Chapter 02: Patient and Family Response to the Critical Care Experience

Chapter 02: Patient and Family Response to the Critical Care Experience

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

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

ANS:  B

The nurse can give a status report related to the patient’s condition and current treatment plan as well as ensure that the family has daily meeting time with the intensivist for an update on diagnoses, prognoses, and the like. Pamphlets are helpful; however, the nurse should also explain the equipment that is at this patient’s bedside and not assume that everyone can read and understand written material. Limiting the information to that provided by the physician is unnecessary and will not meet the family’s information needs. Most family members are concerned about the patient’s general condition and treatment plan. They do not want or need a detailed list of medications, doses, or other treatments.

DIF:    Cognitive Level: Apply/Application                                  REF:   p. 23

OBJ:   Describe common family needs and family-centered nursing interventions.

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Psychosocial Integrity

2. 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?

ANS:  A

New unit design trends to promote family-centered care include patient rooms that provide a larger family space and comfortable furniture and storage to promote open visitation, including overnight stays in the patient’s room. Ready access to diagnostic testing, including portable equipment, is an important trend; however, the purpose for this is to prevent the need for transport, not to foster family-centered care. A waiting room in close proximity to the unit with amenities is a nice feature; however, it does not need to be large if adequate space is incorporated into the patient’s room. A scenic garden for meditation may assist in reducing family members’ stress, but proximity to the patient is the greatest need.

DIF:    Cognitive Level: Apply/Application                                  REF:   p. 19

OBJ:   Describe common family needs and family-centered nursing interventions.

TOP:   Nursing Process Step: Planning

MSC:  NCLEX Client Needs Category: Psychosocial Integrity

3. The nurse is caring for a patient who sustained a head injury and is unresponsive to painful stimuli. Which intervention is most appropriate while bathing the patient?

ANS:  C

Although unconscious, many patients can hear, understand, and respond to stimuli. Therefore, it is important to converse with the patient and reorient her to the environment. Some, but not all, family members may want to get involved in direct care; it is not known if this individual is a willing participant, and talking about who’s who in the family is inappropriate while providing direct care to the patient. Although the patient is unconscious, communication and simple conversations remain important interventions. Use of the television to provide sensory input that the patient regularly enjoys is a nursing intervention, but turning on the news for the sake of the nurse is not appropriate.

DIF:    Cognitive Level: Apply/Application                                  REF:   p. 20

OBJ:   Describe stressors in the critical care environment and strategies to reduce them.

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Psychosocial Integrity

4. Sleep often is disrupted for critically ill patients. Which nursing intervention is most appropriate to promote sleep and rest?

ANS:  A

Planning care to promote periods of uninterrupted rest is important. Consulting with the pharmacist to adjust a medication schedule is an excellent example of this intervention. It is important for family members to communicate with the patient; however, rest periods must be scheduled. Family members can be present in the room while remaining quiet during these scheduled times. The television may be useful if it is part of the patient’s normal routine for sleep; however, it does not consistently provide white noise or distraction. Lights should be dimmed during scheduled rest periods and at night to facilitate sleep and rest.

DIF:    Cognitive Level: Apply/Application                                  REF:   p. 20

OBJ:   Discuss the impact of critical care hospitalization on the patient and family.

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity—Basic Care and Comfort