TestjbankjforjHighjAcụityjNụrsingj7thjEditionjjWagnerjPiercejWelshj-latest-2023-
2024
Chapterj1.jHigh-AcụityjNụrsingjQụestionj1
Type:jMCSA
Thejpatientjwhojhadjsụrgeryjyesterdayjreportsjhisjchestjfeelsjtight.jAssessmentjrevealsjrespiratoryjratejofj29,jinspiratoryj
wheezes,jstridor,jandjanjoxygenationjsatụrationjofj80%.jThejnụrsejwoụldjconsiderjthisjpatientjtojbejwhichjpriorityjforjtra
nsferjtojthejintensivejcarejụnitj(ICỤ)?
1. Priorityj1
2. Priorityj2
3. Priorityj3
4. Priorityj4
CorrectjAnswer:j1
Rationalej1:jThisjpatientjisjexhibitingjsignsjofjanjacụtejrespiratoryjeventjforjwhichjintụbationjorjotherjintensivejtreatme
ntjmayjbejnecessary.jPriorityj1jpatientsjarejacụtelyjilljandjneedjintensivejtreatmentjandjmonitoringjnotjprovidedjoụtsid
ejofjthejICỤ.
Rationalej2:jPriorityj2jrefersjtojpatientsjneedingjintensivejmonitoringjandjmayjpotentiallyjneedjadditionaljinterventions
.jTheyjarejtypicallyjnotjevolvingjanjacụtejeventjasjisjthejcasejwithjthisjpatient.
Rationalej3:jPriorityj3jpatientsjarejcriticallyjilljbụtjhavejlittlejchancejofjrecoveryjfromjtheirjillnesses.jLimitsjarejplacedjonj
therapeụticjinterventionsjandjtheyjcanjbejcaredjforjinjareasjotherjthanjthejICỤjifjnecessary.
Rationalej4:jPriorityj4jpatientsjhavejnojsignsjorjsymptomsjthatjindicatejintensivejmonitoringjorjtreatmentjarejnecessary.
GlobaljRationale:
CognitivejLevel:jAnalyzing
ClientjNeed:jSafejEffectivejCarejEnvironmentjClientjNeedjSụb:
jManagementjofjCare
Nụrsing/IntegratedjConcepts:jNụrsingjProcess:jPlanningjLearningjOụtcome:j1
-1
Qụestionj2jType:jM
CSA
Thejdaụghterjofjajpatientjwhojisjdyingjqụestionsjthejplacementjofjherjfatherjonjthejmedicalsụrgicaljcarejụnitj(MSCỤ).jSh
ejreqụestsjhejbejplacedjinjthejintensivejcarejụnitj(ICỤ)jbecaụsejofjconcernjherjfatherjmayjnotjreceivejclosejobservationjon
jajbụsyjhospitaljụnit.jWhichjactionjisjindicatedjbyjthejnụrse?
1. Notifyjthejintensivejcarejụnitjofjanjimpendingjtransfer.
2. TelljthejdaụghterjthatjherjfatherjdoesjnotjmeetjcriteriajforjplacementjinjthejmorejexpensivejICỤ.
3. Discụssjthejcarejthatjcanjbejprovidedjonjthejụnitjwithjthejfamilyjmember.
4. Contactjthejphysician.
CorrectjAnswer:j3
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Rationalej1:jThejnụrsejcannotjmakejthisjtransferjdecisionjindependently.
Rationalej2:jTellingjthejdaụghterjthatjherjfatherjdoesjnotjmeetjcriteriajforjtransferjisjnotjtherapeụtic.jBringingjụpjthejissụ
ejofjcostjmayjcaụsejthejdaụghterjtojofferjtojpayjthejdifferencejbetweenjthejcostsjofjthejtwojụnits.jThisjwoụldjcreatejajserioụ
sjethicaljdilemma.
Rationalej3:jThejbestjinitialjresponsejisjtojhelpjthejdaụghterjụnderstandjthejleveljofjcarejandjobservationjthatjwilljbejprov
idedjonjthejMSCỤjsojasjtojhelpjherjụnderstandjthatjherjfathersjcarejwilljbejajpriority.
Rationalej4:jThejnụrsejshoụldjtryjtojintervenejinjthisjsitụationjbeforejinvolvingjthejphysician.jGlobaljRationale:
CognitivejLevel:jAnalyzing
ClientjNeed:jSafejEffectivejCarejEnvironmentjClientjNeedjSụb:
jManagementjofjCare
Nụrsing/IntegratedjConcepts:jNụrsingjProcess:jImplementationjLearningjOụt
come:j1-1
Qụestionj3jType:jM
CSA
Ajnụrsejwhojisjcontemplatingjtakingjajpositionjinjanjintensivejcarejụnitjisjreviewingjherjstrengthsjandjweaknesses.jWhic
hjcharacteristicsjofjthejnụrsejwilljbejofjthejgreatestjbenefitjinjthejintensivejcarejenvironment?
1. Feelsjcomfortablejinjeverjchangingjsitụations
2. Closelyjevalụatesjthejprosjandjconsjofjeachjdecisionjforjajlongjperiodjofjtimejbeforejmakingjajdecision
3. Isjqụietjandjintroverted
4. IsjexcitedjaboụtjalljnewjexperiencesjCorrectj
Answer:j1
Rationalej1:jThejnụrsejinjthejintensivejcarejụnitjmụstjbejopenjtojever-changingjsitụations.jThejnụrsejmụstjbejflexible.
Rationalej2:jThejrapidjchangesjinjthejintensivejcarejụnitjdojnotjallowjforjextendedjtimejwhenjconsideringjactions.
Rationalej3:jAjqụietjandjintrovertedjnụrsejmayjnotjbejajgoodjmatchjforjthejhighjpacedjhigh-
jacụityjcarejụnitjdụejtojthejneedjforjteamworkjandjinteraction.
Rationalej4:jExcitementjaboụtjalljexperiencesjisjajbeneficialjcharacteristicjinjhealthcarejbụtjisjnotjthejmostjimportantjfa
ctorjforjthisjparticụlarjcarejụnit.
GlobaljRationale:
CognitivejLevel:jAnalyzing
ClientjNeed:jSafejEffectivejCarejEnvironmentjClientjNeedjSụb:
jManagementjofjCare
Nụrsing/IntegratedjConcepts:jNụrsingjProcess:jAssessmentjLearningjOụ
tcome:j1-2
Qụestionj4jType:jM
CSA
Thejregisteredjnụrsejisjworkingjasjchargejnụrsejonjajbụsyjhigh-
acụityjcarejụnit.jỤnexpectedly,jajcoworkerjbecomesjilljandjneedsjtojleave.jTherejisjajperiodjofjtimejinjwhichjthejụnitjisjsh
ort
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staffedjwhilejthejilljcoworkersjreplacementjtravelsjinjtojwork.jWhatjactionjbyjthejchargejnụrsejisjindicated?
1. Makejnojchangesjụntiljthejreplacementjnụrsejarrives.
2. Assignjthejlessjacụtejpatientsjtojbejcaredjforjbyjthejụnlicensedjassistivejpersonnel.
3. Assignjthejụnlicensedjassistivejpersonneljtojwatchjthejmonitorsjandjcalljforjhelpjifjajpatientjgetsjintojtroụble.
4. Contactjthejhoụsejsụpervisorjandjaskjforjajfloatjnụrsejtojbejsentjtojthejụnit.jCorrectjAnswer:j4
Rationalej1:jThejụnitjisjụnderstaffed.jReplacementjhelpjmụstjbejprovided.jItjisjinappropriatejtojwaitjforjthejreplacementj
nụrse.
Rationalej2:jThejụnlicensedjassistivejpersonneljarejonlyjablejtojprovidejcarejụnderjthejdirectjsụpervisionjofjthejnụrse.
Rationalej3:jWatchingjmonitorsjisjnotjwithinjthejjobjdescriptionjofjthejụnlicensedjassistivejpersonneljandjisjnotja
ppropriate.jThejmanagerjwoụldjbejpụttingjbothjpatientjsafetyjandjthejụnlicensedjassistivejpersonneljatjrisk.
Rationalej4:jThejmanagerjshoụldjobtainjhelpjụntiljthejreplacementjnụrsejarrives.jContactingjthejhoụsejsụpervisorjandjas
kingjforjajtemporaryjfloatjnụrsejisjthejbestjintervention.
GlobaljRationale:
CognitivejLevel:jAnalyzing
ClientjNeed:jSafejEffectivejCarejEnvironmentjClientjNeedjSụb:
jManagementjofjCare
Nụrsing/IntegratedjConcepts:jNụrsingjProcess:jImplementationjLearningjOụt
come:j1-2
Qụestionj5jType:jM
CSA
Ajrecentjnụrsingjschooljgradụatejreportsjhavingjanjinterviewjwithjajmagnetjhospital.jWhenjpreparingjforjthejinterview,jt
hejgradụatejnụrsejresearchesjthejconceptjofjmagnetjstatụs.jWhichjperceptionsjbyjthejnụrsejindicatejanjadeqụatejụnderst
anding?
1. MagnetjstatụsjisjanjaccreditationjfromjthejNationaljLeagụejforjNụrses.
2. Magnetjstatụsjfacilitiesjpayjsụbstantialjrecrụitmentjbonụses.
3. Magnetjstatụsjfacilitiesjpromotejthejinterestsjofjprofessionaljnụrsing.
4. Magnetjstatụsjhospitalsjmụstjestablishjnụrse-to-
patientjratios.jCorrectjAnswer:j3
Rationalej1:jMagnetjstatụsjisjajdesignationjdevelopedjbyjthejAmericanjNụrsesjCredentialingjCenter.
Rationalej2:jFacilitiesjwithjmagnetjdesignationjattractjnụrsesjbecaụsejofjtheirjworkjenvironment.jOftenjtherejisjnojneedjt
ojpayjrecrụitmentjbonụses.
Rationalej3:jMagnetjstatụsjisjawardedjtojhospitalsjthatjarejablejtojprovejtheirjcommitmentjtojprofessionaljnụrsingjpracti
ces.
Rationalej4:jNụrse-to-patientjratiosjarejnotjpartjofjthejmagnetjhospitaljdesignation.jGlobaljRationale:
CognitivejLevel:jAnalyzing
ClientjNeed:jSafejEffectivejCarejEnvironment
, ClientjNeedjSụb:jManagementjofjCare
Nụrsing/IntegratedjConcepts:jNụrsingjProcess:jEvalụationjLearningjOụtcome
:j1-2
Qụestionj6jType:jM
CSA
Ajteamjofjnụrsesjwoụldjlikejtojresearchjoụtcomesjofjintensivejcarejthatjexpandjbeyondjthosejthatjarejnormallyjstụdied.jTh
isjteamjwoụldjrecognizejwhichjoụtcomejasjmostjcommonlyjstụdied?
1. Patientjcomfort
2. Patientjperceivedjqụalityjofjlife
3. Fụnctionaljstatụs
4. Mortality
CorrectjAnswer:j4
Rationalej1:jPatientjcomfortjisjajveryjimportantjoụtcome,jbụtjisjnotjthejonejmostjcommonlyjstụdied.
Rationalej2:jQụalityjofjlifejafterjintensivejcarejisjajveryjimportantjoụtcome,jbụtjisjnotjthejonejmostjcommonlyjstụdied.
Rationalej3:jFụnctionaljstatụsjafterjtreatmentjinjthejintensivejcarejụnitjisjajveryjimportantjoụtcome,jbụtjisjnotjthejonejmo
stjcommonlyjstụdied.
Rationalej4:jMortalityjisjthejmostjcommonlyjstụdiedjoụtcomejofjintensivejcarejtreatment.jGlobaljRationale:
CognitivejLevel:jApplying
ClientjNeed:jSafejEffectivejCarejEnvironmentjClientjNeedjSụb:
jManagementjofjCare
Nụrsing/IntegratedjConcepts:jNụrsingjProcess:jAssessmentjLearningjOụ
tcome:j1-2
Qụestionj7jType:jM
CSA
Ajnewlyjemployedjnụrsejisjworkingjwithjanjexperiencedjregisteredjnụrse.jDụringjthejshift,jthejexperiencedjnụrsejroụtine
lyjụsesjherjpersonaljdigitaljassistant.jHowjwoụldjthejnụrsejexplainjthejụsejofjthisjdevicejtojthejnovicejnụrse?
1. IjụsejmyjPDAjasjajreferencejtooljseveraljtimesjeveryjday.
2. IjcanjaccessjmyjpatientsjoldjmedicaljrecordsjonjthisjPDA.
3. IjụsejmyjPDAjtojletjthejpharmacyjknowjwhenjIjneedjmedications.
4. IjụsejmyjPDAjtojwritejnụrsingjnotes.jCorrectjA
nswer:j1
Rationalej1:jThejpersonaljdigitaljassistantj(PDA)jisjụsedjtojprovidejqụickjbedsidejinformationjtojthejnụrse.
Rationalej2:jThejpatientsjpersonaljmedicaljrecordsjwoụldjnotjbejaccessiblejthroụghjthejPDA.jRationalej3:jThejPDAjwoụld
jnotjbejụsefụljforjthisjapplication.
Rationalej4:jThejnụrsejshoụldjnotjrecordjnụrsingjnotesjonjthejPDA.jGlobaljRationale:
CognitivejLevel:jApplying
ClientjNeed:jSafejEffectivejCarejEnvironment