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A critically ill patient is not expected to survive this admission. The family asks the nurse how the patient is doing. When answering this question, what should the nurse include?
- A. Emphasize that the patient is young and strong and may still survive.
- B. Refer the family to the physician for all details and answers.
- C. Give specific information such as descending trends in parameters.
- D. Ask if the family has determined which funeral home will be called.
Correct Answer: C
Rationale: The correct answer is C because providing specific information such as descending trends in parameters helps the family understand the patient's condition objectively. This allows them to prepare emotionally and make informed decisions. Option A is incorrect because false hope should not be given. Option B is not the best approach as the nurse should still provide some information to the family. Option D is inappropriate and insensitive as it focuses on funeral arrangements rather than addressing the family's concerns about the patient's condition.
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Which statement regarding ethical concepts is true?
- A. A living will is the same as a healthcare proxy.
- B. A signed donor card ensures that organ donation will o ccur in the event of brain death.
- C. A surrogate is a competent adult designated by a perso n to make healthcare decisions in the event the person is incapacitated.
- D. A persistent vegetative state is the same as brain deatha ibnir bm.cooms/tt esstt ates.
Correct Answer: C
Rationale: Rationale: Choice C is correct because a surrogate is indeed a competent adult designated to make healthcare decisions for an incapacitated person. This individual is typically chosen by the person themselves through a legal document like a healthcare proxy. This ensures that someone trusted can make important decisions when the person is unable to do so. Choices A, B, and D are incorrect because a living will and healthcare proxy serve different purposes, a signed donor card does not guarantee organ donation in the event of brain death (medical criteria are also required), and a persistent vegetative state is different from brain death (brain death implies irreversible cessation of brain function while a vegetative state involves some level of brain function).
The nurse is caring for a patient with acute respiratory dist ress syndrome who is hypoxemic despite mechanical ventilation. The primary care provider (PCP) orders a nontraditional ventilator mode as part of treatment. Despite sedation and aabnirba.lcgoems/tieas,t the patient remains restless and appears to be in discomfort. The nurse informs the PCP of this assessment and anticipates what order?
- A. Continuous lateral rotation therapy
- B. Guided imagery
- C. Neuromuscular blockade
- D. Prone positioning
Correct Answer: C
Rationale: The correct answer is C: Neuromuscular blockade.
1. Neuromuscular blockade helps to achieve optimal ventilator synchrony by reducing patient-ventilator asynchrony and improving oxygenation in patients with acute respiratory distress syndrome (ARDS).
2. Despite sedation, the patient's restlessness and discomfort suggest inadequate ventilator synchrony, which can be addressed by neuromuscular blockade.
3. Continuous lateral rotation therapy (A) and prone positioning (D) are interventions for improving ventilation and oxygenation in ARDS but do not directly address patient-ventilator synchrony.
4. Guided imagery (B) is a non-pharmacological technique for relaxation and pain management, which may not address the underlying issue of ventilator synchrony in this case.
Comparing the patient’s current (home) medications with those ordered during hospitalization and communicating a complete list of medications to the next care provider when the patient is transferred within an organization or to another setting a re strategies toward best achieving what patient related goal?
- A. Improving accuracy of patient identification.
- B. Preventing errors related to look-alike and sound-alike medications.
- C. Reconciling medications across the continuum of care.
- D. Reducing harms associated with administration of anti coagulants.
Correct Answer: C
Rationale: Step 1: Reconciling medications is essential for patient safety as it involves comparing current and ordered medications to ensure accuracy.
Step 2: This process helps prevent medication errors, adverse drug reactions, and duplications across different care settings.
Step 3: Communicating a complete list of medications to the next care provider ensures continuity of care and reduces the risk of medication discrepancies.
Step 4: By reconciling medications across the continuum of care, healthcare providers can better coordinate patient care and optimize treatment outcomes.
In summary, choice C is correct as it focuses on medication reconciliation to improve patient safety and care coordination. Choices A, B, and D are incorrect as they do not directly address the comprehensive process of reconciling medications across care settings.
The charge nurse is responsible for making the patient ass ignments on the critical care unit. She assigns the experienced, certified nurse to care for thea abicrbu.cteomly/t eisltl patient diagnosed with sepsis who also requires continuous renal replacement therapy and mechanical ventilation. She assigns the nurse with less than 1 year of experience to two patients who are more stable. This assignment reflects implementation of what guiding framework?
- A. Crew resource management model
- B. National Patient Safety Goals
- C. Quality and Safety Education for Nurses (QSEN) mod el
- D. Synergy model of practice
Correct Answer: D
Rationale: The correct answer is D: Synergy model of practice. The Synergy model emphasizes matching nurse competencies with patient needs for optimal outcomes. In this scenario, the charge nurse assigned the experienced, certified nurse to a complex patient requiring specialized care (sepsis, renal replacement therapy, ventilation), aligning with the model's principle of matching nurse expertise to patient acuity. Assigning the less experienced nurse to stable patients aligns with the model's focus on optimizing patient outcomes by matching nurse competencies appropriately.
A: Crew resource management model focuses on teamwork and communication to enhance safety, not specifically on nurse-patient assignments.
B: National Patient Safety Goals are broad guidelines for improving patient safety, not specific to nurse-patient assignments.
C: Quality and Safety Education for Nurses (QSEN) model focuses on integrating quality and safety competencies into nursing education, not specifically on nurse-patient assignments.
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.