Test Bank Critical Care Nursing:
Diagnosis and Management,
8th edition (Urden),
Chapter 1-41 | All Chapters
,Chapter 01: Critical Care Nursing Practice
Urden: Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. During World War II, what type of wards were developed to care for critically injured
patients?
a. Intensive care
b. Triage
c. Shock
d. Postoperative
ANS: C
During World War II, shock wards were established to care for critically injured patients.
Triage wards establish the order in which a patient is seen or treated upon arrival to a hospital.
Postoperative wards were developed in 1900 and later evolved into intensive care units.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 1
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
2. What type of practitioner has a broad depth of specialty knowledge and expertise and manages
complex clinical and system issues?
a. Registered nurses
b. Advanced practice nurses
c. Clinical nurse leaders
d. Intensivists .
ANS: B
Advanced practice nurses (APNs) have a broad depth of knowledge and expertise in their
specialty area and manage complex clinical and systems issues. Intensivists are medical
practitioners who manage the critical ill patient. Registered nurses (RNs) are generally direct
care providers. Clinical nurse leaders (CNLs) generally do not manage system issues.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 2
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
3. What type of practitioner is instrumental in ensuring care that is evidence based and that
safety programs are in place?
a. Clinical nurse specialist
b. Advanced practice nurse
c. Registered nurses
d. Nurse practitioners
ANS: A
, Clinical nurse specialists (CNSs) serve in specialty roles that use their clinical, teaching,
research, leadership, and consultative abilities. They are instrumental in ensuring that care is
evidence based and that safety programs are in place. Advanced practice nurses (APNs) have
a broad depth of knowledge and expertise in their specialty area and manage complex clinical
and systems issues. Registered nurses are generally direct care providers. Nurse practitioners
(NPs) manage direct clinical care of groups of patients.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 2
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
4. Which professional organization administers critical care certification exams for registered
nurses?
a. State Board of Registered Nurses
b. National Association of Clinical Nurse Specialist
c. Society of Critical Care Medicine
d. American Association of Critical-Care Nurses
ANS: D
American Association of Critical-Care Nurses (AACN) administers certification exams for
registered nurses. The State Board of Registered Nurses (SBON) does not administer
certification exams. National Association of Clinical Nurse Specialists (NACNS) does not
administer certification exams. Society of Critical Care Medicine (SCCM) does not
administer nursing certification exams for registered nurses.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 3
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and EffecN tivUeR
CSarINnGviTroBnm.eCntOM
eE
5. Emphasis is on human integrity and stresses the theory that the body, mind, and spirit are
interdependent and inseparable. This statement describes which methodology of care?
a. Holistic care
b. Individualized care
c. Cultural care
d. Interdisciplinary care
ANS: A
Holistic care focuses on human integrity and stresses that the body, mind, and spirit are
interdependent and inseparable. Individualized care recognizes the uniqueness of each
patient’s preferences, condition, and physiologic and psychosocial status. Cultural diversity in
health care is not a new topic, but it is gaining emphasis and importance as the world becomes
more accessible to all as the result of increasing technologies and interfaces with places and
peoples. Interdisciplinary care is care among a variety of health care professionals with the
patient’s health as the common goal.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 4
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
6. The American Association of Critical-Care Nurses (AACN) has developed short directives
that can be used as quick references for clinical use that are known as
, a. Critical Care Protocol.
b. Practice Policies.
c. Evidence-Based Research.
d. Practice Alerts.
ANS: D
The American Association of Critical-Care Nurses (AACN) has promulgated several
evidence-based practice summaries in the form of “Practice Alerts.” Evidence-based nursing
practice considers the best research evidence on the care topic along with clinical expertise of
the nurse and patient preferences. Critical care protocol and practice policies are established
by individual institutions.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 3
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
7. What type of therapy is an option to conventional treatment?
a. Alternative
b. Holistic
c. Complementary
d. Individualized
ANS: A
The term alternative denotes that a specific therapy is an option or alternative to what is
considered conventional treatment of a condition or state. The term complementary was
proposed to describe therapies that can be used to complement or support conventional
treatments. Holistic care focuses on human integrity and stresses that the body, mind, and
spirit are interdependent and N URparSI
inse NG. InTB
able di.
viC OM
dualized care recognizes the uniqueness of
each patient’s preferences, condition, and physiologic and psychosocial status.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 4
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
8. Prayer, guided imagery, and massage are all examples of what type of treatment?
a. Alternative therapy
b. Holistic care
c. Complementary care
d. Individualized care
ANS: C
The term complementary was proposed to describe therapies that can be used to complement
or support conventional treatments. Spirituality, prayer, guided imagery, massage, and
animal-assisted therapy are all examples of complementary care. The term alternative denotes
that a specific therapy is an option or alternative to what is considered conventional treatment
of a condition or state. Holistic care focuses on human integrity and stresses that the body,
mind, and spirit are interdependent and inseparable. Individualized care recognizes the
uniqueness of each patient’s preferences, condition, and physiologic and psychosocial status.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 4
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
, 9. What is the systematic decision-making model used by nurses termed?
a. Nursing diagnosis
b. Nursing interventions
c. Nursing evaluations
d. Nursing process
ANS: D
The nursing process is a systematic decision-making model that is cyclic, not linear. An
essential and distinguishing feature of any nursing diagnosis is that it describes a health
condition. Nursing interventions constitute the treatment approach to an identified health
alteration. Evaluation of attainment of the expected patient outcomes occurs formally at
intervals designated in the outcome criteria.
PTS: 1 DIF: Cognitive Level: Understanding REF: n/a
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
10. What is a health condition primarily resolved by nursing interventions or therapies called?
a. Nursing diagnosis
b. Nursing interventions
c. Nursing outcomes
d. Nursing process
ANS: A
An essential and distinguishing feature of any nursing diagnosis is that it describes a health
condition. Nursing interventions constitute the treatment approach to an identified health
alteration. Evaluation of attaiN
nmeRnt oIf thG
e exBp.
ecCtedMpatient outcomes occurs formally at
U S N T O
intervals designated in the outcome criteria. The nursing process is a systematic
decision-making model that is cyclic, not linear.
PTS: 1 DIF: Cognitive Level: Remembering REF: n/a
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
11. Designing therapeutic activities that move a patient from one state of health to another is an
example of which of the following?
a. Nursing diagnosis
b. Nursing interventions
c. Nursing outcomes
d. Nursing process
ANS: B
Nursing interventions constitute the treatment approach to an identified health alteration. An
essential and distinguishing feature of any nursing diagnosis is that it describes a health
condition. Evaluation of attainment of the expected patient outcomes occurs formally at
intervals designated in the outcome criteria. The nursing process is a systematic
decision-making model that is cyclic, not linear.
PTS: 1 DIF: Cognitive Level: Remembering REF: n/a
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
,12. A patient was admitted to a rural critical care unit in Montana. Critical care nurses are
assisting with monitoring and care of the patient from the closest major city. What is this type
of practice termed?
a. Tele-nursing
b. Tele-ICU
c. Tele-informatics
d. Tele-hospital
ANS: B
Tele-ICU is a form of telemedicine. Telemedicine was initially used in outpatient areas,
remote rural geographic locations, and areas where there was a dearth of medical providers.
Currently, there are tele-ICUs in areas where there are limited resources onsite. However,
experts (critical care nurses, intensivists) are located in a central distant site.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 5
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
13. Which core competency for interprofessional practice can be described as working with
individuals of other professions to maintain a climate of mutual respect and shared values?
a. Interprofessional teamwork and team-based care
b. Values and ethics for interprofessional practice
c. Interprofessional communication
d. Roles and responsibilities for collaborative practice
ANS: B
Values and ethics for interproNfesRsionI
al pG
ractB
ic.
eCmeaM
n working with individuals of other
U S N T O
professions to maintain a climate of mutual respect and shared values. Roles and
responsibilities for collaborative practice include using knowledge of one’s own role and the
roles of other professions to appropriately assess and address the health care needs of the
patients and populations served. Interprofessional communication includes communicating
with patients, families, communities, and other health professionals in a responsive and
responsible manner that supports a team approach to maintaining health and treatment of
disease. Interprofessional teamwork and team-based care means applying
relationship-building values and principles of team dynamics to perform effectively in
different team roles to plan and deliver patient population-centered care that is safe, timely,
efficient, effective, and equitable.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 5|Box 1-5
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
14. What is the stepwise decision-making flowchart for a specific care process named?
a. Algorithm
b. Practice guideline
c. Protocol
d. Order set
ANS: A
, An algorithm is a stepwise decision-making flowchart for a specific care process or processes.
A practice guideline is usually created by an expert panel and developed by a professional
organization. Protocols are more directive and rigid than guidelines, and providers are not
supposed to vary from a protocol. An order set consists of preprinted provider orders that are
used to expedite the order process after a standard has been validated through analytic review
of practice and research.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 6
OBJ: Nursing Process Step: Intervention TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
15. Which nursing intervention continues to be one of the most error-prone for critical care
nurses?
a. Inappropriate care
b. Intimidating and disruptive clinician behavior
c. Injury to patients by falls
d. Medication administration
ANS: D
Medication administration continues to be one of the most error-prone nursing interventions
for critical care nurses. Intimidating and disruptive clinician behaviors can lead to errors and
preventable adverse patient outcomes. Patient safety has been described as an ethical
imperative and one that is inherent in health care professionals’ actions and interpersonal
processes; examples include inappropriate care and injury to patients by falls.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 7
OBJ: Nursing Process Step: Assessment TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and EffecN tivUeR
CSarINnGviTroBnm.eCntOM
eE
16. A practitioner and nurse are performing a dressing change on an unresponsive patient in room
14. The practitioner asks the nurse for an update on the patient in room 13. Which action
should the nurse take next?
a. Give the update to the practitioner.
b. Refuse to give the update because of Health Insurance Portability and
Accountability Act (HIPAA) requirements.
c. Give the update because the is patient’s unconscious.
d. Refuse to give the update because of Occupational Safety and Health
Administration (OSHA) requirements.
ANS: B
Most specific to critical care clinicians is the privacy and confidentiality related to protection
of health care data. This has implications when interacting with family members and others
and the often very close work environments, tight working spaces, and emergency situations.
A patient’s unconscious state is not a reason for another patient’s care to be discussed in his or
her presence. Research shows hearing is the last sense to deteriorate. Occupational Safety and
Health Administration (OSHA) has to do with safety in the workplace, not privacy and
confidentiality.
PTS: 1 DIF: Cognitive Level: Applying REF: p. 8
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
,MULTIPLE RESPONSE
1. What considerations are taken into account in evidence-based nursing practice? (Select all that
apply.)
a. Clinical expertise of the nurse
b. Availability of staff and facility equipment
c. Research evidence on the topic
d. Patient knowledge of the disease
e. Patient preference regarding care
ANS: A, C, E
Evidence-based nursing practice considers the best research evidence on the care topic along
with clinical expertise of the nurse and patient preferences. For instance, when determining
the frequency of vital sign measurement, the nurse would use available research and nursing
judgment (stability, complexity, predictability, vulnerability, and resilience of the patient).
Availability of staff and facility equipment and the patient’s knowledge of the disease do not
factor into evidence-based nursing practices.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 3
OBJ: Nursing Process Step: Assessment TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
2. The concept of diversity encompasses what thoughts and actions? (Select all that apply.)
a. Sensitivity to ethnic differences
b. Openness to different lifestyles
c. Openness to different valN ues R I G B.C M
U S N T
d. Reticence to different beliefs O
e. Lack of concern regarding different opinions
ANS: A, B, C
Diversity includes not only ethnic sensitivity but also sensitivity to openness to difference
lifestyles, opinions, values, and beliefs. Reticence and lack of concern are not part of the
concept of diversity.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 4
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
3. According to American Association of Critical-Care Nurses, what are the responsibilities of a
critical care nurse? (Select all that apply.)
a. Respecting the values, beliefs, and rights of the patient
b. Intervening when the best interest of the patient is in question
c. Helping the patient obtain necessary care
d. Making decisions for the patient and patient’s family
e. Monitoring and safeguarding the quality of care the patient receives
f. Acting as a gatekeeper for the patient, the patient’s family, and other health care
professionals
ANS: A, B, C, E
, American Association of Critical-Care Nurses (AACN) critical care nurse role responsibilities
include respecting the values, beliefs, and rights of the patient; intervening when the best
interest of the patient is in question; helping the patient obtain necessary care; and monitoring
and safeguarding the quality of care the patient receives. The nurse is not to make decisions
for the patient or the patient’s family but should support their decisions. The nurse should act
as a liaison, not a gatekeeper, for the patient and the patient’s family and other health care
professionals.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 2|Box 1-1
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
4. According to Kupperschmidt, what factors are needed to become a skilled communicator?
(Select all that apply.)
a. Becoming candid
b. Becoming reflective
c. Setting goals
d. Surveying the team
e. Becoming aware of self-deception
ANS: A, B, E
Kupperschmidt and colleagues posed a five-factor model for becoming a skilled
communicator: becoming aware of self-deception, becoming authentic, becoming candid,
becoming mindful, and becoming reflective, all of which lead to being a skilled
communicator. The HWE model was offered by Blake, who suggested five steps: rallying the
team, surveying the team, establishing work groups, setting goals and developing action steps,
and celebrating successes along the way. B.C M
N R I G
U S N T O
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 9
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
, Critical Care Nursing 8th Edition Urden Test Bank
Chapter 02: Ethical Issues
Urden: Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. What is the difference between ethics and morals?
a. Ethics is more concerned with the “why” of behavior.
b. Ethics provides a framework for evaluation of the behavior.
c. Ethics is broader in scope than morals.
d. Ethics concentrates on the right or wrong behavior based on religion and culture
values.
ANS: A
Ethics are concerned with the basis of the action rather than whether the action is right or
wrong, good or bad.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 12
OBJ: Nursing Process Step: General TOP: Ethics
MSC: NCLEX: Safe and Effective Care Environment
2. A patient’s wife has been informed by the practitioner that her spouse has permanent
quadriplegia. The wife states that she does not want anyone to tell the patient about his injury.
The patient asks the nurse about what has happened. The nurse has conflicting emotions about
how to handle the situation. What is the nurse experiencing?
a. Autonomy
b. Moral distress
c. Moral doubt .
d. Moral courage
ANS: B
The nurse has been placed in a situation initially causing moral distress and is struggling with
determining the ethically appropriate action to take. Moral courage is the freedom to advocate
for oneself, patients, and peers. Autonomy is an ethical principle. Moral doubt is not part of
the American Association of Critical-Care Nurses (AACN) framework. The 4A’s to Rise
Above Moral Distress.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 12
OBJ: Nursing Process Step: General TOP: Ethics
MSC: NCLEX: Safe and Effective Care Environment
3. By what action can critical care nurses can best enhance the principle of autonomy?
a. Presenting only the information to prevent relapse in a patient
b. Assisting with only tasks that cannot be done by the patient
c. Providing the patient with all of the information and facts
d. Guiding the patient toward the best choices for care
ANS: C
Patients and families must have all the information about a certain situation to make an
autonomous decision that is best for them.
PTS: 1 DIF: Cognitive Level: Applying REF: pp. 15-16
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