ADULT HEALTH NURSING III 2026
CERTIFICATION EVALUATION EXAM
QUESTIONS AND ANSWERS MASTER FILE
◉ PCU vs ICU. Answer: -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. Answer: #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. Answer: -information
,-reassurance
-access
They need these bc without them they feel powerless and will show
signs of this
◉ Unstable client S/S. Answer: -↓ 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. Answer: 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
-O2 airway management
-12 EKG
-labs, meds
-critical thinking in action, contact the provider fast
◉ Palliative care vs hospice. Answer: 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. Answer: 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
-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
CERTIFICATION EVALUATION EXAM
QUESTIONS AND ANSWERS MASTER FILE
◉ PCU vs ICU. Answer: -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. Answer: #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. Answer: -information
,-reassurance
-access
They need these bc without them they feel powerless and will show
signs of this
◉ Unstable client S/S. Answer: -↓ 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. Answer: 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
-O2 airway management
-12 EKG
-labs, meds
-critical thinking in action, contact the provider fast
◉ Palliative care vs hospice. Answer: 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. Answer: 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
-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
