Chapter 14- Rapid Response Teams and Transport of the Critically Ill Patient My Nursing Test Banks

 

1.

A nurse working in the ICU of a rural hospital is trying to make the case to the administration to create an RRT for the hospital. There have been a number of preventable deaths at the hospital recently. Which case provides the best support for the nurses argument that the hospital needs such a team?

A)

A patient died of cardiac arrest because medical staff did not respond quickly enough to his condition.

B)

A patient died of an overdose of medication due to a medication error.

C)

A patient died of an infection after a surgeon failed to scrub in properly before surgery.

D)

A patient died from head trauma after slipping on a wet surface in her room in the ICU.

2.

An RRT has just been created at a hospital. An RN from the ICU has been appointed as the leader and is planning a training session for other members of the RRT. Which topics would be appropriate to include in the training? Select all that apply.

A)

The benefits of early rescue

B)

Triage skills and advanced cardiac life support

C)

Equipment needed for air transport of a patient between facilities

D)

Expectations of RRT members when responding to a call

E)

EMTALA guidelines for requirements for evaluating a patients suitability for transfer

F)

Guided imagery to assist patients dealing with severe pain

3.

A patient must be transferred from one hospital to another due to lack resources at the sending hospital needed by the patient. Which of the following conditions would incline the transport team of the hospital to choose ground transport as opposed to air? Select all that apply.

A)

Heavy rainfall is in the area.

B)

The hospitals are 20 miles apart.

C)

The patient needs a time-sensitive intervention.

D)

Traffic on the ground is minimal.

4.

A patient with a spine injury is being transferred to another hospital. What special intervention should the nurse make to prepare the patient for air transport?

A)

Stabilize the patients back with a back board.

B)

Send the patients medical chart with him.

C)

Contact the receiving hospital to confirm that they have a bed for him.

D)

Conduct preflight screen for patient fear or anxiety related to flying.

5.

The medical director of hospital has received several requests for patient transfers to other facilities. Based on the Emergency Medical Transfer Active Labor Act, which of the following cases would justify interfacility transfer? Select all that apply.

A)

A patient requires emergency coronary angioplasty and the sending hospital is not equipped to perform this service.

B)

The family of a patient severely injured in a car wreck in another state requests that the patient be transferred to a facility where they live.

C)

The administration of the hospital requests that a patient who lacks health insurance be transferred to a facility that can better absorb the cost of his care.

D)

A surgeon at the receiving hospital has unique experience performing a procedure that the patient requires.

6.

A Medicare patient who has been in the ICU for 6 weeks is being transferred to a larger facility that can better support the costs of her care. The medical director at the sending hospital weighs the pros and cons of ground versus air transport and opts for air transport because of the long distance between the two hospitals. The receiving hospital is contacted, and approval is given to transfer the patient. The nurse attending the patient works with the transport team to make sure that all medical devices needed by the patient are available during the flight. The physician at the receiving hospital is waiting for the patient as soon as she arrives. Which part of the transfer plan failed in this situation?

A)

Determination of the appropriateness of the transfer

B)

Selection of mode of transport

C)

Communication between the sending and receiving hospitals

D)

Collaboration among health care team members at the sending hospital

7.

The medical director of a hospital must decide whether to transfer a heart transplant patient by ground or air transport to another facility that can provide the care the patient needs. Which of the transfer is this decision made in?

A)

Phase one: Notification and acceptance by receiving facility

B)

Phase two: Preparation of the patient by the transport team

C)

Phase three: The transport process

D)

Phase four: Turnover of the patient to the receiving facility

8.

A patient is being prepared for transfer to another facility via air transport (phase two of transfer). Which of the following is a role of the transport nurse at this time?

A)

Suggest ground transport for the patient, as the receiving hospital is not far away.

B)

Screen the patient for fear or anxiety of flying.

C)

Call in an updated report on the patients status to the RN on the receiving unit.

D)

Delivery of patient belongings to the receiving staff.

9.

A nurse in the ICU participates in an evaluation of a recent patient transport. In which phase of patient transfer does this occur?

A)

Phase two: Preparation of the patient by the transport team

B)

Phase three: The transport process

C)

Phase four: Turnover of the patient to the receiving facility

D)

Phase five: Post-transport continuous quality improvement monitoring

10.

The transport nurse is accompanying her patient in transit by helicopter from one facility to another. Which of the following is an intervention the nurse would most likely be making at this time?

A)

Contacting the RN on the receiving unit to note a change in the patients vital signs

B)

Administering antiemetic medication to the patient to prevent air sickness

C)

Endotracheal intubation

D)

Communication with the patients family regarding details of the transport

11.

The nurse is on a committee establishing a rapid response team for the hospital. What is the best rationale for establishing a rapid response team?

A)

Mandated by accreditation standards

B)

Provides early treatment of hemodynamic instability

C)

Relieves general floor staff of need to assess patients

D)

Takes the place of cardiopulmonary resuscitation teams

12.

The nurse is assisting in the establishment of a rapid response team for the hospital. Effective use of an RRT requires clear understanding of the role of the team. What is the major function of an RRT?

A)

Perform bedside invasive procedures on general nursing units.

B)

Assess all hospital patients for initial signs of hemodynamic instability.

C)

Provide critical care expertise on general nursing units when needed.

D)

Act as the transport team when patients require transfers to other facilities.

13.

The nurse is on a committee working toward establishing a rapid response team. What is the most important consideration in establishing such a team?

A)

Number of cardiopulmonary arrests in the hospital yearly

B)

Gaining support of senior hospital leadership

C)

Availability of nurse practitioner to lead the team

D)

Identifying possible negative effects on patient outcomes

14.

Based on family request, a critically ill patient is being transferred from one facility to another. What is the most important criterion the nurse should determine before the transfer?

A)

How stable the patient is

B)

If the receiving facility has a bed available

C)

Who the attending physician is

D)

If the benefits of transfer outweigh the risks

15.

A critically ill patient is being transferred from one agency to another. Under what circumstances should the transfer most clearly be done by air as opposed to ground transport?

A)

Current weather includes limited visibility

B)

Minimal ground traffic

C)

Ground transfer takes too much time

D)

Agencies are in close proximity

16.

The nurse is preparing a critically ill patient for interagency transfer by air transport. What nursing action most clearly illustrates the physiologic changes expected during air transport?

A)

Ensuring that copies of medical records and diagnostics go with the patient

B)

Giving the family clear directions to the receiving agency

C)

Inserting a nasogastric tube before the transfer

D)

Ensuring that the patient is heavily sedated during transport

17.

The nurse is preparing a critically ill patient for transfer to another facility. Based on the criteria established by the Emergency Medical Transfer Active Labor Act (EMTALA), what patient situation would prevent transfer?

A)

The sole reason for transfer is the patients uninsured status.

B)

The patient has been stabilized before the transfer.

C)

The receiving agency has the expertise to care for the patient.

D)

Transfer records are complete and sent with the patient.

18.

Two agencies are discussing implementing a collaborative interfacility transfer plan. What is the most important component of such a plan?

A)

One agency has more sophisticated medical capabilities than the other.

B)

Each agency has a clear understanding of its roles and responsibilities.

C)

Transfers are accomplished with maximum speed and efficiency.

D)

The two agencies are separated by distance necessitating air transport.

19.

The nurse is initiating the transfer of a critically ill patient from one agency to another. During the first phase of this transfer, what is the most important nursing responsibility?

A)

Ensure that appropriate care equipment is available in the transfer vehicle.

B)

Determine the willingness of the receiving agency to accept the patient.

C)

Give the family detailed directions to the receiving agency.

D)

Copy the patients medical records to accompany him or her.

20.

A critically ill patient needs an x-ray procedure that cannot be done at the bedside. What precautions should the nurse implement to protect the patient during transfer to the radiology department?

A)

Arrange for the usual patient transport technicians to transfer the patient.

B)

Ensure that a critical care nurse and one other person accompany the patient.

C)

Assume that all necessary equipment will be ready in the radiology department.

D)

Keep the patients medical record in the critical care unit to preserve privacy.

21.

A patient who fell off a horse and may have a cervical spine fracture is being transferred to another agency for more definitive care. During phase two of the transfer, the presence of what equipment would be most important for this patient?

A)

Two large-bore intravenous lines

B)

A cardiac defibrillator

C)

A cervical collar

D)

Supplemental oxygen therapy

22.

A patient with severe blood loss from a motor vehicle crash is being transported by air transport for definitive care. During phase two of the transfer, what is the most important nursing action?

A)

Determine the route and method for transport.

B)

Evaluate the patient outcome after transport.

C)

Verify that the receiving facility will accept the patient.

D)

Start at least two large-bore intravenous lines.

Answer Key

1.

A

2.

A, B, D

3.

A, B, D

4.

D

5.

A, B, D

6.

A

7.

A

8.

B

9.

D

10.

A

11.

B

12.

C

13.

B

14.

D

15.

C

16.

C

17.

A

18.

B

19.

B

20.

B

21.

C

22.

D

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