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What term is used to describe a specific request made by a competent person that directs medical care related to life-prolonging procedures if the pa tient loses capacity to make decisions?
- A. Do not resuscitate order
- B. Healthcare proxy
- C. Informed consent
- D. Living will
Correct Answer: D
Rationale: The correct answer is D, Living will. A living will is a legal document that outlines a person's preferences for medical treatment if they become unable to communicate their wishes. It specifically addresses life-prolonging procedures. Option A, Do not resuscitate order, is a specific directive to not perform CPR in case of cardiac arrest, not a comprehensive medical care directive. Option B, Healthcare proxy, is a person designated to make medical decisions on behalf of a patient who is unable to do so, not the specific directive itself. Option C, Informed consent, refers to the process of obtaining permission from a patient before conducting a healthcare intervention, not a directive for life-prolonging procedures.
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The family members of a patient who has just been admitted to the intensive care unit (ICU) with multiple traumatic injuries have just arrived in the ICU waiting room. Which action should the nurse take next?
- A. Explain ICU visitation policies and encourage family visits.
- B. Immediately take the family members to the patient’s bedside.
- C. Describe the patient’s injuries and the care that is being provided.
- D. Invite the family to participate in a multidisciplinary care conference.
Correct Answer: A
Rationale: The correct answer is A: Explain ICU visitation policies and encourage family visits. This is the best course of action because it prioritizes the needs of the family members by providing them with information on visitation policies and encouraging them to visit the patient. This helps establish communication, support, and involvement in the patient's care. It also respects the family's emotional needs during a challenging time.
Choices B, C, and D are incorrect:
B: Immediately taking the family members to the patient's bedside may overwhelm them and disrupt the patient's care.
C: Describing the patient's injuries and care being provided should be done in a more controlled environment to ensure the family's understanding and emotional readiness.
D: Inviting the family to a multidisciplinary care conference may be premature without first addressing their immediate concerns and providing support.
Which interventions may be included during “terminal we aning”? (Select all that apply.)
- A. Complete extubation following ventilator withdrawal
- B. Discontinuation of artificial ventilation but maintenanc e of the artificial airway
- C. Discontinuation of anxiolytic and pain medications
- D. Titration of ventilator support based upon blood gas de terminations
Correct Answer: B
Rationale: The correct answer is B because during terminal weaning, the artificial ventilation is discontinued while maintaining the artificial airway to ensure comfort and support. This allows the patient to breathe on their own with support as needed.
Explanation:
1. Option A: Complete extubation following ventilator withdrawal may not be suitable during terminal weaning as it involves removing the breathing tube entirely.
2. Option C: Discontinuation of anxiolytic and pain medications may not always be appropriate during terminal weaning as it depends on the patient's comfort needs.
3. Option D: Titration of ventilator support based on blood gas determinations is not typically done during terminal weaning as the focus is on gradual withdrawal of ventilation support while maintaining comfort.
The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period of time. Which of the following nursing interventions would improve the patient’s well-being and reduce anxiety the most?
- A. Arrange for the patient’s dog to be brought into the unit (per protocol).
- B. Contact the pet therapy department to bring a therapy d og in to visit.
- C. Secure the harpist to come and play soothing music fora bairnb. choomu/tre set very afternoon.
- D. Wheel the patient out near the unit aquarium to observ e the tropical fish.
Correct Answer: B
Rationale: The correct answer is B because pet therapy has been shown to reduce anxiety and improve well-being in hospitalized patients. Interacting with therapy dogs can provide comfort, companionship, and a distraction from the hospital environment. Bringing in a therapy dog can help the trauma patient feel more relaxed and supported during their extended hospital stay.
Choice A may be comforting but does not address the therapeutic benefits of pet therapy. Choice C may provide soothing music, but pet therapy has been specifically proven to reduce anxiety in patients. Choice D, observing fish in an aquarium, may be calming but does not involve the interactive benefits of pet therapy.
To verify the correct placement of an oral endotracheal tube (ET) after insertion, the best initial action by the nurse is to:
- A. Auscultate for the presence of bilateral breath sounds.
- B. Obtain a portable chest x-ray to check tube placement.
- C. Observe the chest for symmetric chest movement with ventilation.
- D. Use an end-tidal CO2 monitor to check for placement in the trachea.
Correct Answer: D
Rationale: The correct answer is D because using an end-tidal CO2 monitor is the most reliable method to confirm correct endotracheal tube placement in the trachea. This method detects exhaled CO2, indicating proper tube placement in the trachea. It is a quick and efficient way to confirm placement without delay, reducing the risk of complications.
A: Auscultating for bilateral breath sounds is not as reliable because breath sounds may be heard even if the tube is misplaced.
B: Obtaining a portable chest x-ray is not the best initial action as it takes time and delays confirming tube placement.
C: Observing chest movement may not provide conclusive evidence of proper tube placement and can lead to misinterpretation.
In summary, using an end-tidal CO2 monitor is the most accurate and efficient method to verify correct endotracheal tube placement compared to the other options.
Which of the following is (are) official journal(s) of the A merican Association of Critical-Care Nurses? (Select all that apply.)
- A. American Journal of Critical Care
- B. Critical Care Clinics of North America
- C. Critical Care Nurse
- D. Critical Care Nursing Quarterly
Correct Answer: A
Rationale: Step-by-step rationale:
1. The American Association of Critical-Care Nurses (AACN) publishes the American Journal of Critical Care (AJCC).
2. The AJCC is a peer-reviewed journal that covers critical care nursing practice, research, and education.
3. The content in AJCC aligns with AACN's mission and standards for critical care nursing.
4. Hence, AJCC is an official journal of AACN.
Summary of other choices:
- B: Critical Care Clinics of North America - Not an official journal of AACN.
- C: Critical Care Nurse - Not an official journal of AACN.
- D: Critical Care Nursing Quarterly - Not an official journal of AACN.