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Which of the following statements regarding pain and anxiety are true? (Select all that apply.)
- A. Anxiety is a state marked by apprehension, agitation, a utonomic arousal, and/or fearful withdrawal.
- B. Critically ill patients often experience anxiety, but they rarely experience pain.
- C. Pain and anxiety are often interrelated and may be diffaibciurbl.tc otmo /tdeisft ferentiate because their physiological and behavioral manifestations are similar.
- D. Pain is defined by each patient; it is whatever the perso n experiencing the pain says it is.
Correct Answer: A
Rationale: Rationale:
A: Correct. Anxiety is characterized by apprehension, agitation, autonomic arousal, and fearful withdrawal, which are distinct from pain.
B: Incorrect. Critically ill patients can experience both anxiety and pain, as pain is not exclusive to them.
C: Incorrect. While pain and anxiety can be interrelated, they can be differentiated based on their unique physiological and behavioral manifestations.
D: Incorrect. Pain is a subjective experience, but it is not solely defined by the individual; objective assessments are also important.
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Assuming each of these patients was discharged from the hospital, which older adult patient is at greatest risk for decreased functional status and quality of life?
- A. A 70-year-old who had coronary artery bypass surgery developed complications after surgery and had difficulty being weaned from meacbhirba.ncoicma/tle svt entilation. The patient required a tracheostomy and gastrostomy and is now being discharged to a long-term, acute care hospital. The patient lost their sig nificant other 3 years ago.
- B. A 79-year-old admitted for exacerbation of heart failure manages health care independently but needs diuretic medications adjusted . The patient states being compliant with prescribed medications but sometimes forgets to take them. The patient and 82-year-old spouse consider themselves to be independent and support each other.
- C. A 90-year-old admitted for a carotid endarterectomy lives in an assisted living facility (ALF) but is cognitively intact and claims to be the “social butterfly” at all of the events at the ALF. The patient is hospitalized for 4 days and discharged to the ALF.
- D. An 84-year-old who had stents placed to treat coronary artery occlusion has diabetes that has been managed, lives alone since losin g significant other 10 years ago, and was driving prior to hospitalization. The patieanbitr bw.caoms /dteisst charged home within 3 days of the procedure.
Correct Answer: A
Rationale: The correct answer is A because this patient had a complex surgery with complications, requiring long-term care and loss of a significant other, which can impact their emotional well-being and support system. This can lead to decreased functional status and quality of life.
Choice B is incorrect as the patient has support from a spouse and manages health care independently, indicating a good support system. Choice C is incorrect as the patient is cognitively intact and social, which suggests a good quality of life. Choice D is incorrect as the patient had a less complex procedure, well-managed diabetes, and was living independently, which indicates a lower risk for decreased functional status and quality of life compared to choice A.
The primary health care provider writes an order to discon tinue a patient’s left radial arterial line. When discontinuing the patient’s invasive line, what is the priority nursing action?
- A. Apply an air occlusion dressing to insertion site.
- B. Apply pressure to the insertion site for 5 minutes.
- C. Elevate the affected limb on pillows for 24 hours.
- D. Keep the patient’s wrist in a neutral position.
Correct Answer: B
Rationale: The correct answer is B: Apply pressure to the insertion site for 5 minutes. This is the priority nursing action because it helps prevent bleeding and hematoma formation after removing the arterial line. Applying pressure for 5 minutes allows for adequate hemostasis.
A: Applying an air occlusion dressing to the insertion site is not the priority action. It does not address the immediate need to control bleeding.
C: Elevating the affected limb on pillows for 24 hours is not necessary and does not address the immediate need for hemostasis.
D: Keeping the patient's wrist in a neutral position is not the priority action when discontinuing an arterial line. It does not address the need for hemostasis and preventing bleeding.
The nurse discharging a patient diagnosed with asthma ins tructs the patient to prevent exacerbation by taking what action?
- A. Obtaining an appointment for follow-up pulmonary fuanbcirtbi.oconm s/tteusdt ies 1 week after discharge.
- B. Limiting activity until patient is able to climb two flights of stairs.
- C. Taking all asthma medications as prescribed.
- D. Taking medications on a “prn” basis according to symapbtiorbm.cosm. /test
Correct Answer: C
Rationale: The correct answer is C: Taking all asthma medications as prescribed. This is the most appropriate action to prevent exacerbation of asthma symptoms. By taking medications as prescribed, the patient can effectively manage and control their asthma, reducing the risk of exacerbation. Following the prescribed medication regimen helps to keep inflammation in check and maintain airway function.
Choice A is incorrect because while follow-up appointments are important, they do not directly prevent exacerbation. Choice B is incorrect as limiting activity may not address the underlying cause of exacerbation. Choice D is incorrect as taking medications on an "as needed" basis may not provide consistent control of asthma symptoms, leading to potential exacerbation.
What were the findings of the Study to Understand Progno ses and Preferences for Outcomes and Risks of Treatment (SUPPORT)?
- A. Clear communication is typical in the relationships bet ween most patients and healthcare providers.
- B. Critical care units often meet the needs of dying patients and their families.
- C. Disparities exist between patients’ care preferences anadb iarbc.tcuomal/t ecsat re provided.
- D. Pain and suffering of patients at end of life is well cont rolled in the hospital.
Correct Answer: C
Rationale: The correct answer is C because the SUPPORT study revealed disparities between patients' care preferences and the actual care provided. This is supported by the findings that many patients did not receive treatments aligned with their preferences. Choice A is incorrect because the study actually highlighted communication challenges between patients and healthcare providers. Choice B is incorrect as the study showed that critical care units often do not meet the needs of dying patients and their families. Choice D is incorrect as the study found that pain and suffering of patients at the end of life are not always well controlled in hospitals.
When it is noted that a patient’s endotracheal tube is not se cured tightened, he respiratory care practitioner assists the nurse in taping the tube. After the tu be is retaped, the nurse auscultates the patient’s lungs and notes that the breath sounds over the left lung fields are absent. The nurse suspects is the cause of this finding?
- A. The endotracheal tube is in the right mainstem bronchus.
- B. The patient has a left pneumothorax.
- C. The patient has aspirated secretions during the proceduarbeir.b .com/test
- D. The stethoscope earpiece is clogged with wax.
Correct Answer: A
Rationale: The correct answer is A: The endotracheal tube is in the right mainstem bronchus. When the endotracheal tube is not secured properly and is retaped, there is a possibility that it may have migrated into the right mainstem bronchus, leading to absent breath sounds in the left lung fields. This condition is known as endobronchial intubation. In such cases, ventilation primarily occurs in the right lung, resulting in decreased or absent breath sounds on the contralateral side. Choices B, C, and D are incorrect as they do not explain the absence of breath sounds over the left lung fields in this specific scenario.