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One of the strategies shown to reduce perception of stress in critically ill patients and their families is support of spirituality. What nursing action is most clearly supportive of the patients spirituality?
- A. Referring patients to the Catholic chaplain
- B. Providing prayer booklets to patients and families
- C. Asking about beliefs about the universe
- D. Avoiding discussing religion with those of other faiths
Correct Answer: C
Rationale: The correct answer is C because asking about beliefs about the universe allows the nurse to understand the patient's spiritual needs and provide appropriate support. This action shows respect for the patient's beliefs and can help establish a connection between the patient and the nurse. Referring patients to a specific religious figure (choice A) may not align with the patient's beliefs. Providing prayer booklets (choice B) assumes the patient's belief system and may not be helpful. Avoiding discussing religion (choice D) can hinder the nurse-patient relationship and overlook potential sources of support for the patient.
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The charge nurse is responsible for making the patient ass ignments on the critical care unit. She assigns the experienced, certified nurse to care for thea abicrbu.cteomly/t eisltl patient diagnosed with sepsis who also requires continuous renal replacement therapy and mechanical ventilation. She assigns the nurse with less than 1 year of experience to two patients who are more stable. This assignment reflects implementation of what guiding framework?
- A. Crew resource management model
- B. National Patient Safety Goals
- C. Quality and Safety Education for Nurses (QSEN) mod el
- D. Synergy model of practice
Correct Answer: D
Rationale: The correct answer is D: Synergy model of practice. The Synergy model emphasizes matching nurse competencies with patient needs for optimal outcomes. In this scenario, the charge nurse assigned the experienced, certified nurse to a complex patient requiring specialized care (sepsis, renal replacement therapy, ventilation), aligning with the model's principle of matching nurse expertise to patient acuity. Assigning the less experienced nurse to stable patients aligns with the model's focus on optimizing patient outcomes by matching nurse competencies appropriately.
A: Crew resource management model focuses on teamwork and communication to enhance safety, not specifically on nurse-patient assignments.
B: National Patient Safety Goals are broad guidelines for improving patient safety, not specific to nurse-patient assignments.
C: Quality and Safety Education for Nurses (QSEN) model focuses on integrating quality and safety competencies into nursing education, not specifically on nurse-patient assignments.
Which of the following professional organizations best supports critical care nursing practice?
- A. American Association of Critical-Care Nurses
- B. American Heart Association
- C. American Nurses Association
- D. Society of Critical Care Medicine
Correct Answer: A
Rationale: The correct answer is A: American Association of Critical-Care Nurses (AACN). This organization focuses exclusively on critical care nursing, offering specialized education, resources, and certifications for critical care nurses. AACN advocates for high standards of care in critical care settings. The other choices do not specifically cater to critical care nursing practice. The American Heart Association focuses on cardiovascular health, the American Nurses Association is a general nursing organization, and the Society of Critical Care Medicine is more physician-centric. Therefore, A is the best choice for supporting critical care nursing practice.
The nurse understands that many strategies are available to address ethical issues that may occur; these strategies include which of the following? (Select all that apply.)
- A. Change-of-shift report updates
- B. Ethics consultation services
- C. Formal multiprofessional ethics committees
- D. Pastoral care services
Correct Answer: B
Rationale: The correct answer is B: Ethics consultation services. These services involve seeking guidance from experts to navigate complex ethical dilemmas. They provide in-depth analysis and recommendations based on ethical principles, helping healthcare professionals make informed decisions. Change-of-shift report updates (A) are essential for continuity of care but do not directly address ethical issues. Formal multiprofessional ethics committees (C) are valuable for reviewing policies and addressing systemic ethical concerns but may not be readily available for immediate guidance. Pastoral care services (D) offer spiritual support but may not always have the expertise to handle complex ethical dilemmas. Ethics consultation services (B) are the most suitable option for addressing specific ethical issues promptly and effectively.
A hospice patient develops a pressure ulcer despite proper repositioning. What should the nurse include in the care plan?
- A. Implement more aggressive wound care strategies.
- B. Ensure adequate hydration and nutrition.
- C. Discuss the prognosis and expected outcomes with the family.
- D. Encourage increased physical activity to improve circulation.
Correct Answer: A
Rationale: The correct answer is A because implementing more aggressive wound care strategies is essential for managing pressure ulcers effectively. This includes proper wound cleaning, debridement, and dressing changes to promote healing. Adequate hydration and nutrition (choice B) are important but may not directly address the pressure ulcer. Discussing prognosis and expected outcomes (choice C) is important but may not directly impact wound healing. Encouraging increased physical activity (choice D) may be contraindicated due to the patient's condition.
A patient with end-stage heart failure is experiencing consaibdirebr.caobmle/te dsty spnea. What is the appropriate pharmacological management of this symptom ?
- A. Administration of 6 mg of midazolam and initiation of a continuous midazolam infusion.
- B. Administration of morphine, 5 mg IV bolus, and initia tion of a continuous morphine infusion.
- C. Hourly increases of the midazolam (Versed) infusion b y 100% dose increments.
- D. Hourly increases of the morphine infusion by 100% dose increments.
Correct Answer: B
Rationale: The correct answer is B: Administration of morphine, 5 mg IV bolus, and initiation of a continuous morphine infusion. Morphine is the preferred pharmacological management for severe dyspnea in end-stage heart failure due to its potent analgesic and anxiolytic properties.
Step-by-step rationale:
1. Morphine is a potent opioid that helps relieve dyspnea by reducing anxiety, decreasing respiratory drive, and improving overall comfort.
2. The initial IV bolus of 5 mg provides rapid relief of dyspnea.
3. Initiating a continuous morphine infusion ensures sustained relief of dyspnea.
4. Midazolam (choice A) is a benzodiazepine used for sedation and anxiety, but it is not the first-line treatment for dyspnea in this scenario.
5. Increasing the midazolam (choice C) or morphine (choice D) infusions by 100% dose increments hourly is not appropriate as