Question 1

Patients often have recollections of the critical care experience.Which is likely to be the most common recollection of patients who required endotracheal intubation and mechanical ventilation?

Accepted Answer

A)  Difficulty in communicating 
B)  Inability to get comfortable 
C)  Pain 
D)  Sleep disruption

Question 2

Family assessment can be challenging,and each nurse may obtain additional information regarding family structure and dynamics.What is the best way to share this information from shift to shift?

Accepted Answer

A)  Create an informal family information sheet that is kept on the bedside clipboard.That way, everyone can review it quickly when needed. 
B)  Develop a standardized reporting form for family information that is incorporated into the patient's medical record and updated as needed. 
C)  Require that the charge nurse have a detailed list of information about each patient and family member.Thus, someone on the unit is always knowledgeable about potential issues. 
D)  Try to remember to discuss family structure and dynamics as part of the change-of-shift report.

Question 3

To reduce relocation stress in patients transferring out of the intensive care unit,the nurse can (Select all that apply.)

Accepted Answer

A)  ask the nurses on the intermediate care unit to give the family a tour of the new unit. 
B)  contact the intensivist to see if the patient can stay one additional day in the critical care unit so that he and his family can adjust better to the idea of a transfer. 
C)  ensure that the patient will be located near the nurses' station in the new unit. 
D)  invite the nurse who will be assuming the patient's care to meet with the patient and family in the critical care unit prior to transfer. 
E)  help the patient and family focus on the positive meaning of a transfer.

Question 4

Changing visitation policies can be challenging.The nurse manager recognizes which of the following as an effective strategy for promoting changes in practice?

Accepted Answer

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.

Question 5

Family members have a need for information.Which interventions best assist in meeting this need?

Accepted Answer

A)  Handing family members a pamphlet that explains all of the critical care equipment 
B)  Providing a daily update of the patient's progress and facilitating communication with the intensivist 
C)  Telling them that you are not permitted to give them a status report but that they can be present at 4:00 PM for family rounds with the intensivist 
D)  Writing down a list of all new medications and doses and giving the list to family members during visitation

Question 6

Critical illness often results in family conflicts.Which scenario is most likely to result in the greatest conflict?

Accepted Answer

A)  A 21-year-old college student of divorced parents hospitalized with multiple trauma.She resides with her mother.The parents are amicable with each other and have similar values.The father blames the daughter's boyfriend for causing the accident. 
B)  A 36-year-old male admitted for a ruptured cerebral aneurysm.He has been living with his 34-year-old girlfriend for 8 years, and they have a 4-year-old daughter.He does not have a written advance directive.His parents arrive from out-of-state and are asked to make decisions about his health care.He has not seen them in over a year. 
C)  A 58-year-old male admitted for coronary artery bypass surgery.He has been living with his same-sex partner for 20 years in a committed relationship.He has designated his sister, a registered nurse, as his health care proxy in a written advance directive. 
D)  A 78-year-old female admitted with gastrointestinal bleeding.Her hemoglobin is decreasing to a critical level.She is a Jehovah's Witness and refuses the treatment of a blood transfusion.She is capable of making her own decisions and has a clearly written advance directive declining any transfusions.Her son is upset with her and tells her she is "committing suicide."

Question 7

Which intervention is appropriate to assist the patient in coping with admission to the critical care unit?

Accepted Answer

A)  Allowing unrestricted visiting by several family members at one time 
B)  Explaining all procedures in easy-to-understand terms 
C)  Providing back massage and mouth care 
D)  Turning down the alarm volume on the cardiac monitor

Question 8

The nurse is a member of a committee to design a critical care unit in a new building.Which design trend would best facilitate family-centered care?

Accepted Answer

A)  Ensure that the patient's room is large enough and has adequate space for a sleeper sofa and storage for family members' personal belongings. 
B)  Include a diagnostic suite in close proximity to the unit so that the patient does not have to travel far for testing. 
C)  Incorporate a large waiting room on the top floor of the hospital with a scenic view and amenities such as coffee and tea. 
D)  Provide access to a scenic garden for meditation.

Exam 2: Patient and Family Response to the Critical Care Experience