Nokea
What were identified as the first critical care units? (Select all that apply.)
- A. Burn units.
- B. Coronary care units
- C. Recovery rooms.
- D. Neonatal intensive care units.
Correct Answer: A
Rationale: The correct answer is A: Burn units. Burn units were identified as the first critical care units due to the complex and intensive care required by burn patients. These units were established to provide specialized care for burn victims, including wound management, infection control, and fluid resuscitation.
Summary:
- Burn units were the first critical care units due to the specialized care needed for burn patients.
- Coronary care units focus on cardiac conditions, not the first identified critical care units.
- Recovery rooms are for post-operative care, not specifically for critical care.
- Neonatal intensive care units are specialized for newborns, not the first critical care units.
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Which of the following are components of the Institute for Healthcare Improvement’s (IHI’s) ventilator bundle? (Select all that apply.)
- A. Interrupt sedation each day to assess readiness to extub aa bit re b.. c om/test
- B. Maintain head of bed at least 30 degrees elevation.
- C. Provide deep vein thrombosis prophylaxis.
- D. Provide prophylaxis for peptic ulcer disease.
Correct Answer: A
Rationale: The correct answer is A because interrupting sedation daily to assess readiness to extubate is a key component of IHI's ventilator bundle to prevent ventilator-associated pneumonia. This practice helps prevent over-sedation, reduce the duration of mechanical ventilation, and decrease the risk of complications. The other choices, B, C, and D, are incorrect as they are not specific components of the IHI's ventilator bundle. Maintaining head of bed elevation, providing deep vein thrombosis prophylaxis, and prophylaxis for peptic ulcer disease are important aspects of critical care but are not directly related to the ventilator bundle protocol outlined by IHI.
A nurse observes that a 38-year-old single father whose 11-year-old daughter is in the ICU is struggling to explain to his 6-year-old son the likelihood that the daughter will die. The young boy asks what will happen to his sister when she dies, but the father breaks down in tears and seems unable to respond. Which of the following would be the most appropriate intervention for the nurse to make?
- A. Suggest that the father contact his pastor, rabbi, or other spiritual leader for counself or him and his son
- B. Sit down with the father and son and share her own religious beliefs
- C. Ask the patients doctor to explain to the father the odds of the daughter surviving
- D. Leave the father and son to grieve alone
Correct Answer: A
Rationale: The correct answer is A. The nurse should suggest that the father contact his spiritual leader for counseling. This option is appropriate as it recognizes the importance of spirituality in coping with difficult situations. It offers emotional support and guidance to the father and his son during a time of crisis.
Option B is incorrect as the nurse sharing her own religious beliefs may not align with the father's beliefs, potentially causing confusion or discomfort.
Option C is not the best intervention, as the doctor's role is primarily medical, and explaining the odds of survival may not address the emotional and spiritual needs of the family.
Option D is also incorrect as leaving the father and son to grieve alone does not provide them with the necessary support and guidance during such a challenging time.
The patient is receiving neuromuscular blockade. Which nursing assessment indicates a target level of paralysis?
- A. Glasgow Coma Scale score of 3
- B. Train-of-four yields two twitches
- C. Bispectral index of 60
- D. CAM-ICU positive
Correct Answer: B
Rationale: The correct answer is B: Train-of-four yields two twitches. This assessment indicates a target level of paralysis because a train-of-four ratio of 2 twitches out of 4 suggests a 50% neuromuscular blockade, which is often the goal for patients receiving paralysis for procedures or ventilation.
A: A Glasgow Coma Scale score of 3 assesses consciousness, not neuromuscular blockade.
C: A Bispectral index of 60 measures depth of anesthesia, not paralysis level.
D: CAM-ICU assesses delirium, not neuromuscular blockade.
The nurse cares for a patient with lung cancer in a home hospice program. Which action by the nurse is most appropriate?
- A. Discuss cancer risk factors and appropriate lifestyle modifications.
- B. Encourage the patient to discuss past life events and their meaning.
- C. Teach the patient about the purpose of chemotherapy and radiation.
- D. Accomplish a thorough head-to-toe assessment several times a week.
Correct Answer: B
Rationale: The correct answer is B because in a home hospice program, it is essential for the nurse to provide holistic care that includes addressing the patient's emotional and psychological needs. Encouraging the patient to discuss past life events and their meaning can help them process emotions, find closure, and improve their quality of life. This approach aligns with the principles of palliative care, which focus on enhancing comfort and well-being.
Choice A is incorrect because discussing cancer risk factors and lifestyle modifications may not be relevant or beneficial for a patient in a hospice program. Choice C is incorrect because chemotherapy and radiation are typically not part of hospice care, which focuses on comfort rather than curative treatments. Choice D is incorrect because a thorough head-to-toe assessment multiple times a week may not be necessary or appropriate for a patient in a hospice program.
What is the most common cause of a pulmonary embolus?
- A. An amniotic fluid embolus.
- B. A deep vein thrombosis from lower extremities.
- C. A fat embolus from a long bone fracture.
- D. Vegetation that dislodges from an infected central venous catheter.
Correct Answer: B
Rationale: The correct answer is B: A deep vein thrombosis from lower extremities. Deep vein thrombosis (DVT) is the most common cause of a pulmonary embolus as a blood clot can dislodge from the veins, travel to the lungs, and block blood flow. An amniotic fluid embolus (Choice A) occurs during childbirth and is rare as a cause of pulmonary embolism. A fat embolus (Choice C) typically occurs after a long bone fracture and is more likely to cause issues in the lungs. Vegetation from an infected central venous catheter (Choice D) can cause septic pulmonary embolism, but it is not as common as DVT.