Complete Introduction to Critical Care Nursing 8th Edition Sole Questions & Answers with rationales (Chapter 1 21) TESTBANK

Complete Introduction to Critical Care Nursing 8th Edition Sole Questions & Answers with rationales (Chapter 1 21) TESTBANK Chapter 01: Overview of Critical Care Nursing Sole: Introduction to Critical Care Nursing, 8th Edition MULTIPLE CHOICE 1. 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 American Association of Critical-Care Nurses is the Organization that supports and represents critical care nurses. The American Heart Association supports cardiovascular initiatives. The American Nurses Association supports all nurses. The Society of Critical Care Medicine represents the multi professional critical care team under the direction of an DIF: Cognitive Level: Knowledge OBJ: Discuss the purposes and functions of the professional Orgnization that support critical care practice. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 2. A nurse has been working as a staff nurse in the surgical me/tecsat re unit for 2 years and is interested in certification. Which credential would be most applicable for her to seek? a. ACNPC b. CCNS c. CCRN d. PCCN ANS: C The CCRN certification is appropriate for nurses in bedside practice who care for critically ill patients. The ACNPC certification is for acute care nurse practitioners. The CCNS certification is for critical care clinical nurse specialists. The PCCN certification is for staff nurses working in progressive care, intermediate care, or satbeiprb-.cdoomw/tenstunit settings. DIF: Cognitive Level: Application OBJ: Explain certification options for critical care nurses. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 3. What is the main purpose of certification for critical care nursing? a. To assure the consumer that critical nurses will not b. To help prepare the critical care nurse for graduate school. c. To assist in promoting magnet status for a facility. d. To validate a nurse’s knowledge of critical care nursing. ANS: D Certification assists in validating knowledge of the field, promotes excellence in the profession, and lOMoAR cPS D| helps nurses to maintain their knowledge of critical care nursing. Certification helps to assure the consumer that the nurse has a o/tefskt nowledge; however, it does not ensure that care will be mistake-free. Certification does not prepare one for graduate school; however, achieving certification demonstrates motivation for achievement and professionalism. Magnet facilities are rated on the number of certified nurses; however, that is not the purpose of certification. DIF: Cognitive Level: Analysis OBJ: Explain certification options for critical care nurses. MSC: NCLEX: Safe and Effective Care Environment 4. What is the focus of the synergy model of practice? a. Allowing unrestricted visiting for the patient 24 hours b. Providing holistic and alternative therapies. lOMoAR cPS D| c. Considering the needs of patients and their families, which drives nursing competency. d. Addressing the patients’ needs for energy and support. ANS: C The synergy model of practice states that the needs of d/tefsat milies influence and drive competencies of nurses. Nursing practice based on the synergy model would involve tailored visiting to meet the patient’s and family’s needs and application of alternative therapies if desired by the patient, but that is not the primary focus of the model. DIF: Cognitive Level: Application OBJ: Describe standards of professional practice for critical care nursing. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 5. 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 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 Although one might consider that all of these competencies are being addressed, communication and collaboration with the family and physician best exemplify the competency of collaboration. DIF: Cognitive Level: Analysis OBJ: Describe standards of professional practice for critical care nursing. TOP: Nursing Process Step: N/A MSC: NCLEX: SE/teffset ctive Care Environment 6. The AACN Standards for Acute and Critical Care Nursing Practice uses what framework to guide critical care nursing practice? a. Evidence-based practice b. Healthy work environment c. National Patient Safety Goals d. Nursing process ANS: D The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing process as applied to critically ill patients: collect data, e/tdesiat gnoses, identify expected outcomes, develop a plan of care, implement interventions, and evaluate care. AACN promotes a healthy work environment, but this is not included in the Standards. The Joint Commission has established National Patient Safety Goals, but these are not the AACN Standards. DIF: Cognitive Level: Understand OBJ: Describe standards of professional practice for critical si/tnegst. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 7. The charge nurse is responsible for making the patient assignments on the critical care unit. She assigns the experienced, certified nurse to care for ly/teisltl patient diagnosed 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 what guiding 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 This assignment demonstrates nursing care to meet the needs of the patient. The synergy model notes that the nurse competencies are matched to mn/tet sct haracteristics. Crew resource lOMoAR cPS D| management concepts related to team training, National Patient Safety Goals are specified by The Joint Commission to promote safe care but do not incorporate the synergy model. The Quality and Safety Education for Nurses v/toeslvt es targeted education to undergraduate and graduate nursing students to learn quality and safety concepts. DIF: Cognitive Level: Analysis OBJ: Describe standards of professional practice for critical si/tnegst. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 8. The vision of the American Association of Critical-Care Nurses is a healthcare system driven by achieving what goal? a. Maintaining a healthy work environment. b. Providing care from a multiprofessional team under the direction of a critical care physician. c. Effectively meeting the needs of critically ill patients and families. d. Creating respectful, healing, and humane environments. ANS: C The AACN vision is a healthcare system driven by the needs of critically ill patients and families where critical care nurses make their optimum contributions. AACN promotes initiatives to support a healthy work environment as well e/ctetsftul and healing environments, but that is not the organization’s vision. The SCCM promotes care from a multiprofessional team under the direction of a critical care physician. DIF: Cognitive Level: Knowledge OBJ: Discuss the purposes and functions of the professional organizations that support critical care practice. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 9. What is the most important outcome of effective communication? a. Demonstrating caring practices to family members. b. Ensuring that patient teaching is provided c. Meeting the diversity needs of patients. ANS: D Many errors are directly attributed to faulty communication. Effective communication has been identified as an essential strategy to reduce patient errors and resolve issues related to patient care delivery. Communication may demonstrate a/tecsttices, be used for patient/family teaching, and address diversity needs; however, the main outcome of effective communication is patient safety. DIF: Cognitive Level: Analysis OBJ: Describe quality and safety initiatives related to critical care nursing. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 10. The nurse is caring for a critically ill patient whose urine h/atesstbeen low for 2 consecutive hours. After a thorough patient assessment, you call the primary care provider with the following report. Dr. Smith, I’m calling about Mrs. P., your 65-year-old a. Situation b. Background c. Assessment lOMoAR cPS D| d. Recommendation ANS: B The history and vital signs are part of the background. Information regarding the low urine output is the situation. Information regarding possible m/iteastis part of the nurse’s assessment, and the suggestion for fluids is the recommendation. DIF: Cognitive Level: Understand OBJ: Describe quality and safety initiatives related to critical r/steinstg. TOP: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment 11. 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 e/gteasrtding health care. The nurse discusses the 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 Discussing end-of-life issues is an example of a nurse acting ethically on behalf of the patient and family. The example does not relate to acquiring knowledge, promoting patient safety, or using research in practice. DIF: Cognitive Level: Analysis OBJ: Describe standards of care and performance for critical care nursing. TOP: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment 12. Which of the following assists the critical care nurse in t/hteastt care is appropriate and based on research? a. Clinical practice guidelines b. Computerized physician order entry c. Consulting with advanced practice nurses d. Implementing Joint Commission National Patient Safety Goals ANS: A Clinical practice guidelines are being implemented to t /cteasrt e is appropriate and based on research. Some physician order entry pathways, but not all, are based on research recommendations. Some advanced practice nurses, but not all, are well versed in evidence-based practices. The National Patient Safety Gr/etecsot mmendations to reduce errors using evidence-based practices. DIF: Cognitive Level: Analysis lOMoAR cPS D| OBJ: Describe standards of professional practice for critical si/tnegst. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 13. Comparing the patient’s current (home) medications with those ordered during hospitalization and communicating a complete list of medications to the re/tepstrovider when the patient is transferred within an organization or to another setting are strategies toward best achieving what patient related goal? a. Improving accuracy of patient identification. b. Preventing errors related to look-alike and sound-alike medications. c. Reconciling medications across the continuum of care. d. Reducing harms associated with administration of anticoagulants. ANS: C These are steps recommended in the National Patient Safety Goals to reconcile medications across the continuum of care. Improving accuracy of patient identification is another National Patient Safety Goal. Preventing errors related to o/tuenstd-alike medications is done to improve medication safety, not medication reconciliation. Reducing harms associated with administration of anticoagulants is another National Patient Safety Goal. DIF: Cognitive Level: Comprehension OBJ: Describe quality and safety initiatives related to critical care nursing. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 14. 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 o/tefsvt entilator-associated pneumonia. This group of evidence-based interventions is often referred to using what term? a. Bundle of care. b. Clinical practice guideline. c. Patient safety goal. d. Quality improvement initiative. ANS: A lOMoAR cPS D| A group of evidence-based interventions done as a whole to improve outcomes is termed a bundle of care. This is an example of the ventilator bundle. Oftentimes these bundles are derived from clinical practice guidelines and are monitored for compliance as part of quality improvement initiatives. At some point, these may o/ftepstatient safety goals. DIF: Cognitive Level: Analysis OBJ: Describe quality and safety initiatives related to critical care nursing. TOP: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment 15. A nurse who works in an intermediate care unit has h/tiegsht nursing turnover. The nurse manager is often considered to be an autocratic leader by staff members and that leadership style is contributing to turnover. The nurse asks to be involved in developing new guidelines to prevent pressure ulcers in the patient population. The nurse manager suggests that the nurse has not yet had enough experience to be on v/teesnttion task force. This situation and setting is an example of what form of ineffective leadership? a. Creating a barrier to inter-staff communication. b. Supporting a work environment that is unhealthy. c. Displaying ineffective decision making. d. Demonstrating nursing practice that is not evidence-based. ANS: B These are examples of an unhealthy work environment. A healthy work environment values communication, collaboration, and effective decision making. It also has authentic leadership. It is not an example of handoff communication, which is communication that occurs to transition patient care from one staff member to another. N DIF: Cognitive Level: Analysis lOMoAR cPS D| OBJ: Describe standards of professional practice for critical care nursing. TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment 16. 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 o/teusnt ds. c. Nurses and physicians must work collaboratively and synergistically to influence care. d. Unique needs of patients and their families influence petencies. The synergy model of practice is care based on the unique needs and characteristics of the patient and family members. Although critical care s/tebsat sed on the synergy model, the model does not specifically address certification. Inclusion of family members into the daily rounds is an example of implementation of the synergy model. With the focus on patients and family members with nurse interaction, the synergy model does not address physician collaboration. DIF: Cognitive Level: Application OBJ: Describe standards of professional practice for critical si/tnegst. TOP: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 17. A nurse who plans care based on the patient’s gender, ,ms/pteisrtituality, and lifestyle is said to demonstrate what focus? a. Becoming a moral advocate. b. Facilitating all forms of learning. c. Responding to diversity. d. Using effective clinical judgment. ANS: C Response to diversity considers all of these aspects when ng/teastnd implementing care. A moral agent helps resolve ethical and clinical concerns. Consideration of these factors does not necessarily facilitate learning. Clinical judgment uses other factors as well. DIF: Cognitive Level: Comprehension OBJ: Describe standards of professional practice for critical care nursing. TOP: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity MULTIPLE RESPONSE