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All of the patient’s children are distressed by the possibility of removing life-support treatments. The child who is most upset tells the nurse, “T his is the same as killing! I thought you were supposed to help!” What response would the nur se provide to the family?
- A. “This is a process of allowing death to occur naturally after the injuries that were sustained in a serious accident.”
- B. “The hospital would never allow us to do that kind of thing.”
- C. “Let’s talk about this calmly, and I will explain why asasbiirsbt.ecodm s/tuesict ide is appropriate in this case.”
- D. “Your parent lived a long and productive life.”
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Acknowledges the child's distress and concerns.
2. Explains the concept of allowing natural death after serious injuries.
3. Helps the family understand the ethical and medical reasoning behind removing life support.
4. Shows empathy and provides education to address misconceptions.
Summary of other choices:
B: Incorrect - Avoids addressing the family's concerns and provides a vague response.
C: Incorrect - Contains a typo and does not directly address the child's distress or misunderstanding.
D: Incorrect - Irrelevant response that does not address the ethical dilemma at hand.
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The nurse manager is assisting a nurse with improving organizational skills and time management. Which nursing activity is the priority in pre-planning a schedule for selected nursing activities in the daily assignment?
- A. Tracheostomy tube suctioning.
- B. Medication administration.
- C. Colostomy care instruction.
- D. Client personal hygiene.
Correct Answer: B
Rationale: The correct answer is B: Medication administration. This is the priority because medication administration is time-sensitive and crucial for patient safety. It requires precise timing and cannot be delayed. Tracheostomy tube suctioning (A), colostomy care instruction (C), and client personal hygiene (D) are important nursing activities but can be adjusted within the schedule based on patient needs and acuity levels. Prioritizing medication administration ensures that patients receive their medications on time, preventing adverse events and promoting optimal health outcomes.
A Muslim patient has been admitted to the critical care unit with complications after childbirth. Based on the Synergy Model, which nurse would be the most inappropriate to assign to care for this patient?
- A. New graduate female nurse
- B. Most experienced female nurse
- C. New graduate male nurse
- D. Female nurse with postpartum experience
Correct Answer: C
Rationale: Step-by-step rationale:
1. The Synergy Model emphasizes matching nurse competencies with patient needs.
2. A male nurse may not be culturally appropriate for a Muslim female patient due to religious beliefs.
3. Gender segregation is important in Islamic culture, especially concerning intimate care.
4. Therefore, assigning a new graduate male nurse to care for a Muslim female patient in critical condition is the most inappropriate choice.
Summary:
- Choice A is incorrect because being a new graduate does not impact cultural competence.
- Choice B is incorrect as experience does not necessarily make a nurse the best fit for a specific patient.
- Choice D is incorrect as postpartum experience is relevant, but cultural considerations are more critical in this scenario.
As part of nursing management of a critically ill patient, o rders are written to keep the head of the bed elevated at 30 degrees, awaken the patient from se dation each morning to assess readiness to wean from mechanical ventilation, and implement oral care protocols every 4 hours. These interventions are done as a group to reduce thabei rrbi.csokm o/tef svt entilator-associated pneumonia. This group of evidence-based interventions is often referred to using what term?
- A. Bundle of care.
- B. Clinical practice guideline.
- C. Patient safety goal.
- D. Quality improvement initiative.
Correct Answer: A
Rationale: The correct answer is A: Bundle of care. A bundle of care refers to a set of evidence-based interventions that, when implemented together, have been shown to improve patient outcomes. In this scenario, keeping the head of the bed elevated, daily awakening from sedation, and oral care protocols are bundled together to reduce the risk of ventilator-associated pneumonia. This approach is based on the idea that implementing multiple interventions simultaneously is more effective than individual interventions alone.
Choices B, C, and D are incorrect because:
B: Clinical practice guidelines provide recommendations for healthcare providers based on evidence but do not necessarily involve a group of interventions bundled together.
C: Patient safety goals are specific objectives aimed at improving patient safety outcomes, but they do not specifically refer to a group of interventions bundled together.
D: Quality improvement initiatives focus on improving processes and outcomes in healthcare settings but do not necessarily involve a group of interventions bundled together for a specific purpose like in this case.
The VALUE mnemonic is a helpful strategy to enhance communication with family members of critically ill patients. Which of the following statements describes a VALUE strategy?
- A. View the family as guests on the unit.
- B. Acknowledge family emotions.
- C. Learn as much as you can about family structure and f unction.
- D. Use a trained interpreter if the family does not speak English.
Correct Answer: B
Rationale: The correct answer is B: Acknowledge family emotions. This is a key component of the VALUE strategy as it emphasizes empathy and understanding towards the emotions that family members may be experiencing during a difficult time. By acknowledging their emotions, healthcare providers can build trust and establish a supportive relationship with the family.
Choice A is incorrect because the VALUE strategy focuses on treating family members as integral members of the care team, not just as guests. Choice C is incorrect as learning about family structure and function is important but not specifically part of the VALUE strategy. Choice D is incorrect as using a trained interpreter is important for effective communication but is not specific to the VALUE mnemonic.
Slow continuous ultrafiltration is also known as isolated ultrafiltration and is used to
- A. remove plasma water in cases of volume overload.
- B. remove fluids and solutes through the process of convection.
- C. remove plasma water and solutes by adding dialysate.
- D. combine ultrafiltration, convection, and dialysis.
Correct Answer: A
Rationale: The correct answer is A because slow continuous ultrafiltration removes excess plasma water in cases of volume overload by applying a pressure gradient across a semipermeable membrane. This process helps to achieve fluid balance without removing solutes.
Choice B is incorrect because convection is not the primary mechanism of slow continuous ultrafiltration.
Choice C is incorrect as dialysate is not added in slow continuous ultrafiltration.
Choice D is incorrect as slow continuous ultrafiltration does not combine all three processes of ultrafiltration, convection, and dialysis.