Nokea
The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)
- A. Acidosis
- B. Hypokalemia
- C. Volume overload
- D. Hyperkalemia
Correct Answer: C
Rationale: The correct answer is C: Volume overload. In acute kidney injury, impaired kidney function leads to fluid retention, causing volume overload. Dialysis helps remove excess fluid to restore fluid balance. Acidosis and hyperkalemia are potential complications of acute kidney injury but not the primary reasons for initiating dialysis. Hypokalemia is unlikely in acute kidney injury due to impaired excretion of potassium by the kidneys. Therefore, the most common reason for initiating dialysis in acute kidney injury is to manage volume overload.
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Positive end-expiratory pressure (PEEP) is a mode of ventaiblairbto.croym /atessst istance that produces which of the following conditions
- A. Each time the patient initiates a breath, the ventilator d elivers a full preset tidal volume.
- B. For each spontaneous breath taken by the patient, the tidal volume is determined by the patient’s ability to generate negative pressure.
- C. The patient must have a respiratory drive, or no breaths will be delivered.
- D. There is pressure remaining in the lungs at the end of eaxbiprbi.rcaotmio/tens tt hat is measured in cm H O.
Correct Answer: D
Rationale: The correct answer is D because positive end-expiratory pressure (PEEP) is a mode of ventilation where pressure is maintained in the lungs at the end of expiration. This helps prevent alveolar collapse and improves oxygenation. Option A is incorrect because PEEP does not deliver a full preset tidal volume with each breath initiation. Option B is incorrect because tidal volume in PEEP is not solely determined by the patient's ability to generate negative pressure. Option C is incorrect because in PEEP, breaths are delivered irrespective of the patient's respiratory drive.
The nurse returns from the cardiac catheterization laboratory with a patient following insertion of a pulmonary artery catheter and assists in transferring th e patient from the stretcher to the bed. Prior to obtaining a cardiac output, which action is m ost important for the nurse to complete?
- A. Document a pulmonary artery catheter occlusion press ure.
- B. Zero reference the transducer system at the phlebostatic axis.
- C. Inflate the pulmonary artery catheter balloon with 1 m L air.
- D. Inject 10 mL of 0.9% normal saline into the proximal port.
Correct Answer: B
Rationale: The correct answer is B: Zero reference the transducer system at the phlebostatic axis. This is the most important action before obtaining a cardiac output because zero referencing ensures accurate pressure readings. The phlebostatic axis is the level of the atria when the patient is supine, and zeroing at this point minimizes errors in pressure measurements.
Choice A is incorrect because documenting a pulmonary artery catheter occlusion pressure is not the priority at this stage. Choice C is incorrect as inflating the balloon with air should be done after zero referencing. Choice D is incorrect as injecting normal saline into the port is not necessary before zero referencing.
The nurse is a member of a committee to design a critical care unit in a new building. Which design trend would best be implemented to facilitate famil y-centered care?
- A. Ensuring that the patient’s room is large enough to inc lude a sleeper sofa and storage for family members’ personal belongings.
- B. Including a diagnostic suite in close proximity to the u nit so that the patient does not have to travel far for testing.
- C. Incorporating a large waiting room on the top floor of athbierb .hcooms/pteistta l with a scenic view and amenities such as coffee and tea.
- D. Providing access to a scenic garden for meditation.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Family-centered care promotes involvement of family members in patient care.
2. A sleeper sofa in the patient's room allows family members to stay overnight, enhancing support for the patient.
3. Storage for personal belongings ensures families can have essentials close by, increasing comfort and convenience.
4. These design elements facilitate family presence, communication, and participation in care, aligning with family-centered care principles.
Summary of Incorrect Choices:
B. Having a diagnostic suite nearby is convenient but not directly related to family-centered care principles.
C. A waiting room with amenities is beneficial but does not directly involve families in patient care.
D. Access to a garden for meditation is helpful for relaxation but does not emphasize family involvement in care.
A client is receiving atenolol (Tenormin) 25 mg PO after a myocardial infarction. The nurse determines the client's apical pulse is 65 beats per minute. What action should the nurse implement next?
- A. Measure the blood pressure.
- B. Reassess the apical pulse.
- C. Notify the healthcare provider.
- D. Administer the medication.
Correct Answer: D
Rationale: The correct answer is D: Administer the medication. Atenolol is a beta-blocker used to reduce heart rate and blood pressure. In this scenario, the client's apical pulse of 65 beats per minute is within the normal range for a client taking atenolol after a myocardial infarction. Therefore, the nurse should proceed with administering the medication as prescribed to help maintain the client's heart rate and blood pressure within the therapeutic range.
A: Measuring the blood pressure is important but not the immediate next step as the client's heart rate is within the normal range.
B: Reassessing the apical pulse is unnecessary since it is already within the normal range for a client on atenolol.
C: Notifying the healthcare provider is not indicated as there are no signs of concern with the client's heart rate at 65 bpm.
A nurse is weaning a 68-kg male patient who has chronic obstructive pulmonary disease (COPD) from mechanical ventilation. Which patient assessment finding indicates that the weaning protocol should be stopped?
- A. The patient’s heart rate is 97 beats/min.
- B. The patient’s oxygen saturation is 93%.
- C. The patient’s respiratory rate is 32 breaths/min.
- D. The patient’s spontaneous tidal volume is 450 mL.
Correct Answer: C
Rationale: The correct answer is C because a respiratory rate of 32 breaths/min indicates increased work of breathing, which could be a sign of respiratory distress. In a patient being weaned from mechanical ventilation, an elevated respiratory rate suggests that the patient may not be able to sustain adequate ventilation on their own. This warrants stopping the weaning protocol to prevent respiratory failure.
Choice A is incorrect because a heart rate of 97 beats/min is within normal range for an adult. Choice B is incorrect because an oxygen saturation of 93% is acceptable for a patient with COPD. Choice D is incorrect because a tidal volume of 450 mL is adequate for a patient weaning from mechanical ventilation.