NUR 445 Final Exam Review Questions
and Correct Answers
Mannitol ✅diuretic. Forces urine production in pt with AKI or ICP. SE: fluid and
electrolyte imbalance, thirst, headache, blurred vision
Atropine ✅anticholinergic or anti parasympathetic. Treatment for bradycardia. SE:
overstimulation of SNS (dry eyes/mouth, constipation)
Nitroprusside ✅centrally-acting vasodilator, can be used in a hypertensive emergency.
SE: chest pain/discomfort, irregular HR, lightheadednes, dizziness, trouble breathing
Clonidine ✅alpha 2 adrenergic agonist (decreases HR by relaxing blood vessels) can
be used in hypertensive urgency. SE: anxiety, chest pain/discomfort, confused,
decreased UO, dialated neck veins, drowsiness
Lactulose ✅PO lactulose to rid excess ammonia through stool for patients with liver
cirrhosis, increased bowel movements SE: gas, bloating, burping, stomach
pain/discomfort, nausea, cramps
Tpa (tissue plasminogen activator)- a.k.a alteplase ✅clot buster- helps to break down
blood clot, tx for ischemic stroke, SE: n/v, hypotension, dizziness, mild fever, allergic
rxns
Teamstepps- mutual support ✅assist each other, provide/receive feedback, exert
assertive/advocacy behaviour if pt safety is threatened
Task assistance- ✅climate fostered to expect assitance to be sought and offered to
reduce error occurance
Feedback ✅information provided for the purpose of improving team performance (it's
timely, respectful, specific, directed toward improvement, considerate)
Formal feedback ✅retrospective, scheduled. Ie; collab discussions, case conferences,
individual performance reviews
Informal feedback ✅in real time, ongoing, development of skills/knowledge, ie;
huddles, briefs
Advocacy and assertion ✅for patient, firm but respectful
, Assertive statement: ✅respectful/supportive of authority; clearly asserts
concerns/suggestions; nonthreatening but ensures that critical info is addressed
Five step process: ✅open the discussion, state the concern, state the problem, offer a
solution, obtain and agreement
CUS ✅concerned, uncomfortable, safety issue
Conflict in teams: ✅1. Informational "we have different info!" 2. Interpersonal- hostile
and harassing behavior
2 ways to resolve conflict in teams: ✅two challenge rule (for informational conflict) &
DESC (for informational and interpersonal conflict)
Two challenge rule ✅invoke when initial assertion is ignored, assertively voice your
concern AT LEAST twice to ensure that it has been heard, challenged member must
acknowledge, if outcome is not acceptable, take stronger course of action and/or chain
of command, empower any team member to "stop the line" if he/she/they
sense/discovers a breach of safety (this action is never to be taken lightly but requires
immediate cessation of the process and resolution of the safety issue
DESC ✅1. Describe the specific situation 2.express your concerns about the action 3.
Suggest other alternatives 4. Consqueces should be stated 5. Discussion is timely and
private, work on win-win; frame the problem in terms of your own experience using "I"
statements; avoid blame statements; critique is NOT criticism; focus on whats right not
who's right
Alarm fatigue ✅clinicians experience high exposure to medical device alarms, causing
alarm desensitization and leading to missed alarms or delayed response. Reduce alarm
fatigue, make sure you set alarms based on needs of pt (ie if pt has 130 bpm afib don't
set tele alarm for 110)
Purpose od palliative care ✅an interdisciplinary approach to relieve suffering and
improve QOL
Effective communication- goals of care (family centered approach) ✅1. ID advanced
directives, code status 2. Hold a pt/family meeting in early days of ICU 3. Outline steps
to be taken to accomplish goals 4. Communicate care plan 5. Interdisciplinary approach
to make decisions 6. If pts lack capacity or legal rep, a guardian should take over
Improve staff communication ✅1. Test results to right people on time 2. Use
medications safely 3. Label medications 4. Take extra care with patients on blood
thinners 5. Record patient medication history and pass it along (PTA meds) 6. Rights of
med safety --> right med, route, time, dose, reason, documentation
