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Family members have a need for information. Which intervention best assists in meeting this need?
- A. Handing family members a pamphlet that explains all of the critical care equipment
- B. Providing a daily update of the patient’s progress and f acilitating communication with the intensivist
- C. Telling them that you are not permitted to give them a status report but that they can be present at 4:00 PM for family rounds with the intensivist
- D. Writing down a list of all new medications and doses a nd giving the list to family members during visitation
Correct Answer: B
Rationale: The correct answer is B because providing a daily update of the patient's progress and facilitating communication with the intensivist directly addresses the family members' need for information in a timely and personalized manner. This intervention ensures that the family is kept informed about the patient's condition and treatment plan, fostering transparency and trust. It also allows for any questions or concerns to be addressed promptly, aiding in the family's understanding and involvement in the patient's care.
Now, let's summarize why the other choices are incorrect:
A: Handing out a pamphlet may provide information, but it lacks the personalized touch and real-time updates that are crucial for meeting the family's need for information.
C: Restricting information and only allowing family members to be present at specific times may create frustration and hinder communication, not effectively meeting their information needs.
D: Providing a list of medications is helpful, but it does not offer a comprehensive update on the patient's progress or facilitate direct communication with the medical team, which are
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As part of the Synergy Model, the nurse has identified a patient characteristic of resiliency. What patient behavior demonstrates resiliency?
- A. Dysfunctional grieving behaviors after receiving bad news
- B. Developing a list of questions for the physician
- C. Denial of any possible negative outcomes for a procedure
- D. Assigning blame to others for undesired outcomes of illness
Correct Answer: B
Rationale: The correct answer is B because developing a list of questions for the physician shows active engagement in their healthcare, seeking information, and taking control of their situation, which are characteristics of resiliency. This behavior indicates the patient's willingness to understand and cope with their health condition. Choices A, C, and D are incorrect as they demonstrate maladaptive coping mechanisms such as dysfunctional grieving, denial, and blame assignment, which are not indicative of resiliency. Resiliency involves adaptability, problem-solving, and seeking support, which are better exemplified by choice B.
Which nursing interventions would best support the family of a critically ill patient?
- A. Encouraging family members to stay all night in case t he patient needs them.
- B. Giving a condition update each morning and whenever changes occur.
- C. Limiting visitation from children into the critical care u nit.
- D. Providing beverages and snacks in the waiting room.
Correct Answer: B
Rationale: The correct answer is B because giving regular condition updates promotes transparency and communication, reducing anxiety for the family. This intervention helps them stay informed and involved in the patient's care. Choice A may lead to caregiver fatigue and is not sustainable. Choice C limits family support and may increase stress. Choice D focuses on comfort but does not address the family's need for information.
Conditions that produce acute kidney injury by directly acting on functioning kidney tissue are classified as intrarenal. The most common intrarenal condition is
- A. prolonged ischemia.
- B. exposure to nephrotoxic substances.
- C. acute tubular necrosis (ATN).
- D. hypotension for several hours.
Correct Answer: C
Rationale: Rationale:
1. Acute tubular necrosis (ATN) is the most common intrarenal condition as it directly affects kidney tubules.
2. ATN is characterized by damage to renal tubular cells due to various factors like toxins or ischemia.
3. Prolonged ischemia (choice A) can lead to ATN but is not the most common intrarenal condition.
4. Exposure to nephrotoxic substances (choice B) can cause ATN, but ATN itself is more common.
5. Hypotension for several hours (choice D) can result in ischemia and subsequent ATN, but ATN is still the primary intrarenal condition.
The nurse is caring for a patient in the critical care unit whaobi,r ba.cfotemr/ tebset ing declared brain dead, is being managed by the OPO transplant coordinator. Thir ty minutes into the shift, assessment by the nurse includes a blood pressure 75/50 mm Hg, hear t rate 85 beats/min, and respiratory rate 12 breaths/min via assist/control ventilation. The oxygen saturation (SpO ) is 99% and 2 core temperature 93.8° F. Which primary care provider ord er should the nurse implement first?
- A. Apply forced air warming device to keep temperature > 96.8° F
- B. Obtain basic metabolic panel every 4 hours until surgery
- C. Begin phenylephrine (Neo-Synephrine) for systolic BP < 90 mm Hg
- D. Draw arterial blood gas every 4 hours until surgery
Correct Answer: C
Rationale: The correct answer is C: Begin phenylephrine (Neo-Synephrine) for systolic BP < 90 mm Hg. The nurse should implement this order first because the patient's low blood pressure (75/50 mm Hg) indicates hypotension, which can lead to inadequate perfusion to vital organs. Phenylephrine is a vasoconstrictor that can help increase the patient's blood pressure and improve perfusion. It is crucial to address hypotension promptly to prevent further complications.
Choice A is incorrect because maintaining the patient's temperature above 96.8°F is not the most urgent concern in this scenario. Choice B is incorrect as obtaining a basic metabolic panel every 4 hours is not the immediate priority when the patient is experiencing hypotension. Choice D is incorrect as drawing arterial blood gas every 4 hours is not the most urgent intervention needed to address the patient's low blood pressure.
To verify the correct placement of an oral endotracheal tube (ET) after insertion, the best initial action by the nurse is to:
- A. Auscultate for the presence of bilateral breath sounds.
- B. Obtain a portable chest x-ray to check tube placement.
- C. Observe the chest for symmetric chest movement with ventilation.
- D. Use an end-tidal CO2 monitor to check for placement in the trachea.
Correct Answer: D
Rationale: The correct answer is D because using an end-tidal CO2 monitor is the most reliable method to confirm correct endotracheal tube placement in the trachea. This method detects exhaled CO2, indicating proper tube placement in the trachea. It is a quick and efficient way to confirm placement without delay, reducing the risk of complications.
A: Auscultating for bilateral breath sounds is not as reliable because breath sounds may be heard even if the tube is misplaced.
B: Obtaining a portable chest x-ray is not the best initial action as it takes time and delays confirming tube placement.
C: Observing chest movement may not provide conclusive evidence of proper tube placement and can lead to misinterpretation.
In summary, using an end-tidal CO2 monitor is the most accurate and efficient method to verify correct endotracheal tube placement compared to the other options.