A COMPREHENSIVE EXAM STUDY GUIDE LATEST
UPDATED 2026/2027
NR 341 COMPLEX ADULT HEALTH
Exam One
Chapters 1, 2, 3, 4, 5, 9, 10, 14
This blueprint is not inclusive of all content which may be on the exam.
Chapter 1 Overview of Critical Care Nursing
• Definition of critical care nursing
• Evolution of critical care
• Professional organizations
o American association of critical-care nurses
o Society of critical care medicine
o Other professional organizations
• Certification
• Standards
• Critical care nurse characteristics
• Quality and safety emphasis
• Evidence-based practice
• Healthy work environment
o Communication
o Collaboration
• Other trends and issues
Chapter 2 Patient and Family Response to the Critical Care Experience
• Introduction
• The critical care environment
• The critically ill patient
o Discharge from critical care and quality of life after critical care
o Geriatric concerns
• Family members of the critically ill patient
o Family assessment
o Family needs
o Communication
o Visitation
o Family presence during procedures and resuscitation
o Practice alerts
Chapter 3 Ethical and Legal Issues in Critical Care Nursing
• Introduction
• Ethical obligations and nurse advocacy
• Ethical decision making
• Ethical principles
, o Creating an ethical environment
• Increasing nurses’ involvement in ethical decision making
• Selected ethical topics in critical care
o Informed consent
▪ Elements of informed consent
o Decisions regarding life-sustaining treatment
▪ Cardiopulmonary resuscitation decisions
▪ Withholding or withdrawing life support
o End-of-life issues
▪ Patient self-determination act
▪ Advance directives
o Organ and tissue transplantation
Chapter 4 End-of-Life Care in the Critical Care Unit
• Introduction
o Effects on nurses and the healthcare team
• Dimensions of end-of-life care
o Palliative care
o Communication and conflict resolution
o Withholding, limiting, or withdrawing therapy
▪ Ventilator withdrawal
▪ Other commonly withheld therapies
▪ Hospice referral
o Emotional and psychological care of the patient and family
o Caregiver organizational support
• Culturally competent end-of-life care
Chapter 5 Comfort and Sedation
• Introduction
• Definitions of pain and anxiety
• Predisposing factors to pain and anxiety
• Physiology of pain and anxiety
o Pain
o Anxiety
• Positive effects of pain and anxiety
• Negative effects of pain and anxiety
o Physical effects
o Psychological effects
• Assessment
o Pain measurement tools
o Pain measurement tools for nonverbal patients
o Anxiety and sedation measurement tools
▪ Sedation scales