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NUR 240: NUR 240 Final Exam: 100 % Verified Questions & Answers: Latest Updated, Exams of Nursing

Highland Community CollegeNursing

The nurse reviews assessment data on a group of patients. Which patient should the nurse identify as experiencing a critical illness? 1. Chronic airflow limitation with VS: BP 110/72, P 110, R 16 2. Acute bronchospasm with VS: BP 100/60, P 124, R 32 3. Motor vehicle crash with VS: BP 124/74, P 74, R 18 4. Chronic renal failure on hemodialysis with no urine output with VS: BP 98/50, P 108, R 12 (Ans- 2 Which patient should the nurse expect to be transferred to a critical care unit? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Experiences an acetaminophen overdose 2. Diagnosed with an acute mental illness 3. Receiving treatment for chronic renal failure 4. New onset of acute decompensated heart failure 5. Treatment for bacteremia from an infected foot wound (Ans- 1,4,5 The nurse employed in a hospital in a small rural town would expect to provide which level of care in the critical care unit?

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NUR 240 Final Exam: Questions &
Answers
The nurse reviews assessment data on a group of patients. Which patient
should the nurse identify as experiencing a critical illness?
1. Chronic airflow limitation with VS: BP 110/72, P 110, R 16
2. Acute bronchospasm with VS: BP 100/60, P 124, R 32
3. Motor vehicle crash with VS: BP 124/74, P 74, R 18
4. Chronic renal failure on hemodialysis with no urine output with VS: BP
98/50, P 108, R 12
(Ans- 2
Which patient should the nurse expect to be transferred to a critical care
unit? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
1. Experiences an acetaminophen overdose
2. Diagnosed with an acute mental illness
3. Receiving treatment for chronic renal failure
4. New onset of acute decompensated heart failure
5. Treatment for bacteremia from an infected foot wound
(Ans- 1,4,5
The nurse employed in a hospital in a small rural town would expect to
provide which level of care in the critical care unit?
1. Level I
2. Level II
3. Level III
4. It is unlikely that the hospital would have a critical care unit.
(Ans- 3
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Download NUR 240: NUR 240 Final Exam: 100 % Verified Questions & Answers: Latest Updated and more Exams Nursing in PDF only on Docsity!

NUR 240 Final Exam: Questions &

Answers

The nurse reviews assessment data on a group of patients. Which patient should the nurse identify as experiencing a critical illness?

  1. Chronic airflow limitation with VS: BP 110/72, P 110, R 16
  2. Acute bronchospasm with VS: BP 100/60, P 124, R 32
  3. Motor vehicle crash with VS: BP 124/74, P 74, R 18
  4. Chronic renal failure on hemodialysis with no urine output with VS: BP 98/50, P 108, R 12 (Ans- 2 Which patient should the nurse expect to be transferred to a critical care unit? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  5. Experiences an acetaminophen overdose
  6. Diagnosed with an acute mental illness
  7. Receiving treatment for chronic renal failure
  8. New onset of acute decompensated heart failure
  9. Treatment for bacteremia from an infected foot wound (Ans- 1,4, The nurse employed in a hospital in a small rural town would expect to provide which level of care in the critical care unit?
  10. Level I
  11. Level II
  12. Level III
  13. It is unlikely that the hospital would have a critical care unit. (Ans- 3

With which individuals should the nurse expect to provide patient care in an "open" ICU?

  1. Multidisciplinary team with physicians who are also responsible for patients on other units
  2. Multidisciplinary team that includes a physician employed by the hospital
  3. Physician in charge of patient care who is a specialist in critical care
  4. Primary care physician who must consult a critical care specialist (Ans- 1 What should the nurse who provides care to patients in a critical care unit realize the role of technology is on the amount of errors?
  5. It relies heavily on human decision making.
  6. Devices are programmed to function without double checks.
  7. It makes the workload seem overwhelming to health care providers.
  8. There is uniform equipment throughout each facility. (Ans- 2 What should the nurse identify as an example of an installed forcing function or a system-level firewall to prevent errors when providing patient care?
  9. Prior to administration of insulin, two nurses check the dose.
  10. Prior to obtaining a medication, height, weight, and allergies are recorded.
  11. All medications are checked by two nurses prior to administration.
  12. Undiluted potassium chloride is not available on critical care units. (Ans- 4 The nurse realizes that the increased use of technology in critical care units has resulted in which consequence for patient care?
  13. Decreased risk of errors in patient care
  14. Decreased therapeutic nurse-patient communication
  15. Improved overall patient satisfaction with care
  16. Improved patient safety across the entire spectrum (Ans- 2
  1. Assisting and supporting the patient and family as they reveal their needs
  2. Alerting the physician to concerns about client placement after hospitalization
  3. Encouraging and supporting a patient's spouse in preparing for a family meeting
  4. Seeing the big picture when planning patient care (Ans- 1,2,3, A nurse is preparing to communicate an issue about patient care to a physician using the SBAR technique. Which phrase is an appropriate initial statement?
  5. "I am concerned about..."
  6. "The patient's immediate history is..."
  7. "I think the problem is..."
  8. "I would like you to..." (Ans- 1 Which statement should the nurse include for "A-Assessment" in the SBAR technique for communication?
  9. "I think the problem is..."
  10. "The patient's vital signs are..."
  11. "The patient's treatments are..."
  12. "I would like you to..." (Ans- 1 Which statement should the nurse use when concluding SBAR communication about a patient issue?
  13. "The patient's immediate history is..."
  14. "The patient's physical findings are..."
  15. "I am requesting that you..."
  16. "I have assessed the patient personally." (Ans- 3

The nurse collaborates with other members of the health care team to effect optimal outcomes in patient care. Which characteristics of emotional maturity is the nurse using? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.

  1. Maintaining current skills
  2. Being a lifelong learner
  3. Actively identifying best practices
  4. Overlooking one's own shortcomings
  5. Willing to take responsibility for failures (Ans- 1,2,3, Which informal power bases should the nurse use in the health care setting? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  6. Expertise
  7. Goodwill
  8. Information
  9. Observation
  10. Collaboration (Ans- 1,2, Which action ensures that a patient has consented to care?
  11. Provide a consent form to sign to receive medications.
  12. Ask the patient to sign a consent form to have dressings changed.
  13. Discuss a consent form to sign to be turned in bed.
  14. Explain how a dressing is to be changed. (Ans- 4 For what can the nurse be held liable if forcibly inserting a nasogastric tube against a patient's wishes?
  15. Negligence
  16. Malpractice
  17. Damages
  1. Realizing that nurses maintain power in bedside decision making
  2. Knowing the right thing to do but not being able to do it
  3. Leaving employment as a critical care nurse (Ans- 1,2,4, What might occur when a nurse employs conscientious refusal to participate? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  4. Dismissal from a nursing position
  5. Employer sanctions
  6. Support from nursing administrators
  7. Protection from the state boards of nursing
  8. Support by the patient (Ans- 1, Which symptoms indicate a nurse is experiencing compassion fatigue? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  9. Difficulty separating work from personal life
  10. Excessively high tolerance for frustration
  11. Having a completely laissez-faire attitude
  12. Decreased functioning in nonprofessional situations
  13. Dreads working with certain types of patients (Ans- 1,4, The nurse is providing care to patients in a Level II general critical care unit. For which types of patient problems will this nurse most likely provide care? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  14. Exacerbation of heart failure
  15. Wound infection
  16. Burns over 50% of total body surface
  17. Kidney transplant
  1. Reattachment of a traumatic amputation of the left leg (Ans- 1, A patient is admitted to an "open" intensive care unit. In addition to the nurse, which health care providers will assist in the care of this patient? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  2. Pharmacist
  3. Respiratory therapist
  4. Attending physician
  5. Dietician
  6. Social worker (Ans- 1,2, The critical care nurse is identifying patients at risk for safety and medical errors. Which patients should the nurse identify as being at risk for these issues? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  7. Patient in isolation with MRSA
  8. Patient who does not understand English
  9. Patient with end stage renal disease and a respiratory rate of 8 per minute
  10. Patient recovering from pacemaker insertion
  11. Patient with pulmonary edema (Ans- 1,2, The nurse manager of a critical care unit is explaining the AACN Synergy Model to the critical care nurses. What should the manager include as basic parts of this model? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  12. Based on the patients' characteristics
  13. Based on the competencies of the nurses
  14. Patient outcomes will be measured
  15. The nurses' assessment of patient outcomes will be measured
  1. Act
  2. Assert (Ans- 1,2,3, The critical care nurse is experiencing psychologic symptoms of compassion fatigue. What strategies should the nurse use to enhance psychological well-being? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  3. Make time for recreational activities.
  4. Practice yoga for relaxation.
  5. Plan to take a walk in the park at least once a week.
  6. Monitor food and beverage intake.
  7. Darken the room and limit activities before sleep. (Ans- 1,2, The nurse manager is planning the staffing budget for the next fiscal year. What action should the manager take to ensure that staffing is adequate?
  8. Study the results of the organization's staffing evaluation.
  9. Meet with other nurse managers to compare staffing needs.
  10. Remember that nurses should not work more than 72 hours each week.
  11. Review staff competency needs with the director of human resources. (Ans- 1 The critical care nurse discusses a patient's change in status with the health care provider, pharmacist, and physical therapist. Which QSEN competency is this nurse demonstrating?
  12. Patient-centered care
  13. Quality improvement
  14. Evidence-based practice
  15. Teamwork and collaboration (Ans- 4 The nurse plans to question a health care provider's choice of medication for a critically ill patient. Which statement demonstrates assertive communication?
  16. "At times I think it would be wise to update the prescribing references that are used."
  1. "I learned that this medication might not be effective with this health problem. Would you explain choosing it?"
  2. "This patient is getting worse, and it is because someone prescribed an antiquated medication to treat the problem."
  3. "I realize I am only a nurse, but I can read and I learned that this medication is a poor choice to treat this medical problem." (Ans- 2 The adult daughter of a client with end-stage kidney disease informs the health care provider that all interventions are to be provided even though the client is heard telling the spouse that "enough is enough." What should be done first when analyzing this situation?
  4. Identify significant information.
  5. Determine the decision maker for the client.
  6. Estimate the resources needed for care.
  7. Calculate the expense of providing care to the client (Ans- 1 The nurse manager reviews the standards of self-care for caregivers during a staff meeting. Which staff nurse comment indicates that teaching about the standards has been effective?
  8. "I will consider yoga classes."
  9. "I will play tennis with my sister at least twice a week."
  10. "I do love to read, but at times I review the events of the day and I'm distracted."
  11. "Going to the zoo with my nephew might be a good idea if I'm not needed for overtime." (Ans- 2 The nurse identifies a patient in the critical care unit as having "resiliency." What characteristic has the nurse identified in the patient?
  12. Motivation to reduce anxiety through positive self-talk
  13. Ability to bounce back quickly after an insult
  14. Physical strength to endure extreme physical stressors
  15. Ability to return to a state of equilibrium (Ans- 2 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
  1. Make sure the patient always responds and is cooperative before giving care.
  2. Explain to the family that the patient will not understand or remember any of the discomfort associated with care. (Ans- 1 Which communication strategy should the critical care nurse use when communicating with a ventilated patient?
  3. Use professional terminology and provide the patient with detailed information.
  4. Use simple language and explain in other terms if the patient does not seem to understand.
  5. Provide minimal information so the patient is not overwhelmed.
  6. Discuss issues primarily with the family because the patient is unlikely to understand the information. (Ans- 2 During an assessment, a ventilated patient begins to frown and wiggle about in bed. Which assessment strategy would be most helpful for the nurse to validate these observations?
  7. Glasgow Scale
  8. Maslow's hierarchy levels
  9. Critical-Care Pain Observation Tool (CPOT)
  10. Vital signs trends (Ans- 3 Which parameter indicates that a patient in the intensive care unit being mechanically ventilated is ready for an interruption in sedation? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  11. MAP of 75 and heart rate of 76
  12. Awakens with verbal stimuli
  13. Frowns when turned but otherwise shows no muscular tension
  14. Activates the ventilator alarms, but the alarms stopped spontaneously
  15. Receives neuromuscular blocking agents to ensure adequate ventilation (Ans- 1,2,3,

A patient scores positive on the Confusion Assessment Method of the Intensive Care Unit (CAM-ICU). Which nursing diagnosis would have the highest priority based on this positive score?

  1. Injury, Risk for
  2. Family Processes, Altered
  3. Social Interaction, Impaired
  4. Memory Impaired Answer: 1 (Ans- 1 Which nursing action would be appropriate when the nurse initiates an infusion of morphine sulfate for a post-operative patient who is experiencing pain?
  5. Anticipate that the patient will begin to experience the effect of the morphine 15 minutes after the start of the infusion.
  6. Provide additional intermittent boluses of morphine sulfate if the patient experiences breakthrough pain.
  7. Complete the Critical-Care Pain Observation Tool scale 5 minutes after increasing the infusion rate each time.
  8. Begin the infusion at the lowest ordered dose, and increase the rate every 30 minutes if the patient continues to have pain. (Ans- 2 Which strategies should the nurse include in the plan of care when trying to minimize sleep disruptions for a patient in an ICU? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  9. Instituting a short course of therapy for sleeping agents
  10. Accurate scoring and vigilance in sedation and sedation scoring
  11. Managing the environment to reduce lighting and sound
  12. Minimizing staff interruptions during sleep periods
  13. Scheduling treatments only during the day or at least 4 hours apart at night (Ans- 1,2,3,

Which nursing diagnosis should receive the highest priority when caring for a patient who is receiving total parenteral nutrition?

  1. Infection, Risk for
  2. Trauma, Risk for
  3. Skin Integrity, Impaired
  4. Fluid Volume, Risk for Imbalance (Ans- 1 What should the nurse do to meet the needs of the critically ill patient's family members? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  5. Express an attitude of hope, honesty, open communication, and caring
  6. State specific facts about the patient's condition in a timely manner
  7. Plan regular times for family visits throughout the day
  8. Limit the number of visitors to significant others
  9. Communicate to a single family member to cut down time wasted repeating information to all visitors (Ans- 1,2, Which statement describing the needs of family members of critically ill patients has yet to be validated by research?
  10. "Not knowing is the worst part" of waiting.
  11. Families in the waiting room have no effect on patient outcomes.
  12. "Hovering" in the proximity phase is characterized by confusion and tension.
  13. A unified message from staff minimizes family stressors. (Ans- 2 The nurse addresses the family needs of a critically ill patient. Which family need was not identified?
  14. Proximity
  15. Information
  16. Assurance
  17. Timeliness (Ans- 4

When planning care to meet the needs of families of critically ill patients, the nurse should include which strategies by Miracle (2006)? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.

  1. Information about how to contact the primary doctor if needed
  2. Frequent verbal communication to clarify the purpose of unit, equipment, procedures, waiting areas, phones, and so on
  3. Regular family conferences to meet patient goals and progress
  4. A consistent nurse, and unified staff responses if that nurse is not available
  5. A way to contact family through a specific family member by phone if needed (Ans- 1,3, A physician suggests that a patient being mechanically ventilated, needing immediate transport to CT scan, and having severe pain be given IV fentanyl (Sublimaze) rather than morphine sulfate for pain management. Why is fentanyl (Sublimaze) preferred?
  6. Rapid administration does not have any hemodynamic consequences.
  7. It has a more rapid onset and a shorter duration of action.
  8. Weaning of a continuous infusion is never needed due to its short half- life.
  9. It is not likely to cause respiratory depression (Ans- 2 A patient being mechanically ventilated receives midazolam (Versed) for sedation. What findings indicate to the nurse that the patient is receiving an appropriate dose of this medication?
  10. Awake with a respiratory rate of 38 and a heart rate of 132
  11. Asleep but withdrawing from noxious stimuli with a heart rate of 80
  12. Awake with a heart rate of 124 and attempting to pull out the IV
  13. Asleep but awakening to light touch with a heart rate of 72 (Ans- 4 The nurse cares for a patient recovering from surgery who is being mechanically ventilated and experiencing pain. Which approach should the nurse use first to assess this patient's pain?

The nurse providing care to a patient who is unresponsive and being mechanically ventilated uses unintentional distractions. What is the nurse doing when providing care? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.

  1. Singing
  2. Humming
  3. Joking
  4. Talking to a colleague
  5. Apologizing for causing pain (Ans- 1,2, What strategies should the nurse use to communicate with an older adult patient who is intubated and being mechanically ventilated? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  6. Make sure the patient is wearing eyeglasses.
  7. Speak slowly.
  8. Decide on which gestures mean "yes" and "no."
  9. Have questions and possible answers ready so the patient can point to the response.
  10. Ask several questions at a time to limit interruptions in rest periods. (Ans- 1,2,3, A patient in the critical care unit demonstrates increasing agitation. What should the nurse use to assess this patient's agitation level? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  11. Sedation Assessment Scale (SAS)
  12. Richmond Agitation-Sedation Scale (RASS)
  13. Glasgow Scale
  14. Reaction Level Scale
  15. Ventilator Adjusted Motor Assessment Scoring Scale (Ans- 1,

The nurse plans to use music therapy to help reduce a critically ill patient's level of anxiety. What should the nurse do when using this complementary and alternative therapy? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.

  1. Ask family members to identify the patient's preferred music.
  2. Plan for the music to be played for 30 uninterrupted minutes.
  3. Listen to the music in advance to make sure it does not have lyrics.
  4. Ensure that the music beats are between 60 to 80 per minute.
  5. Play the music from a CD player on the bedside table. (Ans- 1,2,3, The nurse assesses the nutritional needs of a patient in the intensive care unit. What information is essential for the nurse to obtain during this assessment? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  6. Patient's current height and weight
  7. Food allergies
  8. Use of nutritional supplements
  9. If the patient can swallow
  10. Amount of water consumed each day (Ans- 1,2,3, The nurse is a member of a committee that is designing improvements to the critical care waiting areas. What improvements should the nurse suggest to enhance the comfort of family members of critical care patients? Select all that apply. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
  11. Plan for a large space to be used for the waiting areas.
  12. Provide coffee and soft drinks in the waiting area.
  13. Place televisions and DVD players in the waiting area.
  14. Find space for sleeping rooms.
  15. Use dark paint and minimal lighting in the waiting areas. (Ans- 1,2,3,