Black & Hawks: Medical-Surgical Nursing: Clinical Management for

Positive Outcomes, 7th Edition

Chapter 9: Critical Care

MULTIPLE CHOICE

1. The nurse reminds a group of students that intensive care units (ICUs) as specialized
care spaces were initiated by
a. Florence Nightingale in the 1880s.
b. Johns Hopkins in the 1890s.
c. U.S. Army in the 1940s.
d. Chicago General in the 1920s.
ANS: a
Florence Nightingale organized a special unit for postoperative soldiers in the 1880s.

DIF: Cognitive Level: Knowledge REF: Text Reference: 159

TOP: Nursing Process Step: Intervention
MSC: NCLEX: Health Promotion and Maintenance

2. The ICU nurse cautions a client that of all the stressors the client will experience, one
of the most disrupting is
a. sense of isolation.
b. persistent pain.
c. alteration in sleep.
d. fear of the unknown.
ANS: c
There are many stressors to the ICU client, but alteration in sleep patterns potentiates all
the other options.

DIF: Cognitive Level: Application REF: Text Reference: 160

TOP: Nursing Process Step: Intervention MSC: NCLEX: Psychosocial Integrity

3. Critical care units (CCUs) have been developed in almost all hospitals because such
units
a. contain costs.
b. allow for concentration of expert personnel.
c. separate the seriously ill from the other clients.
d. can offer special services to the family.
ANS: b
The CCU offers a space in which a concentration of expert personnel can be assigned to
monitor and apply highly technological machines such as ventilators. The concentration
of personnel does not reduce cost.

Elsevier items and derived items 2005 by Elsevier Inc.

Chapter 9: Critical Care 2

DIF: Cognitive Level: Analysis REF: Text Reference: 160

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

4. When assuming the care of a client on a ventilator, the nurse can best allay the sense
of isolation by
a. putting the call light within reach.
b. establishing a simple communication system.
c. explaining the purpose of the bedside equipment.
d. allowing frequent visitation by family.
ANS: b
The establishment of a simple communication system for clients who cannot talk is very
important.

DIF: Cognitive Level: Analysis REF: Text Reference: 160

TOP: Nursing Process Step: Intervention MSC: NCLEX: Psychosocial Integrity

5. The ICU nurse makes her presence known frequently to the client and explains all
equipment and tests in an attempt to decrease the common ICU response of
a. fear.
b. powerlessness.
c. disorientation.
d. frustration.
ANS: b
An overwhelming sense of powerlessness is the overall recurrent theme verbalized by
ICU clients.

DIF: Cognitive Level: Application REF: Text Reference: 160

TOP: Nursing Process Step: Intervention MSC: NCLEX: Psychosocial Integrity

6. The nurse explains the new innovation that allows family members access to the ICU
to obtain information about the client by
a. placing a phone at the bedside of all clients.
b. giving family members a walkie-talkie to contact the nurse.
c. establishing a password to protect confidentiality.
d. sending e-mail to and from the family waiting room.
ANS: c
The establishment of a password to obtain updates per phone allows the family wider
access to the ICU and also protects the privacy and confidentiality of the client.

DIF: Cognitive Level: Application REF: Text Reference: 162

TOP: Nursing Process Step: Intervention MSC: NCLEX: Psychosocial Integrity

7. Studies have shown that despite all the provisions made by ICUs and staff, families
still
a. feel rejected.

Elsevier items and derived items 2005 by Elsevier Inc.

Chapter 9: Critical Care 3

b. resent crowded spaces.

c. need reassurance.
d. want technical information.
ANS: c
Families often find the ICU experience as difficult as the client does. Research indicates
that despite all efforts of the ICU staff, the need for reassurance and non-technical
information remains unanswered in many cases.

DIF: Cognitive Level: Analysis REF: Text Reference: 163

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

Elsevier items and derived items 2005 by Elsevier Inc.