Answers to Chapter NCLEX-Style Review Questions

Chapter 1, Critical Care Nursing Practice: Promoting Excellence Through Caring,

Collaboration, and Evidence Answers to Chapter NCLEX-Style Review Questions

• An ICU nurse modifies a plan of care based on a patient’s cultural values. Which of

the following nurse characteristics of the Synergy Model is reflected with this intervention?

• Facilitation of learning
• Clinical inquiry
• Response to diversity
• Caring practices

Answer c: Response to diversity is defined as the sensitivity to recognize, appreciate, and incorporate differences into the provision of care. Differences may include, but are not limited to, cultural differences, spiritual beliefs, gender, race, ethnicity, lifestyle, socioeconomic status, age, and values. Developing a plan of care based on a patient’s cultural values is an example of response to diversity. The other three nurse competencies are not reflected in modifying a plan of care based on a patient’s cultural values.

• Based on expressed patient preferences, the ICU incorporates complementary

therapies to help with symptom management. This is an example of which nurse competency of the Synergy Model?

• Systems thinking
• Response to diversity

(Critical Care Nursing A Holistic Approach, 10e Patricia Gonce Morton, Dorrie K. Fontaine) (Solution Manual, For Complete File, Download link at the end of this File) 1 / 4

• Clinical judgment
• Caring practices

Answer d: Caring practices is defined as nursing activities that create a compassionate, supportive, and therapeutic environment for patients and staff, with the aim of promoting comfort and healing and preventing unnecessary suffering. These include, but are not limited to, vigilance, engagement, and responsiveness of care givers, including family and health care personnel. An example of caring practice includes incorporation of requested complementary therapies. The other three nurse competencies are not reflected by incorporating complementary therapies into a patient’s plan of care.

• Which of the following illustrates high levels of collaboration for the ICU nurse?
• Following a health care provider’s orders
• Developing strategies based on the needs of the patient
• Working on behalf of patients when strategies are not being consistent with one’s

own philosophy

• Encouraging contributions from others at team meetings

Answer d: Collaboration is defined as working with others (e.g., patients, families, health care providers) in a way that promotes/encourages each person’s contributions toward achieving optimal/realistic patient/family goals and involves intra- and interdisciplinary work with colleagues and community. Working on behalf of patients when strategies are not being consistent with one’s own philosophy is an example of 2 / 4

advocacy and moral agency. Developing strategies based on the needs of the patient is an example of clinical judgment. Following a health care provider’s orders is an example of level 1 clinical judgment.

• Which of the following interventions would most likely augment evidence-based

practice use in the clinical setting?

• Increasing staff’s knowledge of evidence-based practice
• Assisting nurses to evaluate research studies
• Teaching staff how to access electronic databases
• Enhancing teamwork among staff in the unit

Answer d: Teamwork is important to successful implementation of evidence-based

changes in practice. Increasing staff’s knowledge of EBP and helping nurses learn how to access electronic databases and evaluate research studies are important first steps in implementing evidence-based practice; however, it often takes many years before implementation can take place.

• In order to decrease the number of medication errors, one strategy may include

focusing on which of the following elements of a healthy work environment?

• True collaboration
• Effective decision making
• Skilled communication
• Appropriate staffing 3 / 4

Answer c: If skilled communication is in place, data suggest that there may be fewer medication errors. The AACN Standards For Establishing And Sustaining Healthy Work Environments document provides examples of how poor communication among members of the multidisciplinary team led to fatal medication errors. Further, The Joint Commission provided data supporting that poor communication is a primary root cause of a high percentage of sentinel events that were reported.

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