Nokea
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.
You may also like to solve these questions
Which of the following are physiological effects of positive end-expiratory pressure (PEEP) used in the treatment of acute respiratory distress syndrom e (ARDS)? (Select all that apply.)
- A. Increase functional residual capacity
- B. Prevent collapse of unstable alveoli
- C. Improve arterial oxygenation
- D. Open collapsed alveoli
Correct Answer: A
Rationale: The correct answer is A: Increase functional residual capacity. Positive end-expiratory pressure (PEEP) helps increase the functional residual capacity by keeping the alveoli open at the end of expiration. This prevents alveolar collapse, improves ventilation-perfusion matching, and enhances oxygenation.
B: Prevent collapse of unstable alveoli - This is incorrect because PEEP actually helps prevent the collapse of all alveoli, not just unstable ones.
C: Improve arterial oxygenation - This is partially correct, but the primary mechanism through which PEEP improves oxygenation is by increasing functional residual capacity.
D: Open collapsed alveoli - This is incorrect because PEEP helps prevent alveolar collapse rather than actively opening already collapsed alveoli.
A patient is declared brain dead and a do not resuscitate (DNR) order is put in place. The nurse caring for the patient does not agree with this manne r of care but does not express any concerns to the charge nurse. The nurse’s feeling that the p atient is being killed will likely create what response for this nurse?
- A. A sense of abandonment
- B. Increased family stress
- C. Moral distress
- D. A sense of negligence
Correct Answer: C
Rationale: The correct answer is C: Moral distress. In this scenario, the nurse is experiencing conflicting moral values between the decision made for the patient and their own beliefs. This internal conflict leads to moral distress, a common response when healthcare professionals feel unable to act in accordance with their ethical beliefs. This can lead to emotional turmoil, frustration, and moral residue.
A: A sense of abandonment is incorrect because the nurse is still caring for the patient, so there is no physical abandonment.
B: Increased family stress is incorrect as the nurse's internal conflict does not directly impact family stress.
D: A sense of negligence is incorrect as negligence implies failure to provide proper care, which is not the case here.
In the critically ill patient, an incomplete assessment and/or management of pain or anxiety may be hampered by which of the following? (Select all that apply.)
- A. Administration of neuromuscular blocking agents
- B. Delirium
- C. Effective nurse communication and assessment skills
- D. Nonverbal patients
Correct Answer: A
Rationale: Step-by-step rationale:
1. Administration of neuromuscular blocking agents can hinder pain or anxiety assessment as it paralyzes the patient, preventing them from communicating discomfort.
2. Delirium may affect the patient's ability to express pain or anxiety, but it does not directly impede assessment and management.
3. Effective nurse communication and assessment skills facilitate, rather than hamper, pain or anxiety assessment.
4. Nonverbal patients can still communicate pain or anxiety through nonverbal cues, so they do not necessarily hinder assessment.
A statement that provides a legally recognized descriptiona obifrb a.cno min/tedsitv idual’s desires regarding care at the end of life is referred to as what?
- A. Advance directive
- B. Guardianship ad item
- C. Healthcare proxy
- D. Power of attorney
Correct Answer: A
Rationale: The correct answer is A: Advance directive. An advance directive is a legal document that outlines a person's wishes regarding medical treatment and care at the end of life. It allows individuals to specify their preferences for medical interventions if they become unable to communicate.
Summary of other choices:
B: Guardianship ad item - This does not specifically pertain to an individual's end-of-life care wishes.
C: Healthcare proxy - While similar to an advance directive, a healthcare proxy specifically designates a person to make medical decisions on behalf of the individual, rather than specifying their own wishes.
D: Power of attorney - This grants someone the authority to make legal decisions on behalf of the individual, but it does not specifically address end-of-life care preferences.
A 28-year-old patient who has deep human bite wounds on the left hand is being treated in the urgent care center. Which action will the nurse plan to take?
- A. Prepare to administer rabies immune globulin (BayRab).
- B. Assist the health care provider with suturing the bite wounds.
- C. Teach the patient the reason for the use of prophylactic antibiotics.
- D. Keep the wounds dry until the health care provider can assess them.
Correct Answer: C
Rationale: The correct answer is C: Teach the patient the reason for the use of prophylactic antibiotics. This is the most important action because human bites can introduce harmful bacteria into the wound, leading to infection. Prophylactic antibiotics help prevent infection in deep human bite wounds.
Choice A is incorrect because rabies immune globulin is not indicated for human bite wounds. Choice B is incorrect because suturing human bite wounds can trap bacteria and increase the risk of infection. Choice D is incorrect because keeping the wounds dry is not sufficient; proper wound cleaning and antibiotic treatment are essential in this case.