High Acuity Nursing Exam Solutions
Course Introduction
High Acuity Nursing explores the specialized knowledge and advanced clinical skills required to care for patients experiencing severe, life-threatening health conditions in critical care settings such as intensive care units, emergency departments, and trauma centers. The course emphasizes comprehensive patient assessment, rapid decision-making, advanced interventions, and the use of sophisticated technology to support organ function and stabilization. It also addresses interprofessional collaboration, ethical and legal considerations, and strategies for effective communication with patients and their families during high-stress situations, preparing students to deliver safe, compassionate, and evidence-based care in high acuity environments.
Recommended Textbook
Introduction to Critical Care Nursing 7th Edition by Mary Lou Sole
Available Study Resources on Quizplus 21 Chapters
757 Verified Questions
757 Flashcards
Source URL: https://quizplus.com/study-set/1966
Page 2
Chapter 1: Overview of Critical Care Nursing
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/39100
Sample Questions
Q1) The family members of a critically ill patient bring a copy of the patient's living will to the hospital,which identifies the patient's wishes regarding health care.You discuss contents of the living will with the patient's physician.This is an example of implementation of which of the AACN Standards of Professional Performance?
A) Acquires and maintains current knowledge of practice
B) Acts ethically on the behalf of the patient and family
C) Considers factors related to safe patient care
D) Uses clinical inquiry and integrates research findings in practice
Answer: B
Q2) 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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3
Chapter 2: Patient and Family Response to the Critical Care Experience
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28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/39101
Sample Questions
Q1) Changing visitation policies can be challenging.The nurse manager recognizes which of the following as an effective strategy for promoting changes in practice?
A) Ask the clinical nurse specialist to lead a journal club on open visitation after each nurse is tasked to read one research article about visitation.
B) Discuss the pros and cons of open visitation at the next staff meeting.
C) Invite the nurses with the most experience to develop a revised policy.
D) Task the unit-based nurse practice council to invite volunteers to serve on the council to revise the current policy toward more liberal visitation.
Answer: D
Q2) The VALUE mnemonic is a helpful strategy to enhance communication with family members of critically ill patients.Which of the following statements describes a VALUE strategy?
A) View the family as guests on the unit.
B) Acknowledge family emotions.
C) Learn as much as you can about family structure and function.
D) Use a trained interpreter if the family does not speak English.
Answer: B
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Page 4
Chapter 3: Ethical and Legal Issues in Critical Care Nursing
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) The nurse knows that which of the following statements about organ donation is true?
A) Anyone who is comfortable approaching the family should discuss the option of organ donation.
B) Brain death determination is required before organs can be retrieved for transplant.
C) Donation of selected organs after cardiac death is ethically acceptable.
D) Family members should consider the withdrawal of life support so that the patient can become an organ donor.
Answer: C
Q2) The nurse is caring for a patient with severe neurological impairment following a massive stroke.The physician has ordered tests to determine brain death.The nurse understands that criteria for brain death include
A) absence of cerebral blood flow.
B) absence of brainstem reflexes on neurological examination.
C) Cheyne-Stokes respirations.
D) flat electroencephalogram.
E) responding only to painful stimuli.
Answer: A,B,D
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5
Chapter 4: End-Of-Life Care and Palliative Care in Critical Care Settings
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) The patient's spouse is terrified by the prospect of removing life-sustaining treatments from the patient and asks why anyone would do that.The nurse explains,
A) "It is to save you money so that you won't have such a large financial burden."
B) "It will preserve limited resources for the hospital so that other patients may benefit from them."
C) "It is to discontinue treatments that are not helping your loved one and that may be very uncomfortable."
D) "We have done all we can for your loved one, and any more treatment would be futile."
Q2) 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.
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Page 6
Chapter 5: Comfort and Sedation
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33 Verified Questions
33 Flashcards
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Sample Questions
Q1) The nurse wishes to assess the quality of a patient's pain.Which of the following questions is appropriate to obtain this assessment if the patient is able to give a verbal response?
A) "Is the pain constant or intermittent?"
B) "Is the pain sharp, dull, or crushing?"
C) "What makes the pain better? Worse?"
D) "When did the pain start?"
Q2) The assessment of pain and anxiety is a continuous process.When critically ill patients exhibit signs of anxiety,the nurse's first priority is to
A) administer antianxiety medications as ordered.
B) administer pain medication as ordered.
C) identify and treat the underlying cause.
D) reassess the patient hourly to determine whether symptoms resolve on their own.
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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Chapter 6: Nutritional Support
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) 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.
Q2) A patient with a history of emphysema,diabetes,and hyperlipidemia is in the critical care unit on a ventilator.The nutrition assessment notes that the patient has a protein and vitamin deficiency and is underweight.Which formula for nutritional assessment is most appropriate?
A) Elemental protein formula
B) Fiber-added formula
C) High medium-chain triglyceride formula
D) Lactose-free formula
Q3) Risks of total parenteral nutrition include:
A) diarrhea.
B) elevated blood sugar.
C) infection at the catheter site.
D) volume overload.
E) aspiration.
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Chapter 7: Dysrhythmia Interpretation and Management
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59 Verified Questions
59 Flashcards
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Sample Questions
Q1) The nurse using cardiac monitoring understands that each horizontal box on the electrocardiogram (ECG)paper 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 patient has an irregular heart rhythm.To determine an accurate heart rate,the nurse would first
A) identify the markers on the ECG paper that indicate a 6-second strip.
B) count the number of small boxes between two consecutive P waves.
C) count the number of small boxes between two consecutive QRS complexes.
D) divides the number of complexes in a 6-second strip by 10.
Q3) The nurse caring for patients on cardiac monitors assesses the patient with a prolonged QT interval for
A) electrolyte disturbances such as hypokalemia.
B) symptomatic bradycardias.
C) the development of lethal dysrhythmias.
D) difficulty maintaining the blood pressure.
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Chapter 8: Hemodynamic Monitoring
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) 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
Q2) The nurse is caring for a patient with a left radial arterial line and a pulmonary artery catheter inserted into the right subclavian vein.Which action by the nurse best ensures the safety of the patient being monitored with invasive hemodynamic monitoring lines?
A) Document all waveform values.
B) Limit the pressure tubing length.
C) Zero reference the system daily.
D) Ensure alarm limits are turned on.
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Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
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Sample Questions
Q1) 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 H2O.
Q2) A patient's status worsens and needs mechanical ventilation.The pulmonologist wants the patient to receive 10 breaths/min from the ventilator but wants to encourage the patient to breathe spontaneously between the mechanical breaths at his own tidal volume.This mode of ventilation is called
A) assist/control ventilation.
B) controlled ventilation.
C) intermittent mandatory ventilation.
D) positive end-expiratory pressure.
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Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) A patient develops frequent ventricular ectopy.The nurse prepares to administer which drug?
A) Adenosine
B) Atropine
C) Lidocaine
D) Magnesium
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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12
Chapter 11: Organ Donation
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) The nurse is caring for a mechanically ventilated patient following bilateral lung transplantation.When planning the care of this patient,what is the priority nursing intervention?
A) Thirty-degree elevation of head of bed
B) Endotracheal suctioning as needed
C) Frequent side to side repositioning
D) Sequential compression stockings
Q2) A nurse is caring for a patient declared brain dead following a car crash in preparation for the harvesting of organs.The patient's urine output was 1050 mL in the last hour.What medication does the nurse prepare to administer?
A) Vasopressin
B) Methylprednisolone
C) Desmopressin acetate
D) Esmolol
Q3) Which clinical scenario best represents hyperacute rejection?
A) A cardiac transplant patient with a 3-month history of shortness of breath
B) A lung transplant patient with small pustules that follow a dermatome
C) A liver transplant patient with several small lumps under the skin
D) An implanted renal transplant that, upon reperfusion, becomes cyanotic
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Page 13
Chapter 12: Shock,sepsis,and Multiple Organ Dysfunction Syndrome
34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/39111
Sample Questions
Q1) The nurse is caring for a patient admitted with hypovolemic shock.The nurse palpates thready brachial pulses but is unable to auscultate a blood pressure.What is the best nursing action?
A) Assess the blood pressure by Doppler.
B) Estimate the systolic pressure as 60 mm Hg.
C) Obtain an electronic blood pressure monitor.
D) Record the blood pressure as "not assessable."
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) The nurse is administering intravenous norepinephrine at 5 mcg/kg/min via a 20-gauge peripheral intravenous (IV)catheter.Which assessment finding requires immediate action by the nurse?
A) Blood pressure 100/60 mm Hg
B) Swelling at the IV site
C) Heart rate of 110 beats/min
D) Central venous pressure (CVP) of 8 mm Hg
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Chapter 13: Cardiovascular Alterations
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37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/39112
Sample Questions
Q1) A patient with a 10-year history of heart failure presents to the emergency department reporting severe shortness of breath.Assessment reveals crackles throughout the lung fields and labored breathing.The patient takes beta blockers,ACE inhibitors,and diuretics as directed.What treatment strategies does the nurse plan to implement for immediate short-term management?
A) Dobutamine
B) Intraaortic balloon pump
C) Nesiritide
D) Ventricular assist device
E) Biventricular pacemaker
Q2) A patient is having an emergent coronary intervention,and the nurse is starting an infusion of abciximab.The patient asks what the purpose of this drug is.What response by the nurse is best?
A) "This will help prevent chest pain until the intervention is complete."
B) "This medication dries oral and respiratory secretions during the procedure."
C) "This is a mild sedative and amnesic agent, so you'll be very relaxed."
D) "This drug helps prevent blood clotting and is often used for this procedure."
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Chapter 14: Nervous System Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/39113
Sample Questions
Q1) The nurse receives a patient from the emergency department following a closed head injury.After insertion of an ventriculostomy,the nurse assesses the following vital signs: blood pressure 100/60 mm Hg,heart rate 52 beats/min,respiratory rate 24 breaths/min,oxygen saturation (SpO<sub>2</sub>)97% on supplemental oxygen at 45% via Venturi mask,Glasgow Coma Scale score of 4,and intracranial pressure (ICP)of 18 mm Hg.Which provider prescription should the nurse institute first?
A) Mannitol 1 g intravenous
B) Portable chest x-ray
C) Seizure precautions
D) Ancef 1 g intravenous
Q2) The nurse is caring for a patient from a rehabilitation center with a preexisting complete cervical spine injury who is complaining of a severe headache.The nurse assesses a blood pressure of 180/90 mm Hg,heart rate 60 beats/min,respirations 24 breaths/min,and 50 mL of urine via indwelling urinary catheter for the past 4 hours.What is the best action by the nurse?
A) Administer acetaminophen as ordered for the headache.
B) Assess for a kinked urinary catheter and assess for bowel impaction.
C) Encourage the patient to take slow, deep breaths.
D) Notify the provider of the patient's blood pressure.
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Chapter 15: Acute Respiratory Failure
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/39114
Sample Questions
Q1) 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.
Q2) The nurse is caring for a patient with acute respiratory failure and identifies "Risk for Ineffective Airway Clearance" as a nursing diagnosis.A nursing intervention relevant to this diagnosis is to
A) elevate the head of the bed to 30 degrees.
B) obtain an order for venous thromboembolism prophylaxis.
C) provide adequate sedation.
D) reposition the patient every 2 hours.
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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Page 17
Chapter 16: Acute Kidney Injury
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50 Verified Questions
50 Flashcards
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Sample Questions
Q1) 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.
Q2) The nurse is caring for an elderly patient who was admitted with renal insufficiency.An expected laboratory finding for this patient may be A) an increased glomerular filtration rate (GFR).
B) a normal serum creatinine level.
C) increased ability to excrete drugs.
D) hypokalemia.
Q3) The most common cause of acute kidney injury in critically ill patients is A) sepsis.
B) fluid overload.
C) medications.
D) hemodynamic instability.
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18
Chapter 17: Hematological and Immune Disorders
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56 Verified Questions
56 Flashcards
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Sample Questions
Q1) Although monocytes may circulate for only 36 hours,they can survive for months or even years as tissue macrophages.Monocytes found in the liver are called
A) alveolar macrophages.
B) Kupffer's cells.
C) histiocytes.
D) monokines.
Q2) When examining the patient's laboratory values,the nurse notices an elevation in the eosinophil count.The nurse realizes that eosinophils become elevated
A) with acute bacterial infections.
B) in response to allergens and parasites.
C) when the spleen is removed.
D) in situations that do not require phagocytosis.
Q3) Accepted treatments for disseminated intravascular coagulation (DIC)may require A) platelet infusions.
B) administration of fresh frozen plasma.
C) cryoprecipitate.
D) packed RBCs.
E) heparin.
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Chapter 18: Gastrointestinal Alterations
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52 Verified Questions
52 Flashcards
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Sample Questions
Q1) The nurse is assessing a patient admitted with pancreatitis.In doing so,the nurse
A) palpates the pancreas for size and shape.
B) emphasizes to the patient that pancreatic inflammation does not spread.
C) assesses symptoms that could indicate involvement of the stomach.
D) explains to the patient that back pain is not a sign of pancreatitis.
Q2) The patient is admitted with the diagnosis of GI bleeding.The patient's heart rate is 140 beats per minute,and the blood pressure is 84/44 mm Hg.These values may indicate:
A) a need for hourly vital signs.
B) approximately 25% loss of total blood volume.
C) resolution of hypovolemic shock.
D) increased blood flow to the skin, lungs, and liver.
Q3) When assessing bowel sounds,the nurse
A) uses the "bell" part of the stethoscope.
B) listens at least 15 minutes.
C) expects bowel sounds to be regular in rhythm.
D) listens for 5 minutes before noting "absent bowel sounds."
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Chapter 19: Endocrine Alterations
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35 Flashcards
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Sample Questions
Q1) The most significant clinical finding of acute adrenal crisis associated with fluid and electrolyte imbalance is
A) fluid volume excess.
B) hyperglycemia.
C) hyperkalemia
D) hypernatremia
Q2) A patient with newly diagnosed type 1 diabetes is being transitioned from an infusion of intravenous (IV)regular insulin to an intensive insulin therapy regimen of insulin glargine and insulin aspart.How should the nurse manage this transition in insulin delivery?
A) Administer the insulin glargine and continue the IV insulin infusion for 24 hours.
B) Administer the insulin glargine and discontinue the IV infusion in several hours.
C) Discontinue the IV infusion and administer the insulin aspart with the next meal.
D) Discontinue the IV infusion and administer the Lantus insulin at bedtime.
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Chapter 20: Trauma and Surgical Management
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) In the trauma patient,symptoms of decreased cardiac output are most commonly caused by
A) cardiac contusion.
B) cardiogenic shock.
C) hypovolemia.
D) pericardial tamponade.
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) A 63-year-old patient is admitted with new-onset fever; flulike symptoms; blisters over the arms,chest,and neck; and red,painful oral mucous membranes.The patient should be further evaluated for which possible non-burn-injured skin disorder?
A) Toxic epidermal necrolysis
B) Staphylococcal scalded skin syndrome
C) Necrotizing soft tissue infection
D) Graft-versus-host disease
Q2) The nurse is caring for a patient who has undergone skin grafting of the face and arms for burn wound treatment.A primary nursing diagnosis is
A) altered nutrition, less than body requirements.
B) body image disturbance.
C) decreased cardiac output.
D) fluid volume deficit.
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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