Critically Ill Patient questions and
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The nurse identifies a patient in the critical care unit as having "resiliency." What characteristic has the
nurse identified in the patient?
1. Motivation to reduce anxiety through positive self-talk
2. Ability to bounce back quickly after an insult
3. Physical strength to endure extreme physical stressors
4. Ability to return to a state of equilibrium - CORRECT ANSWERS Correct Answer: 2
Rationale 1: This is not a definition of resiliency.
Rationale 2: The correct definition of "resiliency" is the ability to bounce back quickly after an insult. The
degree of resiliency is placed along a continuum between being unable to mount a response to having
strong reserves.
Rationale 3: This is not a definition of resiliency.
Rationale 4: This is not a definition of resiliency.
While caring for a patient in the critical care unit, the nurse realizes that the patient's care needs must
be a balance between the patient's long-term prognosis and the family's expectations of recovery.
Which of the AACN Synergy Model's characteristics does this situation describe?
1. Complexity
2. Predictability
3. Participation in care
4. Resource availability - CORRECT ANSWERS Correct Answer: 1
Rationale 1: This situation describes the characteristic of complexity that is the intricate entanglement of
two or more systems; for example, a patient's illness with complex family dynamics.
,Rationale 2: This situation does not describe predictability.
Rationale 3: This situation does not describe participation in care.
Rationale 4: This situation does not described resource availability.
The nurse realizes that which stressor is one of the primary concerns of critically ill patients and should
be routinely included during assessments?
1. Inability to control elimination
2. Lack of family support
3. Hunger
4. Altered ability to communicate - CORRECT ANSWERS Correct Answer: 4
Rationale 1: The inability to control elimination is not identified as a primary concern of critically ill
patients.
Rationale 2: Lack of family support is not identified as a primary concern of critically ill patients.
Rationale 3: Hunger is not identified as a primary concern of critically ill patients.
Rationale 4: Altered ability to communicate is identified as a primary concern of critically ill patients.
A patient has just completed a preoperative education session prior to undergoing coronary artery
bypass surgery. Which patient statements indicate that teaching has been effective?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. "I understand that I will have to blink my eyes to respond after the breathing tube is in my throat."
2. "I will be given frequent mouth care to help me when I am thirsty."
3. "I will be able to move about freely in bed and into the chair without help while connected to the
electronic equipment for monitoring."
4. "I may need something to help me rest due to the unfamiliar lights and sounds of the ICU unit."
5. "I might not behave like my usual self after the surgery but it will be because of the medications and
my illness." - CORRECT ANSWERS Correct Answer: 1,2,4,5
, Rationale 1: An alternate method of communication discussed in advance of tube placement will assist
in better communication after the tube is inserted to aid the breathing process.
Rationale 2: While intubated, oral hygiene is needed to prevent mucosal drying due to the inability of
the patient to take oral fluids.
Rationale 3: This statement indicates that additional teaching is required because the patient will not be
able to move freely in bed and into a chair without assistance while being electronically monitored.
Rationale 4: Due to environmental lights, sounds, and difference in sleeping environment, additional
aids, such as drug management, may be needed to assist the patient to rest at night.
Rationale 5: A patient concern in the critical care area is the inability to control self. This statement
indicates the patient's understanding of the teaching.
When providing care to critically ill patients, whether they are responsive or unresponsive, the nurse
should:
1. Clearly explain what care is to be done before starting the activity.
2. Perform the activity and then let the patient rest without explaining the care.
3. Make sure the patient always responds and is cooperative before giving care.
4. Explain to the family that the patient will not understand or remember any of the discomfort
associated with care. - CORRECT ANSWERS Correct Answer: 1
Rationale 1: By explaining to both the responsive and unresponsive patient, the nurse provides
orientation, reassurance, respect, and assessment of the patient's mental status. Seeking permission
and apologizing if discomfort is involved will also minimize the stress of the critically ill patient by
allowing the patient to hear what is about to occur. Even the unresponsive patient has been known to
explain procedures, conversations, and feelings once he or she has awakened.
Rationale 2: If the patient is not informed, autonomy and the right to choose have been violated; in
addition, the stress of the unknown may be perceived incorrectly by the patient as an assault.
Rationale 3: Some unresponsive patients will never respond; therefore, the care would not be
performed as needed. Cooperation is also not possible in some cases whereby the patient has altered
thinking. Although the nurse desires these, the care should not be stopped just because they cannot be
obtained. Explaining should still be done and the care should proceed as needed.
Rationale 4: The nurse cannot always reassure the family that the patient will not remember.