High Acuity Nursing Question Bank
Course Introduction
High Acuity Nursing explores the specialized knowledge and advanced clinical skills required to care for patients experiencing life-threatening or complex health conditions in acute and critical care settings. The course examines pathophysiology, assessment, monitoring, rapid decision-making, and intervention techniques for individuals with acute respiratory, cardiovascular, neurological, or multi-system disorders. Emphasis is placed on evidence-based practice, interprofessional collaboration, and prioritization of care in high-pressure environments to ensure optimal outcomes for critically ill patients and their families.
Recommended Textbook
Introduction to Critical Care Nursing 7th Edition by Sole
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21 Chapters
757 Verified Questions
757 Flashcards
Source URL: https://quizplus.com/study-set/570
Page 2
Chapter 1: Overview of Critical Care Nursing
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/10613
Sample Questions
Q1) The vision of the American Association of Critical-Care Nurses is a health care system driven by
A) a healthy work environment.
B) care from a multiprofessional team under the direction of a critical care physician.
C) the needs of critically ill patients and families.
D) respectful, healing, and humane environments.
Answer: C
Q2) As part of nursing management of a critically ill patient,orders are written to keep the head of the bed elevated at 30 degrees,awaken the patient from sedation each morning to assess readiness to wean from mechanical ventilation,and implement oral care protocols every 4 hours.These interventions are done as a group to reduce the risk of ventilator-associated pneumonia.This group of evidence-based interventions is often called a
A) bundle of care.
B) clinical practice guideline.
C) patient safety goal.
D) quality improvement initiative.
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/10614
Sample Questions
Q1) Sleep often is disrupted for critically ill patients.Which nursing intervention is most appropriate to promote sleep and rest?
A) Consult with the pharmacist to adjust medication times to allow periods of sleep or rest between intervals.
B) Encourage family members to talk with the patient whenever they are present in the room.
C) Keep the television on to provide white noise and distraction.
D) Leave the lights on in the room so that the patient is not frightened of his or her surroundings.
Answer: A
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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Chapter 3: Ethical and Legal Issues in Critical Care Nursing
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23 Verified Questions
23 Flashcards
Source URL: https://quizplus.com/quiz/10615
Sample Questions
Q1) The nurse utilizes which of the following strategies when encountering an ethical dilemma in practice? (Select all that apply.)
A) Change-of-shift report updates
B) Ethics consultation services
C) Formal multiprofessional ethics committees
D) Pastoral care services
E) Social work consultation
Answer: B,C
Q2) 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
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Page 5
Chapter 4: End-of-Life Care and Palliative Care in Critical Care Settings
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/10616
Sample Questions
Q1) 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
Q2) Which of the following statements about palliative care is accurate?
A) Withholding and withdrawing life-sustaining treatment are distinctly different in the eyes of the legal community.
B) Reducing distressing symptoms is the primary goal of palliative care.
C) Only the patient can determine what constitutes palliative care for him or her.
D) Withdrawing life-sustaining treatments is considered euthanasia in most states.
Q3) 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.
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Chapter 5: Comfort and Sedation
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33 Verified Questions
33 Flashcards
Source URL: https://quizplus.com/quiz/10617
Sample Questions
Q1) The nurse is assessing the patient's pain using the Critical Care Pain Observation Tool.Which of the following assessments would indicate the greatest likelihood of pain and need for nursing intervention?
A) Absence of vocal sounds
B) Fighting the ventilator
C) Moving legs in bed
D) Relaxed muscles in upper extremities
Q2) The patient is receiving neuromuscular blockade.Which nursing assessment indicates a target level of paralysis?
A) Glasgow Coma Scale score of 3
B) Train-of-four yields two twitches
C) Bispectral index of 60
D) CAM-ICU positive
Q3) The primary mode of action for neuromuscular blocking agents used in the management of some ventilated patients is
A) analgesia.
B) anticonvulsant therapy.
C) paralysis.
D) sedation.
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Page 7
Chapter 6: Nutritional Support
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/10618
Sample Questions
Q1) Which statements about total parenteral nutrition are correct? (Select all that apply.)
A) assessing fluid volume status and preventing infection are important nursing considerations.
B) fingerstick glucose levels are assessed every 6 hours and prn.
C) total parenteral nutrition is administered through a feeding tube and pump.
D) total parenteral nutrition with added lipids provides adequate levels of protein, carbohydrates, and fats.
E) soy-based lipids should not be given during the first week of a critical illness.
Q2) In addition to residual stomach volume,what other evidence suggests feeding intolerance?
A) Abdominal distension
B) Absence of tympany on percussion
C) Active bowel sounds
D) Elevated blood glucose by fingerstick
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Chapter 7: Dysrhythmia Interpretation and Management
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59 Verified Questions
59 Flashcards
Source URL: https://quizplus.com/quiz/10619
Sample Questions
Q1) 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.
Q2) The patient has a permanent pacemaker inserted.The provider has set the pacemaker to the demand mode at a rate of 60 beats per minute.The nurse realizes that A) the pacemaker will pace only if the patient's intrinsic heart rate is less than 60 beats per minute.
B) the demand mode often competes with the patient's own rhythm.
C) the demand mode places the patient at risk for the R-on-T phenomenon.
D) the fixed-rate mode is safer and is the mode of choice.
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9
Chapter 8: Hemodynamic Monitoring
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10620
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) Which nursing actions are most important for a patient with a right radial arterial line? (Select all that apply.)
A) Checking the circulation to the right hand every 2 hours
B) Maintaining a pressurized flush solution to the arterial line setup
C) Monitoring the waveform on the monitor for dampening
D) Restraining all four extremities with soft limb restraints
E) Ensuring all junctions remain tightly connected
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Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/10621
Sample Questions
Q1) Current guidelines recommend the oral route for endotracheal intubation.The rationale for this recommendation is that nasotracheal intubation is associated with a greater risk for A) basilar skull fracture.
B) cervical hyperextension.
C) impaired ability to "mouth" words.
D) sinusitis and infection.
Q2) Pulse oximetry measures
A) arterial blood gases.
B) hemoglobin values.
C) oxygen consumption.
D) oxygen saturation.
Q3) The nurse is assessing the exhaled tidal volume (EV<sub>T</sub>)in a mechanically ventilated patient.The rationale for this assessment is to A) assess for tension pneumothorax.
B) assess the level of positive end-expiratory pressure.
C) compare the tidal volume delivered with the tidal volume prescribed.
D) determine the patient's work of breathing.
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Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/10622
Sample Questions
Q1) The patient has been admitted to a critical care unit with a diagnosis of acute myocardial infarction.Suddenly the monitor alarms and the screen shows a flat line.What action should the nurse take first?
A) Administer epinephrine by intravenous push.
B) Begin chest compressions.
C) Check patient for unresponsiveness.
D) Defibrillate at 360 J.
Q2) It is determined that the patient needs a transcutaneous pacemaker until a transvenous pacemaker can be inserted.What is the most appropriate nursing intervention?
A) Apply conductive gel to the skin.
B) Provide adequate sedation and analgesia.
C) Recheck leads to make sure that the rhythm is asystole.
D) Set the milliamperes to 2 mA below the capture level.
Q3) When doing manual ventilations during a code,the nurse would administer ventilations following which guideline?
A) Approximately 8 to 10 breaths per minute
B) During the fifth chest compression
C) Every 3 seconds or 20 times per minute
D) While compressions are stopped
Page 12
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Chapter 11: Organ Donation
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10623
Sample Questions
Q1) The family of a critically ill patient has asked to discuss organ donation with the patient's nurse.When preparing to solve the family's questions,the nurse understands which concern(s)most often influence a family's decision to donate? (Select all that apply.)
A) Donor disfigurement influences on funeral care
B) Fear of inferior medical care provided to donor
C) Age and location of all possible organ recipients
D) Concern that donated organs will not be used
E) Fear that the potential donor may not be deceased
F) Concern over financial costs associated with donation
Q2) 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
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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/10624
Sample Questions
Q1) The nurse is caring for an 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.
Q2) 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
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14
Chapter 13: Cardiovascular Alterations
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37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/10625
Sample Questions
Q1) Identify the priority interventions for managing symptoms of an acute myocardial infarction (AMI)in the ED.(Select all that apply.)
A) Administration of morphine
B) Administration of nitroglycerin (NTG)
C) Dopamine infusion
D) Oxygen therapy
E) Transfusion of packed red blood cells
Q2) The patient's spouse is feeling overwhelmed about cooking different dinners for the patient and the rest of the family to satisfy a cholesterol-reducing diet.Which response by the nurse is best?
A) "It will be worth it to have a healthy spouse, won't it?"
B) "The low-cholesterol diet is one from which everyone can benefit."
C) "As long as you change at least a few things in the diet, it will be okay."
D) "You can go on the diet with him, and then let the children eat whatever they want."
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Chapter 14: Nervous System Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10626
Sample Questions
Q1) The nurse responds to a high heart rate alarm for a patient in the neurological intensive care unit.The nurse arrives to find the patient sitting in a chair experiencing a tonic-clonic seizure.What is the best nursing action?
A) Assist the patient to the floor and provide soft head support.
B) Insert a nasogastric tube and connect to continuous wall suction.
C) Open the patient's mouth and insert a padded tongue blade.
D) Restrain the patient's extremities until the seizure subsides.
Q2) The nurse,caring for a patient following a subarachnoid hemorrhage,begins a nicardipine infusion.Baseline blood pressure assessed by the nurse is 170/100 mm Hg.Five minutes after beginning the infusion at 5 mg/hr,the nurse assesses the patient's blood pressure to be 160/90 mm Hg.What is the best action by the nurse?
A) Stop the infusion for 5 minutes.
B) Increase the dose by 2.5 mg/hr.
C) Notify the provider of the BP.
D) Begin weaning the infusion.
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16
Chapter 15: Acute Respiratory Failure
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/10627
Sample Questions
Q1) The nurse is caring for a patient with acute respiratory distress syndrome who is hypoxemic despite mechanical ventilation.The provider prescribes 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 provider of this assessment and anticipates an order for
A) continuous lateral rotation therapy.
B) guided imagery.
C) neuromuscular blockade.
D) prone positioning.
Q2) The patient with acute respiratory distress syndrome (ARDS)would exhibit which of the following symptoms?
A) Decreasing PaO<sub>2</sub> levels despite increased FiO<sub>2</sub> administration
B) Elevated alveolar surfactant levels
C) Increased lung compliance with increased FiO<sub>2</sub> administration
D) Respiratory acidosis associated with hyperventilation
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Chapter 16: Acute Kidney Injury
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50 Verified Questions
50 Flashcards
Source URL: https://quizplus.com/quiz/10628
Sample Questions
Q1) Noninvasive diagnostic procedures used to determine kidney function include which of the following? (Select all that apply.)
A) Kidney, ureter, bladder ( KUB ) x-ray
B) Renal ultrasound
C) Magnetic resonance imaging ( MR)
D) Intravenous pyelography ( IVP )
E) Renal angiography
Q2) The nurse is caring for a patient who has a temporary percutaneous dialysis catheter in place.In caring for this patient,the nurse should
A) apply a sterile gauze dressing to maintain sterility.
B) replace the transparent dressing every 10 days to prevent manipulation.
C) assess the catheter site for redness and/or swelling.
D) use the catheter for drawing blood samples to reduce patient discomfort.
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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Page 18
Chapter 17: Hematological and Immune Disorders
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56 Verified Questions
56 Flashcards
Source URL: https://quizplus.com/quiz/10629
Sample Questions
Q1) The nurse is caring for a patient who has undergone a splenectomy and notices that the patient's platelet count has increased.The nurse realizes that the increase is due to
A) platelet response to infection.
B) stimulation secondary to erythropoietin.
C) the patient's inability to store platelets.
D) the platelet's 120-day life cycle.
Q2) 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.
Q3) Of the four major blood components,plasma
A) is made up of circulating ions.
B) comprises about 55% of blood volume.
C) is transported to the cells by serum proteins.
D) comprises about 45% of blood volume.
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Chapter 18: Gastrointestinal Alterations
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/10630
Sample Questions
Q1) 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.
Q2) Infection by Helicobacter pylori bacteria is a major cause of
A) duodenal ulcers.
B) Cushing's ulcers.
C) Curling's ulcers.
D) stress ulcers.
Q3) Nursing priorities for the management of acute pancreatitis include: (Select all that apply.)
A) managing respiratory dysfunction.
B) assessing and maintaining electrolyte balance.
C) withholding analgesics that could mask abdominal discomfort.
D) stimulating gastric content motility into the duodenum.
E) utilizing supportive therapies aimed at decreasing gastrin release.
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Chapter 19: Endocrine Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10631
Sample Questions
Q1) 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
Q2) 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
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Chapter 20: Trauma and Surgical Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/10632
Sample Questions
Q1) Which of the following statements apply to trauma patients and their potential complications? (Select all that apply.)
A) Indwelling urinary catheters are a source of infection.
B) Patients often develop infection and sepsis secondary to central line catheters.
C) Pneumonia is often an adverse outcome of mechanical ventilation.
D) Wounds require sterile dressings to prevent infection.
Q2) Which of the following findings require immediate nursing interventions in a patient with a traumatic brain injury? (Select all that apply.)
A) Mean arterial pressure 48 mm Hg
B) Elevated serum blood alcohol level
C) Nonreactive pupils
D) Respiratory rate of 10 breaths/min
E) Open skull fracture
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Chapter 21: Burns
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/10633
Sample Questions
Q1) The nurse is caring for a burn-injured patient who weighs 154 pounds,and the burn injury covers 50% of his body surface area.The nurse calculates the fluid needs for the first 24 hours after a burn injury using a standard fluid resuscitation formula of 4 mL/kg/% burn of intravenous (IV)fluid for the first 24 hours.The nurse plans to administer what amount of fluid in the first 24 hours?
A) 2800 mL
B) 7000 mL
C) 14 L
D) 28 L
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.
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