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The nurse is caring for a patient who requires administration of a neuromuscular blocking (NMB) agent to facilitate ventilation with non-traditional m odes. The nurse understands that neuromuscular blocking agents provide what outcome?
- A. Lessened antianxiety
- B. Complete analgesia.
- C. High levels of sedation.
- D. No sedation or analgesia.
Correct Answer: D
Rationale: The correct answer is D: No sedation or analgesia. Neuromuscular blocking agents do not provide sedation or pain relief; they solely act on skeletal muscles to induce paralysis for procedures like intubation. Choice A is incorrect because NMB agents do not affect anxiety levels. Choice B is incorrect because NMB agents do not provide analgesia. Choice C is incorrect because NMB agents do not induce sedation. The primary purpose of NMB agents is to induce muscle paralysis without affecting consciousness or pain perception.
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One of the strategies shown to reduce perception of stress in critically ill patients and their families is support of spirituality. What nursing action is most clearly supportive of the patients spirituality?
- A. Referring patients to the Catholic chaplain
- B. Providing prayer booklets to patients and families
- C. Asking about beliefs about the universe
- D. Avoiding discussing religion with those of other faiths
Correct Answer: C
Rationale: The correct answer is C because asking about beliefs about the universe allows the nurse to understand the patient's spiritual needs and provide appropriate support. This action shows respect for the patient's beliefs and can help establish a connection between the patient and the nurse. Referring patients to a specific religious figure (choice A) may not align with the patient's beliefs. Providing prayer booklets (choice B) assumes the patient's belief system and may not be helpful. Avoiding discussing religion (choice D) can hinder the nurse-patient relationship and overlook potential sources of support for the patient.
Which is likely the most common recollection from a patie nt who required endotracheal intubation and mechanical ventilation?
- A. Difficulty communicating
- B. Inability to get comfortable
- C. Pain
- D. Sleep disruption
Correct Answer: A
Rationale: The correct answer is A: Difficulty communicating. When a patient undergoes endotracheal intubation and mechanical ventilation, they are unable to speak normally. This leads to frustration and anxiety due to the inability to communicate effectively with healthcare providers and loved ones. The lack of communication can also impact their emotional well-being. Choices B, C, and D are less likely as the most common recollection because patients might not remember feeling uncomfortable, experiencing pain, or having sleep disruption during sedation and ventilation. Additionally, the inability to communicate is a primary concern for patients in this situation.
A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which additional assessment should the nurse make?
- A. Has the client experienced constipation recently?
- B. Did the client miss any doses of the medication?
- C. How long has the client been taking the medication?
- D. Does the client use any tobacco products?
Correct Answer: C
Rationale: The correct answer is C. Assessing how long the client has been taking clonidine is crucial as drowsiness is a common side effect that typically improves over time as the body adjusts to the medication. This information helps determine if the drowsiness is a temporary side effect or a more concerning issue.
Choice A (constipation) is not directly related to drowsiness as a side effect of clonidine. Choice B (missed doses) may contribute to drowsiness but is not the primary assessment priority. Choice D (tobacco use) is not directly related to clonidine-induced drowsiness.
A critically ill patient is not expected to survive this admission. The family asks the nurse how the patient is doing. When answering this question, what should the nurse include?
- A. Emphasize that the patient is young and strong and may still survive.
- B. Refer the family to the physician for all details and answers.
- C. Give specific information such as descending trends in parameters.
- D. Ask if the family has determined which funeral home will be called.
Correct Answer: C
Rationale: The correct answer is C because providing specific information such as descending trends in parameters helps the family understand the patient's condition objectively. This allows them to prepare emotionally and make informed decisions. Option A is incorrect because false hope should not be given. Option B is not the best approach as the nurse should still provide some information to the family. Option D is inappropriate and insensitive as it focuses on funeral arrangements rather than addressing the family's concerns about the patient's condition.
The nurse is caring for a patient with acute respiratory dist ress syndrome who is hypoxemic despite mechanical ventilation. The primary care provider (PCP) orders a nontraditional ventilator mode as part of treatment. Despite sedation and aabnirba.lcgoems/tieas,t the patient remains restless and appears to be in discomfort. The nurse informs the PCP of this assessment and anticipates what order?
- A. Continuous lateral rotation therapy
- B. Guided imagery
- C. Neuromuscular blockade
- D. Prone positioning
Correct Answer: C
Rationale: The correct answer is C: Neuromuscular blockade.
1. Neuromuscular blockade helps to achieve optimal ventilator synchrony by reducing patient-ventilator asynchrony and improving oxygenation in patients with acute respiratory distress syndrome (ARDS).
2. Despite sedation, the patient's restlessness and discomfort suggest inadequate ventilator synchrony, which can be addressed by neuromuscular blockade.
3. Continuous lateral rotation therapy (A) and prone positioning (D) are interventions for improving ventilation and oxygenation in ARDS but do not directly address patient-ventilator synchrony.
4. Guided imagery (B) is a non-pharmacological technique for relaxation and pain management, which may not address the underlying issue of ventilator synchrony in this case.