Nokea
The nurse is educating a group of nursing students about end-of-life care. Which statement by a student indicates the need for further teaching?
- A. Terminally ill patients may benefit from around-the-clock analgesics.
- B. Hospice care can be initiated when curative treatment is no longer effective.
- C. Hydration and nutrition should always be maintained until the patient dies.
- D. Emotional support is a key component of end-of-life care.
Correct Answer: C
Rationale: The correct answer is C because maintaining hydration and nutrition until the patient dies is not always appropriate in end-of-life care, as some patients may be unable to tolerate oral intake or may be close to the end of life where artificial nutrition and hydration may not provide benefit and may even cause discomfort.
Explanation:
A: A is correct because terminally ill patients may indeed benefit from continuous pain management to ensure comfort.
B: B is correct because hospice care is typically initiated when curative treatment is no longer effective and focuses on providing comfort and quality of life.
D: D is correct because emotional support is crucial in end-of-life care to address the patient's psychological well-being and provide comfort.
In summary, choice C is incorrect as it does not consider individual patient needs and preferences in end-of-life care.
You may also like to solve these questions
Which of the following is a National Patient Safety Goal? a(bSirebl.ceocmt /taelslt that apply.)
- A. Accurately identify patients.
- B. Eliminate use of patient restraints.
- C. Reconcile medications across the continuum of care.
- D. Reduce risks of healthcare-acquired infection.
Correct Answer: A
Rationale: Rationale: Accurately identifying patients is a National Patient Safety Goal to prevent errors in patient care. Proper patient identification ensures correct treatments and medications are given, reducing harm. Restraint elimination, medication reconciliation, and infection reduction are important goals but not specific National Patient Safety Goals. Accurate patient identification directly addresses patient safety concerns.
A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min. Spontaneous reabsiprbi.rcaotmio/tensst are 12 breaths/min. After receiving a dose of morphine sulfate, respirations decrease to 4 breaths/min. Which acid-base disturbance will likely occur?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: D
Rationale: The correct answer is D (Respiratory alkalosis). Morphine sulfate can cause respiratory depression, leading to decreased respiratory rate. In this case, the patient's breaths decrease from 12 to 4 breaths/min, indicating hypoventilation. With decreased ventilation, there is less CO2 elimination, resulting in respiratory alkalosis. The other choices can be ruled out: A (Metabolic acidosis) and B (Metabolic alkalosis) are less likely caused by morphine sulfate, and C (Respiratory acidosis) is incorrect because the scenario describes hypoventilation, not hyperventilation.
The nurse is assessing the exhaled tidal volume (EV ) in a mechanically ventilated patient. T What is the rationale for this assessment?
- A. Assess for tension pneumothorax.
- B. Assess the level of positive end-expiratory pressure.
- C. Compare the tidal volume delivered with the tidal volu me prescribed.
- D. Determine the patient’s work of breathing.
Correct Answer: D
Rationale: The correct answer is D: Determine the patient’s work of breathing. Assessing the exhaled tidal volume (EV) in a mechanically ventilated patient helps determine how much effort the patient is exerting to breathe. By monitoring the EV, the nurse can evaluate the patient's respiratory status and adjust ventilator settings if needed. It is crucial to ensure that the patient is not working too hard to breathe, as this can lead to respiratory distress.
Incorrect answers:
A: Assess for tension pneumothorax - Tension pneumothorax is typically assessed through other means such as physical examination and chest X-ray.
B: Assess the level of positive end-expiratory pressure - The level of positive end-expiratory pressure is usually set based on the patient's condition and not solely based on the exhaled tidal volume.
C: Compare the tidal volume delivered with the tidal volume prescribed - This comparison is important but does not directly relate to assessing the patient's work of breathing.
The family is considering withdrawing life-sustaining measures from the patient. The nurse knows that ethical principles for withholding or withdrawi ng life-sustaining treatments include which of the following?
- A. Any treatment may be withdrawn and withheld, includ ing nutrition, antibiotics, and blood products.
- B. Doses of analgesic and anxiolytic medications must be adjusted carefully and should not exceed usual recommended limits.
- C. Life-sustaining treatments may be withdrawn while a patient is receiving paralytic agents.
- D. The goal of withdrawal and withholding of treatments is to hasten death and thus relieve suffering.
Correct Answer: A
Rationale: The correct answer is A because it aligns with the ethical principle of patient autonomy, which emphasizes the patient's right to make decisions about their own care. Withholding or withdrawing life-sustaining treatments, including nutrition, antibiotics, and blood products, respects the patient's autonomy. This choice also reflects the principle of beneficence, as it aims to prevent unnecessary suffering and respects the patient's wishes.
Option B is incorrect because it focuses on pain and anxiety management rather than the broader ethical considerations of withholding life-sustaining treatments.
Option C is incorrect because withdrawing life-sustaining treatments while a patient is receiving paralytic agents can pose additional risks and complications, potentially conflicting with the principles of nonmaleficence and beneficence.
Option D is incorrect because the primary goal of withdrawing or withholding treatments is not to hasten death but to respect the patient's autonomy and quality of life. This choice does not align with the ethical principles of patient-centered care.
What is the most critical element of effective early end-of-life decision making?
- A. Control of distressing symptoms such as nausea, anxie ty, and pain.
- B. Effective communication between the patient, family, aabnirdb. choema/tletsht care team throughout the course of the illness.
- C. Organizational support of palliative care principles.
- D. Relocation the dying patient from the critical care unit to a lower level of care.
Correct Answer: B
Rationale: The correct answer is B because effective communication ensures that the patient's wishes and values are understood and respected, leading to informed decision-making. It also promotes shared decision-making among the patient, family, and healthcare team, enhancing the quality of care. Choices A, C, and D are incorrect because while they are important aspects of end-of-life care, they do not address the core element of communication in facilitating meaningful and informed decisions.