NSG 430 EXAM 1 QUESTIONS AND
ANSWERS GRADED A+ 2026
Patient stability - ANS -mild signs of deterioration: mild confusion, tachypnea
-6-8 hours before cardiac or respiratory arrest
PCU vs ICU - ANS -ICU nursing is delivering ICU care to patients wherever they may be
-PCU is progressive care units (intermediate or step down) that provide transition between ICU
and general care unit
>at risk for serious complications
Complexity of unstable clients - ANS #1: physiologically unstable
-critical analysis and decision making
#2: risk of complications
-frequent assess and treatments, high risk of delirium
#3: IV polypharmacy-titration
-vasoactive, thrombolytics, sedation, insulin, nutrition
#4: advanced tachnology/devices
-vents, ICP, svO2, CCRT
#5 psychosocial, ethical and safety concerns
Needs of caregivers - ANS -information
-reassurance
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 1
,-access
They need these bc without them they feel powerless and will show signs of this
Unstable client S/S - ANS -↓ Level of consciousness, Anxiety, Confusion, Weakness,
Restlessness
Feeling of impending doom
-Cool, clammy skin, Pallor, Cyanosis
-Dysrhythmias, Tachycardia
-Hypotension, Narrowed pulse pressure
-Rapid, weak, thready pulses
-Tachypnea, dyspnea, or shallow, irregular respirations
-↓ O2 saturation
-Temperature dysregulation• Chills
-Obvious hemorrhage or injury, Nausea and vomiting
Rapid response - ANS FUNCTIONS
-identification and activation on client deterioration
-initiate response for assessment, intervention, triage
-bedside nurse gives SBAR!
FAILURE TO RECOGNIZE
-failure to recognize changes, diagnostics, clinical deviations from normal, lack of nurse intuition
TEAM
-respiratory ventilates
-nursing supervisor is general support
-provider is hospitalist
-ICU nurse and assigned client nruse
PROTOCOLS
-begin tx before provider arrives
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 2
,-O2 airway management
-12 EKG
-labs, meds
-critical thinking in action, contact the provider fast
Palliative care vs hospice - ANS PALLIATIVE
-*begins during RESTORATIVE or curative health care
-indication: diagnosis of a life-limiting illness
HOSPICE
-life expectancy is 6 months or less
-requires physician certification
END OF LIFE CARE GOALS
-when death is imminent
-provide comfort, improve quality of remaining life, ensure dignified death
End of life - ANS MANIFESTATIONS
-decreased metabolism, body function
-respiration ceases first, heart stops beating after a few mins
-slow, irregular breathing, cheyne-stokes respirations
-inability to cough or clear secretions (death rattle= grunting, gurgling, congested breathing)
-*hearing is the last sense to disappear
-decreased sensation, perception of pain and touch
-blurred vision, absent blink reflex, patient appears to stare, eyelids half open
-decreased taste and smell
-mottling on hands, feet, arms, legs
-cold and clammy skin
-cyanosis of nose, nail beds, knees
-*waxlike skin when very near death
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 3
, -gradual urinary output decrease, incontinent of urine, unable to urinate
-slowing of GI, accumulation of gas, distention and nausea
-loss of sphincter control
-bowel movement may occur at death
-trouble holding bosy posture and alignment
-loss of facial muscle time: sagging jaw, difficulty speaking, loss of gag reflex, swallowing is
difficult
-increased heart rate, then later slowing and weakend pulse
-irregular rhythm of heart, decreased BP, delayed absorption of IM or SQ drugs
PSYCHOSOCIAL MANIFESTATIONS
-altered decision making
-anxiety, fear- spirituality associated with decreased dispair
-life review
-peacefulness, saying goodbyes, withdrawal
End of life cont. - ANS -pay attention to nonverbal cues
-provide culturally competent care
-decisional capacity: ability to consent and refuse care (organ tissue donate, advance directives,
resuscitation, etc)
-organ donation: with persons consent before death and family permission after death
-physician assisted suicide: hastens death
Nursing management and role of nurse for end of life care - ANS -relieve suffering
-clarify misunderstanding about use of pain meds. addiction is not a concern when providing
comfort for terminally ill.
-double effect: morally permissible to give a med that has potential for harm if given to relieve
pain but *not intended to hasten death
GUIDES TO CARE
-code of ethics for nurses- relieve suffering
-principle of beneficence- care is provided to benefit
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 4
ANSWERS GRADED A+ 2026
Patient stability - ANS -mild signs of deterioration: mild confusion, tachypnea
-6-8 hours before cardiac or respiratory arrest
PCU vs ICU - ANS -ICU nursing is delivering ICU care to patients wherever they may be
-PCU is progressive care units (intermediate or step down) that provide transition between ICU
and general care unit
>at risk for serious complications
Complexity of unstable clients - ANS #1: physiologically unstable
-critical analysis and decision making
#2: risk of complications
-frequent assess and treatments, high risk of delirium
#3: IV polypharmacy-titration
-vasoactive, thrombolytics, sedation, insulin, nutrition
#4: advanced tachnology/devices
-vents, ICP, svO2, CCRT
#5 psychosocial, ethical and safety concerns
Needs of caregivers - ANS -information
-reassurance
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 1
,-access
They need these bc without them they feel powerless and will show signs of this
Unstable client S/S - ANS -↓ Level of consciousness, Anxiety, Confusion, Weakness,
Restlessness
Feeling of impending doom
-Cool, clammy skin, Pallor, Cyanosis
-Dysrhythmias, Tachycardia
-Hypotension, Narrowed pulse pressure
-Rapid, weak, thready pulses
-Tachypnea, dyspnea, or shallow, irregular respirations
-↓ O2 saturation
-Temperature dysregulation• Chills
-Obvious hemorrhage or injury, Nausea and vomiting
Rapid response - ANS FUNCTIONS
-identification and activation on client deterioration
-initiate response for assessment, intervention, triage
-bedside nurse gives SBAR!
FAILURE TO RECOGNIZE
-failure to recognize changes, diagnostics, clinical deviations from normal, lack of nurse intuition
TEAM
-respiratory ventilates
-nursing supervisor is general support
-provider is hospitalist
-ICU nurse and assigned client nruse
PROTOCOLS
-begin tx before provider arrives
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 2
,-O2 airway management
-12 EKG
-labs, meds
-critical thinking in action, contact the provider fast
Palliative care vs hospice - ANS PALLIATIVE
-*begins during RESTORATIVE or curative health care
-indication: diagnosis of a life-limiting illness
HOSPICE
-life expectancy is 6 months or less
-requires physician certification
END OF LIFE CARE GOALS
-when death is imminent
-provide comfort, improve quality of remaining life, ensure dignified death
End of life - ANS MANIFESTATIONS
-decreased metabolism, body function
-respiration ceases first, heart stops beating after a few mins
-slow, irregular breathing, cheyne-stokes respirations
-inability to cough or clear secretions (death rattle= grunting, gurgling, congested breathing)
-*hearing is the last sense to disappear
-decreased sensation, perception of pain and touch
-blurred vision, absent blink reflex, patient appears to stare, eyelids half open
-decreased taste and smell
-mottling on hands, feet, arms, legs
-cold and clammy skin
-cyanosis of nose, nail beds, knees
-*waxlike skin when very near death
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 3
, -gradual urinary output decrease, incontinent of urine, unable to urinate
-slowing of GI, accumulation of gas, distention and nausea
-loss of sphincter control
-bowel movement may occur at death
-trouble holding bosy posture and alignment
-loss of facial muscle time: sagging jaw, difficulty speaking, loss of gag reflex, swallowing is
difficult
-increased heart rate, then later slowing and weakend pulse
-irregular rhythm of heart, decreased BP, delayed absorption of IM or SQ drugs
PSYCHOSOCIAL MANIFESTATIONS
-altered decision making
-anxiety, fear- spirituality associated with decreased dispair
-life review
-peacefulness, saying goodbyes, withdrawal
End of life cont. - ANS -pay attention to nonverbal cues
-provide culturally competent care
-decisional capacity: ability to consent and refuse care (organ tissue donate, advance directives,
resuscitation, etc)
-organ donation: with persons consent before death and family permission after death
-physician assisted suicide: hastens death
Nursing management and role of nurse for end of life care - ANS -relieve suffering
-clarify misunderstanding about use of pain meds. addiction is not a concern when providing
comfort for terminally ill.
-double effect: morally permissible to give a med that has potential for harm if given to relieve
pain but *not intended to hasten death
GUIDES TO CARE
-code of ethics for nurses- relieve suffering
-principle of beneficence- care is provided to benefit
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 4
