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A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining a fractured bone. The healthcare provider explains the surgery needed to immobilize the fracture. Which action should be implemented to obtain a valid informed consent?
- A. Obtain the permission of the custodial parent for the surgery.
- B. Notify the non-custodial parent to also sign a consent form.
- C. Instruct the client sign the consent before giving medications.
- D. Obtain the signature of the client’s stepfather for the surgery.
Correct Answer: A
Rationale: The correct answer is A: Obtain the permission of the custodial parent for the surgery. In this scenario, the client is a minor (16 years old), which means they are not legally able to provide informed consent for medical procedures. The custodial parent holds legal responsibility for the minor's healthcare decisions. Thus, obtaining the permission of the custodial parent is crucial to ensure valid informed consent.
Choice B is incorrect because the non-custodial parent's consent may not be legally required if the custodial parent is available to provide consent. Choice C is incorrect because obtaining consent should precede any administration of medications. Choice D is incorrect as the stepfather's consent may not hold legal weight unless designated as a legal guardian.
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After a change-of-shift report on a ventilator weaning unit, which patient should the nurse assess first?
- A. Patient who failed a spontaneous breathing trial and has been placed in rest mode on the ventilator.
- B. Patient who is intubated and has continuous partial pressure end-tidal CO2 (PETCO2) monitoring.
- C. Patient with central venous oxygen saturation (ScvO2) of 69% while on bilevel positive airway pressure (BiPAP).
- D. Patient who was successfully weaned and extubated 4 hours ago and now has no urine output for the last 6 hours.
Correct Answer: D
Rationale: The correct answer is D - Patient who was successfully weaned and extubated 4 hours ago and now has no urine output for the last 6 hours. This patient should be assessed first because the absence of urine output for 6 hours after being extubated could indicate acute kidney injury or other serious complications that need immediate attention. Urine output is a crucial indicator of renal function and can reflect the patient's overall hemodynamic status. In contrast, the other choices do not present immediate life-threatening conditions. Choice A involves a patient in rest mode post-failed breathing trial, which does not require immediate assessment. Choice B mentions continuous PETCO2 monitoring, which is important but not as urgent as assessing a patient with no urine output. Choice C describes a patient with a ScvO2 of 69%, which may need monitoring but does not indicate an urgent priority compared to assessing a patient with no urine output after recent extubation.
The nurse is caring for a patient who has sustained blunt trauma to the left flank area, and is evaluating the patient’s urinalysis results. The nurse should become concerned when
- A. creatinine levels in the urine are similar to blood levels of creatinine.
- B. sodium and chloride are found in the urine.
- C. urine uric acid levels have the same values as serum levels.
- D. red blood cells and albumin are found in the urine.
Correct Answer: D
Rationale: The correct answer is D because the presence of red blood cells and albumin in the urine indicates possible kidney damage from the blunt trauma. This is concerning as it may suggest renal injury or dysfunction.
A: Creatinine levels in the urine being similar to blood levels is normal as creatinine is filtered by the kidneys.
B: Sodium and chloride being present in the urine is expected as they are components of urine.
C: Urine uric acid levels matching serum levels is common as uric acid is excreted by the kidneys.
In summary, the presence of red blood cells and albumin in the urine is abnormal and indicates potential kidney damage, making it the correct answer.
The nurse is educating a patient’s family member about a pulmonary artery catheter (PAC). Which statement by the family member best indicates undaebrisrbt.acnomd/itnesgt of the purpose of the PAC?
- A. “The catheter will provide multiple sites to give intravenous fluid.”
- B. “The catheter will allow the primary health care provid er to better manage fluid therapy.”
- C. “The catheter tip comes to rest inside my brother’s pul monary artery.”
- D. “The catheter will be in position until the heart has a chance to heal.”
Correct Answer: B
Rationale: The correct answer is B because it shows understanding that the PAC helps in managing fluid therapy effectively. The PAC measures pressures in the heart and lungs, guiding fluid management. Choice A is incorrect as the PAC is not primarily for IV fluid administration. Choice C shows understanding of the catheter placement but not its purpose. Choice D is incorrect as the PAC is not for the heart to heal but to monitor cardiac status.
The patient is in the critical care unit and will receive dialysis this morning. The nurse will (Select all that apply.)
- A. evaluate morning laboratory results and report abnormal results.
- B. administer the patient’s antihypertensive medications.
- C. assess the dialysis access site and report abnormalities.
- D. weigh the patient to monitor fluid status.
Correct Answer: A
Rationale: The correct answer is A because evaluating morning lab results is crucial to monitor the patient's condition before dialysis. Abnormal results may impact the dialysis treatment plan. Option B is incorrect as administering antihypertensive medications is not directly related to dialysis. Option C is incorrect as assessing the dialysis access site is the responsibility of the dialysis team. Option D is incorrect as weighing the patient is not typically done immediately before dialysis.
Continuous venovenous hemodialysis is used to
- A. remove fluids and solutes through the process of convection.
- B. remove plasma water in cases of volume overload.
- C. remove plasma water and solutes by adding dialysate.
- D. combine ultrafiltration, convection and dialysis
Correct Answer: D
Rationale: The correct answer is D because continuous venovenous hemodialysis combines ultrafiltration, convection, and dialysis techniques. Ultrafiltration removes excess fluid, convection helps in removing solutes, and dialysis involves the diffusion of solutes across a semipermeable membrane. This comprehensive approach ensures effective removal of both fluid and solutes in critically ill patients.
Incorrect Answer Analysis:
A: Removing fluids and solutes through convection alone is not the complete process in continuous venovenous hemodialysis.
B: While volume overload is addressed, continuous venovenous hemodialysis involves more than just removing plasma water.
C: Adding dialysate is not the primary method in continuous venovenous hemodialysis; it involves ultrafiltration, convection, and dialysis techniques.