Nokea
Bioethical issue should be describe as _____.
- A. the withholding of food and treatment at the request of the patient in a written advance directive given before a patient acquired permanent brain damage from an accident
- B. the physician's making all decisions of client management without getting input from the patient
- C. after the patient gives permission, the physician's disclosing all information to the family for this support in the management of the patient
- D. a research project that included treating all regular employed personnel and not treating all casual employed to compare the outcome of specific drug therapy
Correct Answer: A
Rationale: The bioethical issue described in option A revolves around the concept of advance directives. Advance directives are legal documents that outline a person's wishes regarding medical treatment in the event that they are unable to communicate those wishes themselves. In this scenario, the issue pertains to the withholding of food and treatment based on a written advance directive that was made before the patient suffered permanent brain damage. This raises important ethical considerations about respecting a patient's autonomy and adhering to their previously expressed wishes, even in difficult circumstances. The decision to withhold treatment in such a situation is a complex bioethical issue that needs to be handled carefully while balancing the principles of autonomy and beneficence.
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While Mrs. Mely is on TPN she suddenly complained of slight chest pain, dyspnea and appears cyanotic. You suspect that she is experiencing what possible IMMEDIATE complication?
- A. Sepsis due to IV 1ine
- B. Hyperglycemia.
- C. Air embolism
- D. Allergic reaction to TPN
Correct Answer: C
Rationale: The symptoms described in the scenario - chest pain, dyspnea, and cyanosis - are indicative of a potential air embolism. Air embolism occurs when air enters the bloodstream, leading to blockages in blood vessels and impeding oxygen delivery to tissues. In patients receiving Total Parenteral Nutrition (TPN) through intravenous lines, the risk of air embolism exists during line manipulations, disconnections, or improper priming of the tubing. The sudden onset of symptoms like chest pain and cyanosis in a patient on TPN should raise suspicion for an air embolism, as it requires immediate intervention to prevent further complications such as cardiac arrest or stroke.
Which of the following is a common complication of untreated gonorrhea or chlamydia infection in women?
- A. Cervical dysplasia
- B. Ectopic pregnancy
- C. Urinary incontinence
- D. Pelvic organ prolapse
Correct Answer: B
Rationale: Ectopic pregnancy is a common complication of untreated gonorrhea or chlamydia infection in women. This occurs when a fertilized egg implants and grows outside the uterus, typically in one of the fallopian tubes. Both gonorrhea and chlamydia can lead to scarring of the fallopian tubes due to untreated inflammation and infection. This scarring may obstruct the fallopian tubes, making it difficult for the fertilized egg to travel to the uterus for implantation. As a result, the egg may implant and grow in the fallopian tube, leading to an ectopic pregnancy. Ectopic pregnancies are dangerous and can result in serious complications for the woman, including rupture of the fallopian tube, internal bleeding, and potentially life-threatening situations. It is crucial to seek prompt treatment for gonorrhea and chlamydia to prevent such severe outcomes.
Which of the following structures is responsible for transporting food from the oral cavity to the esophagus during swallowing?
- A. Tongue
- B. Pharynx
- C. Esophagus
- D. Epiglottis
Correct Answer: B
Rationale: The pharynx is the structure responsible for transporting food from the oral cavity to the esophagus during swallowing. When food is chewed and mixed with saliva in the oral cavity, it forms a bolus that is propelled to the pharynx by the tongue. The pharynx serves as a common passageway for both air and food, allowing the bolus to pass into the esophagus while preventing it from entering the trachea. The epiglottis, although important in preventing food from entering the airway, is not directly involved in the transportation of food from the oral cavity to the esophagus.
A patient with acute respiratory distress syndrome (ARDS) develops refractory hypoxemia despite maximal ventilatory support and prone positioning. Which of the following adjunctive therapies is most likely to improve oxygenation and reduce mortality in this patient?
- A. High-frequency oscillatory ventilation (HFOV)
- B. Continuous renal replacement therapy (CRRT)
- C. Extracorporeal membrane oxygenation (ECMO)
- D. Inhaled nitric oxide (iNO)
Correct Answer: C
Rationale: In a patient with ARDS who is experiencing refractory hypoxemia despite maximal ventilatory support and prone positioning, the use of extracorporeal membrane oxygenation (ECMO) is a potentially life-saving adjunctive therapy. ECMO works by providing temporary support for gas exchange outside the body, allowing the lungs to rest and heal while providing adequate oxygenation and carbon dioxide removal. The use of ECMO has been associated with improved oxygenation and reduced mortality in severe cases of ARDS, especially in patients who fail conventional therapies. High-frequency oscillatory ventilation (HFOV) has not consistently shown mortality benefit in ARDS, continuous renal replacement therapy (CRRT) is not directly indicated for hypoxemia in ARDS, and inhaled nitric oxide (iNO) has shown limited benefit in improving oxygenation in ARDS without a clear impact on mortality.
A postpartum client exhibits signs of depression, including tearfulness, feelings of guilt, and decreased interest in self-care. Which nursing intervention should be prioritized?
- A. Encouraging participation in support groups for new mothers
- B. Referring the client to a mental health professional for counseling
- C. Administering antidepressant medication as prescribed
- D. Assessing for risk of harm to self or infant
Correct Answer: D
Rationale: The prioritized nursing intervention in this situation should be assessing for the risk of harm to self or infant. It is crucial to ensure the safety of the postpartum client and her infant as depression can increase the risk of self-harm or harm to the newborn. By assessing for any potential risks, the nurse can take appropriate actions to prevent any harm and ensure the well-being of both the client and the infant. Once the assessment is completed, further interventions like encouraging participation in support groups, referring to a mental health professional, or administering medications can be considered based on the assessment findings.