses that the body, mind, and spirit are

BA

interdependent and inseparable. Individualized care recognizes the uniqueness of each patients

ST

preferences, condition, and physiologic and psychosocial status. Cultural diversity in health care is not a new topic, but it is gaining emphasis and importance as the world becomes more

TE

accessible to all as the result of increasing technologies and interfaces with places and peoples.

Interdisciplinary care is care among a variety of health care professionals with the patients health

N

G

as the common goal.

U

R

that are known as

SI

6. The AACN has developed short directives that can be used as quick references for clinical use

.N

a. Critical Care Protocol.

W W W

b. Practice Policies. c. Evidence-Based Research. d. Practice Alerts.

ANS: D

The AACN has promulgated several evidence-based practice summaries in the form of Practice Alerts. Evidence-based nursing practice considers the best research evidence on the care topic

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along with clinical expertise of the nurse, and patient preferences. Critical care protocol and practice policies are established by individual institutions.

7. A specific therapy or care that is an option to what is considered conventional treatment of a

O M

condition is known as

.C

a. Guided Imagery.

LD

b. holistic care. c. complementary care.

O R

d. individualized care.

KS

W

ANS: C

Complementary therapies offer patients, families, and health care providers additional options to

N

assist with healing and recovery. The term complementary was proposed to describe therapies

BA

that can be used to complement or support conventional treatments.

ST

8. Animal assisted, guided imagery, and massage are all examples of

TE

a. alternative therapy.

R

SI

d. individualized care.

N

c. complementary care.

G

b. holistic care.

.N

U

ANS: C

W W W

The term complementary was proposed to describe therapies that can be used to complement or support conventional treatments. Spirituality, prayer, guided imagery, massage, and animalassisted therapy are all examples of complementary care. Alternative denotes that a specific

therapy is an option or alternative to what is considered conventional treatment of a condition or state. Holistic care focuses on human integrity and stresses that the body, mind, and spirit are interdependent and inseparable. Individualized care recognizes the uniqueness of each patients preferences, condition, and physiologic and psychosocial status.

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9. A patient was admitted to a rural ICU in Montana. Critical care nurses are assisting with monitoring and care of the patient from the closest major city. This is an example of a. telemedicine.

O M

b. tele-ICU.

.C

c. tele-informatics.

LD

d. tele-hospital.

O R

ANS: B

Telemedicine was initially used in outpatient areas, remote rural geographic locations, and areas

W

where there was a dearth of medical providers. Currently, there are tele-ICUs in areas where

KS

there are limited resources onsite. However, experts (critical care nurses, intensivists) are located

N

in a central distant site.

ST

shared values best describes the concept of

BA

10. Working with individuals of other professions to maintain a climate of mutual respect and

TE

a. interprofessional teamwork and team-based care. b. values and ethics for interprofessional practice.

G

c. interprofessional communication.

SI

N

d. roles and responsibilities for collaborative practice.

U

R

ANS: B

.N

Values and ethics for interprofessional practice mean working with individuals of other

W W W

professions to maintain a climate of mutual respect and shared values. Roles and responsibilities for collaborative practice include using knowledge of ones own role and the roles of other professions to appropriately assess and address the health care needs of the patients and populations served. Interprofessional communication includes communicating with patients, families, communities, and other health professionals in a responsive and responsible manner that supports a team approach to maintaining health and treatment of disease. Interprofessional teamwork and team-based care means applying relationship-building values and principles of

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team dynamics to perform effectively in different team roles to plan and deliver patient population-centered care that is safe, timely, efficient, effective, and equitable.

O M

11. A stepwise decision-making flowchart for a specific care process is known as a(n) a. algorithm.

.C

b. practice guideline.

LD

c. protocol.

O R

d. order set.

W

ANS: A

KS

An algorithm is a stepwise decision-making flowchart for a specific care process or processes. A practice guideline is usually created by an expert panel and developed by a professional

N

organization. Protocols are more directive and rigid than guidelines, and providers are not

BA

supposed to vary from a protocol. An order set consists of preprinted provider orders that are

ST

used to expedite the order process after a standard has been validated through analytical review

TE

of practice and research.

12. _____ continues to be one of the most error-prone nursing interventions for critical care

SI

a. Inappropriate care

N

G

nurses.

R

b. Intimidating and disruptive clinician behavior

U

c. Injury to patients by falls

W W W

.N

d. Medication administration ANS: D

Medication administration continues to be one of the most error-prone nursing interventions for critical care nurses. Intimidating and disruptive clinician behaviors can lead to errors and preventable adverse patient outcomes. Patient safety has been described as an ethical imperative and one that is inherent in health care professionals actions and interpersonal processes; examples include inappropriate care and injury to patients by falls.

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MULTIPLE RESPONSE 1. Evidence-based nursing practice takes into account (Select all that apply)

O M

a. clinical expertise of the nurse. b. availability of staff and facility equipment.

.C

c. research evidence on the topic.

LD

d. patient knowledge of the disease.

O R

e. patient preference regarding care

W

ANS: A, C, E

KS

Evidence-based nursing practice considers the best research evidence on the care topic along with clinical expertise of the nurse and patient preferences. For instance, when determining the

N

frequency of vital sign measurement, the nurse would use available research and nursing

BA

judgment (stability, complexity, predictability, vulnerability, and resilience of the patient).

ST

Availability of staff and facility equipment and the patients knowledge of the disease do not

TE

factor into evidence-based nursing practices.

2. According to Kupperschmidt, to become a skilled communicator, one must (Select all that

N

G

apply)

SI

a. become candid.

R

b. become reflective.

U

c. set goals and develop action plans.

.N

d. survey the team.

W W W

e. become aware of self-deception.

ANS: A, B, E Kupperschmidt and colleagues posed a five-factor model for becoming a skilled communicator: becoming aware of self-deception, becoming authentic, becoming candid, becoming mindful, and becoming reflective, all of which lead to being a skilled communicator. The HWE model was offered by Blake, who suggested five steps: rallying the team, surveying the team,

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establishing work groups, setting goals and developing action steps, and celebrating successes along the way.

O M

Chapter 2: Ethical and Legal Issues

.C

MULTIPLE CHOICE

LD

1. The difference between ethics and morals is that ethics

O R

a. is more concerned with the why of behavior.

W

b. provides a framework for evaluation of the behavior.

KS

c. is broader in scope than morals.

N

d. concentrates on the right or wrong behavior based on religion and culture values.

BA

ANS: A

ST

Ethics are concerned with the basis of the action rather than whether the action is right or wrong,

TE

good or bad.

2. A clients wife has been informed by the physician that her spouse has a permanent C2C3

G

spinal injury, which has resulted in permanent quadriplegia. The wife states that she does not

N

want the physician or nursing staff to tell the client about his injury. The client is awake, alert,

SI

and oriented when he asks his nurse to tell him what has happened. The nurse has conflicting

U

R

emotions about how to handle the situation and is experiencing

.N

a. autonomy.

W W W

b. moral distress. c. moral doubt. d. moral courage.

ANS: B The nurse has been placed in a situation initially causing moral distress and is struggling with determining the ethically appropriate action to take. Moral courage is the freedom to advocate

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for oneself, patients, and peers. Autonomy is an ethical principle. Moral doubt is not part of the AACN framework The 4As to Rise Above Moral Distress.

O M

3. Critical care nurses can best enhance the principle of autonomy by a. presenting only the information to prevent relapse in a patient.

.C

b. assisting with only tasks that cannot be done by the patient.

LD

c. providing the patient with all of the information and facts.

O R

d. guiding the patient toward the best choices for care.

W

ANS: C

KS

Clients and families must have all the information about a certain situation to make an

N

autonomous decision that is best for them.

BA

4. Which of the following ethical principles is most important when soliciting informed consent

ST

from a client? a. Nonmaleficence

TE

b. Fidelity

G

c. Beneficence

SI

N

d. Veracity

U

R

ANS: D

.N

Veracity is important when soliciting informed consent because the client needs to be aware of

W W W

all potential risks of and benefits to be derived from specific treatments or their alternatives.

5. Fidelity includes faithfulness and promise-keeping to clients, and it incorporates the added concepts of a. confidentiality and privacy. b. truth and reflection. c. autonomy and paternalism.

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d. beneficence and nonmaleficence.

ANS: A

O M

Confidentiality is a right involving the sharing of client information with only those involved in

the clients care. Privacy includes confidentiality but goes further to include the right to privacy of

.C

person and personal space, such as ensuring that a client is adequately covered during a

LD

procedure.

O R

6. Which statement best reflects the concept of allocation of resources within the critical care

W

setting?

a. Limitations of resources force reexamination of goals of critical care for clients.

KS

b. Care is provided equally to all those who need the resources.

N

c. Equal access is available for those with the same condition or diagnosis.

BA

d. Technologic advances are available to most of those in a given community.

ST

ANS: A

TE

Limited resources force society and critical care health practitioners to reexamine goals of

N

G

critical care for clients.

SI

7. When deciding whether to withdraw or withhold treatment, it is important to

R

a. examine ones own beliefs to guide the family to a correct decision.

.N

U

b. approach the family with honesty and provide clear information. c. simply follow the advance directive if available.

W W W

d. allow the physician to approach the family.

ANS: B

This is a difficult time, and the nurse needs to be attuned to the familys needs by providing timely information, honesty, and clear treatment options and by listening to the family.

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8. The Code of Ethics for Nursing provides a framework for the nurse in ethical decision making and

b. allows the nurse to focus on the good of society rather than the uniqueness of the client.

.C

c. was recently adopted by the American Nurses Association.

O R

LD

d. provides society with a set of expectations of the profession.

ANS: D

O M

a. is usurped by state or federal laws.

W

The Code of Ethics for Nursing provides a framework for the nurse to follow in ethical decision

KS

making and provides society with a set of expectations of the profession.

BA

N

9. Ethical decisions are best made by a. following the guidelines of a framework or model.

ST

b. having the client discuss alternatives with the physician or nurse.

TE

c. prioritizing the greatest good for the greatest number of persons.

N

G

d. careful consideration by the Ethics Committee after all diagnostic data are reviewed.

SI

ANS: A

R

To facilitate the ethical decision-making process, a model or framework must be used so that all

.N

W W W

care.

U

involved will consistently and clearly examine the multiple ethical issues that arise in critical

10. The first step of the ethical decision-making process is a. consulting with an authority. b. identifying the health problem. c. delineating the ethical problem from other types of problems. d. identifying the client as the primary decision maker.

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ANS: B Step one involves identifying the major aspects of the clients medical and health problems.

Consulting an authority is not always necessary in the process. Delineating the ethical problem

O M

from other types of problems may not be necessary. Identification of the client as primary

.C

decision maker is not part of the process.

LD

11. Values clarification can assist the client to clarify his or her own values to facilitate effective

O R

decision making. Which of the following nursing activities is incorporated into this intervention? a. Avoid the use of open-ended questions.

W

b. Use multiple sessions to cross-examine the client to ensure he or she is clear about personal values.

N

KS

c. Use appropriate questions to assist the client in reflecting on the situation and what is personally important.

ST

BA

d. Encourage members of the health care team to relate how they would make the decision.

TE

ANS: C

As a patient advocate, the nurse provides more information as needed, clarifies points, reinforces

N

G

information, and provides support during the decision-making process.

SI

12. Institutional ethics committees (IECs) review ethical cases that are problematic for the

R

practitioner. Major functions of IECs include

.N

U

a. consultation with purely binding recommendations.

W W W

b. support and education to health care providers. c. conflict resolution for moral dilemmas. d. recommendations that are binding in all cases.

ANS: B

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The IEC can function in a variety of ways, serving as consultants, providing education, and helping resolve ethical conflicts or dilemmas for health care providers. Recommendations from the formal IEC may or may not be binding and are relative to the situation at hand.

O M

13. In the ethical decision-making process, after the identification of alternative options has been

.C

established,

LD

a. an outcome for each action must be predicted.

c. the choice of one option compromises the option not chosen.

O R

b. the team must determine which options to present to the patient or family.

W

d. no action is not an option in this step of the decision-making process.

KS

ANS: A

N

After the identification of alternative options, the outcome of each action must be predicted.

BA

Consideration also must be given to the no action option, which is another choice.

ST

14. A clients wife has been informed by the physician that her spouse has a permanent C2C3

TE

spinal injury, which has resulted in permanent quadriplegia. The wife states that she does not want the physician or nursing staff to tell the client about his injury. The client is awake, alert,

G

and oriented when he asks his nurse to tell him what has happened. Based on which ethical

SI

N

principles does the nurse answer the patients questions?

R

a. Veracity

U

b. Justice

.N

c. Autonomy

W W W

d. Nonmaleficence ANS: C

Autonomy is a freedom of choice or a self-determination that is a basic human right. It can be experienced in all human life events.

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Priorities in Critical Care Nursing 8th edition Urden Stacy Lough Test Bank Full ACCESS Test Bank From Link Below https://nursylab.com/products/priorities-in-critical-care-nursing -8th-edition-urden-stacy-lough-test-bank/ TestBank Directly From The publisher, 100% Verified Answers.

COVERS ALL CHAPTERS. Download Immediately

https://nursylab.com/products/priorities-in-critical-care-nursing-8th-edition-urden-stacy-lough-test-bank/