Critical Care Evolve NCLEX questions
1. The family of a critically ill patient whose care has been deemed futile has
decided to withhold treatments. Which action should the nurse take to initiate
the family's wishes?
1. Turn the patient every 2 hours.
2. Refrain from giving the patient medications.
3. Slowly wean the patient off the ventilator.
4. Obtain signatures for "do not resuscitate" orders.: 2. Refrain from giving the
patient medications.
To withhold treatment is a decision not to administer selected treatments in cases
in which care is considered futile. Withdrawal is a removal of treatments, such
as mechanical ventilation. "Do not resuscitate" is a written order not to initiate
life-support measures in the event of cardiopulmonary arrest. Turning the patient
every two hours is not an example of withholding treatment.
2. The nurse is caring for a patient who is unresponsive, unable to communi-
cate, and has no voluntary action or cognition. The condition is considered
permanent. The term for this condition is
1. terminal condition.
2. non-heart beating donor.
3. persistent vegetative state.
4. brain death.: 3. persistent vegetative state.
This is the definition of persistent vegetative state. These individuals are not brain
dead and are not necessarily terminal. A non-heart beating donor would be someone
with cardiac death. See Table 3-2 for definitions.
3. A 33-year-old patient is admitted with closed head trauma following a motor
vehicle crash. She has a signed organ donor card expressing her wish to
become an organ donor. Brain death is established; however, her spouse
refuses to sign consent for organ donation. Which ethical principle is being
violated by her spouse?
1. Beneficence
2. Autonomy
3. Justice
4. Veracity: 2. Autonomy
The patient's spouse is violating her autonomy to make her own decision regarding
organ donation. Beneficence is action intended to benefit the patient. Justice is
, Critical Care Evolve NCLEX questions
defined as being fair or just to the wider community in terms of the consequences
of an action. Veracity is the obligation to tell the truth.
4. After reviewing her patient assignments, the nurse recognizes a conflict of
interest with one of the patients. Which action should the nurse take to resolve
this conflict?
1. The nurse should maintain minimal contact with the patient throughout the
shift.
2. The nurse should keep all assigned patients for the day.
3. The nurse should ask other staff to provide care for the patient if a conflict
arises with the patient.
4. The nurse should request a change in assignment if care of the assigned
pa: The nurse should request a change in assignment if care of the assigned patient
violates his or her ethical principles.
A nurse can request a change in assignment if care of the patient violates his or her
principles. However, care must be assumed by another nurse so that the patient
is not abandoned. The nurse should take action to resolve the conflict instead of
seeking intervention by other staff members or limiting exposure to the patient. The
nurse should be fully present for each patient and ready to help when needed.
5. The nurse has just listened to a lecture on the hospital's ethics committee.
Which statement indicates that the teaching has been effective?
1. "It serves to educate and to develop guidelines."
2. "Its goal is to protect the hospital's interests."
3. "Its members consist only of physicians and nurses."
4. "It deals with generalities instead of specific issues.": 1. "It serves to educate
and to develop guidelines."
An ethics committee is involved in education and guideline development in addition
to providing ethics consultation. Its members include a variety of professionals,
including physicians and nurses. An ethics committee primarily deals with specific
ethical issues referred to them. An ethics committee protects the interest of the
patient, not the hospital.
6. Which action by the nurse is an example of extraordinary care?
1. Ensuring proper nutrition
2. Initiating hemodialysis
3. Administering antibiotics on time
4. Inserting an IV for hydration: 2. Initiating hemodialysis
Hemodialysis is considered an extraordinary measure, which is a complex, exper-
, Critical Care Evolve NCLEX questions
imental, or invasive procedure. Antibiotics, nutrition, and hydration are considered
ordinary care.
7. The critical care nurse must demonstrate characteristics of ethical nursing
practice, which include (Select all that apply.)
Select all that apply.
1. trust.
2. compassion.
3. disclosure.
4. collaboration.: 1. trust.
Compassion, collaboration, accountability, and trust are essential characteristics of
ethical nursing practice.
2. compassion.
Compassion, collaboration, accountability, and trust are essential characteristics of
ethical nursing practice.
4. collaboration.
Compassion, collaboration, accountability, and trust are essential characteristics of
ethical nursing practice.
8. The family has decided to withdraw life support. Which actions by the nurse
are consistent with this decision? (Select all that apply.)
Select all that apply.
1. Initiating "do not resuscitate" orders
2. Stopping tube feedings
3. Weaning the patient from mechanical ventilation
4. Discontinuing comfort measures
5. Beginning continuous renal replacement therapy: 1. Initiating "do not re-
suscitate" ordersWithdrawal from life support would include writing DNR orders,
stopping tube feedings, and weaning from the ventilator. Comfort measures are
always provided even though life support is withdrawn or withheld. Patient comfort
is of primary importance. Continuous renal replacement therapy is considered an
extraordinary measure.
2. Stopping tube feedingsWithdrawal from life support would include writing DNR
orders, stopping tube feedings, and weaning from the ventilator. Comfort measures
are always provided even though life support is withdrawn or withheld. Patient com-
, Critical Care Evolve NCLEX questions
fort is of primary importance. Continuous renal replacement therapy is considered
an extraordinary measure.
3. Weaning the patient from mechanical ventilationWithdrawal from life support
would include writing DNR orders, stopping tube feedings, and weaning from the
ventilator. Comfort measures are always provided even though life support is with-
drawn or withheld. Patient comfort
9. Which nursing actions contain the elements of informed consent? (Select
all that apply.)
Select all that apply.
1. Scheduling time for the patient to meet with the health care provider
2. Writing the consent on a standardized form
3. Obtaining voluntary permission for what is to be done
4. Ensuring that the patient and family members understand what is to be
done (competence): 1. Scheduling time for the patient to meet with the health care
provider
Informed consent is a process, not a form. Competence is essential, along with
adequate explanations and voluntary agreement for what is to be done.
4. Ensuring that the patient and family members understand what is to be done
(competence)
Informed consent is a process, not a form. Competence is essential, along with
adequate explanations and voluntary agreement for what is to be done.
10. Which nursing actions indicate an understanding of ethical decisions?
(Select all that apply.)
Select all that apply.
1. Being knowledgeable on relevant ethical principles
2. Respecting the patient's wishes and goals
3. Discussing potential outcomes of options with the patient
4. Discussing burden versus benefit with the patient: 1. Being knowledgeable on
relevant ethical principles
All are correct as noted in Figure 3-1.
2. Respecting the patient's wishes and goals
All are correct as noted in Figure 3-1.
4. Discussing burden versus benefit with the patient
All are correct as noted in Figure 3-1.
1. The family of a critically ill patient whose care has been deemed futile has
decided to withhold treatments. Which action should the nurse take to initiate
the family's wishes?
1. Turn the patient every 2 hours.
2. Refrain from giving the patient medications.
3. Slowly wean the patient off the ventilator.
4. Obtain signatures for "do not resuscitate" orders.: 2. Refrain from giving the
patient medications.
To withhold treatment is a decision not to administer selected treatments in cases
in which care is considered futile. Withdrawal is a removal of treatments, such
as mechanical ventilation. "Do not resuscitate" is a written order not to initiate
life-support measures in the event of cardiopulmonary arrest. Turning the patient
every two hours is not an example of withholding treatment.
2. The nurse is caring for a patient who is unresponsive, unable to communi-
cate, and has no voluntary action or cognition. The condition is considered
permanent. The term for this condition is
1. terminal condition.
2. non-heart beating donor.
3. persistent vegetative state.
4. brain death.: 3. persistent vegetative state.
This is the definition of persistent vegetative state. These individuals are not brain
dead and are not necessarily terminal. A non-heart beating donor would be someone
with cardiac death. See Table 3-2 for definitions.
3. A 33-year-old patient is admitted with closed head trauma following a motor
vehicle crash. She has a signed organ donor card expressing her wish to
become an organ donor. Brain death is established; however, her spouse
refuses to sign consent for organ donation. Which ethical principle is being
violated by her spouse?
1. Beneficence
2. Autonomy
3. Justice
4. Veracity: 2. Autonomy
The patient's spouse is violating her autonomy to make her own decision regarding
organ donation. Beneficence is action intended to benefit the patient. Justice is
, Critical Care Evolve NCLEX questions
defined as being fair or just to the wider community in terms of the consequences
of an action. Veracity is the obligation to tell the truth.
4. After reviewing her patient assignments, the nurse recognizes a conflict of
interest with one of the patients. Which action should the nurse take to resolve
this conflict?
1. The nurse should maintain minimal contact with the patient throughout the
shift.
2. The nurse should keep all assigned patients for the day.
3. The nurse should ask other staff to provide care for the patient if a conflict
arises with the patient.
4. The nurse should request a change in assignment if care of the assigned
pa: The nurse should request a change in assignment if care of the assigned patient
violates his or her ethical principles.
A nurse can request a change in assignment if care of the patient violates his or her
principles. However, care must be assumed by another nurse so that the patient
is not abandoned. The nurse should take action to resolve the conflict instead of
seeking intervention by other staff members or limiting exposure to the patient. The
nurse should be fully present for each patient and ready to help when needed.
5. The nurse has just listened to a lecture on the hospital's ethics committee.
Which statement indicates that the teaching has been effective?
1. "It serves to educate and to develop guidelines."
2. "Its goal is to protect the hospital's interests."
3. "Its members consist only of physicians and nurses."
4. "It deals with generalities instead of specific issues.": 1. "It serves to educate
and to develop guidelines."
An ethics committee is involved in education and guideline development in addition
to providing ethics consultation. Its members include a variety of professionals,
including physicians and nurses. An ethics committee primarily deals with specific
ethical issues referred to them. An ethics committee protects the interest of the
patient, not the hospital.
6. Which action by the nurse is an example of extraordinary care?
1. Ensuring proper nutrition
2. Initiating hemodialysis
3. Administering antibiotics on time
4. Inserting an IV for hydration: 2. Initiating hemodialysis
Hemodialysis is considered an extraordinary measure, which is a complex, exper-
, Critical Care Evolve NCLEX questions
imental, or invasive procedure. Antibiotics, nutrition, and hydration are considered
ordinary care.
7. The critical care nurse must demonstrate characteristics of ethical nursing
practice, which include (Select all that apply.)
Select all that apply.
1. trust.
2. compassion.
3. disclosure.
4. collaboration.: 1. trust.
Compassion, collaboration, accountability, and trust are essential characteristics of
ethical nursing practice.
2. compassion.
Compassion, collaboration, accountability, and trust are essential characteristics of
ethical nursing practice.
4. collaboration.
Compassion, collaboration, accountability, and trust are essential characteristics of
ethical nursing practice.
8. The family has decided to withdraw life support. Which actions by the nurse
are consistent with this decision? (Select all that apply.)
Select all that apply.
1. Initiating "do not resuscitate" orders
2. Stopping tube feedings
3. Weaning the patient from mechanical ventilation
4. Discontinuing comfort measures
5. Beginning continuous renal replacement therapy: 1. Initiating "do not re-
suscitate" ordersWithdrawal from life support would include writing DNR orders,
stopping tube feedings, and weaning from the ventilator. Comfort measures are
always provided even though life support is withdrawn or withheld. Patient comfort
is of primary importance. Continuous renal replacement therapy is considered an
extraordinary measure.
2. Stopping tube feedingsWithdrawal from life support would include writing DNR
orders, stopping tube feedings, and weaning from the ventilator. Comfort measures
are always provided even though life support is withdrawn or withheld. Patient com-
, Critical Care Evolve NCLEX questions
fort is of primary importance. Continuous renal replacement therapy is considered
an extraordinary measure.
3. Weaning the patient from mechanical ventilationWithdrawal from life support
would include writing DNR orders, stopping tube feedings, and weaning from the
ventilator. Comfort measures are always provided even though life support is with-
drawn or withheld. Patient comfort
9. Which nursing actions contain the elements of informed consent? (Select
all that apply.)
Select all that apply.
1. Scheduling time for the patient to meet with the health care provider
2. Writing the consent on a standardized form
3. Obtaining voluntary permission for what is to be done
4. Ensuring that the patient and family members understand what is to be
done (competence): 1. Scheduling time for the patient to meet with the health care
provider
Informed consent is a process, not a form. Competence is essential, along with
adequate explanations and voluntary agreement for what is to be done.
4. Ensuring that the patient and family members understand what is to be done
(competence)
Informed consent is a process, not a form. Competence is essential, along with
adequate explanations and voluntary agreement for what is to be done.
10. Which nursing actions indicate an understanding of ethical decisions?
(Select all that apply.)
Select all that apply.
1. Being knowledgeable on relevant ethical principles
2. Respecting the patient's wishes and goals
3. Discussing potential outcomes of options with the patient
4. Discussing burden versus benefit with the patient: 1. Being knowledgeable on
relevant ethical principles
All are correct as noted in Figure 3-1.
2. Respecting the patient's wishes and goals
All are correct as noted in Figure 3-1.
4. Discussing burden versus benefit with the patient
All are correct as noted in Figure 3-1.
