Acute Care Nursing Textbook
Exam Questions
Course Introduction
Acute Care Nursing focuses on the advanced knowledge and clinical skills necessary for managing patients with severe, rapidly changing, or life-threatening medical conditions in high-intensity healthcare settings such as emergency departments, intensive care units, and surgical recovery rooms. This course covers the assessment, diagnosis, treatment, and evidence-based interventions for acute health problems, emphasizing rapid clinical decision-making, interprofessional collaboration, patient safety, and the use of medical technology. Nursing students will develop critical thinking abilities to prioritize care, respond to complex emergencies, and advocate for patients and families while maintaining ethical and compassionate care standards.
Recommended Textbook
Introduction to Critical Care Nursing 6th Edition by Mary Lou Sole
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21 Chapters
756 Verified Questions
756 Flashcards
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Chapter 1: Overview of Critical Care Nursing
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Sample Questions
Q1) Which of the following is (are)official journal(s)of the American Association of Critical-Care Nurses? (Select all that apply.)
A) American Journal of Critical Care
B) Critical Care Clinics of North America
C) Critical Care Nurse
D) Critical Care Nursing Quarterly
Answer: A,C
Q2) The synergy model of practice focuses on:
A) allowing unrestricted visiting for the patient 24 hours each day.
B) holistic and alternative therapies.
C) needs of patients and their families, which drives nursing competency.
D) patients' needs for energy and support.
Answer: C
Q3) Which of the following professional organizations best supports critical care nursing practice?
A) American Association of Critical-Care Nurses
B) American Heart Association
C) American Nurses Association
D) Society of Critical Care Medicine
Answer: A
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Chapter 2: Patient and Family Response to the Critical Care Experience
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Sample Questions
Q1) The wife of a patient who is hospitalized in the critical care unit following resuscitation for a sudden cardiac arrest at work demands to meet with the nursing manager.She states,"I want you to reassign my husband to another nurse.His current nurse is not in the room enough to make sure he is okay." The nurse recognizes that this response most likely is due to the wife's:
A) desire to pursue a lawsuit if the assignment is not changed.
B) inability to participate in the husband's care.
C) lack of prior experience in a critical care setting.
D) sense of loss of control of the situation.
Answer: D
Q2) The critical care environment is often stressful to a critically ill patient.Identify stressors that are common.(Select all that apply.)
A) Alarms that sound from various devices
B) Bright, fluorescent lighting
C) Lack of day-night cues
D) Sounds from the mechanical ventilator
E) Visiting hours tailored to meet individual needs
Answer: A,B,C,D
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Chapter 3: Ethical and Legal Issues in Critical Care Nursing
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Sample Questions
Q1) A specific request made by a competent person that directs medical care related to life-prolonging procedures if the patient loses capacity to make decisions is called a:
A) do not resuscitate order.
B) healthcare proxy.
C) informed consent.
D) living will.
Answer: D
Q2) Which of the following organizations requires a mechanism for addressing ethical issues?
A) American Association of Critical-Care Nurses
B) American Hospital Association
C) Society of Critical Care Medicine
D) The Joint Commission
Answer: D
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Chapter 4: End-Of-Life Care in the Critical Care Unit
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Sample Questions
Q1) The family is considering withdrawing life-sustaining measures from the patient.The nurse knows that ethical principles for withholding or withdrawing life-sustaining treatments include which of the following?
A) Any treatment may be withdrawn and withheld, including nutrition, antibiotics, and blood products.
B) Doses of analgesic and anxiolytic medications must be adjusted carefully and should not exceed usual recommended limits.
C) Life-sustaining treatments may be withdrawn while a patient is receiving paralytic agents.
D) The goal of withdrawal and withholding of treatments is to hasten death and thus relieve suffering.
Q2) Which therapeutic interventions may be withdrawn or withheld from the terminally ill client? (Select all that apply.)
A) Antibiotics
B) Dialysis
C) Nutrition
D) Pain medications
E) Simple nursing interventions such as repositioning and hygiene
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Chapter 5: Comfort and Sedation
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Sample Questions
Q1) The nurse is caring for a patient receiving benzodiazepine intermittently.The nurse understands that the best way to administer such drugs is to:
A) administer around the clock, rather than as needed, to ensure constant sedation.
B) administer the medications through the feeding tube to prevent complications.
C) give the highest allowable dose for the greatest effect.
D) titrate to a predefined endpoint using a standard sedation scale.
Q2) Nociceptors differ from other nerve receptors in the body in that they:
A) adapt very little to continual pain response.
B) inhibit the infiltration of neutrophils and eosinophils.
C) play no role in the inflammatory response.
D) transmit only the thermal stimuli.
Q3) The nurse recognizes that which patient is likely to benefit most from patient-controlled analgesia?
A) 21-year-old with a C4 fracture and quadriplegia
B) 45-year-old with femur fracture and closed head injury
C) 59-year-old postoperative elective bariatric surgery
D) 70-year-old postoperative cardiac surgery; mild dementia
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Page 7
Chapter 6: Nutritional Support
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Sample Questions
Q1) A patient is receiving enteral feedings and has just vomited 250 mL of milky green liquid.The nurse holds the tube feeding,which had been infusing at 100 mL/hr.The nurse knows that the next action should be:
A) connect the feeding tube to suction.
B) continue the tube feeding.
C) decrease the tube feeding.
D) recheck the residual in 2 hours.
Q2) The best nursing approach to prevent feeding tube obstruction is:
A) dilute the feeding to make it flow more easily.
B) flush the tube every 4 hours with 20 to 30 mL of tap water.
C) pass a stylet daily to keep the tubing clear.
D) use a larger bore tube where possible.
Q3) The nurse identifies which patient at greatest risk for malabsorption of protein?
A) The patient with gallbladder obstruction
B) The patient with ileitis
C) The patient with distal colon resection
D) The patient with jejunal tumor
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Chapter 7: Dysrhythmia Interpretation and Management
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Sample Questions
Q1) Electrocardiogram (ECG)paper contains a standardized grid where the horizontal axis measures time and the vertical axis measures voltage or amplitude.The nurse must understand that each horizontal box indicates:
A) 200 milliseconds or 0.20 seconds duration.
B) 40 milliseconds or 0.04 seconds duration.
C) 3 seconds duration.
D) millivolts of amplitude.
Q2) The QT interval is the total time taken for ventricular depolarization and repolarization.Prolongation of the QT interval:
A) decreases the risk of lethal dysrhythmias.
B) usually occurs when heart rate increases.
C) increases the risk of lethal dysrhythmias.
D) can only be measured with irregular rhythms.
Q3) The patient is admitted with a condition that requires cardiac rhythm monitoring.To apply the monitoring electrodes,the nurse must first:
A) apply a moist gel to the chest.
B) make certain that the electrode gel is dry.
C) avoid soaps to avoid skin irritation.
D) clip chest hair if needed.
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Page 9
Chapter 8: Hemodynamic Monitoring
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Sample Questions
Q1) The nurse is preparing to obtain a right atrial pressure (RAP/CVP)reading.What are the most appropriate nursing actions? (Select all that apply.)
A) Compare measured pressures with other physiological parameters.
B) Flush the central venous catheter with 20 mL of sterile saline.
C) Inflate the balloon with 3 mL of air and record the pressure tracing.
D) Obtain the right atrial pressure measurement during end exhalation.
E) Zero reference the transducer system at the level of the phlebostatic axis.
Q2) When performing an initial pulmonary artery occlusion pressure (PAOP),what are the best nursing actions? (Select all that apply.)
A) Inflate the balloon for no more than 8 to 10 seconds while noting the waveform change.
B) Inflate the balloon with air, recording the volume necessary to obtain a reading.
C) Maintain the balloon in the inflated position for 8 hours following insertion.
D) Zero reference and level the air-fluid interface of the transducer at the level of the phlebostatic axis.
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Chapter 9: Ventilatory Assistance
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Sample Questions
Q1) The nurse is assisting with endotracheal intubation and understands correct placement of the endotracheal tube in the trachea would be identified by which of the following? (Select all that apply.)
A) Auscultation of air over the epigastrium
B) Equal bilateral breath sounds upon auscultation
C) Position above the carina verified by chest x-ray
D) Positive detection of carbon dioxide (CO<sub>2</sub>) through CO<sub>2</sub> detector devices
Q2) Positive end-expiratory pressure (PEEP)is a mode of ventilatory assistance that produces the following condition:
A) Each time the patient initiates a breath, the ventilator delivers a full preset tidal volume.
B) For each spontaneous breath taken by the patient, the tidal volume is determined by the patient's ability to generate negative pressure.
C) The patient must have a respiratory drive, or no breaths will be delivered.
D) There is pressure remaining in the lungs at the end of expiration that is measured in cm H?O.
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Page 11
Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) Which code drugs can be given safely through an endotracheal tube? (Select all that apply.)
A) Adenosine
B) Atropine
C) Epinephrine
D) Vasopressin
Q2) During a code,the nurse would place paddles for anterior defibrillation in what locations?
A) Second intercostal space, left sternal border and fourth intercostal space, left midclavicular line
B) Second intercostal space, right sternal border and fourth intercostal space, left midaxillary line
C) Second intercostal space, right sternal border and fifth intercostal space, left midclavicular line
D) Fourth intercostal space, right sternal border and fifth intercostal space, left midclavicular line
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Chapter 11: Shock, sepsis, and Multiple Organ Dysfunction Syndrome
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Sample Questions
Q1) The nurse is caring for a patient admitted with the early stages of septic shock.The nurse assesses the patient to be tachypneic,with a respiratory rate of 32 breaths/min.Arterial blood gas values assessed on admission are pH 7.50,CO<sub>2</sub> 28 mm Hg,HCO<sub>3</sub> 26.Which diagnostic study result reviewed by the nurse indicates progression of the shock state?
A) pH 7.40, CO<sub>2</sub> 40, HCO<sub>3</sub> 24
B) pH 7.45, CO<sub>2</sub> 45, HCO<sub>3</sub> 26
C) pH 7.35, CO<sub>2</sub> 40, HCO<sub>3</sub> 22
D) pH 7.30, CO<sub>2</sub> 45, HCO<sub>3</sub> 18
Q2) The nurse is caring for an 18-year-old athlete with a possible cervical spine (C5)injury following a diving accident.The nurse assesses a blood pressure of 70/50 mm Hg,heart rate 45 beats/min,and respirations 26 breaths/min.The patient's skin is warm and flushed.What is the best interpretation of these findings by the nurse?
A) The patient is developing neurogenic shock.
B) The patient is experiencing an allergic reaction.
C) The patient most likely has an elevated temperature.
D) The vital signs are normal for this patient.
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Page 13
Chapter 12: Cardiovascular Alterations
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Sample Questions
Q1) A patient has been prescribed nitroglycerin in the ED for chest pain.In taking the health history,the nurse will be sure to verify whether the patient has taken medications prior to admission for:
A) Erectile dysfunction
B) Prostate enlargement
C) Asthma
D) Peripheral vascular disease
Q2) A patient is admitted with an angina attack.The nurse anticipates which drug regimen to be initiated?
A) ACE inhibitors and diuretics
B) Morphine sulfate and oxygen
C) Nitroglycerin, oxygen, and beta-blockers
D) Statins, bile acid, and nicotinic acid
Q3) A patient has elevated blood lipids.The nurse anticipates which classification of drugs to be prescribed for the patient?
A) Bile acid resins
B) Nicotinic acid
C) Nitroglycerin
D) Statins
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Page 14
Chapter 13: Nervous System Alterations
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35 Flashcards
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Sample Questions
Q1) The nurse is to administer 100 mg phenytoin (Dilantin)intravenous (IV).Vital signs assessed by the nurse include blood pressure 90/60 mm Hg,heart rate 52 beats/min,respiratory rate 18 breaths/min,and oxygen saturation (SpO<sub>2</sub>)99% on supplemental oxygen at 3 L/min by cannula.To prevent complications,what is the best action by the nurse?
A) Administer over 2 minutes.
B) Administer over 5 minutes.
C) Mix medication with 0.9% normal saline.
D) Administer via central line.
Q2) While caring for a patient with a traumatic brain injury,the nurse assesses an ICP of 20 mm Hg and a CPP of 85 mm Hg.What is the best interpretation by the nurse?
A) Both pressures are high.
B) Both pressures are low.
C) ICP is high; CPP is normal.
D) ICP is high; CPP is low.
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Chapter 14: Acute Respiratory Failure
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Sample Questions
Q1) Which of the following treatments may be used to dissolve a thrombus that is lodged in the pulmonary artery?
A) Aspirin
B) Embolectomy
C) Heparin
D) Thrombolytics
Q2) The nurse is caring for a patient with acute respiratory distress syndrome who is hypoxemic despite mechanical ventilation.The physician orders a nontraditional ventilator mode as part of treatment.Despite sedation and analgesia,the patient remains restless and appears to be in discomfort.The nurse informs the physician of this assessment and anticipates an order for:
A) continuous lateral rotation therapy.
B) guided imagery.
C) neuromuscular blockade.
D) prone positioning.
Q3) A definitive diagnosis of pulmonary embolism can be made by:
A) arterial blood gas (ABG) analysis.
B) chest x-ray examination.
C) pulmonary angiogram.
D) ventilation-perfusion scanning.
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Chapter 15: Acute Kidney Injury
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Sample Questions
Q1) An advantage of peritoneal dialysis is that:
A) peritoneal dialysis is time intensive.
B) a decreased risk of peritonitis exists.
C) biochemical disturbances are corrected rapidly.
D) the danger of hemorrhage is minimal.
Q2) The patient is admitted to the unit with the diagnosis of rhabdomyolysis.The patient is started on intravenous (IV)fluids and IV mannitol.Because mannitol is an osmotic diuretic,the nurse should:
A) assess the patient's hearing.
B) assess the patient's lungs.
C) decrease IV fluids once the diuretic has been administered.
D) give extra doses prior to giving radiological contrast agents.
Q3) The term used to describe an increase in blood urea nitrogen (BUN)and serum creatinine is:
A) oliguria.
B) azotemia.
C) acute kidney injury.
D) prerenal disease.
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Chapter 16: Hematological and Immune Disorders
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Sample Questions
Q1) Exudate formation at the inflammatory site functions to: (Select all that apply.)
A) opsonize bacteria.
B) dilute toxins.
C) deliver proteins.
D) attach to the target cell.
E) carry away toxins.
Q2) Causes of anemia include: (Select all that apply.)
A) hypoxic states.
B) blood loss.
C) impaired production of red blood cells.
D) increased destruction of red blood cells.
E) chronic obstructive pulmonary disease.
Q3) The patient is admitted with multiple myeloma.The nurse assesses the patient and is aware that the symptom most unique to this disease is:
A) fever.
B) night sweats.
C) bone pain.
D) lymph node enlargement.
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Chapter 17: Gastrointestinal Alterations
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Sample Questions
Q1) The patient is ordered to have large volume gastric lavage.The nurse will most likely need to:
A) insert a small-bore nasogastric tube.
B) use 2 to 4 liters of room temperature normal saline.
C) remove the nasogastric tube before lavage is started.
D) insert a large-bore nasogastric tube.
Q2) The nurse is assessing a patient who is admitted with abdominal pain.To detect abdominal masses,the nurse:
A) observes for skin pigmentation and discolorations.
B) looks for pulsations originating from the vena cava.
C) has the patient take a deep breath.
D) watches for signs of pain and distention.
Q3) Trends in nutritional management of the patient with pancreatitis are changing.As a result,the nurse understands that:
A) patients with pancreatitis must eat nothing in order to prevent release of secretin.
B) nasogastric suction is essential in treating patients with pancreatitis.
C) a nasogastric tube is no longer required to treat patients with ileus.
D) immediate oral feeding in patients with mild pancreatitis may help recovery.
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Chapter 18: Endocrine Alterations
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Sample Questions
Q1) In the management of diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome,when is an intravenous (IV)solution that contains dextrose started?
A) Never; normal saline is the only appropriate solution in diabetes management
B) When the blood sugar reaches 70 mg/dL
C) When the blood sugar reaches 150 mg/dL
D) When the blood glucose reaches 250 mg/dL
Q2) Acute adrenal crisis is caused by:
A) acute renal failure.
B) deficiency of corticosteroids.
C) high doses of corticosteroids.
D) overdose of testosterone.
Q3) The nurse is providing postoperative care to a patient who underwent a transsphenoidal hypophysectomy for a benign pituitary tumor.The nurse administers replacement hydrocortisone,thyroid hormone,and vasopressin.The nurse evaluates that the vasopressin replacement is effective when:
A) the patient's blood glucose is 110 mg/dL.
B) the patient maintains a core body temperature of 98.2° F ( 36.8° C ).
C) the patient's urine specific gravity decreases.
D) 2 liters of urine are produced in a 24-hour period.
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Page 20
Chapter 19: Trauma and Surgical Management
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Sample Questions
Q1) Which of the following patients have the greatest risk of developing acute respiratory distress syndrome (ARDS)after traumatic injury?
A) A patient who has a closed head injury with a decreased level of consciousness
B) A patient who has a fractured femur and is currently in traction
C) A patient who has received large volumes of fluid and/or blood replacement
D) A patient who has underlying chronic obstructive pulmonary disease
Q2) When providing information on trauma prevention,it is important to realize that individuals age 35 to 54 years are most likely to experience which type of trauma incident?
A) High-speed motor vehicle crashes
B) Poisonings from prescription or illegal drugs
C) Violent or domestic traumatic altercations
D) Work-related falls
Q3) Which of the following best defines the term traumatic injury?
A) All trauma patients can be successfully rehabilitated.
B) Traumatic injuries cause more deaths than heart disease and cancer.
C) Alcohol consumption, drug abuse, or other substance abuse contribute to traumatic events.
D) Trauma mainly affects the older adult population.
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Page 21
Chapter 20: Burns
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Sample Questions
Q1) Which of the following statements about the pain management of a burn victim are true? (Select all that apply.)
A) Additional pain medication may be needed because of rapid body metabolism.
B) Pain medication should be given before procedures such as debridement, dressing changes, and physical therapy.
C) Patients with a history of drug and alcohol abuse will require higher doses of pain medication.
D) The intramuscular route is preferred for pain medication administration.
Q2) A burn patient in the rehabilitation phase of injury is increasingly anxious and unable to sleep.The nurse should consult with the provider to further assess the patient for: A) acute delirium.
B) posttraumatic stress disorder.
C) suicidal intentions.
D) bipolar disorder.
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22
Chapter 21: Solid Organ Transplantation
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Sample Questions
Q1) A renal transplant recipient presents to the outpatient transplant clinic with blood glucose values for the past 3 days exceeding 250 mg/dL.The patient takes prednisone 5 mg daily and tacrolimus (Prograf)2 mg twice daily.Hemoglobin A1C level drawn the day of the clinic appointment was 8.5%.What is the best interpretation of this finding by the nurse?
A) The patient is at increased risk for infection.
B) The patient has developed posttransplant diabetes.
C) Temporary elevations in blood sugars are normal.
D) Discontinuation of steroids will normalize values.
Q2) The transplant clinic nurse is educating a patient about the renal criteria that must be met in order to be placed on the transplant waiting list.Which statement by the patient best indicates an understanding of the criteria?
A) "I qualify if my glomerular filtration rate is less than 20 mL per minute."
B) "I will not qualify until I have to go on regular hemodialysis treatments."
C) "My blood type does not have to be a match with the donor blood type."
D) "The national waiting list is based on the ability to pay for medications."
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