The condition of a critically ill patient with a living will has deteriorated. The patient’s partner wants “everything done,” regardless of the patient’s wishe s. Which ethical principle is the partner violating?
- A. Autonomy
- B. Beneficence
- C. Justice
- D. Nonmaleficence
Correct Answer: A
Rationale: The correct answer is A: Autonomy. Autonomy is the ethical principle that respects an individual's right to make decisions about their own care and treatment. In this scenario, the partner wanting "everything done" regardless of the patient's wishes violates the patient's autonomy by not honoring their previously expressed wishes outlined in the living will. This decision disregards the patient's right to make choices about their own healthcare. Choices B, C, and D are incorrect because:
B: Beneficence focuses on doing good for the patient, but in this case, the partner's actions are not necessarily in the patient's best interest.
C: Justice pertains to fairness and equal treatment, which is not directly relevant to the situation described.
D: Nonmaleficence is the principle of doing no harm, but in this scenario, the harm is not necessarily physical but rather a violation of the patient's autonomy.
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The nurse is caring for a patient with a left radial arterial lianbierb, .caonmd/t eas tp ulmonary artery catheter inserted into the right subclavian vein. Which action by th e nurse best ensures the safety of the patient being monitored with invasive hemodynamic moni toring lines?
- A. Document all waveform values.
- B. Limit the pressure tubing length.
- C. Zero reference the system daily.
- D. Ensure alarm limits are turned on.
Correct Answer: C
Rationale: The correct answer is C: Zero reference the system daily. Zero referencing ensures accuracy and calibration of pressure monitoring system by setting the baseline pressure to zero. This is crucial to prevent inaccuracies in measurements. Choice A is important but doesn't directly address the accuracy of the monitoring system. Choice B may help in preventing errors but doesn't address the accuracy of pressure measurement. Choice D is important for alerting the nurse but doesn't directly relate to the accuracy of hemodynamic monitoring.
The nurse is caring for a patient with cystic fibrosis (CF) and understands that treatment consists of which of the following? (Select all that apply.)
- A. Airway clearance therapies
- B. Antibiotic therapy
- C. Nutritional support
- D. Tracheostomy
Correct Answer: A
Rationale: The correct answer is A: Airway clearance therapies. In cystic fibrosis (CF), mucus buildup in the lungs can lead to infections and breathing difficulties. Airway clearance therapies help loosen and clear this mucus, improving lung function. Antibiotic therapy (B) is used to treat infections but is not specific to CF treatment. Nutritional support (C) is crucial in CF due to malabsorption, but it is not the primary treatment. Tracheostomy (D) is a surgical procedure to create an airway bypassing the upper respiratory tract and is not a standard treatment for CF.
When addressing an ethical dilemma, contextual, physiolo gical, and personal factors of the situation must be considered. Which of the following is an example of a personal factor?
- A. The hospital has a policy that everyone must have an aadbvirba.ncocme/dte sdt irective on the chart.
- B. The patient has lost 20 pounds in the past month and is fatigued all of time.
- C. The patient has expressed their beliefs concerning wha t quality of life means and their wishes.
- D. The primary care provider considers care to be futile in a given situation.
Correct Answer: C
Rationale: The correct answer is C because the patient's expressed beliefs and wishes regarding quality of life are personal factors that directly influence the ethical dilemma. This factor reflects the individual's values, beliefs, and preferences, which are essential in making ethical decisions that respect the patient's autonomy. Considering the patient's beliefs helps healthcare professionals navigate complex ethical situations by aligning the care provided with the patient's values. Choices A, B, and D do not directly relate to personal factors but rather focus on hospital policies, physiological symptoms, and the provider's perspective, respectively. Personal factors are crucial in ethical decision-making as they center on the patient's autonomy and preferences.
The nurse identifies a client's needs and formulates the nursing problem of, 'Imbalanced nutrition: less than body requirements, related to mental impairment and decreased intake, as evidenced by increasing confusion and weight loss of more than 30 pounds over the last 6 months.' Which short-term goal is best for this client?
- A. Verbalize understanding of plan and of intention to eat meals.
- B. Eat 50% of six small meals each day by the end of one week.
- C. Meals prepared during hospitalization will be fed by the nurse.
- D. Demonstrate progressive weight gain toward the ideal weight.
Correct Answer: B
Rationale: The correct short-term goal for the client with imbalanced nutrition is choice B: Eat 50% of six small meals each day by the end of one week. This goal is specific, measurable, achievable, relevant, and time-bound (SMART). By setting a goal for the client to eat a specific amount of meals within a defined timeframe, it allows for objective monitoring of progress. This goal also addresses the client's decreased intake and aims to improve their nutritional status gradually.
Choice A is incorrect as verbalizing understanding does not directly address the client's nutritional needs. Choice C is not appropriate as it does not promote independence in meal consumption. Choice D is not the best short-term goal as it focuses on the outcome of weight gain rather than the process of increasing food intake. Overall, choice B is the most appropriate short-term goal as it targets the client's specific nutritional needs and provides a clear direction for intervention.
The nurse is caring for a 48-year-old patient who is intubated and on a ventilator following extensive abdominal surgery. Although the patient is respo nsive, the nurse is not able to read the patient’s lips as the patient attempts to mouth the words. Which of the following assessment tools would be the most appropriate for the nu rse to use when assessing the patient’s pain level? (Select all that apply.)
- A. The FACES scale
- B. Pain Intensity Scale
- C. The PQRST method
- D. The Visual Analogue Scale
Correct Answer: A
Rationale: The correct answer is A: The FACES scale. This scale uses facial expressions to assess pain, making it suitable for a patient who is unable to verbalize. The nurse can show the patient a series of faces depicting varying levels of pain and ask them to point to the one that best represents their pain level. This method is non-verbal and easy for patients to understand.
The other choices are incorrect:
B: The Pain Intensity Scale requires the patient to rate their pain on a numerical scale, which may be difficult for a non-verbal patient.
C: The PQRST method is a mnemonic for assessing pain characteristics (provocation, quality, region, severity, timing), but it requires patient communication.
D: The Visual Analogue Scale involves marking a point on a line to indicate pain intensity, which is not suitable for a non-verbal patient.