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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.
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Which of the following are accepted nonpharmacological approaches to managing pain and/or anxiety in critically ill patients? (Select all that apply.)
- A. Environmental manipulation
- B. Explanations of monitoring equipment
- C. Guided imagery
- D. Music therapy
Correct Answer: A
Rationale: Step 1: Environmental manipulation involves adjusting factors like lighting, noise levels, and room temperature to create a soothing environment, which can help reduce pain and anxiety.
Step 2: By controlling the physical surroundings, patients may feel more comfortable and relaxed, leading to improved pain management and reduced anxiety levels.
Step 3: Explanations of monitoring equipment and guided imagery are not directly related to environmental changes that can impact pain and anxiety.
Step 4: Music therapy, while beneficial for some patients, is not categorized as environmental manipulation.
The patient has just returned from having an arteriovenous fistula placed. The patient asks, “When will they be able to use this and take this other catheter out?” The nurse should reply,
- A. “It can be used immediately, so the catheter can come out anytime.”
- B. “It will take 2 to 4 weeks to heal before it can be used.”
- C. “The fistula will be usable in about 4 to 6 weeks.”
- D. “The fistula was made using graft material, so it depends on the manufacturer.”
Correct Answer: C
Rationale: The correct answer is C: “The fistula will be usable in about 4 to 6 weeks.” The rationale for this is that an arteriovenous fistula typically requires 4 to 6 weeks to mature and be ready for use. During this time, the fistula develops the necessary blood flow for efficient dialysis.
Choice A is incorrect because immediate use of the fistula is not recommended as it needs time to mature. Choice B is incorrect as it underestimates the time needed for the fistula to heal and mature. Choice D is incorrect as the usability of the fistula is not dependent on the manufacturer but rather on the patient's individual healing process.
While neuromuscular blocking agents are used in the management of some ventilated patients what is their primary mode of action?
- A. Analgesia
- B. Anticonvulsant
- C. Paralysis
- D. Sedation
Correct Answer: C
Rationale: The correct answer is C: Paralysis. Neuromuscular blocking agents work by blocking the transmission of nerve impulses at the neuromuscular junction, leading to muscle paralysis. This is essential in ventilated patients to facilitate mechanical ventilation and prevent patient-ventilator dyssynchrony.
Rationale:
A: Analgesia - Neuromuscular blocking agents do not provide pain relief. They do not have any direct analgesic properties.
B: Anticonvulsant - Neuromuscular blocking agents do not prevent or treat seizures. They do not have anticonvulsant effects.
D: Sedation - While sedatives may be used in conjunction with neuromuscular blocking agents, the primary mode of action of these agents is muscle paralysis, not sedation.
Which treatment can be used to dissolve a thrombus that is lodged in the pulmonary artery?
- A. Aspirin
- B. Embolectomy
- C. Heparin
- D. Thrombolytics
Correct Answer: D
Rationale: The correct answer is D: Thrombolytics. Thrombolytics are medications that can dissolve blood clots, making them effective in treating a thrombus lodged in the pulmonary artery. They work by activating the body's natural clot-dissolving system. Aspirin (A) is an antiplatelet drug and may prevent further clot formation but cannot dissolve an existing thrombus. Embolectomy (B) is a surgical procedure to remove a clot and is invasive, usually reserved for cases where thrombolytics are contraindicated. Heparin (C) is an anticoagulant that prevents clot formation but does not dissolve existing clots like thrombolytics do.
The vision of the American Association of Critical-Care N urses is a healthcare system driven by achieving what goal?
- A. Maintaining a healthy work environment.
- B. Providing care from a multiprofessional team under th e direction of a critical care physician.
- C. Effectively meeting the needs of critically ill patients a nd families.
- D. Creating respectful, healing, and humane environments.
Correct Answer: D
Rationale: The correct answer is D because the vision of the American Association of Critical-Care Nurses focuses on creating respectful, healing, and humane environments. This aligns with the core values of nursing, emphasizing compassion, dignity, and patient-centered care. A is incorrect as the focus is not solely on the work environment. B is incorrect as it emphasizes the role of physicians over the collaborative approach advocated by the AACN. C is incorrect as it only addresses meeting patient needs, whereas the vision encompasses a broader scope of creating healing environments.