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Both the electroencephalogram (EEG) monitor and the Bis pectral Index Score (BIS) or Patient State Index (PSI) analyzer monitors are used to ass ess patient sedation levels in critically ill patients. Why are the BIS and PSI monitors simpler to use?
- A. They are only be used on heavily sedated patients.
- B. They can only be used on pediatric patients.
- C. They provide raw EEG data and a numeric value.
- D. They require only five leads.
Correct Answer: C
Rationale: The correct answer is C because BIS and PSI monitors provide both raw EEG data and a numeric value, simplifying the interpretation of patient sedation levels. Raw EEG data offers detailed information on brain activity, while the numeric value allows for quick assessment. This simplifies the monitoring process compared to interpreting raw EEG data alone.
Choice A is incorrect as BIS and PSI monitors are not restricted to heavily sedated patients. Choice B is incorrect as they are not limited to pediatric patients. Choice D is incorrect as the number of leads required does not determine the simplicity of use; it is the data interpretation that matters.
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The nurse identifies a client's needs and formulates the nursing problem of, 'Imbalanced nutrition: less than body requirements, related to mental impairment and decreased intake, as evidenced by increasing confusion and weight loss of more than 30 pounds over the last 6 months.' Which short-term goal is best for this client?
- A. Verbalize understanding of plan and of intention to eat meals.
- B. Eat 50% of six small meals each day by the end of one week.
- C. Meals prepared during hospitalization will be fed by the nurse.
- D. Demonstrate progressive weight gain toward the ideal weight.
Correct Answer: B
Rationale: The correct short-term goal for the client with imbalanced nutrition is choice B: Eat 50% of six small meals each day by the end of one week. This goal is specific, measurable, achievable, relevant, and time-bound (SMART). By setting a goal for the client to eat a specific amount of meals within a defined timeframe, it allows for objective monitoring of progress. This goal also addresses the client's decreased intake and aims to improve their nutritional status gradually.
Choice A is incorrect as verbalizing understanding does not directly address the client's nutritional needs. Choice C is not appropriate as it does not promote independence in meal consumption. Choice D is not the best short-term goal as it focuses on the outcome of weight gain rather than the process of increasing food intake. Overall, choice B is the most appropriate short-term goal as it targets the client's specific nutritional needs and provides a clear direction for intervention.
The patient is getting hemodialysis for the second time when he complains of a headache and nausea and, a little later, of becoming confused. The nurse realizes these are symptoms of
- A. dialyzer membrane incompatibility.
- B. a shift in potassium levels.
- C. dialysis disequilibrium syndrome.
- D. hypothermia.
Correct Answer: C
Rationale: The correct answer is C: dialysis disequilibrium syndrome. This occurs when there is a rapid decrease in urea concentration in the blood during hemodialysis, causing fluid shifts and cerebral edema leading to symptoms like headache, nausea, and confusion. Dialyzer membrane incompatibility (A) would present with allergic reactions, not neurological symptoms. A shift in potassium levels (B) may cause muscle weakness or cardiac arrhythmias, but not the described symptoms. Hypothermia (D) would present with low body temperature and shivering, not the neurological symptoms mentioned.
A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min. Spontaneous reabsiprbi.rcaotmio/tensst are 12 breaths/min. After receiving a dose of morphine sulfate, respirations decrease to 4 breaths/min. Which acid-base disturbance will likely occur?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: D
Rationale: The correct answer is D (Respiratory alkalosis). Morphine sulfate can cause respiratory depression, leading to decreased respiratory rate. In this case, the patient's breaths decrease from 12 to 4 breaths/min, indicating hypoventilation. With decreased ventilation, there is less CO2 elimination, resulting in respiratory alkalosis. The other choices can be ruled out: A (Metabolic acidosis) and B (Metabolic alkalosis) are less likely caused by morphine sulfate, and C (Respiratory acidosis) is incorrect because the scenario describes hypoventilation, not hyperventilation.
When assessing an older patient admitted to the emergency department (ED) with a broken arm and facial bruises, the nurse observes several additional bruises in various stages of healing. Which statement or question by the nurse is most appropriate?
- A. Do you feel safe in your home?
- B. You should not return to your home.
- C. Would you like to see a social worker?
- D. I need to report my concerns to the police.
Correct Answer: A
Rationale: The correct answer is A: "Do you feel safe in your home?" This question is most appropriate because it directly addresses the potential issue of elder abuse without assuming or accusing the patient. It allows the patient to disclose any safety concerns and initiates a conversation about their well-being. Options B and D are inappropriate as they are accusatory and may escalate the situation. Option C is not as direct and may not effectively address the safety concerns of the patient.
What is the most critical element of effective early end-of-life decision making?
- A. Control of distressing symptoms such as nausea, anxie ty, and pain.
- B. Effective communication between the patient, family, aabnirdb. choema/tletsht care team throughout the course of the illness.
- C. Organizational support of palliative care principles.
- D. Relocation the dying patient from the critical care unit to a lower level of care.
Correct Answer: B
Rationale: The correct answer is B because effective communication ensures that the patient's wishes and values are understood and respected, leading to informed decision-making. It also promotes shared decision-making among the patient, family, and healthcare team, enhancing the quality of care. Choices A, C, and D are incorrect because while they are important aspects of end-of-life care, they do not address the core element of communication in facilitating meaningful and informed decisions.