Question 1

Critical care units (CCUs) have been developed in almost all hospitals because such units&#10;A) allow for concentration of expert personnel.&#10;B) can offer special services to the family.&#10;C) contain costs.&#10;D) separate the seriously ill from the other clients.

Accepted Answer

The CCU offers a space in which a concentration of expert personnel can be assigned to monitor and apply highly technological machines such as ventilators. The concentration of personnel does not reduce cost.

Question 2

The population that is increasingly using critical care units and needing specialized nursing care is the population of&#10;A) elderly.&#10;B) middle-age adults.&#10;C) underserved pregnant women.&#10;D) uninsured.

Accepted Answer

Clients needing critical care do span the life span; however, those ages 65 and older comprise an increasing number of such clients. Of all hospital beds, more than 50% are filled with the elderly. The physiologic changes that accompany aging, plus chronic conditions seen in this age group, lead to an increased need for critical care beds.

Question 3

The nurse admitting clients to an intensive care unit understands that research demonstrates best client outcomes when clients&#10;A) are in an area that allows liberal family visitation.&#10;B) have consistent nurses caring for them.&#10;C) have state of the art physiologic monitoring.&#10;D) receive multidisciplinary care led by an intensivist.

Accepted Answer

Studies showed a 30% reduction in intensive care unit stay when care was delivered by an intensivist-lead multidisciplinary team as opposed to an attending physician.

Question 4

The nurse admitting clients to the critical care unit understands that priority clients for this area are those who need&#10;A) a cleaner environment to prevent nosocomial infections.&#10;B) continuous physiologic monitoring.&#10;C) frequent vital sign checks.&#10;D) private rooms conducive to rest and sleep.

Accepted Answer

The critical care unit is designed to provide intensive care to patients who require continuous monitoring and interventions for their physiologic stability. Patients may have multiple lines and tubes in place, and frequent assessments are needed to assess their response to treatment and overall condition. While infection prevention measures are important in any healthcare setting, it is not the primary reason for admitting patients to the critical care unit. Private rooms are also not a priority as the focus is on providing timely interventions and care.

Question 5

A nurse who is acting in a manner that respects and supports the client's and family's basic rights, values, and beliefs is functioning in which professional role?&#10;A) Advocate&#10;B) Caregiver&#10;C) Critical thinker&#10;D) Manager

Accepted Answer

See Box 7-3 for more description of advocacy in critical care. A nurse functioning in the caregiver role provides bedside care. A critical thinker evaluates all options and chooses the best response when faced with a dilemma. A manager coordinates care.

Question 6

A critical care nurse understands that stressors affecting both the client and the client's family include (Select all that apply)&#10;A) disorientation.&#10;B) fear.&#10;C) immobility.&#10;D) pain.&#10;E) privacy.

Accepted Answer

Clients and their families have multiple stressors in the critical care environment. Lack of privacy is one of them as are the other four options.

Question 7

The ICU nurse planning care for a critically ill client tries to arrange care to minimize the most disruptive stressor for the client, which is&#10;A) alteration in sleep.&#10;B) fear of the unknown.&#10;C) persistent pain.&#10;D) sense of isolation.

Accepted Answer

There are many stressors to the ICU client, but alteration in sleep patterns supercedes all the other options.

Question 8

The essential nurse competency that the critical care nurse uses when providing best care practices is&#10;A) advocacy.&#10;B) clinical inquiry.&#10;C) clinical judgment.&#10;D) systems thinking.

Accepted Answer

Advocacy is working on another's behalf when that person is not capable of advocating for himself/herself. Clinical judgment is the reasoning used by a health care provider when delivering care. Systems thinking is using tools and knowledge to work within the interconnected health care system. Clinical inquiry is the ongoing process of questioning and evaluating practice, providing informed practice, and innovating through research and experiential learning. All are essential nurse competencies for the critical care nurse.

Question 9

A nurse working in critical care would plan interactions with clients' families based on the understanding that families most need&#10;A) knowledge.&#10;B) respect.&#10;C) sleep.&#10;D) spiritual support.

Accepted Answer

Studies consistently show that the family's need for knowledge is consistent. While all options are valid, need-to-know is most important. Nurses tend to greatly underestimate their role in keeping families' needs satisfied. Providing information from one consistent nurse is very valuable and helpful to most families.

Question 10

A nurse working in the critical care unit would assess the client's complexity by asking questions related to&#10;A) ability of the client and family to make sound decisions.&#10;B) effect of family, stress, and environmental factors on the client.&#10;C) interplay of multiple medical problems on the current condition.&#10;D) the client's ability to use compensatory coping mechanisms.

Accepted Answer

Complexity is a client characteristic that assesses the intricate entanglement of two or more systems, such as physiologic, emotional, family, and environment. Option a refers to participation in decision-making, option c is not a client characteristic, and option d is resiliency.

Deck 7: Critical Care