Test Bank for Critical Care Nursing: Diagnosis and Management, 9th Edition (Chapters 1-27)

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Test Bank - Critical Care Nursing-Diagnosisand Management, 9th EditionChapter 1-41

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TEST BANKCritical Care Nursing: Diagnosis and ManagementLinda D. Urden, Kathleen M. Stacy, and Mary E. Lough9th Edition

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Chapter 01: Critical Care Nursing PracticeUrden: Critical Care Nursing, 9th EditionMULTIPLE CHOICE1.During World War II, what types of wards were developed to care for critically injuredpatients?a.Intensive careb.Triagec.Shockd.PostoperativeANS:CDuring World War II, shock wards were established to care for critically injured patients.Triage wards establish the order in which a patient is seen or treated upon arrival to ahospital. Postoperative wards were developed in 1900 and later evolved into intensive careunits.PTS:1DIF:Cognitive Level: RememberingREF:p. 2OBJ:Nursing Process Step: N/ATOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment2.What type of practitioner has a broad depth of specialty knowledge and expertise andmanages complex clinical and system issues?a.Registered nursesb.Advanced practice nursesc.Clinical nurse leadersd.IntensivistsANS:BAdvanced practice nurses (APNs) have a broad depth of knowledge and expertise in theirspecialty area and manage complex clinical and systems issues. Intensivists are medicalpractitioners who manage the critical ill patient. Registered nurses (RNs) are generally directcare providers. Clinical nurse leaders (CNLs) generally do not manage system issues.PTS:1DIF:Cognitive Level: RememberingREF:p. 5OBJ:Nursing Process Step: N/ATOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment3.What type of practitioner is instrumental in ensuring care that is evidence based and thatsafety programs are in place?a.Clinical nurse specialistb.Advanced practice nursec.Registered nursesd.Nurse practitionersANS:A____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)1 | P a g e

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Clinical nurse specialists (CNSs) serve in specialty roles that use their clinical, teaching,research, leadership, and consultative abilities. They are instrumental in ensuring that care isevidence based and that safety programs are in place. Advanced practice nurses (APNs)have a broad depth of knowledge and expertise in their specialty area and manage complexclinical and systems issues. Registered nurses are generally direct care providers. Nursepractitioners (NPs) manage direct clinical care of groups of patients.PTS:1DIF:Cognitive Level: RememberingREF:p. 6OBJ:Nursing Process Step: N/ATOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment4.Which professional organization administers critical care certification exams for registerednurses?a.State Board of Registered Nursesb.National Association of Clinical Nurse Specialistc.Society of Critical Care Medicined.American Association of Critical-Care NursesANS:DAmerican Association of Critical-Care Nurses (AACN) administers certification exams forregistered nurses. The State Board of Registered Nurses (SBON) does not administercertification exams. National Association of Clinical Nurse Specialists (NACNS) does notadminister certification exams. Society of Critical Care Medicine (SCCM) does notadminister nursing certification exams for registered nurses.PTS:1DIF:Cognitive Level: RememberingREF:p. 7OBJ:Nursing Process Step:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment5.Emphasis is on human integrity and stresses the theory that the body, mind, and spirit areinterdependent and inseparable. This statement describes which methodology of care?a.Holistic careb.Individualized carec.Cultural cared.Interdisciplinary careANS:AHolistic care focuses on human integrity and stresses that the body, mind, and spirit areinterdependent and inseparable. Individualized care recognizes the uniqueness of eachpatient’s preferences, condition, and physiologic and psychosocial status. Cultural diversityin health care is not a new topic, but it is gaining emphasis and importance as the worldbecomes more accessible to all as the result of increasing technologies and interfaces withplaces and peoples. Interdisciplinary care is care among a variety of health careprofessionals with the patient’s health as the common goal.PTS:1DIF:Cognitive Level: RememberingREF:p. 12OBJ:Nursing Process Step: N/ATOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)2 | P a g e

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6.The American Association of Critical-Care Nurses (AACN) has developed short directivesthat can be used as quick references for clinical use that are known asa.Critical Care Protocol.b.Practice Policies.c.Evidence-Based Research.d.Practice Alerts.ANS:DThe American Association of Critical-Care Nurses (AACN) has promulgated severalevidence-based practice summaries in the form of “Practice Alerts.” Evidence-based nursingpractice considers the best research evidence on the care topic along with clinical expertiseof the nurse and patient preferences. Critical care protocol and practice policies areestablished by individual institutions.PTS:1DIF:Cognitive Level: RememberingREF:p. 9OBJ:Nursing Process Step: N/ATOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment7.What type of therapy is an option to conventional treatment?a.Alternativeb.Holisticc.Complementaryd.IndividualizedANS:AThe termalternativedenotes that a specific therapy is an option or alternative to what isconsidered conventional treatmor state. The termcomplementarywasproposed to describe therapiescomplement or support conventionaltreatments. Holistic care focuses on human integrity and stresses that the body, mind, andspirit are interdependent and inseparable. Individualized care recognizes the uniqueness ofeach patient’s preferences, condition, and physiologic and psychosocial status.PTS:1DIF:Cognitive Level: RememberingREF:p. 16OBJ:Nursing Process Step: N/ATOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment8.Prayer, guided imagery, and massage are all examples of what type of treatment?a.Alternative therapyb.Holistic carec.Complementary cared.Individualized careANS:C____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)3 | P a g e

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The termcomplementarywas proposed to describe therapies that can be used tocomplement or support conventional treatments. Spirituality, prayer, guided imagery,massage, and animal-assisted therapy are all examples of complementary care. The termalternativedenotes that a specific therapy is an option or alternative to what is consideredconventional treatment of a condition or state. Holistic care focuses on human integrity andstresses that the body, mind, and spirit are interdependent and inseparable. Individualizedcare recognizes the uniqueness of each patient’s preferences, condition, and physiologic andpsychosocial status.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 16 | p. 17OBJ:Nursing Process Step: N/ATOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment9.What is the systematic decision-making model used by nurses termed?a.Nursing diagnosisb.Nursing interventionsc.Nursing evaluationsd.Nursing processANS:DThe nursing process is a systematic decision-making model that is cyclic, not linear. Anessential and distinguishing feature of any nursing diagnosis is that it describes a healthcondition. Nursing interventions constitute the treatment approach to an identified healthalteration. Evaluation of attainment of the expected patient outcomes occurs formally atintervals designated in the outcome criteria.PTS:1DIF:derstandingREF:n/aOBJ:Nursing Process Step: GeneralTOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment10.What is a health condition primarily resolved by nursing interventions or therapies called?a.Nursing diagnosisb.Nursing interventionsc.Nursing outcomesd.Nursing processANS:AAn essential and distinguishing feature of any nursing diagnosis is that it describes a healthcondition. Nursing interventions constitute the treatment approach to an identified healthalteration. Evaluation of attainment of the expected patient outcomes occurs formally atintervals designated in the outcome criteria. The nursing process is a systematicdecision-making model that is cyclic, not linear.PTS:1DIF:Cognitive Level: RememberingREF:n/aOBJ:Nursing Process Step: GeneralTOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment11.Designing therapeutic activities that move a patient from one state of health to another is anexample of which of the following?a.Nursing diagnosis____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)4 | P a g e

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b.Nursing interventionsc.Nursing outcomesd.Nursing processANS:BNursing interventions constitute the treatment approach to an identified health alteration. Anessential and distinguishing feature of any nursing diagnosis is that it describes a healthcondition. Evaluation of attainment of the expected patient outcomes occurs formally atintervals designated in the outcome criteria. The nursing process is a systematicdecision-making model that is cyclic, not linear.PTS:1DIF:Cognitive Level: RememberingREF:n/aOBJ:Nursing Process Step: GeneralTOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment12.A patient was admitted to a rural critical care unit in Montana. Critical care nurses areassisting with monitoring and care of the patient from the closest major city. What is thistype of practice termed?a.Tele-nursingb.Tele-ICUc.Tele-informaticsd.Tele-hospitalANS:BTele-ICU is a form of telemedicine. Telemedicine was initially used in outpatient areas,remote rural geographic locations, and areas where there was a dearth of medical providers.Currently, there are tele-ICUs iare limited resources onsite. However,experts (critical care nurses, ined in a central distant site.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 19OBJ:Nursing Process Step: GeneralTOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment13.Which core competency for interprofessional practice can be described as working withindividuals of other professions to maintain a climate of mutual respect and shared values?a.Interprofessional teamwork and team-based careb.Values and ethics for interprofessional practicec.Interprofessional communicationd.Roles and responsibilities for collaborative practiceANS:B____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)5 | P a g e

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Values and ethics for interprofessional practice mean working with individuals of otherprofessions to maintain a climate of mutual respect and shared values. Roles andresponsibilities for collaborative practice include using knowledge of one’s own role and theroles of other professions to appropriately assess and address the health care needs of thepatients and populations served. Interprofessional communication includes communicatingwith patients, families, communities, and other health professionals in a responsive andresponsible manner that supports a team approach to maintaining health and treatment ofdisease. Interprofessional teamwork and team-based care means applyingrelationship-building values and principles of team dynamics to perform effectively indifferent team roles to plan and deliver patient population-centered care that is safe, timely,efficient, effective, and equitable.PTS:1DIF:Cognitive Level: RememberingREF:p. 5 | Box 1-5 1-4 ed.9OBJ:Nursing Process Step: GeneralTOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment14.What is the stepwise decision-making flowchart for a specific care process named?a.Algorithmb.Practice guidelinec.Protocold.Order setANS:AAnalgorithmis a stepwise decision-making flowchart for a specific care process orprocesses. Apractice guidelineis usually created by an expert panel and developed by aprofessional organization.Proctive and rigid than guidelines, andproviders are not supposed to vary from a protocol. Anorder setconsists of preprintedprovider orders that are used to expedite the order process after a standard has beenvalidated through analytic review of practice and research.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 22OBJ:Nursing Process Step: InterventionTOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment15.Which nursing intervention continues to be one of the most error-prone for critical carenurses?a.Inappropriate careb.Intimidating and disruptive clinician behaviorc.Injury to patients by fallsd.Medication administrationANS:DMedication administration continues to be one of the most error-prone nursing interventionsfor critical care nurses. Intimidating and disruptive clinician behaviors can lead to errors andpreventable adverse patient outcomes. Patient safety has been described as an ethicalimperative and one that is inherent in health care professionals’ actions and interpersonalprocesses; examples include inappropriate care and injury to patients by falls.PTS:1DIF:Cognitive Level: RememberingREF:p. 25____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)6 | P a g e

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OBJ:Nursing Process Step: AssessmentTOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care EnvironmentMULTIPLE RESPONSE1.What considerations are taken into account in evidence-based nursing practice? (Select allthat apply, one, some, or all.)a.Clinical expertise of the nurseb.Availability of staff and facility equipmentc.Research evidence on the topicd.Patient knowledge of the diseasee.Patient preference regarding careANS:A, C, EEvidence-based nursing practice considers the best research evidence on the care topic alongwith clinical expertise of the nurse and patient preferences. For instance, when determiningthe frequency of vital sign measurement, the nurse would use available research and nursingjudgment (stability, complexity, predictability, vulnerability, and resilience of the patient).Availability of staff and facility equipment and the patient’s knowledge of the disease do notfactor into evidence-based nursing practices.PTS:1DIF:Cognitive Level: RememberingREF:p. 9OBJ:Nursing Process Step: AssessmentTOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment2.The concept ofdiversityencomhhhts and actions? (Select all that apply, one,some, or all.)a.Sensitivity to ethnic differencesb.Openness to different lifestylesc.Openness to different valuesd.Reticence to different beliefse.Lack of concern regarding different opinionsANS:A, B, CDiversity includes not only ethnic sensitivity but also sensitivity to openness to differencelifestyles, opinions, values, and beliefs. Reticence and lack of concern are not part of theconcept of diversity.PTS:1DIF:Cognitive Level: EvaluatingREF:p. 5OBJ:Nursing Process Step: N/ATOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment3.According to American Association of Critical-Care Nurses, what are the responsibilities ofa critical care nurse? (Select all that apply, one, some, or all.)a.Respecting the values, beliefs, and rights of the patientb.Intervening when the best interest of the patient is in questionc.Helping the patient obtain necessary cared.Making decisions for the patient and patient’s familye.Monitoring and safeguarding the quality of care the patient receives____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)7 | P a g e

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f.Acting as a gatekeeper for the patient, the patient’s family, and other health careprofessionalsANS:A, B, C, EAmerican Association of Critical-Care Nurses (AACN) critical care nurse roleresponsibilities include respecting the values, beliefs, and rights of the patient; interveningwhen the best interest of the patient is in question; helping the patient obtain necessary care;and monitoring and safeguarding the quality of care the patient receives. The nurse is not tomake decisions for the patient or the patient’s family but should support their decisions. Thenurse should act as a liaison, not a gatekeeper, for the patient and the patient’s family andother health care professionals.PTS:1DIF:Cognitive Level: EvaluatingREF:p. 5 | Box 1-1OBJ:Nursing Process Step: N/ATOP:Critical Care Nursing PracticeMSC:NCLEX: Safe and Effective Care Environment____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)8 | P a g e

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Chapter 02: Ethical IssuesUrden: Critical Care Nursing, 9th EditionMULTIPLE CHOICE1.What is the difference between ethics and morals?a.Ethics is more concerned with the “why” of behavior.b.Ethics provides a framework for evaluation of the behavior.c.Ethics is broader in scope than morals.d.Ethics concentrates on the right or wrong behavior based on religion and culturevalues.ANS:AEthics are concerned with the basis of the action rather than whether the action is right orwrong, good or bad.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 12OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment2.A patient’s wife has been informed by the practitioner that her spouse has permanentquadriplegia. The wife states that she does not want anyone to tell the patient about hisinjury. The patient asks the nurse about what has happened. The nurse has conflictingemotions about how to handle the situation. What is the nurse experiencing?a.Autonomyb.Moral distressc.Moral doubtd.Moral courageANS:BThe nurse has been placed in a situation initially causing moral distress and is strugglingwith determining the ethically appropriate action to take. Moral courage is the freedom toadvocate for oneself, patients, and peers. Autonomy is an ethical principle. Moral doubt isnot part of the American Association of Critical-Care Nurses (AACN) framework.The 4A’sto Rise Above Moral Distress.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 12OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment3.By what action can critical care nurses best enhance the principle of autonomy?a.Presenting only the information to prevent relapse in a patientb.Assisting with only tasks that cannot be done by the patientc.Providing the patient with all of the information and factsd.Guiding the patient toward the best choices for careANS:CPatients and families must have all the information about a certain situation to make anautonomous decision that is best for them.____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)9 | P a g e

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PTS:1DIF:Cognitive Level: ApplyingREF:p. 15 | p. 16OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment4.Which ethical principle is most important when soliciting informed consent from a patient?a.Nonmaleficenceb.Fidelityc.Beneficenced.VeracityANS:DVeracity is important when soliciting informed consent because the patient needs to beaware of all potential risks of and benefits to be derived from specific treatments or theiralternatives.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 15OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment5.The principle of respect for persons incorporates what additional concepts?a.Confidentiality and privacyb.Truth and reflectionc.Autonomy and justiced.Beneficence and nonmaleficenceANS:AConfidentiality of patient inforpy in patient interactions must be protectedand honored by health care providers out of respect for persons. Confidentiality is a rightinvolving the sharing of patient information with only those involved in the patient’s care.Privacy includes confidentiality but goes further to include the right to privacy of person andpersonal space, such as ensuring that a patient is adequately covered during a procedure.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 16OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment6.Which action best reflects the concept of beneficence within the critical care setting?a.Advocating for equitable health careb.Promoting for safe patient carec.Ensuring equal access for those with the same condition or diagnosisd.Confirming technologic advances are available to all in a given communityANS:BAdvocating for patient safety is an example of beneficence. The other actions are examplesof justice.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 15 | Box 2-2OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)10 | P a g e

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7.Which statement best describes the concept of paternalism?a.Encouraging the patient to ambulate after surgeryb.Demanding the patient get out of bed to sit in a chairc.Following the patient’s advance directive despite family objectionsd.Administering antibiotics for a viral infectionANS:BEncouraging the patient to ambulate after surgery is an example of beneficence. Demandingthe patient get out of bed to sit in a chair is an example of paternalism. Following thepatient’s advance directive despite family objections is an example of autonomy.Administering antibiotics for a viral infection is an example of physiologic futility.PTS:1DIF:Cognitive Level: ApplyingREF:p. 18OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment8.Which statement regarding the Code of Ethics for Nursing is accurate?a.The Code of Ethics for Nurses is usurped by state or federal laws.b.It allows the nurse to focus on the good of society rather than the uniqueness of thepatient.c.The Code of Ethics for Nurses was recently adopted by the American NursesAssociation.d.It provides society with a set of expectations of the nursing profession.ANS:DThe Code of Ethics for Nursinork for the nurse to follow in ethicaldecision-making and providesyf expectations of the profession.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 19OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment9.Ethical decisions are best made by performing which action?a.Following the guidelines of a framework or modelb.Having the patient discuss alternatives with the practitioner or nursec.Prioritizing the greatest good for the greatest number of personsd.Studying by the Ethics Committee after all diagnostic data are reviewedANS:ATo facilitate the ethical decision-making process, a model or framework must be used sothat all involved will consistently and clearly examine the multiple ethical issues that arisein critical care.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 20OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment10.What is the first step of the ethical decision-making process?a.Consulting with an authority____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)11 | P a g e

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b.Identifying the health problemc.Delineating the ethical problem from other types of problemsd.Identifying the patient as the primary decision makerANS:BStep one involves identifying the major aspects of the patient’s medical and healthproblems. Consulting an authority is not always necessary in the process. Delineating theethical problem from other types of problems may not be necessary. Identification of thepatient as primary decision maker is not part of the process.PTS:1DIF:Cognitive Level: RememberingREF:p. 20OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment11.A practitioner is suggesting treatments to a patient that are contrary to the patient’spreferences. What is this practice called?a.Invaluable deficiencyb.Physiologic uselessnessc.Ethical futilityd.Situational insufficiencyANS:CEthical futility is treatment that will not serve the underlying interests, values, andpreferences of the patient such as when a practitioner’s idea of benefit is contrary to thevalues and preferences of the patient.PTS:1DIF:CmemberingREF:p. 18OBJ:Nursing Process Step:EthicsMSC:NCLEX: Safe and Effective Care Environment12.Institutional ethics committees (IECs) review ethical cases that are problematic for thepractitioner. What is the major function of an IEC?a.Consultation with purely binding recommendationsb.Support and education to health care providersc.Conflict resolution for moral dilemmasd.Recommendations that are binding in all casesANS:BThe Institutional Ethics Committee (IEC) can function in a variety of ways, serving asconsultants, providing education, and helping resolve ethical conflicts or dilemmas forhealth care providers. Recommendations from the formal IEC may or may not be bindingand are relative to the situation at hand.PTS:1DIF:Cognitive Level: RememberingREF:p. 22OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment13.Developing an organizational policy that supports unobstructed access to the ethicscommittee by health care team members is one example of a proactive approach to dealingwith what issue?____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)12 | P a g e

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a.Moral distressb.Surrogate decision makersc.Paternalismd.Patient advocacyANS:AEvery organization must develop policies that support unobstructed access to resources suchas the ethics committees to mitigate the harmful effects of moral distress in the pursuit ofcreating a healthy work environment.PTS:1DIF:Cognitive Level: RememberingREF:p. 12 | p. 13 | Box 2-1OBJ:Nursing Process Step: AssessmentTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment14.The nurse is using the SFNO approach to case analysis to facilitate ethical decision-making.What justification criteria may be used to help explain the reasons for selection of oneoption over another?a.Effectivenessb.Usefulnessc.Legal ramificationsd.EconomicsANS:AJustification criteria may be helpful in explaining the reasons for selecting one or twooptions as superior. These include necessity, effectiveness, proportionality, leastinfringement, and proper process. Usefulness, legal ramifications, and economics are notpart of the criteria.PTS:1DIF:Cognitive Level: RememberingREF:p. 21 | Box 2-8OBJ:Nursing Process Step: AssessmentTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment15.The nurse is using the SFNO approach to case analysis to facilitate ethical decision-making.Which question is important to ask when considering stakeholders?a.Are there reasons to give priority to one stakeholder over another?b.Will the stakeholders abide by the decision?c.Will the stakeholders want to be present during the ethics consultation?d.Do the stakeholders understand how to use the SFNO model?ANS:AIn the SFNO model, questions about stakeholders include:• Who has a stake in the decision being made? Why?• Who will be significantly affected by the decision made? Why?• Are there reasons to give priority to one stakeholder over another? The other questions arenot relevant to this process.PTS:1DIF:Cognitive Level: EvaluatingREF:p. 21 | Box 2-8OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)13 | P a g e

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MULTIPLE RESPONSE1.Which is/are criteria for defining an ethical dilemma? (Select all that apply, one, some, orall.)a.An awareness of different optionsb.An issue in which only one viable option existsc.The choice of one option compromises the option not chosend.An issue that has different optionse.When the healthcare team is in agreement on what to doANS:A, C, DThe criteria for identifying an ethical dilemma are threefold: (1) an awareness of thedifferent options, (2) an issue that has different options, and (3) the choice of one optionover another compromises the option not chosen.PTS:1DIF:Cognitive Level: RememberingREF:p. 21 | Box 2-8OBJ:Nursing Process Step: AssessmentTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment2.Which situations are early signs of an ethical dilemma? (Select all that apply, one, some, orall.)a.Disagreements among health care team membersb.Failure to discuss end-of-life issues with patientc.Aggressive pain managementd.Belief that treatment is harmfule.Following the patient’s advance directive despite family objectionsf.Providing hope to the patieANS:A, B, DDisagreements among health care team members, failure to discuss end-of-life issues withpatient, and belief that treatment is harmful are early signs or indicators of an ethicaldilemma.PTS:1DIF:Cognitive Level: ApplyingREF:p. 19 | Box 2-5OBJ:Nursing Process Step: GeneralTOP:EthicsMSC:NCLEX: Safe and Effective Care Environment____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)14 | P a g e

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Chapter 03: Legal IssuesUrden: Critical Care Nursing, 9th EditionMULTIPLE CHOICE1.What is the legal standard of care for a nurse’s actions?a.Minimal competency under the state Nurse Practice Actb.The ability to distinguish what is right or wrong for the patientc.The demonstration of satisfactory knowledge of policies and proceduresd.The care that an ordinary prudent nurse would perform under the samecircumstancesANS:DThe legal standard of care for nurses is established by expert testimony and is generally “thecare that an ordinarily prudent nurse would perform under the same circumstances.”PTS:1DIF:Cognitive Level: UnderstandingREF:p. 27OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment2.A patient is admitted with chest pain, and his electrocardiogram shows elevated STsegments. The nurse bases her plan of care on the nursing diagnosis of pneumonia. Whattype of negligence may be present?a.Assessment failureb.Planning failurec.Implementation failured.Evaluation failureANS:BBasing nursing care on an erroneous diagnosis is a failure in planning. Standards of careincludeassessment,the collection of relevant data pertinent to the patient’s health orsituation;diagnosis,analysis of the assessment data in determining diagnosis and careissues;implementation,coordinating care delivery and plan and using strategies to promotehealth and a safe environment; andevaluation,evaluation of the progress of the patienttoward attaining outcomes.PTS:1DIF:Cognitive Level: AnalyzingREF:p. 27 | p. 30 | Box 3-3OBJ:Nursing Process Step: AssessmentTOP:LegalMSC:NCLEX: Safe and Effective Care Environment3.What is an injury resulting from the failure to meet an ordinary duty called?a.Negligenceb.Malpracticec.Assaultd.BatteryANS:A____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)15 | P a g e

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Injury resulting from the failure to meet an ordinary duty or standard of care is negligence.Malpractice is a specialized form of negligence. Assault and battery are examples ofintentional acts.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 27 | p. 28OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment4.A night nurse is notified by the laboratory that the patient has a critical magnesium level of1.1 mEq/L. The patient has a do-not-resuscitate order. The nurse does not notify thepractitioner because of the patient’s code status. In doing so, the nurse is negligent for what?a.Failure to analyze the level of care needed by the patientb.Failure to respect the patient’s wishesc.Wrongful deathd.Failure to take appropriate actionANS:DNurses caring for acutely and critically ill patients must appropriately notify physicians ofsituations warranting treatment actions. Furthermore, the full no-code, do-not-resuscitateorder does not exclude this patient from receiving treatment to correct the critical laboratoryvalue. Failure to take appropriate action in cases involving acutely and critically ill patientshas included not only physician-notification issues but also failure to follow physicianorders, failure to properly treat, and failure to appropriately administer medication.PTS:1DIF:Cognitive Level: ApplyingREF:p. 28 | p. 29OBJ:Nursing Process Step: Assessment | Nursing Process Step: ImplementationTOP:LegalMSC:ffective Care Environment5.Two nurses are talking about a patient’s condition in the cafeteria. In doing so, these nursescould be accused of what?a.Failure to take appropriate actionb.Failure to timely communicate patient findingsc.Failure to preserve patient privacyd.Failure to document patient informationANS:CNurses have a duty to preserve patient privacy, and failure to do so is a breach of patientconfidentiality and failure to preserve patient privacy. Nurses should also refrain fromhaving discussions about specific patients with anyone except other health careprofessionals involved in the care of the patient. When discussing specific patients withother health care professionals, it is imperative that patient-specific discussions occur innonpublic settings. Discussions about specific patients are never appropriate in public areassuch as elevators, cafeterias, gift shops, and parking lots.PTS:1DIF:Cognitive Level: ApplyingREF:p. 31OBJ:Nursing Process Step: AssessmentTOP:LegalMSC:NCLEX: Safe and Effective Care Environment6.What is negligence called when it applies to an individual who is a professional?a.Breach____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)16 | P a g e

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b.Malpracticec.Dutyd.HarmANS:BWhereas negligence claims may apply to anyone, malpractice requires the allegedwrongdoer to have special standing as a professional. If a nurse caring for acutely andcritically ill patients is accused of failing to act in a manner consistent with the standard ofcare, that nurse is subject to liability for professional malpractice (negligence applied to aprofessional).PTS:1DIF:Cognitive Level: UnderstandingREF:p. 28OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment7.A nurse fails to recognize an intubated patient’s need for suctioning. The endotracheal tubebecomes clogged, and the patient has a respiratory arrest. What type of negligence may bepresent?a.Assessment failureb.Planning failurec.Implementation failured.Evaluation failureANS:ANurses have a duty to assess and analyze the care required by each patient they care for.Failure to do so puts the nurse at risk for negligence related to failure to assess the patient’sneeds.PTS:1DIF:Cognitive Level: AnalyzingREF:p. 30OBJ:Nursing Process Step: AssessmentTOP:LegalMSC:NCLEX: Safe and Effective Care Environment8.What element of malpractice is based on the existence of a nurse–patient relationship?a.Dutyb.Breachc.Damagesd.Harm caused by the breachANS:ADutyto the injured party is the first element of a malpractice case and is premised on theexistence of a nurse–patient relationship.Breachis failure to act consistently withinapplicable standards of care. Harm caused by the breachoccurs when the patient sustainedinjuries because of the breach of duty.Damagesare derived from the harm or injurysustained by the acutely or critically ill patient and are calculated as a dollar amount.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 28OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)17 | P a g e

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9.A patient is getting heparin by intravenous infusion. The nurse received an order to increasethe heparin infusion rate and obtain a partial thromboplastin time (PTT) in 1 hour. The PTTwas drawn correctly and revealed a critically elevated level. The nurse was busy withanother patient and failed to report the critical result to the physician within 30 minutesaccording to the facility’s policy. Subsequently, the patient sustained a massive intracerebralbleed. What type of negligence may be present?a.Assessment failureb.Planning failurec.Implementation failured.Evaluation failureANS:CFailure to communicate and document patient findings in a timely manner is a form offailure to implement appropriate action.PTS:1DIF:Cognitive Level: AnalyzingREF:p. 30OBJ:Nursing Process Step: AssessmentTOP:LegalMSC:NCLEX: Safe and Effective Care Environment10.On the way to surgery, a patient expresses doubt about proceeding with the plannedprocedure. The patient states that the doctor did not explain it very well and she would liketo talk to her again before starting the procedure. The nurse knows the surgery schedule isvery tight, reassures the patient that everything will be all right, and administers thepreoperative sedation. This scenario describes what possible type of negligence?a.Assessment failureb.Planning failurec.Implementation failured.Evaluation failureANS:DThe nurse has a duty to act as a patient advocate, in this case by holding the preoperativesedation until the doctor and the patient can speak and the patient is satisfied that she has thenecessary information to make this decision.PTS:1DIF:Cognitive Level: AnalyzingREF:p. 31OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment11.Which statement is accurate regarding a nurse’s job description?a.As long as the nurse follows the American Nurses Association Standards of Care,the job description is irrelevant in a negligence allegation.b.Job descriptions must be reflective of the accepted standard of care.c.Institution-specific job descriptions are not legally acceptable.d.Job descriptions should be vague in describing nursing functions to avoid claims ofnegligence.ANS:BAlthough job descriptions can be institution specific, they should be reflective of thenational and community standards of care. Job descriptions are based on professionalaccountability as outlined by state boards of nursing and standards of practice.____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)18 | P a g e

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PTS:1DIF:Cognitive Level: UnderstandingREF:p. 29OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment12.The ability to practice as a licensed professional nurse is a privilege granted by what entity?a.Employee contractb.State legislaturec.State boards of nursingd.CongressANS:BThe very ability to practice as a licensed professional nurse is a privilege granted by thestate and is a function of each state’s authority to promote and protect the health and welfareof its citizens. State boards of nursing (BON) are administrative bodies created by—and thatoperate under—state statutes, or more generally written state laws created by statelegislatures and signed by the governor. In turn, the BONs develop more specific rules (orregulations) for obtaining and maintaining licensure.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 24OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment13.Why is restraining a competent patient against his or her wishes considered an intentionaltort?a.The nurse did not document the patient’s need for restraints.b.The nurse failed to get a phrestraints.c.The nurse touched the patient in an unauthorized manner.d.The nurse does not inform the patient that the restraints were needed.ANS:CAssault and battery are examples of intentional torts that are frequently brought againsthealth care providers. Battery occurs if the health care professional actually touches thepatient in an unauthorized manner. The act of restraining a patient without consent isbattery.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 32OBJ:Nursing Process Step: InterventionTOP:LegalMSC:NCLEX: Safe and Effective Care Environment14.What is the best action a nurse could take to prevent allegations of malpractice?a.Carrying malpractice insuranceb.Clarifying orders with the nursing supervisorc.Delegating care to nursing assistantsd.Providing care according to standards of practiceANS:D____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)19 | P a g e

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Maintaining standards of practice is the best way to reduce risk. The hallmark of riskreduction is knowledge of the professional standards of care, delivery and documentation ofthat care, and consistent demonstration that the standards are met. Nurses caring for acutelyand critically ill patients may be alleged to have acted in a manner that is inconsistent withstandards of care or standards of professional practice and may find themselves involved incivil litigation that focuses in whole or in part on the alleged failure.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 24OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment15.While participating in rounds, a nurse is interrupted by the wife of a ventilated patient, whoinforms the nurse that her husband is having difficulty breathing. The patient is found to bedisconnected from the ventilator and unresponsive when the nurse enters the room afterrounds. The alarm mode on the ventilator had been turned off. This situation is an exampleof what legal situation?a.Assaultb.Batteryc.Injuryd.MalpracticeANS:DAll four elements of negligence are present: duty and standard of care, breach of duty,causation, and injury. If a nurse caring for acutely and critically ill patients is accused offailing to act in a manner consistent with the standard of care, that nurse is subject toliability for professional malpractice (negligence applied to a professional). Assault occurs ifthe patient fears harmful or offttery is any intentional act that bringsabout actual harmful or offensive contact with the plaintiff.PTS:1DIF:Cognitive Level: EvaluatingREF:p. 27 | p. 28OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment16.After admission a patient shares with the nurse a concern that her adult children will not beable to reach agreement on what to do if she is no longer able to make decisions for herself.The nurse informs the patient that it is possible to grant authority to one person to makedecision through which mechanism?a.Court-appointed guardianb.Do-not-resuscitate orderc.Durable power of attorney for health cared.Living willANS:C____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)20 | P a g e

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A durable power of attorney for health care includes legally binding documents that allowindividuals to specify a variety of preferences, particular treatments he or she wants toavoid, and circumstances in which he or she wishes to avoid them. The durable power ofattorney for health care is a directive through which a patient designates an “agent,”someone who will make decisions for the patient if the patient becomes unable to do so. Aliving will specifies that if certain circumstances occur, such as terminal illness, the patientwill decline specific treatments, such as cardiopulmonary resuscitation and mechanicalventilation.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 36OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment17.In which situation did the nurse disregard the patient’s right to privacy?a.Informing the physician that the patient was verbalizing suicidal thoughtsb.Notifying the health department of a patient’s tuberculosis diagnosisc.Reporting possible dependent-adult abuse to the policed.Warning a visitor to wear gloves when giving a back rub because the patient isHIV positiveANS:DTelling a visitor of the patient’s HIV status violated the patient’s right to privacy. The nursecould have ensured the visitor’s safety by providing gloves and explaining universalprecautions.PTS:1DIF:Cognitive Level: AnalyzingREF:p. 31OBJ:Nursing Process Step:LegalMSC:NCLEX: Safe and Effective Care Environment18.Which statement best describes the definition of assault?a.An intentional act that causes the patient to believe that harm may have been doneb.A statement that causes injury to the patient’s standing in the communityc.Negligence that results in harm to a spousal relationshipd.An intentional act that brings about harm or offensive contact with the patientANS:AAssault occurs if the patient fears harmful or offensive touching. Battery is defined as anintentional act that brings about harm or offensive contact with the patient.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 32OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment19.During transport to the operating room for mitral valve replacement, a patient with a signedconsent form says that she does not want to go through with the surgery and asks to bereturned to her room. What is the best response from the nurse?a.“The operating room is prepared; let’s not keep the surgeon waiting.”b.“You have the right to cancel surgery, but it could be weeks before you arerescheduled.”c.“You sound frightened; tell me what you are thinking.”____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)21 | P a g e

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d.“Your preoperative medications will have you feeling more relaxed in a minute; itwill be OK.”ANS:CThe patient has the right to withdraw consent at any time. The nurse must listen and thenclarify whether that is really what the patient desires. If it is, the surgeon should then benotified.PTS:1DIF:Cognitive Level: AnalyzingREF:p. 34OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment20.Which situation would be considered a failure of proper implementation?a.Not identifying and analyzing symptoms appropriatelyb.Not documenting the patient’s response to pain medicationc.Not recognizing a malfunctioning chest tubed.Not asking the patient about code or no code wishesANS:BNurses caring for acutely and critically ill patients are required not only to take appropriateaction but also to accurately document their findings, interventions performed, and patients’response to those interventions. Failure to thoroughly and accurately document any aspectof care gives rise to negligence causes of action.PTS:1DIF:Cognitive Level: AnalyzingREF:p. 30OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effement21.Which agency is responsible for maintaining the expectations and limits of nursing practice?a.State Hospital Associationb.Court systemc.State Board of Nursingd.State Department of HealthANS:CState Boards of Nursing (SBONs) maintain expectations for and limits of nursing practice ineach state through the licensure of nurses and also through challenges to nonnurses engagedin professional activities that intrude upon the nursing scope of practice.PTS:1DIF:Cognitive Level: RememberingREF:p. 24OBJ:Nursing Process Step: N/ATOP:Nurse Practice ActMSC:NCLEX: Safe and Effective Care Environment22.A nurse providing care for a patient with a recent tracheostomy notes the presence of anulceration or wound at the tracheotomy site. The nature of the ulceration or wound clearlyindicates it has been present for at least several days. The nurse finds no documentationregarding the ulceration or wound since the insertion of the tracheostomy tube 12 daysearlier. This situation is an example of what legal situations?a.Assessment and implementation failureb.Failure to appropriately diagnose____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)22 | P a g e

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c.Failure to follow practitioner’s ordersd.Planning and evaluation failureANS:AThis situation is an example of the prior nurses’ failure to assess and implementappropriately. Assessment and implementation failures are related to a failure to assess andanalyze a care need, communicate findings to a physician, take appropriate action, anddocument.PTS:1DIF:Cognitive Level: AnalyzingREF:p. 30OBJ:Nursing Process Step: N/ATOP:LegalMSC:NCLEX: Safe and Effective Care Environment23.The patient received a blood transfusion based on test results of critically low hemoglobin.The nurse records vital signs (VS) per hospital protocol. One hour after the transfusion wasstarted, the nurse records VS as temperature (T) 102° F, pulse (P) 110, respirations (R) 24,blood pressure (BP) 136/88. The nurse continues to administer the blood. This situation isan example of what legal situation?a.Malpracticeb.Assaultc.Batteryd.LibelANS:ATo avoid liability associated with administration of blood and blood products, nurses mustcarefully follow organizational procedures and protocols that govern these interventions.Batteryis any intentional act thual harmful or offensive contact with theplaintiff.Assaultoccurs if the pul or offensive touching.Libelis defined aspublishing false statements that are damaging to a person’s reputation.PTS:1DIF:Cognitive Level: AnalyzingREF:p. 33 | p. 34OBJ:Nursing Process Step: N/ATOP:Legal IssuesMSC:NCLEX: Safe and Effective Care EnvironmentMULTIPLE RESPONSE1.What elements or criteria must be present for negligence cases to go forward? (Select allthat apply, one, some, or all.)a.Duty to another personb.Acknowledgement of wrong doingc.Harm that would not have occurred in the absence of the breachd.Breach of dutye.Damages that have a monetary valueANS:A, C, D, EThere are four criteria or elements for all negligence cases: (1) duty to another person; (2)breach of that duty; (3) harm that would not have occurred in the absence of the breach(causation); and (4) damages that have a monetary value. All four elements must be satisfiedfor a case to go forward. Acknowledgment of wrong doing is not required.____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)23 | P a g e

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PTS:1DIF:Cognitive Level: ApplyingREF:p. 27 | p. 28OBJ:Nursing Process Step: N/ATOP:Legal IssuesMSC:NCLEX: Safe and Effective Care Environment2.Which actions by a nurse demonstrate the act of battery? (Select all that apply, one, some,or all.)a.Performing cardiopulmonary resuscitation (CPR) on a patient with ado-not-resuscitate (DNR) orderb.Threatening to punch someonec.Sexual misconduct with a patientd.Drawing blood without the patient’s consente.Threatening to restrain a patient for not using his or her call light for mobilityassistanceANS:A, C, DBattery is any intentional act that brings about actual harmful or offensive contact with theplaintiff. Battery occurs if the health care professional actually touches the patient in anunauthorized manner. Assault occurs if the patient fears harmful or offensive touching.Assault may be alleged if the patient was aware that he or she was going to be touched in amanner not authorized by informed consent. Threatening to punch someone and threateningto restrain a patient for not using his or her call light for mobility assistance are examples ofassault.PTS:1DIF:Cognitive Level: ApplyingREF:p. 32OBJ:Nursing Process Step: N/ATOP:Legal IssuesMSC:NCLEX: Safe and Effective Care Environment____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)24 | P a g e

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Chapter 04: Genetic IssuesUrden: Critical Care Nursing, 9th EditionMULTIPLE CHOICE1.What is a genetic variant that exists in greater than 1% of the population termed?a.Genetic mutationb.Genetic polymorphismc.Genetic deletiond.Tandem repeatANS:BWhen a genetic variant occurs frequently and is present in 1% or more of the population, itis described as agenetic polymorphism. The termgenetic mutationrefers to a change in theDNA genetic sequence that can be inherited that occurs in less than 1% of the population.Genetic material in the chromosome can also bedeletedand new information from anotherchromosome can be inserted or can be atandemrepeat (multiple repeats of the samesequence).PTS:1DIF:Cognitive Level: RememberingREF:p. 43OBJ:Nursing Process Step: GeneralTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance2.Which type of genetic disorder occurs when there is an interaction between genetic andenvironmental factors such as that which occurs with type 2 diabetes?a.Chromosomeb.Mitochondrialc.Multifactorial disordersd.Allele dysfunctionANS:CIn multifactorial disorders there is an interaction between vulnerable genes and theenvironment. Cardiovascular atherosclerotic diseases and type 2 diabetes are examples ofmultifactorial disorders that result from an interaction of genetic and environmental factors.PTS:1DIF:Cognitive Level: UnderstandingREF:p. 46OBJ:Nursing Process Step: GeneralTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance3.Philadelphia translocationis a specific chromosomal abnormality that occurs from areciprocal translocation between chromosomes 9 and 22, where parts of these twochromosomes switch places. This abnormality is associated with which disease?a.Hemophilia Ab.Chronic myelogenous leukemiac.Obesityd.Marfan syndromeANS:B____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)25 | P a g e

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Philadelphia chromosomeorPhiladelphia translocationis a specific chromosomalabnormality associated with chronic myelogenous leukemia. It occurs from a reciprocaltranslocation between chromosomes 9 and 22, where parts of these two chromosomesswitch places. Hemophilia A is a sex-linked inheritance. Obesity is being studied with theFTO gene on chromosome 16. Marfan syndrome is classified as a single-gene disorder.PTS:1DIF:Cognitive Level: RememberingREF:p. 42OBJ:Nursing Process Step: GeneralTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance4.What was the goal of the Human Genome Project?a.Identifying haplotype tagsb.Exposing untaggable SNPs and recombination hot spotsc.Producing a catalog of human genome variationd.Mapping all the human genesANS:DThe Human Genome Project was a huge international collaborative project that began in1990 with the goal of making a map of all the human genes (the genome). The final genomesequence was published in 2003. The HapMap project was to identify haplotype tags. TheGenome-Wide Association Studies was used to expose untaggable SNPs and recombinationhot spots. The 1000 Genomes project was used to map all the human genes.PTS:1DIF:Cognitive Level: RememberingREF:p. 49OBJ:Nursing Process Step: GeneralTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance5.The patient is placed under general anesthesia for a carotid endarterectomy. During thesurgery, the patient develops muscle contracture with skeletal muscle rigidity, acidosis, andelevated temperature. What is a possible cause for malignant hyperthermia?a.Polymorphism inRYR1at chromosome 19q13.1b.Variant in theVKOR1genec.Variant in the cytochrome P450 enzymeCYP2C9gened.Halothane overdoseANS:AIndividuals with polymorphisms in the ryanodine receptor gene (RYR1) at chromosome19q13.1 are at risk of a rare pharmacogenetic condition known asmalignant hyperthermia.In affected individuals, exposure to inhalation anesthetics and depolarizing muscle relaxantsduring general anesthesia induces life-threatening muscle contracture with skeletal musclerigidity, acidosis, and elevated temperature. Warfarin is being researched as a variant in theVKOR1gene and in the cytochrome P450 enzymeCYP2C9gene.PTS:1DIF:Cognitive Level: EvaluatingREF:p. 53 | Box 4-3OBJ:Nursing Process Step: DiagnosisTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance6.What is the study of heredity particularly as it relates to the transfer heritable physicalcharacteristics called?a.Chromatids____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)26 | P a g e

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b.Karyotypec.Geneticsd.HistonesANS:CGeneticsrefers to the study of heredity, particularly as it relates to the ability of individualgenes to transfer heritable physical characteristics. Each somatic chromosome, also called anautosome, is made of two strands, calledchromatids,which are joined near the center. Akaryotypeis the arrangement of human chromosomes from largest to smallest. A specializedclass of proteins calledhistonesorganizes the double-stranded DNA into what looks like atightly coiled telephone cord.PTS:1DIF:Cognitive Level: RememberingREF:p. 54OBJ:Nursing Process Step: GeneralTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance7.What is the study of all the genetic material within the cell and its impact on biologic andphysical characteristics called?a.Chromatidsb.Karyotypec.Genomicsd.HistonesANS:CGenomicsrefers to the study of all of the genetic material within cells and encompasses theenvironmental interaction and impact on biologic and physical characteristics. Each somaticchromosome, also called an autwo strands, calledchromatids,which arejoined near the center. Akaryo ypgment of human chromosomes from largestto smallest. A specialized class of proteins calledhistonesorganizes the double-strandedDNA into what looks like a tightly coiled telephone cord.PTS:1DIF:Cognitive Level: RememberingREF:p. 39OBJ:Nursing Process Step: GeneralTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance8.A specialized class of proteins that organizes the double-stranded DNA into what looks likea tightly coiled telephone cord is known which of the following?a.Chromatidsb.Karyotypec.Genomicsd.HistonesANS:DA specialized class of proteins calledhistonesorganizes the double-stranded DNA into whatlooks like a tightly coiled telephone cord.Genomicsrefers to the study of all of the geneticmaterial within cells and encompasses the environmental interaction and impact on biologicand physical characteristics. Each somatic chromosome, also called an autosome, is made oftwo strands, calledchromatids,which are joined near the center. Akaryotypeis thearrangement of human chromosomes from largest to smallest.____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)27 | P a g e

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PTS:1DIF:Cognitive Level: RememberingREF:p. 39OBJ:Nursing Process Step: GeneralTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance9.To achieve a consistent distance across the width of the DNA strand, the nucleotide baseguanine (G) can only be paired with what other genetic material?a.Adenine (A)b.Thymine (T)c.Cytosine (C)d.Sex chromosome XANS:CFour nucleotide bases—adenine (A), thymine (T), guanine (G), and cytosine (C)—comprisethe “letters” in the genetic DNA “alphabet.” The bases in the double helix are paired T withA and G with C. The nucleotide bases are designed so that only G can pair with C and onlyT can pair with A to achieve a consistent distance across the width of the DNA strand. TheTA and GC combinations are known as base pairs.PTS:1DIF:Cognitive Level: EvaluatingREF:p. 40OBJ:Nursing Process Step: DiagnosisTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance10.Why are monozygotic twins separated at birth used to study the effects of genetics versusenvironment?a.They share an identical genome.b.They have different sex chromosomes.c.They have mirror chromosd.They have identical health issues.ANS:AStudies of identical twins offer a unique opportunity to investigate the association ofgenetics, environment, and health. Identical twins are monozygotic and share an identicalgenome. Monozygotic twins are the same sex. Studies occur much less frequently todaybecause tremendous efforts are made to keep siblings together when they are adopted.Genetics can be stable in a study group, but the environment and health issues are dynamiceven in a controlled study group.PTS:1DIF:Cognitive Level: RememberingREF:p. 48OBJ:Nursing Process Step: GeneralTOP:Genetics in Critical CareMSC:NCLEX: Health Promotion and Maintenance11.The process that is used to make polypeptide chains that constitute proteins can be writtenasa.RNADNAprotein.b.DNARNAprotein.c.proteinRNADNA.d.proteinDNARNA.ANS:B____________________________________________________________________________________________________________________________________________________________________________________________Test Bank - Critical Care Nursing-Diagnosis and Management, 9th Edition (Urden, 2022)28 | P a g e

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