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A 100-kg patient gets hemodialysis 3 days a week. In planning the care for this patient, the nurse recommends
- A. a diet of 2500 to 3500 kcal per day.
- B. protein intake of less than 50 grams per day.
- C. potassium intake of 10 mEq per day.
- D. fluid intake of less than 500 mL per day.
Correct Answer: A
Rationale: The correct answer is A: a diet of 2500 to 3500 kcal per day. During hemodialysis, the patient loses nutrients and energy, so a high-calorie diet is necessary to maintain proper nutrition and energy levels. 2500-3500 kcal/day is a suitable range for a 100-kg patient.
Choice B is incorrect because protein intake should be adequate to prevent malnutrition in hemodialysis patients, typically 1.2g/kg body weight/day. Choice C is incorrect as potassium intake should be restricted in hemodialysis patients due to impaired kidney function. Choice D is incorrect because fluid intake should be individualized based on the patient's fluid status and should not be limited to less than 500 mL per day.
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The family of a critically ill patient has asked to discuss organ donation with the patient’s nurse. When preparing to answer the family’s questions, th e nurse understands which concern(s) most often influence a family’s decision to donate? (Select all that apply.)
- A. Donor disfigurement influences on funeral care
- B. Fear of inferior medical care provided to donor
- C. Age and location of all possible organ recipients
- D. Concern that donated organs will not be used
Correct Answer: A
Rationale: Rationale for Correct Answer A: Donor disfigurement influences on funeral care. Families often consider the impact of organ donation on the appearance of their loved one during funeral arrangements. This concern can significantly influence their decision to donate.
Incorrect Answers:
B: Fear of inferior medical care provided to donor. This is not a common concern as medical care for donors is typically of high quality.
C: Age and location of all possible organ recipients. While important, this is not a primary concern for families when deciding on organ donation.
D: Concern that donated organs will not be used. Families are generally more concerned about the impact on their loved one's appearance post-donation rather than the utilization of organs.
All of the patient’s children are distressed by the possibility of removing life-support treatments. The child who is most upset tells the nurse, “T his is the same as killing! I thought you were supposed to help!” What response would the nur se provide to the family?
- A. “This is a process of allowing death to occur naturally after the injuries that were sustained in a serious accident.”
- B. “The hospital would never allow us to do that kind of thing.”
- C. “Let’s talk about this calmly, and I will explain why asasbiirsbt.ecodm s/tuesict ide is appropriate in this case.”
- D. “Your parent lived a long and productive life.”
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Acknowledges the child's distress and concerns.
2. Explains the concept of allowing natural death after serious injuries.
3. Helps the family understand the ethical and medical reasoning behind removing life support.
4. Shows empathy and provides education to address misconceptions.
Summary of other choices:
B: Incorrect - Avoids addressing the family's concerns and provides a vague response.
C: Incorrect - Contains a typo and does not directly address the child's distress or misunderstanding.
D: Incorrect - Irrelevant response that does not address the ethical dilemma at hand.
The nurse is caring for a critically ill patient with a very concerned family. Given that the family is under high stress, what nursing intervention will best ameliorate their stress while preserving independence?
- A. Encourage the family to participate in patient care tasks.
- B. Teach the family to ask questions of the health care team.
- C. Ask the family to select a family representative for communication.
- D. Limit visits to immediate family members for limited times.
Correct Answer: A
Rationale: The correct answer is A: Encourage the family to participate in patient care tasks. This intervention helps to alleviate stress by involving the family in care, promoting a sense of control and empowerment. It also fosters a collaborative relationship between the family and healthcare team. The other choices are incorrect because B only focuses on asking questions but doesn't actively involve the family in care. C may add pressure on the selected representative and exclude others. D limits family involvement and may increase stress by restricting visitation.
The American Nurses Credential Center Magnet Recognition Program supports many actions to ensure that nurses are engaged and empowered to participate in ethical decision making. Which of the following would assist nurses in being involvabeirdb .icnom r/etesset arch studies?
- A. Education on protection of human subjects
- B. Participation of staff nurses on ethics committees
- C. Written descriptions of how nurses participate in ethic s programs
- D. Written policies and procedures related to response to ethical issues
Correct Answer: A
Rationale: Rationale:
A: Education on protection of human subjects is crucial for nurses to understand ethical principles when conducting research studies. It ensures compliance with ethical guidelines and protection of research participants.
B: Participation of staff nurses on ethics committees is not directly related to conducting research studies and may not specifically involve protection of human subjects.
C: Written descriptions of how nurses participate in ethics programs do not necessarily focus on research studies and may not cover the specific ethical considerations required in research.
D: Written policies and procedures related to response to ethical issues are important but may not provide the necessary knowledge on protection of human subjects for conducting research studies.
A patient nearing death experiences increased secretions and noisy breathing. What is the nurse’s priority intervention?
- A. Provide suctioning every hour.
- B. Administer anticholinergic medications as prescribed.
- C. Elevate the head of the bed and reposition frequently.
- D. Restrict oral intake to minimize secretions.
Correct Answer: B
Rationale: The correct answer is B: Administer anticholinergic medications as prescribed. Anticholinergic medications can help dry up secretions and improve breathing in a patient nearing death. This intervention targets the underlying cause of increased secretions. Suctioning (choice A) may provide temporary relief but does not address the root issue. Elevating the head of the bed and repositioning (choice C) can help with comfort but do not directly address the secretions. Restricting oral intake (choice D) may lead to dehydration and discomfort without effectively managing the secretions. Administering anticholinergic medications is the priority as it directly targets the symptom of increased secretions, improving the patient's comfort and quality of life.