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The nurse is caring for a patient receiving intravenous ibup rofen for pain management. The nurse recognizes which laboratory assessment to be a possaibbirlbe.c soimd/ete set ffect of the ibuprofen?
- A. Elevated creatinine
- B. Elevated platelet count
- C. Elevated white blood count
- D. Low liver enzymes
Correct Answer: A
Rationale: The correct answer is A: Elevated creatinine. Ibuprofen can cause kidney damage, leading to elevated creatinine levels. This is because ibuprofen is metabolized in the kidneys, and prolonged use can impair kidney function. Elevated platelet count (B), elevated white blood count (C), and low liver enzymes (D) are not typically associated with ibuprofen use. Platelet count and white blood count are more related to inflammation or infection, while low liver enzymes are not a common side effect of ibuprofen.
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The nurse is managing a donor patient six hours prior to th e scheduled harvesting of the patient’s organs. Which assessment finding requires imme diate action by the nurse?
- A. Morning serum blood glucose of 128 mg/dL
- B. pH 7.30; PaCO 38 mm Hg; HCO 16 mEq/L 2 3
- C. Pulmonary artery temperature of 97.8° F
- D. Central venous pressure of 8 mm Hg
Correct Answer: B
Rationale: The correct answer is B. The patient's pH of 7.30 indicates acidosis, PaCO2 of 38 mm Hg is low, and HCO3 of 16 mEq/L is also low, suggesting metabolic acidosis. This finding requires immediate action as untreated acidosis can lead to serious complications.
Choice A (morning serum blood glucose of 128 mg/dL) is within normal range and does not require immediate action.
Choice C (pulmonary artery temperature of 97.8°F) is a normal temperature and does not require immediate action.
Choice D (central venous pressure of 8 mm Hg) is within normal range and does not require immediate action.
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.
The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H2O of peak end-expiratory pressure (PEEP). Which action indicates that the new RN is safe?
- A. The RN plans to suction the patient every 1 to 2 hours.
- B. The RN uses a closed-suction technique to suction the patient.
- C. The RN tapes the connection between the ventilator tubing and the ET.
- D. The RN changes the ventilator circuit tubing routinely every 48 hours.
Correct Answer: B
Rationale: The correct answer is B: The RN uses a closed-suction technique to suction the patient. This is the safe action because closed-suction technique minimizes the risk of ventilator-associated infections by maintaining a closed system during suctioning, reducing the exposure to pathogens. Closed-suction systems also help maintain lung compliance and oxygenation levels during the suctioning process.
Rationale: Option A is incorrect because suctioning every 1 to 2 hours may be too frequent and can lead to hypoxia and mucosal damage. Option C is incorrect as taping the connection between the ventilator tubing and ET can interfere with the proper functioning of the ventilator and increase the risk of disconnection. Option D is incorrect because changing ventilator circuit tubing routinely every 48 hours is not evidence-based practice and can increase the risk of contamination and unnecessary costs.
The nurse admits a terminally ill patient to the hospital. What is the first action that the nurse should complete when planning this patient care?
- A. Determine the patient’s wishes regarding end-of-life care.
- B. Emphasize the importance of addressing any family issues.
- C. Discuss the normal grief process with the patient and family.
- D. Encourage the patient to talk about any fears or unresolved issues.
Correct Answer: A
Rationale: The correct answer is A because determining the patient's wishes regarding end-of-life care is crucial in providing patient-centered care and ensuring that the patient's preferences are respected. By understanding the patient's preferences, healthcare providers can tailor the care plan to align with the patient's values and goals. This helps in promoting autonomy, dignity, and quality of life for the patient.
Choices B, C, and D are incorrect because although addressing family issues, discussing grief, and encouraging the patient to express fears are important aspects of caring for a terminally ill patient, they are not the first action that should be completed. Prioritizing the patient's wishes ensures that the care plan is centered around the patient's needs and preferences, which is essential in providing holistic and patient-centered care.
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.