Critical Care Nursing Cardiac Questions

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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
Correct Answer: B

Rationale: The correct answer is B: To strengthen the relationship between the family and health care provider.

Rationale:
1. Open visiting hours encourage family involvement in care, fostering a partnership between healthcare providers and families.
2. Family support can positively impact patient outcomes and satisfaction.
3. It allows families to be updated on the patient's condition and involved in decision-making.
4. Strengthening the relationship can lead to better communication and trust between all parties.

Summary of Incorrect Choices:
A: Open visiting hours may disrupt rest and quiet, but the primary purpose is not to provide rest.
C: Open visiting hours do not aim to control the number of visitors but rather encourage family involvement.
D: While open visiting hours may not provide an entirely undisturbed environment, the focus is on improving family-provider relationships.

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In determining the glomerular filtration rate (GFR) or creatinine clearance, a 24-hour urine is obtained. If a reliable 24-hour urine collection is not possible,

  • A. it is not possible to determine the GFR.
  • B. the BUN may be used to determine renal function.
  • C. an elevated BUN/creatinine ratio can be used.
  • D. a standardized formula may be used to calculate GFR.
Correct Answer: D

Rationale: The correct answer is D because when a reliable 24-hour urine collection is not possible, a standardized formula can be used to estimate GFR. The Cockcroft-Gault equation or the Modification of Diet in Renal Disease (MDRD) equation are commonly used formulas to estimate GFR based on serum creatinine levels, age, gender, and race. These formulas provide a reasonable estimation of kidney function in the absence of a 24-hour urine collection.

Choice A is incorrect because there are alternative methods available to estimate GFR. Choice B is incorrect because BUN alone is not sufficient to accurately determine renal function. Choice C is incorrect because an elevated BUN/creatinine ratio is not a direct measure of GFR and may be influenced by factors other than kidney function, such as hydration status or liver function.

The nurse cites evidence-based practice as a rationale for a patient care decision. What isthe best description of evidence-based practice?

  • A. Decisions based on expert legal testimony
  • B. Use of best available research data
  • C. Evolution of nursing practice over time
  • D. Individual optimization of patient outcomes
Correct Answer: B

Rationale: The correct answer is B: Use of best available research data. Evidence-based practice involves integrating the best available research evidence with clinical expertise and patient values to make informed decisions about patient care. It emphasizes using scientifically proven data to guide practice and improve patient outcomes. Expert legal testimony (A) is not necessarily evidence-based. Evolution of nursing practice over time (C) does not specifically focus on research data. Individual optimization of patient outcomes (D) is a goal of evidence-based practice, but it does not fully encompass the concept.

A male client is angry and is leaving the hospital against medical advice (AMA). The client demands to take his chart with him and states the chart is 'his' and he doesn’t want any more contact with the hospital. How should the nurse respond?

  • A. This hospital does not need to keep it if you are leaving and not returning here.
  • B. Because you are leaving against medical advice, you may not have your chart.
  • C. The information in your chart is confidential and cannot leave this facility legally.
  • D. The chart is the property of the hospital but I will see that a copy is made for you.
Correct Answer: D

Rationale: The correct answer is D because the client's medical chart is the property of the hospital, but the client has the right to a copy of the information. By offering to make a copy of the chart for the client, the nurse respects the client's autonomy while also ensuring that the hospital maintains the original medical record. This response balances the client's rights with legal and ethical considerations.

Choice A is incorrect because the hospital is legally obligated to maintain the client's medical record even if the client leaves against medical advice. Choice B is incorrect as it denies the client access to their medical information, which goes against the principle of patient autonomy. Choice C is also incorrect as it does not address the client's request for a copy of their chart.

Which statement reflects adherence to current recommendations concerning open visitation policies?

  • A. Allowing animals on the unit; however, these can only be “therapy” animals through the hospital’s pet therapy program.
  • B. Allowing family visitation throughout the day except a t change of shift and during rounds.
  • C. Determining, in collaboration with the patient and famaiblyirb, .cwomho/te csta n visit and when.
  • D. Permitting open visitation by adults 18 years of age and older; limit visits of children to 1 hour.
Correct Answer: C

Rationale: The correct answer is C because it reflects patient-centered care by involving patients and families in decision-making. Collaborating with them on visitation preferences promotes a supportive environment. Choice A restricts animal visitation, not addressing human visitors. Choice B limits visitation during specific times, not individualized. Choice D imposes restrictions based on age, not on patient/family preferences. Therefore, Choice C is the most aligned with current recommendations for open visitation policies.

One of the strategies shown to reduce perception of stress in critically ill patients and their families is support of spirituality. What nursing action is most clearly supportive of the patients spirituality?

  • A. Referring patients to the Catholic chaplain
  • B. Providing prayer booklets to patients and families
  • C. Asking about beliefs about the universe
  • D. Avoiding discussing religion with those of other faiths
Correct Answer: C

Rationale: The correct answer is C because asking about beliefs about the universe allows the nurse to understand the patient's spiritual needs and provide appropriate support. This action shows respect for the patient's beliefs and can help establish a connection between the patient and the nurse. Referring patients to a specific religious figure (choice A) may not align with the patient's beliefs. Providing prayer booklets (choice B) assumes the patient's belief system and may not be helpful. Avoiding discussing religion (choice D) can hinder the nurse-patient relationship and overlook potential sources of support for the patient.

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