Emergency and Critical Care Nursing Study Guide Questions
Course Introduction
Emergency and Critical Care Nursing is a specialized course designed to equip nursing students with the knowledge and skills necessary to care for critically ill patients in fast-paced, high-pressure environments such as emergency rooms and intensive care units. The course covers the assessment, prioritization, and management of life-threatening conditions including trauma, cardiac emergencies, respiratory failure, sepsis, and neurological crises. Students will learn advanced clinical interventions, use of specialized equipment, and effective communication within multidisciplinary healthcare teams. Emphasis is placed on critical thinking, rapid decision-making, ethical considerations, patient advocacy, and providing compassionate care to patients and families during acute medical crises.
Recommended Textbook
Introduction to Critical Care Nursing 7th Edition by Mary Lou Sole
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757 Verified Questions
757 Flashcards
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Page 2
Chapter 1: Overview of Critical Care Nursing
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24 Verified Questions
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Source URL: https://quizplus.com/quiz/39100
Sample Questions
Q1) You work in an intermediate care unit and have asked to be involved in developing new guidelines to prevent pressure ulcers in your patient population.The nurse manager tells you that you do not yet have enough experience to be on the prevention task force and that your ideas will be rejected by others.This situation is an example of
A) a barrier to handoff communication.
B) a work environment that is unhealthy.
C) ineffective decision making.
D) nursing practice that is not evidence-based.
Answer: B
Q2) Which strategy is important in addressing issues associated with the aging workforce?
A) Allowing nurses to work flexible shift durations
B) Encouraging older nurses to transfer to an outpatient setting that is less stressful
C) Hiring nurse technicians who are available to assist with patient care, such as turning the patient
D) Remodeling patient care rooms to include devices to assist in patient lifting
E) Developing a staffing model that accurately reflects the unit's needs.
Answer: A,C,D
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Chapter 2: Patient and Family Response to the Critical Care Experience
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) The nurse is assigned to care for a patient who is a non-native English speaker.What is the best way to communicate with the patient and family to provide updates and explain procedures?
A) Conduct a Google search on the computer to identify resources for the patient and family in their native language. Print these for their use.
B) Contact the hospital's interpreter service for someone to translate.
C) Get in touch with one of the residents who you know is fluent in the native language and ask him if he can come up to the unit.
D) Use the patient's 8-year-old child who is fluent in both English and the native language to translate for you.
Answer: B
Q2) The constant noise of a ventilator,monitor alarms,and infusion pumps predisposes the patient to:
A) anxiety.
B) pain.
C) powerlessness.
D) sensory overload.
Answer: D
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Chapter 3: Ethical and Legal Issues in Critical Care Nursing
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Sample Questions
Q1) The nurse is caring for a patient admitted with a traumatic brain injury following a motor vehicle crash.Several weeks later,the patient is still ventilator dependent and unresponsive to stimulation but occasionally takes a spontaneous breath.The physician explains to the family that the patient has severe neurological impairment and is not expected to recover consciousness.The nurse recognizes that this patient is A) an organ donor.
B) brain dead.
C) in a persistent vegetative state.
D) terminally ill.
Answer: C
Q2) Which statement regarding ethical concepts is true?
A) A living will is the same as a health care proxy.
B) A signed donor card ensures that organ donation will occur in the event of brain death.
C) A surrogate is a competent adult designated by a person to make health care decisions in the event the person is incapacitated.
D) A persistent vegetative state is the same as brain death in most states.
Answer: C
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Chapter 4: End-Of-Life Care and Palliative Care in Critical Care Settings
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Sample Questions
Q1) Which statement is true regarding the impact of culture on end-of-life decision making?
A) Cultural beliefs should not take precedence over health care team decisions.
B) It is easy and common to assess cultural beliefs affecting end-of-life care in the intensive care unit.
C) Culture and religious beliefs may affect end-of-life decision making.
D) Perspectives regarding end-of-life care are similar between and within religious groups.
Q2) Designated health care surrogates should base health care decisions on A) personal beliefs and values.
B) recommendations of family members and friends.
C) recommendations of the physician and health care team.
D) wishes previously expressed by the patient.
Q3) The patient's spouse is very upset because his loved one,who is near death,has dyspnea and restlessness.The nurse explains that there are some ways to decrease this discomfort,including:
A) respiratory therapy treatments.
B) opioid medications given as needed.
C) incentive spirometry.
D) increased hydration.
Page 6
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Chapter 5: Comfort and Sedation
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Sample Questions
Q1) The nurse is caring for a patient with hyperactive delirium.The nurse focuses interventions toward keeping the patient:
A) comfortable.
B) nourished.
C) safe.
D) sedated.
Q2) A patient requires pancuronium as part of treatment of refractive increased intracranial pressure.The nursing care for this patient includes:
A) administration of sedatives concurrently with neuromuscular blockade.
B) dangling the patient's feet over the edge of the bed and assisting the patient to sit up in a chair at least twice each day.
C) ensuring that deep vein thrombosis prophylaxis is initiated.
D) providing interventions for eye care, oral care, and skin care.
E) ensuring good nutrition with frequent feedings throughout the day.
Q3) 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.
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Page 7
Chapter 6: Nutritional Support
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Sample Questions
Q1) Approximately 5 days after starting tube feedings,a patient develops extreme diarrhea.A stool specimen is collected to check for which possible cause?
A) Clostridium difficile
B) Escherichia coli
C) Occult blood
D) Ova and parasites
Q2) Risks of total parenteral nutrition include:
A) diarrhea.
B) elevated blood sugar.
C) infection at the catheter site.
D) volume overload.
E) aspiration.
Q3) A patient is receiving enteral feedings and reports fullness and abdominal discomfort.What action by the nurse is best?
A) Connect the feeding tube to suction.
B) Continue the tube feeding.
C) Decrease the tube feeding.
D) Assess the patient's gastric residual.
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8
Chapter 7: Dysrhythmia Interpretation and Management
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Sample Questions
Q1) The patient's heart rate is 165 beats per minute.The cardiac monitor shows a rapid rate with narrow QRS complexes.The P waves cannot be seen,but the rhythm is regular.The patient's blood pressure has dropped from 124/62 mm Hg to 78/30 mm Hg.The patient's skin is cold and diaphoretic,and the patient is complaining of nausea.The nurse prepares the patient for
A) administration of beta blockers.
B) administration of atropine.
C) transcutaneous pacemaker insertion.
D) emergent cardioversion.
Q2) The nurse is reading the cardiac monitor and notes that the patient's heart rhythm is extremely irregular and that there are no discernible P waves.The ventricular rate is 90 beats per minute,and the patient is hemodynamically stable.The nurse realizes that the patient's rhythm is
A) atrial fibrillation.
B) atrial flutter.
C) atrial flutter with rapid ventricular response.
D) junctional escape rhythm.
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Chapter 8: Hemodynamic Monitoring
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Sample Questions
Q1) The nurse is caring for a 70-kg patient in septic shock with a pulmonary artery catheter.Which hemodynamic value indicates an appropriate response to therapy aimed at enhancing oxygen delivery to the organs and tissues?
A) Arterial lactate level of 1.0 mEq/L
B) Cardiac output of 2.5 L/min
C) Mixed venous (SvO<sub>2</sub>) of 40%
D) Cardiac index of 1.5 L/min/m<sup>2</sup>
Q2) A patient is admitted to the hospital with multiple trauma and extensive blood loss.The nurse assesses vital signs to be BP 80/50 mm Hg,heart rate 135 beats/min,respirations 36 breaths/min,cardiac output (CO)of 2 L/min,systemic vascular resistance of 3000 dynes/sec/cm<sup>-5</sup>,and a hematocrit of 20%.The nurse anticipates administration of which the following therapies or medications?
A) Blood transfusion
B) Furosemide
C) Dobutamine infusion
D) Dopamine hydrochloride infusion
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Chapter 9: Ventilatory Assistance
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Sample Questions
Q1) The nurse is caring for a mechanically ventilated patient and responds to a high inspiratory pressure alarm.Recognizing possible causes for the alarm,the nurse assesses for which of the following?
A) Coughing or attempting to talk
B) Disconnection from the ventilator
C) Kinks in the ventilator tubing
D) Need for suctioning
E) Spontaneous breathing
Q2) Pulse oximetry measures
A) arterial blood gases.
B) hemoglobin values.
C) oxygen consumption.
D) oxygen saturation.
Q3) The amount of effort needed to maintain a given level of ventilation is termed A) compliance.
B) resistance.
C) tidal volume.
D) work of breathing.
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11
Chapter 10: Rapid Response Teams and Code Management
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Sample Questions
Q1) A nursing home patient is admitted to the critical care unit with a severe case of pneumonia.No living will or designation of health care surrogate is noted on the chart.In the event this patient needs intubation and/or cardiopulmonary resuscitation,what should be the nurse's action?
A) Activate the code team, but initiate a "slow" code.
B) Call the nursing home to determine the patient's or family's wishes.
C) Code the patient for 5 minutes and then cease efforts.
D) Initiate intubation and/or cardiopulmonary resuscitation efforts.
Q2) A patient has been successfully converted from ventricular tachycardia with a pulse to a sinus rhythm.Upon further assessment,it is noted that the patient is hypotensive.The appropriate treatment for her hypotension may include (Select all that apply)
A) adenosine.
B) dopamine infusion.
C) magnesium.
D) normal saline infusion.
E) sodium bicarbonate.
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12
Chapter 11: Organ Donation
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Sample Questions
Q1) 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 I have end-stage renal disease."
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."
Q2) 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.
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Chapter 12: Shock,sepsis,and Multiple Organ Dysfunction Syndrome
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/39111
Sample Questions
Q1) The nurse has been administering 0.9% normal saline intravenous fluids in a patient with severe sepsis.To evaluate the effectiveness of fluid therapy,which physiological parameters would be most important for the nurse to assess?
A) Breath sounds and capillary refill
B) Blood pressure and oral temperature
C) Oral temperature and capillary refill
D) Right atrial pressure and urine output
Q2) Which patient being cared for in the emergency department is most at risk for developing hypovolemic shock?
A) A patient admitted with abdominal pain and an elevated white blood cell count
B) A patient with a temperature of 102° F and a general dermal rash
C) A patient with a 2-day history of nausea, vomiting, and diarrhea
D) A patient with slight rectal bleeding from inflamed hemorrhoids
Q3) While monitoring a patient for signs of shock,the nurse understands which system assessment to be of priority?
A) Central nervous system
B) Gastrointestinal system
C) Renal system
D) Respiratory system
Page 14
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Chapter 13: Cardiovascular Alterations
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Sample Questions
Q1) The nurse is assessing a patient with left-sided heart failure.Which symptom would the nurse expect to find?
A) Dependent edema
B) Distended neck veins
C) Dyspnea and crackles
D) Nausea and vomiting
Q2) A patient is having a stent and asks why it is necessary after having an angioplasty.Which response by the nurse is best?
A) "The angioplasty was a failure, and so this procedure has to be done to fix the heart vessel."
B) "The stent is inserted to enhance the results of the angioplasty, by helping to keep the vessel open and prevent it from closing again."
C) "This procedure is being done instead of using clot-dissolving medication to help keep the heart vessel open."
D) "The stent will remove any clots that are in the vessel and protect the heart muscle from damage."
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15
Chapter 14: Nervous System Alterations
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35 Verified Questions
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Sample Questions
Q1) The nurse is caring for a mechanically ventilated patient admitted with a traumatic brain injury.Which arterial blood gas value assessed by the nurse indicates optimal gas exchange for a patient with this type of injury?
A) pH 7.38; PaCO<sub>2</sub> 55 mm Hg; HCO<sub>3</sub> 22 mEq/L; PaO<sub>2</sub> 85 mm Hg
B) pH 7.38; PaCO<sub>2</sub> 40 mm Hg; HCO<sub>3</sub> 24 mEq/L; PaO<sub>2</sub> 70 mm Hg
C) pH 7.38; PaCO<sub>2</sub> 35 mm Hg; HCO<sub>3</sub> 24 mEq/L; PaO<sub>2</sub> 85 mm Hg
D) pH 7.38; PaCO<sub>2</sub> 28 mm Hg; HCO<sub>3</sub> 26 mEq/L; PaO<sub>2</sub> 65 mm Hg
Q2) The nurse is caring for a patient 3 days following a complete cervical spine injury at the C3 level.The patient is in spinal shock.Following emergent intubation and mechanical ventilation,what is the priority nursing action?
A) Maintain body temperature.
B) Monitor blood pressure.
C) Pad all bony prominences.
D) Use proper hand washing.
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Chapter 15: Acute Respiratory Failure
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Sample Questions
Q1) The nurse calculates the PaO<sub>2</sub>/FiO<sub>2</sub> ratio for the following values: PaO<sub>2</sub> is 78 mm Hg; FiO<sub>2</sub> is 0.6 (60%).
A) 46.8; meets criteria for ARDS
B) 130; meets criteria for ARDS
C) 468; normal lung function
D) Not enough data to compute the ratio
Q2) The nurse is caring for a patient in acute respiratory failure and understands that the patient should be positioned
A) high Fowler's.
B) side lying with head of bed elevated.
C) sitting in a chair.
D) supine with the bed flat.
E) Trendelenburg.
Q3) The nurse is assessing a patient with acute respiratory distress syndrome.An expected assessment is
A) cardiac output of 10 L/min and low systemic vascular resistance.
B) PAOP of 10 mm Hg and PaO<sub>2</sub> of 55.
C) PAOP of 20 mm Hg and cardiac output of 3 L/min.
D) PAOP of 5 mm Hg and high systemic vascular resistance.
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Page 17
Chapter 16: Acute Kidney Injury
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Sample Questions
Q1) The removal of plasma water and some low-molecular weight particles by using a pressure or osmotic gradient is known as
A) dialysis.
B) diffusion.
C) clearance.
D) ultrafiltration.
Q2) Continuous renal replacement therapy (CRRT)differs from conventional intermittent hemodialysis in that
A) a hemofilter is used to facilitate ultrafiltration.
B) it provides faster removal of solute and water.
C) it does not allow diffusion to occur.
D) the process removes solutes and water slowly.
Q3) The patient is on intake and output (I&O),as well as daily weights.The nurse notes that output is considerably less than intake over the last shift,and daily weight is 1 kg more than yesterday.The nurse should
A) draw a trough level after the next dose of antibiotic.
B) obtain an order to place the patient on fluid restriction.
C) assess the patient's lungs.
D) insert an indwelling catheter.
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Page 18
Chapter 17: Hematological and Immune Disorders
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Sample Questions
Q1) Secondary immunodeficiency involves the loss of a previously functional immune defense system,which can be caused by
A) a single gene defect.
B) AIDS.
C) aging.
D) nutritional deficiencies.
E) immunosuppressive therapies.
Q2) The nurse is assessing a patient being admitted with fatigue and shortness of breath as well as abdominal tenderness.The nurse notes that the patient is jaundiced; the physical examination reports an enlarged liver.The nurse suspects that the patient has
A) aplastic anemia.
B) hemolytic anemia.
C) sickle cell anemia.
D) anemia due to acute blood loss.
Q3) The patient has a platelet count of 9,000/microliter.The nurse realizes that
A) this is a normal platelet level.
B) spontaneous bleeding may occur.
C) the patient is at great risk for fatal hemorrhage.
D) this level is considered slightly low.
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Chapter 18: Gastrointestinal Alterations
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Sample Questions
Q1) The nurse is caring for a patient who has had a portacaval shunt placed surgically.The nurse is aware that this procedure
A) improves survival in patients with varices.
B) decreases the risk of encephalopathy.
C) decreases the incidence of ascites.
D) decreases rebleeding.
Q2) Metronidazole is being given to treat hepatic encephalopathy.When administering this medication,the nurse
A) watches the patient for diarrhea.
B) evaluates renal function daily.
C) assesses the patient for epigastric discomfort.
D) instructs the patient that this medication must be taken for 2 weeks.
Q3) The patient is admitted with pancreatitis and has severe ascites.In caring for this patient,the nurse should
A) monitor the patient's blood pressure and evaluate for signs of dehydration.
B) restrict intravenous and oral fluid intake because of fluid shifts.
C) avoid the use of colloid IV solutions in managing the patient's fluid status.
D) only use crystalloid fluids to prevent IV lines from clotting.
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Chapter 19: Endocrine Alterations
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Sample Questions
Q1) A patient presents to the emergency department with suspected thyroid storm.The nurse should be alert to which of the following cardiac rhythms while providing care to this patient?
A) Atrial fibrillation
B) Idioventricular rhythm
C) Junctional rhythm
D) Sinus bradycardia
Q2) Which of the following patients is at the highest risk for hyperosmolar hyperglycemic syndrome?
A) An 18-year-old college student with type 1 diabetes who exercises excessively
B) A 45-year-old woman with type 1 diabetes who forgets to take her insulin in the morning
C) A 75-year-old man with type 2 diabetes and coronary artery disease who has recently started on insulin injections
D) An 83-year-old, long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza
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Chapter 20: 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) The nurse has admitted a patient to the ED following a fall from a first-floor hotel balcony.The patient smells of alcohol and begins to vomit in the ED.Which of the following interventions is most appropriate?
A) Insert an oral airway to prevent aspiration and to protect the airway.
B) Offer the patient an emesis basin so that you can measure the amount of emesis.
C) Prepare to suction the oropharynx while maintaining cervical spine immobilization.
D) Send a specimen of the emesis to the laboratory for analysis of blood alcohol content.
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22
Chapter 21: Burns
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Sample Questions
Q1) Which complications may manifest after an electrical injury?
A) Long bone fractures
B) Cardiac dysrhythmias
C) Hypertension
D) Compartment syndrome of extremities
E) Dark brown urine
F) Peptic ulcer disease
G) Acute cataract formation
H) Seizures
Q2) Tissue damage from burn injury activates an inflammatory response that increases the patient's risk for
A) acute kidney injury.
B) acute respiratory distress syndrome.
C) infection.
D) stress ulcers.
Q3) Silver is used as an ingredient in many burn dressings because it
A) stimulates tissue granulation.
B) is effective against a wide spectrum of wound pathogens.
C) provides topical pain relief.
D) stimulates wound healing.
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