NUR 445 UPDATED 202 EXAM SCRIPT QUESTIONS AND
ANSWERS GRADED A+
✔✔Historically, why have families been restricted from the ICU? - ✔✔Harmful
physiological consequences, interferes with time nurses need to spend caring for
patients, delays in care
✔✔What are some advantages to having family present during CPR? - ✔✔Family
grasps seriousness of condition, sees firsthand everything was done for the patient,
helps with grieving, doubt is removed, less fear and anxiety, a sense of closure,
✔✔What is cultural competence? - ✔✔Being mindful of your own beliefs and attitudes,
without letting personal bias influence the care of patients with different backgrounds
✔✔Why is culturally competent care essential? - ✔✔to achieve equitable outcomes for
all patients
✔✔Why is it important for nurses to recognize and address barriers to culturally
competent care? - ✔✔to convey respect for the patient's uniqueness, discussing
language preferences, educational material at their level, address sensitivity
✔✔Which senses are involved in sensory output? - ✔✔visual, auditory, olfactory,
gustatory, tactile
✔✔What are the 3 sensory perceptual alterations? - ✔✔sensory overload/deprivation,
delirium, sleep deprivation
✔✔How can nurses act as an advocate in providing rest and sleep? - ✔✔control the
environment and ensure rest throughout the day/night
✔✔What are a few interventions nurses can do to promote uninterrupted rest periods? -
✔✔Relaxing music, ear plugs, control pain, silencing pagers and alarms, lowering lights,
limit visitation, help patient mentally prepare for bedtime
✔✔What are some methods of nonverbal communication used by high acuity patients?
- ✔✔vitals, facial expressions, hand gestures, written messages, computer keyboards,
pointing to letters, coded eye-blink system
✔✔What is palliative care? - ✔✔interdisciplinary approach to relieve suffering and
improve QOL
✔✔What are common symptoms addressed by the palliative care team? - ✔✔shortness
of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping
,✔✔What is the goal of palliative care? - ✔✔to improve quality of life
✔✔Who can initiate a consult to the palliative care team? - ✔✔a nurse, physician, family
member, patient, social worker, or case manager
✔✔What are the benefits of palliative care in the ICU? - ✔✔decreased length of stay,
decreased use of ineffective treatments, decreased anxiety/depression, increased
family satisfaction and understanding, increased symptom assessment, increased
comfort
✔✔Who meets to formulate the palliative care plan? - ✔✔palliative care team, ICU
nurse, other team members
✔✔What is included in a palliative care plan? - ✔✔meet psychological, social, cultural,
and spiritual needs
✔✔Who defines who is family to the patient? - ✔✔The patient defines who they identify
as family
✔✔What is the FICA Spiritual History Tool? - ✔✔Faith and Belief, Importance,
Community, Address in care
✔✔What are the 4 elements of decision-making capacity? - ✔✔the ability to understand
information about options for care, ability to reason and consider options being offered,
ability to communicate a choice, ability to describe consequences of the decision
✔✔What is the proxy decision maker "charged with?" - ✔✔Making decisions that the
patient would make if they were able to make them
✔✔What does offering a menu of choices for code status lead to? - ✔✔Confusion and
inconsistent choices
✔✔What is the goal of AND? - ✔✔to prevent unnecessary suffering and allow nature to
take its course
✔✔What is medical futility? - ✔✔extreme measures to keep someone alive
✔✔What does preparation of withdrawal of life sustaining therapies look like? -
✔✔Assess patient's values, removing equipment, positioning chairs and tissues,
premedication, clamp all lines, cover patient with blanket leaving arms out, turn off
monitors, and provide basic hygiene
✔✔Who must conduct conversations regarding organ donation? - ✔✔an authorized
organ procurement organization (OPO) representative; designated requestor
, ✔✔What can lead to moral distress for ICU nurses? - ✔✔ethical dilemmas
✔✔What are some barriers to end-of-life care? - ✔✔nursing time constraints, staffing
patterns, communication challenges, treatment decisions based on physician and not
patient needs
✔✔What are some nursing suggestions for improving care at the end of life? -
✔✔change environment to accommodate needs, improve management of
pain/discomfort, knowing patient wishes, ceasing treatment when seems futile
✔✔Who can facilitate discussions about treatment preferences and management of s/s
at end of life? - ✔✔The nurse
✔✔How does the Uniform Determination of Death Act (UDDA) define death? - ✔✔Total
irreversible failure of the cardiorespiratory system, or irreversible loss of all brain
functions (stem and neocortex)
✔✔What are the 3 methods for determining death? - ✔✔clinical exam, cerebral
perfusion study, or an EEG
✔✔What are 4 diagnostic criteria that must be met before a clinical diagnosis of brain
death? - ✔✔clinical evidence of an acute CNS catastrophe, exclusion of complicating
medical conditions, no drug intoxication/poisoning, core temp of 90*F
✔✔When is the clinical diagnosis of brain death unable to be used? - ✔✔if the patient
has a toxic or metabolic CNS depression, or cannot initiate respiration as a result of
other injuries or pathology
✔✔What are the 3 cardinal signs of brain death? - ✔✔coma/unresponsive, absence of
brainstem reflexes, and apnea
✔✔What must be documented once death is confirmed? - ✔✔The official time of death
✔✔What are hemodynamics? - ✔✔A physiologic term that refers to the forces involved
in the flow of blood as it circulates through the cardiovascular system
✔✔How can hemodynamics be measured at the most basic level? - ✔✔BP, HR, urine
output
✔✔What is cardiac output? - ✔✔The amount of blood pumped by the heart each minute
✔✔Why is CI more useful than CO? - ✔✔CI takes into account the size and CO of the
person
ANSWERS GRADED A+
✔✔Historically, why have families been restricted from the ICU? - ✔✔Harmful
physiological consequences, interferes with time nurses need to spend caring for
patients, delays in care
✔✔What are some advantages to having family present during CPR? - ✔✔Family
grasps seriousness of condition, sees firsthand everything was done for the patient,
helps with grieving, doubt is removed, less fear and anxiety, a sense of closure,
✔✔What is cultural competence? - ✔✔Being mindful of your own beliefs and attitudes,
without letting personal bias influence the care of patients with different backgrounds
✔✔Why is culturally competent care essential? - ✔✔to achieve equitable outcomes for
all patients
✔✔Why is it important for nurses to recognize and address barriers to culturally
competent care? - ✔✔to convey respect for the patient's uniqueness, discussing
language preferences, educational material at their level, address sensitivity
✔✔Which senses are involved in sensory output? - ✔✔visual, auditory, olfactory,
gustatory, tactile
✔✔What are the 3 sensory perceptual alterations? - ✔✔sensory overload/deprivation,
delirium, sleep deprivation
✔✔How can nurses act as an advocate in providing rest and sleep? - ✔✔control the
environment and ensure rest throughout the day/night
✔✔What are a few interventions nurses can do to promote uninterrupted rest periods? -
✔✔Relaxing music, ear plugs, control pain, silencing pagers and alarms, lowering lights,
limit visitation, help patient mentally prepare for bedtime
✔✔What are some methods of nonverbal communication used by high acuity patients?
- ✔✔vitals, facial expressions, hand gestures, written messages, computer keyboards,
pointing to letters, coded eye-blink system
✔✔What is palliative care? - ✔✔interdisciplinary approach to relieve suffering and
improve QOL
✔✔What are common symptoms addressed by the palliative care team? - ✔✔shortness
of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping
,✔✔What is the goal of palliative care? - ✔✔to improve quality of life
✔✔Who can initiate a consult to the palliative care team? - ✔✔a nurse, physician, family
member, patient, social worker, or case manager
✔✔What are the benefits of palliative care in the ICU? - ✔✔decreased length of stay,
decreased use of ineffective treatments, decreased anxiety/depression, increased
family satisfaction and understanding, increased symptom assessment, increased
comfort
✔✔Who meets to formulate the palliative care plan? - ✔✔palliative care team, ICU
nurse, other team members
✔✔What is included in a palliative care plan? - ✔✔meet psychological, social, cultural,
and spiritual needs
✔✔Who defines who is family to the patient? - ✔✔The patient defines who they identify
as family
✔✔What is the FICA Spiritual History Tool? - ✔✔Faith and Belief, Importance,
Community, Address in care
✔✔What are the 4 elements of decision-making capacity? - ✔✔the ability to understand
information about options for care, ability to reason and consider options being offered,
ability to communicate a choice, ability to describe consequences of the decision
✔✔What is the proxy decision maker "charged with?" - ✔✔Making decisions that the
patient would make if they were able to make them
✔✔What does offering a menu of choices for code status lead to? - ✔✔Confusion and
inconsistent choices
✔✔What is the goal of AND? - ✔✔to prevent unnecessary suffering and allow nature to
take its course
✔✔What is medical futility? - ✔✔extreme measures to keep someone alive
✔✔What does preparation of withdrawal of life sustaining therapies look like? -
✔✔Assess patient's values, removing equipment, positioning chairs and tissues,
premedication, clamp all lines, cover patient with blanket leaving arms out, turn off
monitors, and provide basic hygiene
✔✔Who must conduct conversations regarding organ donation? - ✔✔an authorized
organ procurement organization (OPO) representative; designated requestor
, ✔✔What can lead to moral distress for ICU nurses? - ✔✔ethical dilemmas
✔✔What are some barriers to end-of-life care? - ✔✔nursing time constraints, staffing
patterns, communication challenges, treatment decisions based on physician and not
patient needs
✔✔What are some nursing suggestions for improving care at the end of life? -
✔✔change environment to accommodate needs, improve management of
pain/discomfort, knowing patient wishes, ceasing treatment when seems futile
✔✔Who can facilitate discussions about treatment preferences and management of s/s
at end of life? - ✔✔The nurse
✔✔How does the Uniform Determination of Death Act (UDDA) define death? - ✔✔Total
irreversible failure of the cardiorespiratory system, or irreversible loss of all brain
functions (stem and neocortex)
✔✔What are the 3 methods for determining death? - ✔✔clinical exam, cerebral
perfusion study, or an EEG
✔✔What are 4 diagnostic criteria that must be met before a clinical diagnosis of brain
death? - ✔✔clinical evidence of an acute CNS catastrophe, exclusion of complicating
medical conditions, no drug intoxication/poisoning, core temp of 90*F
✔✔When is the clinical diagnosis of brain death unable to be used? - ✔✔if the patient
has a toxic or metabolic CNS depression, or cannot initiate respiration as a result of
other injuries or pathology
✔✔What are the 3 cardinal signs of brain death? - ✔✔coma/unresponsive, absence of
brainstem reflexes, and apnea
✔✔What must be documented once death is confirmed? - ✔✔The official time of death
✔✔What are hemodynamics? - ✔✔A physiologic term that refers to the forces involved
in the flow of blood as it circulates through the cardiovascular system
✔✔How can hemodynamics be measured at the most basic level? - ✔✔BP, HR, urine
output
✔✔What is cardiac output? - ✔✔The amount of blood pumped by the heart each minute
✔✔Why is CI more useful than CO? - ✔✔CI takes into account the size and CO of the
person
