Chapter 3- The Familys Experience With Critical Illness(FREE) My Nursing Test Banks

 

1.

A patient has just been admitted to the ICU after being in a severe auto accident and losing one of her legs. Her husband has his hand over his heart and complains of a rapid heart rate. The nurse recognizes his condition as a sign of which stage of the general adaptation syndrome to stress?

A)

Alarm stage

B)

Exhaustion stage

C)

Resistance stage

D)

Adaptation stage

2.

The nurse observes that an elderly woman, whose granddaughter has been admitted to the ICU, is struggling to manage her two great-grandsons, who are toddlers, in the waiting room. What is the most likely explanation for the womans inability to manage the children in this situation?

A)

She is senile.

B)

She is in the exhaustion stage of the general adaptation syndrome to stress.

C)

She is assuming the role of caregiver in place of the patient, a role she is not used to.

D)

She has macular degeneration and cannot see well.

3.

A nurse needs to communicate with a patients family regarding consent to treat an unconscious patient in the ICU. Which member of the group should the nurse approach first?

A)

A man she recognizes as the patients brother

B)

A teenage boy who approaches the nurse

C)

A woman who originally escorted the patient in

D)

A woman in the group whom the others look at and call over when the nurse approaches

4.

A new nurse has recently joined the ICU from a different hospital, which had a much stricter policy regarding visiting hours. She expresses concern about the impact of open visiting hours on patient well-being. Which of the following would be the best explanation for the purpose of open visiting hours? Select all that apply.

A)

To better provide rest and quiet

B)

To strengthen the relationship between the family and health care provider

C)

To control the number of visitors for a patient

D)

To provide an undisturbed environment

E)

To decrease the patients anxiety

F)

To increase the satisfaction of the family with the experience

5.

A nurse observes that a 38-year-old single father whose 11-year-old daughter is in the ICU is struggling to explain to his 6-year-old son the likelihood that the daughter will die. The young boy asks what will happen to his sister when she dies, but the father breaks down in tears and seems unable to respond. Which of the following would be the most appropriate intervention for the nurse to make?

A)

Suggest that the father contact his pastor, rabbi, or other spiritual leader for counsel for him and his son

B)

Sit down with the father and son and share her own religious beliefs

C)

Ask the patients doctor to explain to the father the odds of the daughter surviving

D)

Leave the father and son to grieve alone

6.

A patient is experiencing severe pain, despite receiving pain medication for the past 24 hours. The patients wife expresses concern about this to the nurse. Which response by the nurse would be most empowering to the patients family?

A)

Explain that the doctor is an expert on pain medication and that the current level of medication is the best.

B)

Recommend that the family members take turns massaging the patients feet to distract from the pain.

C)

Encourage the family to request that the physician evaluate the patients pain control.

D)

Ask the family to wait another 24 hours to see whether the patients pain level will go down.

7.

The sister of a patient in the ICU has been at the patients bedside non-stop for 48 hours. The nurse suggests to her that she return home to rest. Which of the following is the proper rationale for the nurse making such a suggestion?

A)

The sister is in the way of the health care providers.

B)

The patient may become annoyed by her continual presence.

C)

The patient will recover more easily in peace and quiet.

D)

The sister needs to maintain her own health during this time.

8.

A young man has just arrived at the ICU from out of town and received news that his girlfriend, who is admitted there, likely only has a few days left to live. Which of the following would be the best approach for the nurse to take in caring for the needs of this young man?

A)

Recommending that he go home and rest

B)

Giving him unrestricted visiting hours with the patient

C)

Suggesting that he meet with the hospital chaplain

D)

Recommending that he ask the doctor to evaluate the patients pain control measures

9.

A family of a young girl who has been diagnosed with leukemia has travelled 12 hours by car to admit her to the ICU and be with her during her treatment. Which aspect of the critical care family assistance program would most likely be needed by this family initially?

A)

Educational materials

B)

Weekly group family information sessions

C)

Hospitality programs

D)

Pet therapy

10.

A Muslim woman is admitted to the ICU after suffering severe burns over most of her body. Which of the following would be the most appropriate measure for the nurse, a woman, to take in respect for the cultural practices of this patient?

A)

Insist that only a female doctor be assigned to this patient.

B)

Ensure that no pork products are included in the patients diet.

C)

Ensure that direct eye contact is not made with the patients husband.

D)

Ask the patients husband what religious and cultural preferences should be considered in the patients care.

11.

A client has been admitted after experiencing multiple trauma and is intubated and sedated. When the five members of the immediate family arrive, they are anxious, angry, and very demanding. They all speak loudly at once and ask for many services and answers. What is the best nursing response?

A)

Ask the family to leave until visiting hours begin.

B)

Take them to a private area for initial explanations.

C)

Page security to have them removed from unit.

D)

Show them to the clients bedside and leave them alone.

12.

The client has been in the CCU for several weeks and has been very unstable. One family member stays at the bedside constantly and even naps in a bedside chair. The nurse understands that the family member is exhibiting which family member response to critical illness?

A)

Exhibiting extreme distrust of the health care team

B)

Seeking evidence for future legal or punitive action

C)

Trying to maintain a level of control over the situation

D)

Experiencing extreme fatigue from constant stress

13.

The nurse is caring for a very seriously ill patient in the CCU. The family visits sporadically, stays for only a short time, and does not ask many questions. How could the nurse best begin to involve the family in the patients care?

A)

Ask one family member to assist with the patients bath.

B)

Encourage family members to stay longer at each visit.

C)

Focus nursing efforts on the patients legal next of kin.

D)

Ask the family to complete the Critical Care Family Needs Inventory.

14.

As part of the admission process, the nurse asks several questions about family relationships. The nurse bases these actions on which rationale?

A)

Assessing family relationships is an initial step in including the family in patient care.

B)

These questions are part of the admission assessment tool required by this CCU.

C)

The nurse has a natural curiosity and wishes to know how the family members relate for her own knowledge.

D)

There is an ongoing research study to identify variant family patterns related to disease incidence.

15.

On their first visit to a critically ill patient, family members stand in the doorway of the room, making no effort to approach the patient. What is the most appropriate nursing action?

A)

Instruct the family where the patient can be touched and what to say.

B)

Engage the family in social conversation to ease them into the milieu.

C)

Use visiting hours to explain to the family the general status of the patient.

D)

Leave the family to adjust to the situation when they are ready.

16.

A critically ill patient is not expected to survive this admission. The family asks the nurse how the patient is doing. When answering this question, what should the nurse include?

A)

Emphasize that the patient is young and strong and may still survive.

B)

Refer the family to the physician for all details and answers.

C)

Give specific information such as descending trends in parameters.

D)

Ask if the family has determined which funeral home will be called.

17.

A patients family is exhibiting increasingly impaired coping as the patients condition deteriorates. The nurse asks the family to state the biggest concern from their perspective. What is the most important rationale for this question?

A)

The question indicates active listening on the part of the nurse.

B)

The question is used as a way to validate the familys knowledge.

C)

The question clarifies the nurses understanding of current family needs.

D)

The question promotes problem definition, which helps define the degree of family understanding.

18.

The nurse recommends that the family of a critically ill patient seek help from the Critical Care Family Assistance Program. What benefit for the family does the nurse anticipate?

A)

Reduction of health care cost

B)

More physical comfort

C)

Multidisciplinary support

D)

Health promotion information

19.

While interacting with the family of a critically ill patient, the nurse suggests that the family must be feeling very anxious and perhaps angry. How does this nursing action benefit the family?

A)

Removes the focus of the conversation from the patient

B)

Focusing on feelings helps the family avoid delayed grief and unhealthy coping

C)

Gives validation of need for psychological counseling

D)

Reduces family insistence for patient progress information

20.

The nurse is caring for a patient from a very different cultural group. In delivering care, how can the nurse best demonstrate cultural sensitivity?

A)

Ask the family about their cultural beliefs and customs that may apply.

B)

Assume that the patient and family will adjust to the hospital culture.

C)

Inform the patient and family that the routines of the hospital take precedence.

D)

Do a literature search on the patients culture to determine beliefs.

Answer Key

1.

A

2.

C

3.

D

4.

B, E, F

5.

A

6.

C

7.

D

8.

B

9.

C

10.

D

11.

B

12.

C

13.

D

14.

A

15.

A

16.

C

17.

D

18.

C

19.

B

20.

A

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