Deck 1: High-Acuity Nursing

Question 1

Which actions would the charge nurse evaluate as indicating "alarm fatigue" in a nurse who works in an intensive care unit (ICU)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The nurse completes measuring a patient's urine before responding to a ventilator alarm in the next cubicle.
B)The nurse says,"Would you check this patient's IV? The controller alarm keeps sounding."
C)The manager discovers deactivation of a heart rate alarm in the rooms of two patients assigned to the nurse.
D)The nurse responds to the wrong cubicle when a ventilator alarm sounds.
E)The nurse responds to an alarm while saying,"I wish this patient would stop moving his arm around.It makes his IV alarm sound."

Answer 1

The nurse completes measuring a patient's urine before responding to a ventilator alarm in the next cubicle.
The manager discovers deactivation of a heart rate alarm in the rooms of two patients assigned to the nurse.

Question 2

While orienting to the critical care unit,the newly hired nurse notices that the preceptor is using a tablet computer during medication administration.The new nurse says,"That looks awkward and time consuming." How should the preceptor reply?

A)"It is awkward but it is required and I am getting accustomed to it."
B)"I use it to make certain I am medicating the right patient."
C)"Using a tablet computer actually increases the speed at which I can deliver care."
D)"I use the tablet computer to check on dosing and side effect information when I am giving new medications."

Answer 2

"I use the tablet computer to check on dosing and side effect information when I am giving new medications."

Question 3

A recently hired nurse has been overheard saying she does not need to check as closely on her assigned patients as there are many machines that will "just do it for you." What action by the nurse manager is indicated?

A)The nurse manager should plan a skills check off for the nurse.
B)The nurse should have a notation placed in her file indicating a lack of due care to assigned patients.
C)The manager should issue a verbal warning to the nurse.
D)The nurse manager should discuss assessment priorities with the nurse.

Answer 3

The nurse manager should discuss assessment priorities with the nurse.

Question 4

The daughter of a patient who is dying questions the placement of her father on the medical-surgical care unit (MSCU).She requests he be placed in the intensive care unit (ICU)because of concern her father may not receive close observation on a busy hospital unit.Which action is indicated by the nurse?

A)Notify the intensive care unit of an impending transfer.
B)Tell the daughter that her father does not meet criteria for placement in the more expensive ICU.
C)Discuss the care that can be provided on the unit with the family member.
D)Contact the physician.

Question 5

A group of nurse managers are concerned about a series of recent errors made by several nurses in the critical care units.The mangers should advocate for which change to help promote patient safety?

A)Increased unlicensed personnel for the unit
B)Reduction of the presence of managerial input to encourage staff nurses to assume responsibility for outcomes
C)Pay increases to attract better nurses
D)Increase in the number of nurses on the unit who have baccalaureate degrees

Question 6

The nurse who transferred to the intensive care environment 6 months ago tells the nurse manager that he feels "burned out." The nurse voices curiosity about how this could happen after such a short time in the unit.The charge nurse's response should contain which information?

A)Burnout is not limited to long-term exposure to a work environment.
B)Burnout cannot be predicted.
C)The nurse most likely is not a good candidate for the intensive care unit.
D)The nurse is having a delayed response to change in work environment.

Question 7

The patient who had surgery yesterday reports his chest feels tight.Assessment reveals respiratory rate of 29,inspiratory wheezes,stridor,and an oxygenation saturation of 80%.The nurse would consider this patient to be which priority for transfer to the intensive care unit (ICU)?

A)Priority 1
B)Priority 2
C)Priority 3
D)Priority 4

Question 8

A newly employed nurse is working with an experienced registered nurse.During the shift,the experienced nurse routinely accesses a tablet computer.What advice should the experienced RN offer the newly licensed nurse about this technology?

A)"Be careful that you don't pay more attention to the computer than you do to the patient."
B)"If you send a copy of your patient's order sheet and lab results to the tablet,it can save you time during the day."
C)"I'll show you where there are some stress-relieving games you can access from this tablet."
D)"These tablets are such time-savers.I'll show you a few shortcuts to help you get started."

Question 9

The charge nurse is concerned that a nurse may be developing "burnout" from work in the intensive care unit.Which behaviors would the charge nurse watch for in this nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The nurse is drinking more coffee than earlier in the year.
B)The nurse has gained a noticeable amount of weight in the last 6 months.
C)The nurse volunteers to precept a newly hired nurse.
D)The nurse says,"I'm not going to take care of stupid drug addicts anymore."
E)The nurse has made two minor medication errors in the last week.

Question 10

The registered nurse is working as charge nurse on a busy high-acuity care unit.Unexpectedly,a coworker becomes ill and needs to leave.There is a period of time in which the unit is short staffed while the ill coworker's replacement travels in to work.What action by the charge nurse is indicated?

A)Make no changes until the replacement nurse arrives.
B)Assign the less acute patients to be cared for by the unlicensed assistive personnel.
C)Assign the unlicensed assistive personnel to watch the monitors and call for help if a patient "gets into trouble."
D)Contact the house supervisor and ask for a float nurse to be sent to the unit.

Question 11

A group of nurses have been asked to meet with the emergency department manager for stress debriefing after working an incident in which several children were killed.One of the nurses says,"I don't know why this is necessary.We are all comfortable with our role in trying to save those kids." What response by the manager is indicated?

A)"We need to meet so everyone can share their feelings about our response."
B)"I thought we could use this situation to discuss who would be the best nurse to act as charge nurse when I am away from the department."
C)"We need to meet so that you will have documented stress management education for your next pay raise consideration."
D)"We need to review everyone's actions during the incident to be sure that no one did anything wrong."

Question 12

A nurse says,"I worry that these machines in the intensive care unit interfere with my ability to establish a therapeutic relationship with my patients." What response by the nurse manager is indicated?

A)"Technology improves our patient outcomes."
B)"I completely understand how you feel."
C)"There are ways to increase your interaction with your assigned patients."
D)"These feelings may be a sign that this is not the work environment for you."

Question 13

A nurse who made an error is concerned about what will happen when the mistake is brought to light.What information should the nurse manager provide to this nurse?

A)"If an error is small I see no reason to report it."
B)"All errors are serious and will likely result in some disciplinary action."
C)"No one likes to admit errors but reporting helps others avoid the same mistake."
D)"Errors are human and there is no need to dwell on them."

Question 14

Every bed in the intensive care unit is occupied when a call comes from the emergency department about admitting a patient who was critically injured in an explosion.Which patients would the manager evaluate as a possible transfer to a less acute unit? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)A 70-year-old man who remains hemodynamically unstable after cardiac surgery the previous day
B)A 48-year-old patient who was admitted for diabetic ketoacidosis whose blood glucose is now 240 mg/dL
C)A 40-year-old patient admitted for an unintentional overdose of blood pressure medication who is now conscious and alert
D)An 18-year-old patient who developed a pulmonary embolism this morning and is being mechanically ventilated
E)A 41-year-old patient with severe sepsis secondary to renal failure for whom the family has requested "no code" status

Question 15

The nurse executive is planning education for new nurse managers regarding the AACN Standards for a Healthy Work Environment.Which information should be included?

A)The critical partners in the organization are physicians,members of the administration,and nurse managers.
B)Staff nurses must embrace authentic leadership and value it to ensure an effectively running patient care unit.
C)In critical care units the need for expert clinical skills is more important than simple communication skills.
D)True collaboration must be promoted to ensure a healthy work environment.

Question 16

A recent nursing school graduate reports having an interview with a magnet hospital.When preparing for the interview,the graduate nurse researches the concept of magnet status.Which perceptions by the nurse indicate an adequate understanding?

A)Magnet status is an accreditation from the National League for Nurses.
B)Magnet status facilities pay substantial recruitment bonuses.
C)Magnet status facilities promote the interests of professional nursing.
D)Magnet status hospitals must establish nurse-to-patient ratios.

Question 17

A nurse who is contemplating taking a position in an intensive care unit is reviewing her strengths and weaknesses.Which characteristics of the nurse will be of the greatest benefit in the intensive care environment?

A)Feels comfortable in ever-changing situations
B)Closely evaluates the pros and cons of each decision for a long period of time before making a decision
C)Is quiet and introverted
D)Is excited about all new experiences

Question 18

During the formal time-out process before beginning bedside placement of a transvenous pacemaker,the nurse identifies a piece of equipment that is not working.What actions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Ask the physician if the equipment is necessary for the procedure.
B)Replace the equipment.
C)Tag the equipment as faulty.
D)Report the faulty equipment.
E)Quickly try to diagnose what is wrong with the equipment.

Question 19

A team of nurses would like to research outcomes of intensive care that expand beyond those that are normally studied.This team would recognize which outcome as most commonly studied?

A)Patient comfort
B)Patient perceived quality of life
C)Functional status
D)Mortality

Question 20

The nurse manager of an emergency department has been notified that a patient is being transferred from a rural ED.What should the manager check before responding to this notification? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Has a physician at this hospital agreed to accept the patient?
B)Does the patient have insurance?
C)When is the patient supposed to arrive?
D)Is the patient likely to survive transfer?
E)Is a bed available in the appropriate unit to provide care for the patient?