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A patient who has been diagnosed with inoperable lung cancer and has a poor prognosis plans a trip across the country to settle some issues with their siblings. The nurse recognizes that the patient is manifesting which psychosocial response to death?
- A. Restlessness.
- B. Yearning and protest.
- C. Anxiety about unfinished business.
- D. Fear of the meaninglessness of one’s life.
Correct Answer: C
Rationale: The correct answer is C: Anxiety about unfinished business. The patient's desire to settle issues with their siblings before death indicates a concern about unresolved matters. This response aligns with the concept of psychosocial responses to death, specifically the need for closure and resolution. Restlessness (choice A) may not necessarily indicate a specific focus on unfinished business. Yearning and protest (choice B) typically refer to the initial stages of grief, not specifically related to settling unresolved issues. Fear of the meaninglessness of one's life (choice D) is more existential and philosophical, whereas the patient's focus here is on addressing specific issues with their siblings.
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A 22-year-old patient who experienced a near-drowning accident in a local pool, but now is awake and breathing spontaneously, is admitted for observation. Which assessment will be most important for the nurse to take during the observation period?
- A. Auscultate heart sounds.
- B. Palpate peripheral pulses.
- C. Auscultate breath sounds.
- D. Check pupil reaction to light.
Correct Answer: C
Rationale: The correct answer is C: Auscultate breath sounds. After a near-drowning incident, the main concern is potential respiratory complications such as aspiration pneumonia or pulmonary edema. Auscultating breath sounds will help the nurse assess for any signs of respiratory distress or complications. This assessment is crucial for early detection and intervention.
A: Auscultating heart sounds is important but not as crucial as assessing breath sounds in this scenario.
B: Palpating peripheral pulses is important for circulation assessment but does not address the immediate concern of respiratory complications.
D: Checking pupil reaction to light is more relevant for neurological assessment and not as critical as assessing breathing in this situation.
Which intervention should the nurse include in the plan of care for a female client with severe postpartum depression who is admitted to the inpatient psychiatric unit?
- A. Restrict visitors who irritate the client.
- B. Full rooming-in for the infant and mother.
- C. Supervised and guided visits with infant.
- D. Daily visits with her significant other.
Correct Answer: C
Rationale: The correct answer is C because supervised and guided visits with the infant allow the client to bond with her baby in a safe and structured environment, promoting maternal-infant attachment while ensuring the safety and well-being of both. Restricting visitors who irritate the client (choice A) may increase feelings of isolation and distress. Full rooming-in for the infant and mother (choice B) may overwhelm the client with severe postpartum depression. Daily visits with her significant other (choice D) may not directly address the client's need for bonding with her infant.
The term used to describe an increase in blood urea nitrogen (BUN) and serum creatinine is
- A. oliguria.
- B. azotemia.
- C. acute kidney injury.
- D. prerenal disease.
Correct Answer: B
Rationale: The correct answer is B: azotemia. Azotemia refers to an increase in BUN and serum creatinine levels, indicating impaired kidney function. Oliguria (A) is a decrease in urine output, not specific to BUN and creatinine levels. Acute kidney injury (C) is a broader term encompassing various causes of kidney dysfunction, not specific to elevated BUN and creatinine. Prerenal disease (D) refers to conditions affecting blood flow to the kidneys, not directly related to elevated BUN and creatinine levels.
Which statement is a likely response from someone who h as survived a stay in the critical care unit?
- A. “I don’t remember much about being in the ICU, but if I had to be treated there again, it would be okay. I’m glad I can see my grandchildren again.”
- B. “If I get that sick again, do not take me to the hospital. I would rather die than go through having a breathing tube put in again.”
- C. “My family is thrilled that I am home. I know I need some extra attention, but my children have rearranged their schedules to help me ou t.”
- D. “Since I have been transferred out of the ICU, I cannot get enough to eat. They didn’t let me eat in the ICU, so I’m making up for it no w.”
Correct Answer: A
Rationale: Rationale: Choice A is the correct answer because it reflects a positive attitude towards potential future treatments in the critical care unit and gratitude for being able to see family again. The survivor acknowledges the past experience but remains optimistic.
Summary:
- Choice B is incorrect as it shows a strong aversion to hospital care, indicating a preference for death over treatment.
- Choice C is incorrect as it focuses on the family's reaction and not the survivor's personal experience or perspective.
- Choice D is incorrect as it highlights a trivial aspect (eating) rather than reflecting on the ICU experience or future treatments.
The nurse is concerned that the patient will pull out the en dotracheal tube. As part of the nursing management, the nurse should obtain an order for what intervention?
- A. A Posey-type vest
- B. A higher dosage of lorazepam
- C. Propofol
- D. Soft wrist restraints
Correct Answer: A
Rationale: The correct answer is A. A Posey-type vest is a restraint designed to prevent patients from pulling out medical devices like endotracheal tubes, ensuring their safety. It is a less restrictive option compared to wrist restraints and sedatives (B and C), which can have adverse effects and may not directly address the concern of tube removal. Using a Posey-type vest promotes patient autonomy by allowing some movement while still providing the necessary protection.