Nr 341 Final
Exam 2022
Which of the following professional organizations best supports critical care
nursing practice?
a. American Association of Critical-Care Nurses
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine -ANS a
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. -ANS c
The family of your critically ill patient tells you that they have not spoken
with the physician in over 24 hours and they have some questions that they
want clarified. During morning rounds, you convey this concern to the
attending intensivist and arrange for her to meet with the family at 4:00 PM
in the conference room. Which competency of critical care nursing does this
represent?
a. Advocacy and moral agency in solving ethical issues
b. Clinical judgment and clinical reasoning skills
c. Collaboration with patients, families, and team members
d. Facilitation of learning for patients, families, and team members -ANS c
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 -ANS d
,The family members of a critically ill, 90-year-old patient bring in a copy of
the patient's living will to the hospital, which identifies the patient's wishes
regarding health care. You discuss contents of the living will with the
patient's physician. This is an example of implementation of which of the
AACN Standards of Professional Performance?
a. Acquires and maintains current knowledge of practice
b. Acts ethically on the behalf of the patient and family
c. Considers factors related to safe patient care
d. Uses clinical inquiry and integrates research findings in practice -ANS b
As part of nursing management of a critically ill patient, orders are written to
keep the head of the bed elevated at 30 degrees, awaken the patient from
sedation each morning to assess readiness to wean from mechanical
ventilation, and implement oral care protocols every 4 hours. These
interventions are done as a group to reduce the risk of ventilator-associated
pneumonia. This group of evidence-based interventions is often called a:
a. bundle of care.
b. clinical practice guideline.
c. patient safety goal.
d. quality improvement initiative. -ANS a
Which of the following statements describes the core concept of the synergy
model of practice?
a. All nurses must be certified in order to have the synergy model
implemented.
b. Family members must be included in daily interdisciplinary rounds.
c. Nurses and physicians must work collaboratively and synergistically to
influence care.
d. Unique needs of patients and their families influence nursing
competencies. -ANS d
Which of the following is a National Patient Safety Goal? (Select all that
apply.)
a. Accurately identify patients.
b. Eliminate use of patient restraints.
c. Reconcile medications across the continuum of care.
d. Reduce risks of healthcare-acquired infection. -ANS a,c,d
Which of the following nursing activities demonstrates implementation of the
AACN Standards of Professional Performance? (Select all that apply.)
a. Attending a meeting of the local chapter of the American Association of
Critical-Care Nurses in which a continuing education program on sepsis is
being taught
b. Collaborating with a pastoral services colleague to assist in meeting
spiritual needs of the patient and family
c. Participating on the unit's nurse practice council
,d. Posting an article from Critical Care Nurse on management of venous
thromboembolism for your colleagues to read
e. Using evidence-based strategies to prevent ventilator-associated
pneumonia -ANS a,b,c,d,e
Which scenarios contribute to effective handoff communication at change of
shift? (Select all that apply.)
a. The nephrology consultant physician is making rounds and asks you to
update her on the patient's status and assist in placing a central line for
hemodialysis.
b. The noise level is high because twice as many staff members are present
and everyone is giving report in the nurse's station.
c. The unit has decided to use a standardized checklist/tool for change-of-
shift reports and patient transfers.
d. You and the oncoming nurse conduct a standardized report at the patient's
bedside and review key assessment findings. -ANS c,d
Which strategy is important to addressing issues associated with the aging
workforce? (Select all that apply.)
a. Allowing nurses to work flexible shift durations
b. Encouraging older nurses to transfer to an outpatient setting that is less
stressful
c. Hiring nurse technicians that are available to assist with patient care, such
as turning the patient
d. Remodeling patient care rooms to include devices to assist in patient
lifting -ANS a,c,d
Which of the following strategies will assist in creating a healthy work
environment for the critical care nurse? (Select all that apply.)
a. Celebrating improved outcomes from a nurse-driven protocol with a pizza
party
b. Implementing a medication safety program designed by pharmacists
c. Modifying the staffing pattern to ensure a 1:1 nurse/patient ratio
d. Offering quarterly joint nurse-physician workshops to discuss unit issues
e. Using the Situation-Background-Assessment-Recommendation (SBAR)
technique for handoff communication -ANS a,d,e
The nurse is caring for a patient who is on a cardiac monitor. The nurse
realizes that the sinus node is the pacemaker of the heart because it is:
a. the fastest pacemaker cell in the heart.
b. the only pacemaker cell in the heart.
c. the only cell that does not affect the cardiac cycle.
d. located in the left side of the heart. -ANS A
The cardiac cycle begins with an impulse that is generated from a small
concentrated area of pacemaker cells high in the right atria called the
sinoatrial node (sinus node or SA node). The SA node has the fastest rate of
, discharge and thus is the dominant pacemaker of the heart. The AV node has
pacemaker properties and can discharge an impulse if the SA node fails. The
ventricles have pacemaker capabilities if the sinus node or the AV node
ceases to generate impulses.
One of the functions of the atrioventricular (AV) node is to:
a. pace the heart if the ventricles fail.
b. slow the impulse arriving from the SA node.
c. send the impulse to the SA node.
d. allow for ventricular filling during systole. -ANS b
The normal rate for the SA node when the patient is at rest is:
a. 40 to 60 beats per minute.
b. 60 to 100 beats per minute.
c. 20 to 40 beats per minute.
d. more than100 beats per minute. -ANS b
When assessing the 12-lead electrocardiogram (ECG) or a rhythm strip, it is
helpful to understand that the electrical activity is viewed in relation to the
positive electrode of that particular lead. When an electrical signal is aimed
directly at the positive electrode, the inflection will be:
a. negative.
b. upside down.
c. upright.
d. equally positive and negative. -ANS c
The nurse is examining the patient's cardiac rhythm strip in lead II and
notices that all of the P waves are upright and look the same except one that
has a different shape and is inverted. The nurse realizes that the P wave with
the abnormal shape is probably:
a. from the SA node since all P waves come from the SA node.
b. from some area in the atria other than the SA node.
c. indicative of ventricular depolarization.
d. normal even though it is inverted in lead II. -ANS b
Normally a P wave indicates that the SA node initiated the impulse that
depolarized the atrium. However, a change in the shape of the P wave may
indicate that the impulse arose from a site in the atria other than the SA
node. The P wave represents atrial depolarization. It is usually upright in
leads I and II and has a rounded, symmetrical shape. The amplitude of the P
wave is measured at the center of the waveform and normally does not
exceed three boxes, or 3 millimeters, in height.
The QT interval is the total time taken for ventricular depolarization and
repolarization. Prolongation of the QT interval:
a. decreases the risk of lethal dysrhythmias.
b. usually occurs when heart rate increases.
Exam 2022
Which of the following professional organizations best supports critical care
nursing practice?
a. American Association of Critical-Care Nurses
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine -ANS a
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. -ANS c
The family of your critically ill patient tells you that they have not spoken
with the physician in over 24 hours and they have some questions that they
want clarified. During morning rounds, you convey this concern to the
attending intensivist and arrange for her to meet with the family at 4:00 PM
in the conference room. Which competency of critical care nursing does this
represent?
a. Advocacy and moral agency in solving ethical issues
b. Clinical judgment and clinical reasoning skills
c. Collaboration with patients, families, and team members
d. Facilitation of learning for patients, families, and team members -ANS c
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 -ANS d
,The family members of a critically ill, 90-year-old patient bring in a copy of
the patient's living will to the hospital, which identifies the patient's wishes
regarding health care. You discuss contents of the living will with the
patient's physician. This is an example of implementation of which of the
AACN Standards of Professional Performance?
a. Acquires and maintains current knowledge of practice
b. Acts ethically on the behalf of the patient and family
c. Considers factors related to safe patient care
d. Uses clinical inquiry and integrates research findings in practice -ANS b
As part of nursing management of a critically ill patient, orders are written to
keep the head of the bed elevated at 30 degrees, awaken the patient from
sedation each morning to assess readiness to wean from mechanical
ventilation, and implement oral care protocols every 4 hours. These
interventions are done as a group to reduce the risk of ventilator-associated
pneumonia. This group of evidence-based interventions is often called a:
a. bundle of care.
b. clinical practice guideline.
c. patient safety goal.
d. quality improvement initiative. -ANS a
Which of the following statements describes the core concept of the synergy
model of practice?
a. All nurses must be certified in order to have the synergy model
implemented.
b. Family members must be included in daily interdisciplinary rounds.
c. Nurses and physicians must work collaboratively and synergistically to
influence care.
d. Unique needs of patients and their families influence nursing
competencies. -ANS d
Which of the following is a National Patient Safety Goal? (Select all that
apply.)
a. Accurately identify patients.
b. Eliminate use of patient restraints.
c. Reconcile medications across the continuum of care.
d. Reduce risks of healthcare-acquired infection. -ANS a,c,d
Which of the following nursing activities demonstrates implementation of the
AACN Standards of Professional Performance? (Select all that apply.)
a. Attending a meeting of the local chapter of the American Association of
Critical-Care Nurses in which a continuing education program on sepsis is
being taught
b. Collaborating with a pastoral services colleague to assist in meeting
spiritual needs of the patient and family
c. Participating on the unit's nurse practice council
,d. Posting an article from Critical Care Nurse on management of venous
thromboembolism for your colleagues to read
e. Using evidence-based strategies to prevent ventilator-associated
pneumonia -ANS a,b,c,d,e
Which scenarios contribute to effective handoff communication at change of
shift? (Select all that apply.)
a. The nephrology consultant physician is making rounds and asks you to
update her on the patient's status and assist in placing a central line for
hemodialysis.
b. The noise level is high because twice as many staff members are present
and everyone is giving report in the nurse's station.
c. The unit has decided to use a standardized checklist/tool for change-of-
shift reports and patient transfers.
d. You and the oncoming nurse conduct a standardized report at the patient's
bedside and review key assessment findings. -ANS c,d
Which strategy is important to addressing issues associated with the aging
workforce? (Select all that apply.)
a. Allowing nurses to work flexible shift durations
b. Encouraging older nurses to transfer to an outpatient setting that is less
stressful
c. Hiring nurse technicians that are available to assist with patient care, such
as turning the patient
d. Remodeling patient care rooms to include devices to assist in patient
lifting -ANS a,c,d
Which of the following strategies will assist in creating a healthy work
environment for the critical care nurse? (Select all that apply.)
a. Celebrating improved outcomes from a nurse-driven protocol with a pizza
party
b. Implementing a medication safety program designed by pharmacists
c. Modifying the staffing pattern to ensure a 1:1 nurse/patient ratio
d. Offering quarterly joint nurse-physician workshops to discuss unit issues
e. Using the Situation-Background-Assessment-Recommendation (SBAR)
technique for handoff communication -ANS a,d,e
The nurse is caring for a patient who is on a cardiac monitor. The nurse
realizes that the sinus node is the pacemaker of the heart because it is:
a. the fastest pacemaker cell in the heart.
b. the only pacemaker cell in the heart.
c. the only cell that does not affect the cardiac cycle.
d. located in the left side of the heart. -ANS A
The cardiac cycle begins with an impulse that is generated from a small
concentrated area of pacemaker cells high in the right atria called the
sinoatrial node (sinus node or SA node). The SA node has the fastest rate of
, discharge and thus is the dominant pacemaker of the heart. The AV node has
pacemaker properties and can discharge an impulse if the SA node fails. The
ventricles have pacemaker capabilities if the sinus node or the AV node
ceases to generate impulses.
One of the functions of the atrioventricular (AV) node is to:
a. pace the heart if the ventricles fail.
b. slow the impulse arriving from the SA node.
c. send the impulse to the SA node.
d. allow for ventricular filling during systole. -ANS b
The normal rate for the SA node when the patient is at rest is:
a. 40 to 60 beats per minute.
b. 60 to 100 beats per minute.
c. 20 to 40 beats per minute.
d. more than100 beats per minute. -ANS b
When assessing the 12-lead electrocardiogram (ECG) or a rhythm strip, it is
helpful to understand that the electrical activity is viewed in relation to the
positive electrode of that particular lead. When an electrical signal is aimed
directly at the positive electrode, the inflection will be:
a. negative.
b. upside down.
c. upright.
d. equally positive and negative. -ANS c
The nurse is examining the patient's cardiac rhythm strip in lead II and
notices that all of the P waves are upright and look the same except one that
has a different shape and is inverted. The nurse realizes that the P wave with
the abnormal shape is probably:
a. from the SA node since all P waves come from the SA node.
b. from some area in the atria other than the SA node.
c. indicative of ventricular depolarization.
d. normal even though it is inverted in lead II. -ANS b
Normally a P wave indicates that the SA node initiated the impulse that
depolarized the atrium. However, a change in the shape of the P wave may
indicate that the impulse arose from a site in the atria other than the SA
node. The P wave represents atrial depolarization. It is usually upright in
leads I and II and has a rounded, symmetrical shape. The amplitude of the P
wave is measured at the center of the waveform and normally does not
exceed three boxes, or 3 millimeters, in height.
The QT interval is the total time taken for ventricular depolarization and
repolarization. Prolongation of the QT interval:
a. decreases the risk of lethal dysrhythmias.
b. usually occurs when heart rate increases.
