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Ideally, by whom and when should an advance directive be developed?
- A. Family, if the patient is in critical condition.
- B. Patient as part of the hospital admission process.
- C. Patient before illness or impairment occurs.
- D. Patient’s healthcare surrogate.
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Advance directives should be made by the patient to reflect their wishes.
2. Developing it before illness ensures clarity and avoids confusion.
3. Patients may not be able to make informed decisions in critical conditions.
4. Family or surrogates may not accurately represent the patient's wishes.
Summary:
A - Family in critical condition may not know the patient's wishes.
B - Hospital admission process may be too late for clear decision-making.
D - Healthcare surrogate may not fully understand the patient's preferences.
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A nurse who plans care based on the patient’s gender, ethn ai bc iri bt .y co, ms /p tei sr ti tuality, and lifestyle is said to demonstrate what focus?
- A. Becoming a moral advocate.
- B. Facilitating all forms of learning.
- C. Responding to diversity.
- D. Using effective clinical judgment.
Correct Answer: C
Rationale: The correct answer is C: Responding to diversity. By considering the patient's gender, ethnicity, spirituality, and lifestyle, the nurse is focusing on responding to diversity in patient care. This approach acknowledges and respects the unique characteristics and backgrounds of individual patients, leading to more culturally competent and effective care.
Choice A: Becoming a moral advocate does not directly relate to considering diversity in patient care. It involves standing up for ethical principles and values in healthcare.
Choice B: Facilitating all forms of learning is not specific to addressing diversity in patient care. It pertains to promoting education and understanding in various learning styles.
Choice D: Using effective clinical judgment is important in nursing practice but does not specifically address the focus on diversity in patient care. It pertains to making sound decisions based on clinical knowledge and expertise.
When rewarming a patient who arrived in the emergency department (ED) with a temperature of 87°F (30.6°C), which assessment indicates that the nurse should discontinue active rewarming?
- A. The patient begins to shiver.
- B. The BP decreases to 86/42 mm Hg.
- C. The patient develops atrial fibrillation.
- D. The core temperature is 94°F (34.4°C).
Correct Answer: D
Rationale: The correct answer is D. When rewarming a hypothermic patient, the goal is to gradually increase their core temperature. A core temperature of 94°F (34.4°C) is still below the normal range, but it indicates that the rewarming process is working. Shivering (A) is a normal response to rewarming. A decrease in blood pressure (B) may be expected due to peripheral vasodilation during rewarming. Developing atrial fibrillation (C) may be a concern but does not necessarily indicate that rewarming should be discontinued. Therefore, choice D is correct as it signifies progress in the rewarming process.
A young man has just arrived at the ICU from out of town and received news that his girlfriend, who is admitted there, likely only has a few days left to live. Which of the following would be the best approach for the nurse to take in caring for the needs of this young man?
- A. Recommending that he go home and rest
- B. Giving him unrestricted visiting hours with the patient
- C. Suggesting that he meet with the hospital chaplain
- D. Recommending that he ask the doctor to evaluate the patients pain control measures
Correct Answer: C
Rationale: The correct answer is C: Suggesting that he meet with the hospital chaplain. This approach is best as it addresses the young man's emotional and spiritual needs during a difficult time. The chaplain can provide comfort, support, and guidance in coping with his girlfriend's situation. This option focuses on holistic care and acknowledges the importance of emotional well-being.
A: Recommending that he go home and rest is not the best approach as it dismisses the young man's emotional distress.
B: Giving him unrestricted visiting hours with the patient may not be appropriate as it can be overwhelming and may not address his emotional needs effectively.
D: Recommending that he ask the doctor to evaluate the patient's pain control measures is important but does not directly address the young man's emotional needs in this situation.
Which of the following devices is best suited to deliver 65 % oxygen to a patient who is spontaneously breathing?
- A. Face mask with non-rebreathing reservoir
- B. Low-flow nasal cannula
- C. Simple face mask
- D. Venturi mask
Correct Answer: D
Rationale: The Venturi mask is the best choice for delivering 65% oxygen because it allows precise oxygen concentration delivery through adjustable venturi valves. This device ensures consistent oxygen levels even during variations in patient breathing patterns. Face mask with non-rebreathing reservoir (A) delivers higher oxygen concentrations, low-flow nasal cannula (B) is not suitable for precise oxygen delivery, and simple face mask (C) may not provide the desired oxygen concentration.
The family members of a critically ill, 90-year-old patient bring in a copy of the patient’s living will to the hospital, which identifies the patient’s wiasbhireb.sc orme/gteasrt ding health care. The nurse discusses the contents of the living will with the patient’s physician. This is an example of implementation of which of the AACN Standards of Pr ofessional Performance?
- A. Acquires and maintains current knowledge of practice
- B. Acts ethically on the behalf of the patient and family
- C. Considers factors related to safe patient care
- D. Uses clinical inquiry and integrates research findings i n practice
Correct Answer: C
Rationale: The correct answer is C: Considers factors related to safe patient care. The scenario involves the nurse discussing the patient's living will with the physician, which is essential for ensuring safe patient care by following the patient's preferences. This aligns with the AACN standard of considering factors related to safe patient care, as the nurse is actively involving all relevant parties in decision-making to provide care that is in line with the patient's wishes.
Explanation of why other choices are incorrect:
A: Acquires and maintains current knowledge of practice - While important, this choice does not directly relate to the scenario where the focus is on safe patient care through communication and collaboration.
B: Acts ethically on behalf of the patient and family - While ethics are important, the scenario is more about following the patient's wishes as outlined in the living will rather than making ethical decisions.
D: Uses clinical inquiry and integrates research findings in practice - While valuable in nursing practice, this choice does not directly apply to the scenario where