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In assessing a patient, the nurse understands that what sym ptomology is an early sign of hypoxemia?
- A. Clubbing of nail beds
- B. Cyanosis
- C. Hypotension
- D. Restlessness
Correct Answer: D
Rationale: Step 1: Restlessness is an early sign of hypoxemia due to the body's response to low oxygen levels.
Step 2: Restlessness occurs as the body tries to increase oxygen intake.
Step 3: Other choices are incorrect because clubbing and cyanosis are late signs, while hypotension is not a specific early sign of hypoxemia.
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Which statement is true regarding the impact of culture on end-of-life decision making?
- A. African-Americans prefer more conservative, less invaasbiirvbe.c ocma/rtees to ptions during the end of life.
- B. Caucasians prefer aggressive and more invasive care options during the end of life.
- C. Culture and religious beliefs may affect end-of-life decision making.
- D. Perspectives regarding end-of-life care are similar betwabeirebn.c oamn/dte swt ithin religious groups.
Correct Answer: C
Rationale: Rationale:
1. Culture and religious beliefs can significantly impact end-of-life decision making by influencing values, beliefs, and preferences.
2. These factors may affect choices related to treatment options, quality of life, and spiritual aspects.
3. Different cultural backgrounds may lead to varying perspectives on autonomy, family involvement, and medical interventions.
4. Option A and B make generalizations based on race, which is not accurate as preferences can vary widely within any racial group.
5. Option D is incorrect as perspectives on end-of-life care can vary even within the same religious group due to individual beliefs and interpretations.
The nurse is caring for a patient who has an intra-aortic balloon pump in place. Which action should be included in the plan of care?
- A. Position the patient supine at all times.
- B. Avoid the use of anticoagulant medications.
- C. Measure the patient’s urinary output every hour.
- D. Provide a massive range of motion for all extremities.
Correct Answer: C
Rationale: The correct answer is C: Measure the patient’s urinary output every hour. This is crucial because monitoring urinary output is essential in assessing the patient’s renal function and the effectiveness of the intra-aortic balloon pump in improving cardiac output. Hourly measurement helps in early detection of any changes that may indicate complications.
A: Positioning the patient supine at all times is not necessary and can lead to complications.
B: Avoiding the use of anticoagulant medications is not appropriate as they are often necessary to prevent clot formation around the balloon pump.
D: Providing a massive range of motion for all extremities is not recommended for a patient with an intra-aortic balloon pump as it can dislodge the device or cause harm.
The nurse is caring for a mechanically ventilated patient following bilateral lung transplantation. When planning the care of this patient, what is the priority nursing intervention?
- A. Thirty-degree elevation of head of bed
- B. Endotracheal suctioning as needed
- C. Frequent side to side repositioning
- D. Sequential compression stockings
Correct Answer: A
Rationale: The correct answer is A: Thirty-degree elevation of the head of the bed. This is the priority nursing intervention for a mechanically ventilated patient following bilateral lung transplantation because it helps optimize ventilation-perfusion matching, reduces the risk of aspiration, and improves oxygenation. Elevating the head of the bed also decreases the risk of ventilator-associated pneumonia.
B: Endotracheal suctioning as needed is important but not the priority intervention in this case.
C: Frequent side to side repositioning is important for preventing pressure ulcers but is not the priority for a ventilated patient post-lung transplant.
D: Sequential compression stockings are used for preventing deep vein thrombosis, which is important but not the priority in this scenario.
A nurse is the only one in the ICU who has not achieved certification in critical care nursing. She often will ask her fellow nurses what to do in caring for a patient because she doubts the accuracy of her knowledge and her intuition. She loves her work but wishes she could do it with a greater level of competence. What is the most important effect that obtaining certification would likely 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 making decisions
Correct Answer: D
Rationale: The correct answer is D: Increased confidence in making decisions. Obtaining certification in critical care nursing would likely enhance the nurse's knowledge and skills, leading to increased confidence in making clinical decisions. This confidence would stem from the rigorous training and education required to achieve certification, as well as the validation of her expertise in critical care nursing. With increased confidence, the nurse would be more self-assured in her abilities, leading to improved patient care outcomes.
Choice A: Recognition by peers is not the most important effect because while recognition is a positive outcome, it may not directly impact the nurse's ability to provide better patient care.
Choice B: Increase in salary and rank is not the most important effect because while financial benefits are important, the primary focus of obtaining certification should be on improving competence and patient care.
Choice C: More flexibility in seeking employment is not the most important effect because while certification may open up more job opportunities, the main benefit should be on enhancing the nurse's skills and confidence in providing quality
Which statement is true regarding the effects of caring for dying patients on nurses?
- A. Attendance at funerals is inappropriate and will only c reate additional stress in nurses who are already at risk for burnout.
- B. Caring for dying patients is an expected part of nursingab airnb.dco wm/itells tn ot affect the emotional health of the nurse if he or she maintains a p rofessional approach with each patient and family.
- C. Most nurses who work with dying patients are able to balance care needs of patients with personal emotional needs.
- D. Provision of aggressive care to patients for whom they believe it is futile may result in personal ethical conflicts and burnout for nurses.
Correct Answer: D
Rationale: The correct answer, D, is supported by the fact that providing aggressive care to patients when nurses believe it is futile can lead to personal ethical conflicts and burnout. This is because nurses may experience moral distress when their values conflict with the care they are providing. This can result in emotional exhaustion and decreased job satisfaction, ultimately leading to burnout.
Choice A is incorrect because attending funerals can be a way for nurses to process their grief and find closure, rather than creating additional stress. Choice B is incorrect because caring for dying patients can have emotional impacts on nurses, regardless of their professional approach. Choice C is incorrect because balancing care needs with personal emotional needs can be challenging and may not always be achievable.