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The nurse is assisting with endotracheal intubation of the p atient and recognizes that the procedure will be done in what order? (Put a comma and s pace between each answer choice.)
- A. Assess balloon on endotracheal tube for symmetry and laebairkb.sc.o m/test
- B. Assess lung fields for bilateral expansion.
- C. Inflate balloon of endotracheal tube.
- D. Insert endotracheal tube with laryngoscope and blade.
Correct Answer: D
Rationale: The correct answer is D. The first step in endotracheal intubation is to insert the endotracheal tube with a laryngoscope and blade to visualize the vocal cords and guide the tube into the trachea. This ensures proper placement of the tube for effective ventilation. Assessing the balloon symmetry (Choice A) and lung fields (Choice B) would come after the tube is successfully inserted. Inflating the balloon of the endotracheal tube (Choice C) should be the last step to secure the tube in place.
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The patient’s partner, experiencing anticipatory grieving, tells the nurse, “I don’t see any point in continuing to visit at the bedside, since it’s like I’m not even here.” What is the nurse’s best response to the partner’s statement?
- A. “You’re right, there is no awareness of anything going on now.”
- B. “Unresponsiveness doesn’t mean the sense of hearing is gone and there is a benefit from you being present.”
- C. “I’ll call you if the patient begins responding again.”
- D. “Why don’t you check to see if any other family memb er would like to visit?”
Correct Answer: B
Rationale: The correct answer is B because it acknowledges the partner's feelings while providing information that may help them cope. By stating that unresponsiveness doesn't mean the patient can't hear, the nurse highlights the importance of the partner's presence for emotional support. It encourages the partner to continue visiting, emphasizing their role in providing comfort to the patient.
Choice A is incorrect as it dismisses the partner's feelings and lacks empathy. Choice C is incorrect as it implies the nurse will only involve the partner if the patient responds, neglecting the partner's emotional needs. Choice D is incorrect as it deflects responsibility from addressing the partner's concerns and suggests involving other family members without addressing the partner's feelings directly.
The nurse is caring for a mechanically ventilated patient. T he primary care providers are considering performing a tracheostomy because the patienatb iirsb .hcoamv/itensgt difficulty weaning from mechanical ventilation. Related to tracheostomy, the nurse understands which of the following?
- A. Patient outcomes are better if the tracheostomy is done within a week of intubation.
- B. Percutaneous tracheostomy can be done safely at the b edside by the respiratory therapist.
- C. Procedures performed in the operating room are associaabtirebd.c owmi/ttehs tf ewer complications.
- D. The greatest risk after a percutaneous tracheostomy is accidental decannulation.
Correct Answer: C
Rationale: The correct answer is C: Procedures performed in the operating room are associated with fewer complications. This is because performing a tracheostomy in the operating room allows for better control of the environment, equipment, and expertise of the surgical team. In this setting, the risk of complications such as bleeding, infection, and injury to surrounding structures is minimized.
Choices A, B, and D are incorrect:
A: Patient outcomes are better if the tracheostomy is done within a week of intubation - This statement is not universally true and depends on individual patient factors. Timing of tracheostomy should be based on the patient's clinical condition and not a set timeline.
B: Percutaneous tracheostomy can be done safely at the bedside by the respiratory therapist - While percutaneous tracheostomy can be performed at the bedside, it is typically done by a trained physician or surgeon due to the potential risks and complications involved.
D: The greatest risk after a per
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.
A patient in hospice care is experiencing dyspnea. What is the most appropriate nursing intervention?
- A. Position the patient flat on their back.
- B. Administer oxygen as prescribed.
- C. Restrict fluid intake to reduce congestion.
- D. Perform chest physiotherapy to improve breathing.
Correct Answer: B
Rationale: The correct answer is B: Administer oxygen as prescribed. Dyspnea in a hospice patient often indicates respiratory distress, and administering oxygen can help improve oxygenation and alleviate breathing difficulty. Positioning the patient flat on their back (A) may worsen dyspnea due to increased pressure on the diaphragm. Restricting fluid intake (C) is not appropriate as dehydration can exacerbate respiratory distress. Chest physiotherapy (D) may not be suitable for a hospice patient experiencing dyspnea as it can be physically taxing and may not address the underlying cause effectively.
A young man has just arrived at the ICU from out of town and received news that his girlfriend, who is admitted there, likely only has a few days left to live. Which of the following would be the best approach for the nurse to take in caring for the needs of this young man?
- A. Recommending that he go home and rest
- B. Giving him unrestricted visiting hours with the patient
- C. Suggesting that he meet with the hospital chaplain
- D. Recommending that he ask the doctor to evaluate the patients pain control measures
Correct Answer: C
Rationale: The correct answer is C: Suggesting that he meet with the hospital chaplain. This approach is best as it addresses the young man's emotional and spiritual needs during a difficult time. The chaplain can provide comfort, support, and guidance in coping with his girlfriend's situation. This option focuses on holistic care and acknowledges the importance of emotional well-being.
A: Recommending that he go home and rest is not the best approach as it dismisses the young man's emotional distress.
B: Giving him unrestricted visiting hours with the patient may not be appropriate as it can be overwhelming and may not address his emotional needs effectively.
D: Recommending that he ask the doctor to evaluate the patient's pain control measures is important but does not directly address the young man's emotional needs in this situation.