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.
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A nurse has achieved certification in critical care nursing. What is the most important effect that this certification will have on the nurses practice?
- A. Recognition by peers
- B. Increase in salary and rank
- C. More flexibility in seeking employment
- D. Increased confidence in critical thinking
Correct Answer: D
Rationale: The correct answer is D: Increased confidence in critical thinking. Achieving certification in critical care nursing validates the nurse's expertise and knowledge in this specialized area, leading to increased confidence in their ability to critically think through complex patient situations. This confidence translates into improved clinical decision-making and patient outcomes.
A: Recognition by peers - While recognition by peers is important for professional growth, the primary benefit of certification is enhancing clinical skills.
B: Increase in salary and rank - While certification may lead to salary increases in some cases, the most significant impact is on improving clinical skills.
C: More flexibility in seeking employment - While certification may enhance employability, the focus is on improving critical thinking skills rather than employment opportunities.
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.
The patient’s serum creatinine level is 0.7 mg/dL. The expected BUN level should be
- A. 1 to 2 mg/dL.
- B. 7 to 14 mg/dL.
- C. 10 to 20 mg/dL.
- D. 20 to 30 mg/dL.
Correct Answer: C
Rationale: The correct answer is C (10 to 20 mg/dL). The normal BUN-to-creatinine ratio is approximately 10:1. With a serum creatinine level of 0.7 mg/dL, the expected BUN level should be around 7 to 14 mg/dL. Therefore, choice C (10 to 20 mg/dL) falls within this expected range. Choices A, B, and D are incorrect as they do not align with the typical BUN-to-creatinine ratio and would indicate abnormal kidney function.
The nurse is caring for a patient with an arterial monitoring system. The nurse assesses the patient’s noninvasive cuff blood pressure to be 70/40 mm Hg. The arterial blood pressure measurement via an intraarterial catheter in the same arm is assessed by the nurse to be 108/70 mm Hg. What is the best action by the nurse?
- A. Activate the rapid response system.
- B. Place the patient in Trendelenburg position.
- C. Assess the cuff for proper arm size.
- D. Administer 0.9% normal saline bolus.
Correct Answer: C
Rationale: Rationale for Correct Answer (C - Assess the cuff for proper arm size):
1. The cuff blood pressure (70/40 mm Hg) is significantly lower than the arterial blood pressure (108/70 mm Hg).
2. Discrepancy suggests cuff size mismatch, leading to inaccurate readings.
3. Assessing cuff size ensures accurate blood pressure measurement.
4. Ensures appropriate interventions based on accurate readings.
Summary of Incorrect Choices:
A: Rapid response not warranted based solely on blood pressure discrepancy.
B: Trendelenburg position not indicated for cuff size issue.
D: Normal saline bolus not appropriate without accurate blood pressure measurement.
A patient who is orally intubated and receiving mechanical ventilation is anxious and is fighting the ventilator. Which action should the nurse take next?
- A. Verbally coach the patient to breathe with the ventilator.
- B. Sedate the patient with the ordered PRN lorazepam (Ativan).
- C. Manually ventilate the patient with a bag-valve-mask device.
- D. Increase the rate for the ordered propofol (Diprivan) infusion.
Correct Answer: A
Rationale: The correct answer is A: Verbally coach the patient to breathe with the ventilator. This approach allows the nurse to address the patient's anxiety and help them synchronize their breathing with the ventilator, promoting better ventilation and oxygenation. It is important to first try non-invasive interventions before resorting to sedation or manual ventilation. Sedating the patient (B) should be a last resort to avoid potential complications. Manual ventilation (C) may disrupt the ventilator settings and cause respiratory distress. Increasing the rate of propofol infusion (D) is not indicated unless the patient's sedation level is inadequate.