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What is a minimally acceptable urine output for a patient weighing 75 kg?
- A. Less than 30 mL/hour
- B. 37 mL/hour
- C. 80 mL/hour
- D. 150 mL/hour
Correct Answer: C
Rationale: The correct answer is C (80 mL/hour) because the minimum acceptable urine output for a patient is approximately 0.5-1 mL/kg/hour. For a 75 kg patient, this equates to 37.5-75 mL/hour. Therefore, an output of 80 mL/hour is within this range and is considered minimally acceptable.
A: Less than 30 mL/hour is incorrect because it is below the recommended range for a 75 kg patient.
B: 37 mL/hour is close to the lower end of the acceptable range, but it is not the minimum acceptable output.
D: 150 mL/hour is above the recommended range and would be considered excessive for a 75 kg patient.
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Warning signs that can assist the critical care nurse in reco gnizing that an ethical dilemma may exist include which of the following? (Select all that apply.)
- A. Family members are confused about what is happening to the patient.
- B. Family members are in conflict as to the best treatmen t options. They disagree with each other and cannot come to consensus.
- C. The family asks that the patient not be told of treatmenatb iprbl.aconms./t est
- D. The patient’s condition has changed dramatically for the worse and is not responding to conventional treatment.
Correct Answer: A
Rationale: The correct answer is A because when family members are confused about the patient's condition or treatment, it can indicate a lack of communication or understanding, leading to a potential ethical dilemma. This confusion may result in conflicting views on what is best for the patient, potentially leading to disagreements and ethical conflicts.
Choice B is incorrect because although family conflict can lead to ethical dilemmas, it is not a direct warning sign that an ethical dilemma exists.
Choice C is incorrect because the family asking not to inform the patient about treatment is more related to communication preferences rather than a clear indication of an ethical dilemma.
Choice D is incorrect because a deteriorating patient condition, while concerning, does not directly signal an ethical dilemma unless there are specific ethical considerations involved in the treatment decisions.
What is true regarding pain and anxiety in the healthy individual? (Select all that apply.)
- A. They activate the sympathetic nervous system.
- B. They decrease stress levels.
- C. They help remove one from harm.
- D. They increase performance levels.
Correct Answer: A
Rationale: The correct answer is A because pain and anxiety trigger the sympathetic nervous system's fight-or-flight response, increasing heart rate, blood pressure, and stress hormones to prepare the body for potential danger. This physiological response helps the individual respond to perceived threats. Choices B, C, and D are incorrect because pain and anxiety typically increase stress levels, do not necessarily remove one from harm, and can hinder rather than enhance performance due to distraction and decreased focus.
As the nurse admits a patient with end-stage kidney disease to the hospital, the patient tells the nurse, 'If my heart or breathing stops, I do not want to be resuscitated.' Which action is best for the nurse to take?
- A. Ask if these wishes have been discussed with the healthcare provider.
- B. Place a Do Not Resuscitate (DNR) notation in the patient’s care plan.
- C. Inform the patient that a notarized advance directive must be included in the record.
- D. Advise the patient to designate a person to make health care decisions.
Correct Answer: A
Rationale: Step 1: Asking if these wishes have been discussed with the healthcare provider is important to ensure that the patient's wishes are documented and considered in the care plan.
Step 2: The healthcare provider needs to be aware of the patient's preferences regarding resuscitation to provide appropriate care.
Step 3: This step helps in clarifying the patient's preferences and ensures that the healthcare team follows the patient's wishes.
Step 4: Placing a DNR notation without consulting the healthcare provider may not align with the patient's overall care plan and may lead to potential legal and ethical issues.
Step 5: Informing the patient about notarized advance directives and designating a person for healthcare decisions are important but not the immediate step needed in this scenario.
In summary, choice A is correct as it prioritizes communication with the healthcare provider to ensure the patient's wishes are properly documented and followed. Choices B, C, and D are incorrect because they do not involve confirming the patient's wishes
The nurse is caring for a patient in acute respiratory failure and understands that the patient should be positioned (Select all that apply.)
- A. high Fowler’s.
- B. side lying with head of bed elevated.
- C. sitting in a chair.
- D. supine with the bed flat.
Correct Answer: A
Rationale: The correct answer is A: high Fowler's position. This position promotes optimal lung expansion by allowing the chest to expand fully, improving oxygenation. It also helps reduce the work of breathing. Side lying with the head of the bed elevated (B) may not provide the same level of lung expansion. Sitting in a chair (C) may not be suitable for a patient in acute respiratory failure as it may not provide adequate support for breathing. Supine with the bed flat (D) can worsen respiratory distress by limiting lung expansion.
A patient is transferred to the ICU from the Birth Center of the hospital in the middle of the night after experiencing complications during delivery of her baby. The patients husband is anxious and explains to the ICU nurse that he doesnt understand why his wife has been moved to the ICU. She is going to die, isnt she? he asks the nurse. What is the nurses best response?
- A. Explain that every measure will be taken to provide his wife with the best care possible.
- B. Explain that the nurse is fully trained and has years of experience.
- C. Offer the husband a place to relax.
- D. Have appropriate staff discuss his health insurance with him.
Correct Answer: A
Rationale: The correct answer is A because it addresses the husband's concern directly by assuring him that every measure will be taken to provide the best care for his wife. This response shows empathy and provides reassurance, which is crucial in such a stressful situation. It helps to alleviate the husband's anxiety and fear by emphasizing the hospital's commitment to his wife's well-being.
Explanation for why the other choices are incorrect:
B: This response does not address the husband's immediate concern about his wife's well-being and may come across as dismissive.
C: Offering a place to relax does not address the husband's specific question and does not provide the information he is seeking.
D: Discussing health insurance is not appropriate at this moment of crisis and does not address the husband's fears about his wife's condition.