Exam 1: Rapid Response Teams

Question 1

1. RRTs are activated to provide rapid assessment and intervention to patients in:
   A. cardiopulmonary arrest
   B. acute clinical deterioration in non-ICU units
   C. need of palliative care

Answer 1

B. acute clinical deterioration in non-ICU units

Question 2

2. The afferent arm of the RRT includes RRT
   A. activation
   B. functioning
   C. debriefing

Answer 2

A. activation

Question 3

3. The efferent arm of the RRT includes
   A. recognizing urgent unmet patient needs
   B. assigning clear RRT roles
   C. triaging the patient

Answer 3

C. triaging the patient

Question 4

4. One of the three main reasons for delays in activating an RRT is failure to:
   A. escalate
   B. intervene
   C. notify

Answer 4

A. escalate

Question 5

5. To help identify patients at risk for acute clinical deterioration, EWS use
   A. comorbidity scores
   B. medical history scores
   C. total risk scores

Answer 5

C. total risk scores

Question 6

6. EWS scores can predict cardiac arrest and mortality within how many hours?
   A. 24
   B. 48
   C. 72

Answer 6

B. 48 hours

Question 7

7. Which vital sign is known to be an early indicator of clinical deterioration?
   A. HR
   B. BP
   C. Respiratory Rate

Answer 7

C. Respiratory rate

Question 8

8. Complete documentation of which element is important for any EWS?
   A. demographics
   B. medical history
   C. vital signs

Answer 8

C. vital signs

Question 9

9. Advantages of continuous electronic monitoring systems include all except:
   A. trended data
   B. alarm fatigue
   C. nurse satisfaction

Answer 9

B. alarm fatigue

Question 10

10. The criterion of “worried/concerned” has been incorporated into some EWS or RRT activation
    criteria based on the intuition of
    A. family
    B. nurses
    C. patients

Answer 10

B. nurses

Question 11

11. Which factor results in failure to escalate clinical deterioration to the RRT?
    A. fear of criticism
    B. lack of information
    C. informal hierarchical culture
    D. all of the above

Answer 11

D. all of the above

Question 12

12. Adding a pharmacist to the RRT has not been shown to optimize medication
    A. availability
    B. selection
    C. dosing

Answer 12

A. availability

Question 13

13. Which member of the RRT is typically responsible for leading patient evaluation?
    A. the bedside nurse
    B. the critical care nurse
    C. the nursing supervisor

Answer 13

B. the critical care nurse

Question 14

14. Members of the RRT should have expertise in
    A. nursing research
    B. documentation
    C. crisis management

Answer 14

C. crisis management

Question 15

15. Categories identified as important to the RRT’s effectiveness include
    A. organizational culture
    B. communication
    C. teamwork
    D. all of the above

Answer 15

D. all of the above

Question 16

16. Major benefits of RRTs for clinical nurses include improved
    A. critical thinking skills
    B. documentation skills
    C. management skills

Answer 16

A. critical thinking skills

Question 17

17. What percentage of all RRT activations involves end-of-life decision making?
    A. 14% - 23%
    B. 24% - 33%
    C. 34% - 43%

Answer 17

B. 24% - 33%

Question 18

18. According to Butcher and colleagues, what was the effect of proactive RRT rounding on patients
    discharged from the ICU?
    A. shorter hospital stays
    B. decreased mortality
    C. no improvement in patient outcomes

Answer 18

C. no improvement in patient outcomes

Question 19

failure to rescue

Answer 19

failure to identify deterioration before irreversible

Question 20

why failure to rescue?

Answer 20

breakdown in comms
failure to recognize/monitor
incomplete assmts/inadeq treatments
limitation of monitoring equipment
variation in judgement
inability to initiate interventions independently
failure to escalate