NURS 424 High Acuity Exam #1 Chapter Review
Quizzes Answered + Rationales 2021/2022.
The ICU nurse receives a call from the medical-surgical unit requesting transfer of a patient to
the ICU. The patient is in acute respiratory failure and requires mechanical ventilation. He will
require vasoactive drugs to help manage his profound hypotension. based on the SCCM
prioritization model, what is this patient's priority for ICU placement?
A. Priority 1
B. Priority 2
C. Priority 3
D. Priority 4 ✅ANS- Priority 1
This patient is unstable and requires treatment and monitoring that cannot be provided outside
the ICU (new mechanical ventilation and vasoactive infusions). This condition meets the criteria
for Priority 1 admission
A nurse is interviewing for a position in a community hospital. Hospital brochures describe a
Level III ICU. Which statement describes the resources that the nurse would expect in this
hospital?
A. Those working in the ICU have specialty training and use specialized equipment to care for a
wide variety of client illness and injuries
B. Staff and equipment in the unit are capable of providing comprehensive care for clients with a
variety of illnesses and injuries.
C. Staff in the unit can provide initial stabilization of patients for transfer to more advanced care
D. The hospital is a teaching facility with sophisticated equipment and providers expertise.
✅ANS- Staff in the unit can provide initial stabilization of patients for transfer to more
advanced care
A Level III ICU provides initial stabilization of patients
A hospital has been working to achieve Magnet status. Which statements by an ICU nurse reflect
the benefits of Magnet status? (Select all that apply.)
A. "I feel more ownership in the decisions being made to run the unit."
B. "I don't have a supervise UAPs anymore"
C. "It would be so much easier to work here if the physicians were friendlier"
D. "Taking care of one less patient each shift makes such a difference."
E. "Our pay raise makes working here worth all the stress"
,✅ANS- "I feel more ownership in the decisions being made to run the unit."
"Taking care of one less patient each shift makes such a difference."
1. Nurses who work in Magnet hospitals are more involved in decision making, which increases
their ownership of the decisions.
2. Improved nurse-patient ratios are a benefit of work toward Magnet status
In the middle of a shift a nurse comes to the manager to discuss the acuity level and number of
patients he has been assigned. Which statement would the manager interpret as indicating the
nurse needs further education about nurse-patient ratios?
A. "I cannot provide the amount of care that all these clients need"
B. "Our professional organizations would not approve of exceeding their recommended ratios."
C. "Is there someone who can be called in to help me with this client load?"
D. I am worried I'm going to miss something with one of these clients."
✅ANS- "Our professional organizations would not approve of exceeding their recommended
ratios."
AACN and AMSN do not set recommended ratios.
New, fairly complex monitoring devices have been purchased to replace current monitors in the
ICU. How should the nurse manager plan to introduce this equipment to the unit?
A. Have one device placed in one room and rotate nurses through caring for clients on the
monitor.
B. Require that all nurses caring for patients on this monitor have extensive training on its use.
C. Have all the old monitors replaced with the new devices so that nurses can learn by using the
equipment.
D. Tell the nurses to focus on how to use the monitor when caring for clients for the first few
days. ✅ANS- Require that all nurses caring for patients on this monitor have extensive training
on its use.
All nurses who will use this equipment must be trained in its use before caring for a patient on
the monitor.
What is the best advice that an experienced ICU nurse can offer to new nurses on how to remain
focused on the patient?
A." Learn about the equipment before caring for the client"
B. "Don't come to work in the ICU until you are proficient in all the equipment we use"
,C. "Try to arrange equipment so that you have ample opportunity to use the power of your touch
with the patient."
D. "Until you are comfortable with equipment, ask to be assigned with another nurse."
✅ANS- "Try to arrange equipment so that you have ample opportunity to use the power of
your touch with the patient."
Touch helps to personalize the patient for the nurse. Touch also helps to reduce anxiety in the
patient.
A coworker has become increasingly withdrawn from social activities on the unit. She is often
late for work and is ambivalent about warnings from the nurse manager. She has become hostile
and negative about proposed changes in the unit. The nurse should recognize that the coworker is
exhibiting symptoms of which condition?
A. Burnout
B. Stress
C. Job dissatisfaction
D. Conflict ✅ANS- Burnout
Ambivalence, withdrawal, hostility, and negativity are all symptoms of burnout.
The nurse manager has made a commitment to improve the health of the ICU work environment.
Which activities will help meet that goal? (Select all that apply.)
A. Make every effort to assign patients so that their needs match the nurse's strengths.
B. Set up a program in which a "nurse of the day" is chosen and honored each day.
C. Engage the hospital nurse executive in efforts to improve the health of the entire environment.
D. Role-model successful collaboration with health-care providers.
E. Communicate in a clear and effective manner
✅ANS- A. Make every effort to assign patients so that their needs match the nurse's strengths.
C. Engage the hospital nurse executive in efforts to improve the health of the entire environment.
E. Communicate in a clear and effective manner.
A. Matching patient need to nurse strength reflects appropriate staffing, which is one of the
AACN standards for a healthy work environment.
C. The manager should demonstrate and encourage authentic leadership, embracing healthy
living and environmental strategies.
E. Skilled communication is one of the AACN standards for a healthy work environment.
, The hospital is planning to implement a CPOE system. One of the nurses says, "I don't see how
that is going to help." Which statement by another nurse is a good response to this concern?
A. "You are right, these systems often contribute to medication errors."
B. "I heard that these systems can cause drug-drug interactions"
C. "Actually, hospitals that have used these systems generally see error reduction."
D. The systems may help prevent errors, but they are way too expensive for use in most
hospitals."
✅ANS- "Actually, hospitals that have used these systems generally see error reduction."
CPOE systems have been found to reduce error.
The high-acuity unit's operations council is seeking suggestions concerning the use of
technology to prevent errors on the unit. What statements by nurses are good responses to this
request? (Select all that apply.)
A. "Barcode medication administration (BCMA) has been shown to reduce medication errors."
B. "We could completely eliminate errors if we had new tablet computers."
C. "We need more of the newest infusion pumps. They are always accurate."
D. "Don't purchase anything that isn't fail-safe."
E. "If we had smartphones, we could look up so much information."
✅ANS- A. "Barcode medication administration (BCMA) has been shown to reduce medication
errors."
E. "If we had smartphones, we could look up so much information."
A. BCMA systems do reduce medication errors.
E. Smartphones do allow for quick and convenient access to data.
A client is crying about a below-knee amputation sustained as a pedestrian in a pedestrian-
vehicle crash. She expresses fears about ambulating in physical therapy. The nurse interprets this
situation as a sign that the client is in which stage of grief?
A. Denial
B. Barganing
C. Depression
D. Acceptance ✅ANS- Depression
In the depression phase, the client may be sad and have frequent crying episodes. Fears about the
future are revealed.
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