Understanding the Essentials of Critical Care Nursing 2nd Edition Perrin Test Bank Chapter 1 Question 1
Type: MCSA
Which patient would the nurse identify as experiencing a critical illness? The patient:
- With chronic airflow limitation whose VS are BP 110/72, P 110, R 16
- With acute bronchospasm and whose VS are BP 100/60, P 124, R 32
- Who was involved in a motor vehicle crash whose VS are BP 124/74, P 74, R 18
- On hemodialysis for chronic renal failure with no urine output and whose VS are BP 98/50, P 108, R 12
Correct Answer: 2
Rationale 1: The blood pressure and respiratory rate are considered within normal limits. The heart rate is slightly elevated. Based upon these vital signs, this patient is not critically ill.
Rationale 2: Acute bronchospasm can present a life-threatening situation, which can jeopardize a patient's survival. The patient’s pulse and respiratory rate are elevated, which could indicate a critical illness.
Rationale 3: According to the vital signs, this patient is not critically ill despite being in a motor vehicle crash.
Rationale 4: The patient on receiving hemodialysis for chronic renal failure is not considered critically ill unless another disease process or health issue develops. The patient’s vital signs are consistent with someone with chronic renal failure.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 1-1: Define critical care.
Question 2
Type: MCMA
Of the following patients, which will the nurse expect to be transferred to a critical care unit? The patient:
Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1 / 4
Standard Text: Select all that apply.
- With an acetaminophen overdose
- Suffering from acute mental illness
- With chronic renal failure
- With acute decompensated heart failure
- With bacteremia from an infected foot wound
Correct Answer: 1,4,5
Rationale 1: Critical care units are cost-efficient units for caring for patients with specific organ system failure.Patients with acetaminophen overdose often suffer liver failure as a consequence.
Rationale 2: A patient with acute mental illness would not receive care in a critical care unit. This health problem would be considered noncritical.
Rationale 3: Even though critical care units are cost-efficient units for caring for patients with specific organ system failure, chronic renal failure is not a disease process necessitating the critical care environment.
Rationale 4: The patient with acute decompensated heart failure would receive care in a critical care unit. This patient has a specific organ that has failed.
Rationale 5: Bacteremia can affect many organs and lead to multisystem organ failure. This patient would receive care in a critical care unit.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 1-1: Define critical care.
Question 3
Type: MCSA
The nurse, employed in a hospital in a small rural town, would expect to provide which level of care in the critical care unit?
- Level I
- Level II
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- Level III
- It is unlikely that the hospital would have a critical care unit.
Correct Answer: 3
Rationale 1: This level of care is provided most likely within teaching hospitals and not in a rural facility.
Rationale 2: This level is able to provide comprehensive critical care for most disorders but the unit may not be able to care for specific types of patients. It is unlikely that this level of care would be available in a small rural facility.
Rationale 3: Level III facilities provide initial stabilization of critically ill patients but limited ability to provide comprehensive critical care. A limited number of patients who require routine care may remain in the facility but written policies should be in place determining which patients require transfer and where they ought to be transferred. This level of care is most likely provided in a small rural facility.
Rationale 4: Most hospitals have some level of critical care area.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 1-2: State the three levels of care provided in critical care units.
Question 4
Type: MCSA
The nurse, providing patient care in an "open" ICU, would most likely be working with a:
- Multidisciplinary team with physicians who are also responsible for patients on other units
- Multidisciplinary team that includes a physician employed by the hospital
- Physician in charge of patient care who is a specialist in critical care
- Primary care physician who must consult a critical care specialist
Correct Answer: 1
Rationale 1: In an open ICU, nurses, pharmacists, and respiratory therapists are ICU based but the physicians directing patient care may have other obligations. These physicians may or may not choose to consult an intensivist to assist with the management of their ICU patients.
Rationale 2: This does not describe an open ICU.
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Rationale 3: This does not describe an open ICU.
Rationale 4: This does not describe an open ICU.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 1-3: Compare and contrast "open" and "closed" critical care units.
Question 5
Type: MCSA
The nurse, providing care to patients in a critical care unit, realizes that technology increases the likelihood of
errors when:
- It relies heavily on human decision making.
- Devices are programmed to function without double checks.
- It makes the workload seem overwhelming to health care providers.
- There is uniform equipment throughout each facility.
Correct Answer: 2
Rationale 1: This is not identified as increasing the likelihood of errors in the critical care unit.
Rationale 2: Technology changes the tasks people do by shifting the workload and eliminating human decision making.
Rationale 3: This is not identified as increasing the likelihood of errors in the critical care unit.Rationale 4: This is not identified as increasing the likelihood of errors in the critical care unit.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 1-4: Explain why critical care units are one of the most common sites for health care errors.
Question 6
Type: MCSA
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