Nokea
The nurse wishes to increase the use of evidence-based practice in the critical care unit where he works. What is a significant barrier to the implementation of evidence-based practice?
- A. Use of computerized records by the hospital
- B. Health Information Privacy and Portability Act (HIPPA)
- C. Lack of knowledge about literature searches
- D. Strong collaborative relationships in the work setting
Correct Answer: C
Rationale: Rationale:
The correct answer is C because lack of knowledge about literature searches hinders the ability to find and utilize evidence-based practice guidelines. Nurses need to be skilled in conducting literature searches to access relevant research. Choices A, B, and D are incorrect as they do not directly impede the implementation of evidence-based practice in the critical care unit.
You may also like to solve these questions
A patient declared brain dead is an organ donor. The following events occur: 1300 Diagnostic tests for brain death are completed. 1330 primary care provider reviews diagnostic test results and writes in the progress note that the patient is brain deaadb.i r1b.4co0m0/ tePsat tient is taken to the operating room for organ retrieval. 1800 All organs have b een retrieved for donation. The ventilator is discontinued. 1810 Cardiac monitor shows fla tline. What is the official time of death recorded in the medical record?
- A. 1300
- B. 1330
- C. 1400
- D. 1800
Correct Answer: E
Rationale: The correct answer is not provided, but based on the events described, the official time of death recorded in the medical record should be 1810 (Choice D). At this time, the cardiac monitor shows flatline, indicating the cessation of cardiac activity, which is the universally accepted point of declaring death.
Choice A (1300) is incorrect because that is when diagnostic tests for brain death were completed, but the patient was not officially declared dead at that time.
Choice B (1330) is incorrect as this is when the primary care provider reviewed the test results and documented brain death in the progress note, but the patient was not officially declared dead at this time either.
Choice C (1400) is incorrect as there is no significant event occurring at this time that signifies the patient's death.
Therefore, the most appropriate and official time of death recorded in the medical record would be 1810 when the cardiac monitor shows flatline.
The nurse is caring for a patient with acute kidney injury who is being treated with hemodialysis. The patient asks if he will need dialysis for the rest of his life. Which of the following would be the best response?
- A. “Unfortunately, kidney injury is not reversible; it is permanent.”
- B. “Kidney function usually returns within 2 weeks.”
- C. “You will know for sure if you start urinating a lot all at once.”
- D. “Recovery is possible, but it may take several months.”
Correct Answer: D
Rationale: The correct answer is D: “Recovery is possible, but it may take several months.” This response is the best choice as it provides a balanced and accurate explanation to the patient. Here's the rationale:
1. Hemodialysis is often used as a temporary measure to support kidney function while allowing time for the kidneys to recover.
2. Acute kidney injury can be reversible in some cases, especially if the underlying cause is identified and treated promptly.
3. Recovery time varies for each individual, and it can indeed take several months for kidney function to improve.
4. Choices A, B, and C are incorrect:
- A is overly pessimistic and does not consider the potential for recovery.
- B provides a specific timeframe that may not be accurate for all patients.
- C is not a reliable indicator of kidney function recovery and may lead to confusion.
A patient who has been diagnosed with inoperable lung cancer and has a poor prognosis plans a trip across the country to settle some issues with their siblings. The nurse recognizes that the patient is manifesting which psychosocial response to death?
- A. Restlessness.
- B. Yearning and protest.
- C. Anxiety about unfinished business.
- D. Fear of the meaninglessness of one’s life.
Correct Answer: C
Rationale: The correct answer is C: Anxiety about unfinished business. The patient's desire to settle issues with their siblings before death indicates a concern about unresolved matters. This response aligns with the concept of psychosocial responses to death, specifically the need for closure and resolution. Restlessness (choice A) may not necessarily indicate a specific focus on unfinished business. Yearning and protest (choice B) typically refer to the initial stages of grief, not specifically related to settling unresolved issues. Fear of the meaninglessness of one's life (choice D) is more existential and philosophical, whereas the patient's focus here is on addressing specific issues with their siblings.
Which assessment would cue the nurse to the potential of aa bc iru bt .ce o mre /ts ep sti ratory distress syndrome (ARDS) in a patient admitted with respiratory distress?
- A. Increased oxygen saturation via pulse oximetry
- B. Increased peak inspiratory pressure on the ventilator
- C. Normal chest radiograph with enlarged cardiac structures
- D. PaO /FiO ratio > 300 2 2
Correct Answer: B
Rationale: The correct answer is B. Increased peak inspiratory pressure on the ventilator would cue the nurse to the potential of ARDS in a patient with respiratory distress. ARDS is characterized by severe respiratory failure with bilateral pulmonary infiltrates. An increase in peak inspiratory pressure on the ventilator indicates that the lungs are becoming stiffer, which is a common finding in ARDS due to increased inflammation and fluid accumulation in the alveoli. This finding alerts the nurse to the possibility of ARDS and the need for further assessment and intervention.
Summary of other choices:
A: Increased oxygen saturation via pulse oximetry is a nonspecific finding and may not specifically indicate ARDS.
C: Normal chest radiograph with enlarged cardiac structures is more indicative of heart failure rather than ARDS.
D: PaO2/FiO2 ratio > 300 is a criterion used to diagnose ARDS, but a value higher than 300 actually indicates mild ARDS, so it would not necessarily cue the nurse
The nurse is caring for a patient whose ventilator settings i nclude 15 cm H O of positive end-expiratory pressure (PEEP). The nurse understands that although beneficial, PEEP may result in what possible problem?
- A. Fluid overload secondary to decreased venous return.
- B. High cardiac index secondary to more efficient ventric ular function.
- C. Hypoxemia secondary to prolonged positive pressure a t expiration.
- D. Low cardiac output secondary to increased intrathoracic pressure
Correct Answer: D
Rationale: Rationale for Correct Answer (D - Low cardiac output secondary to increased intrathoracic pressure):
1. PEEP increases intrathoracic pressure, which can impede venous return to the heart.
2. Impaired venous return reduces preload, leading to decreased cardiac output.
3. Decreased cardiac output can result in inadequate tissue perfusion and oxygenation.
4. Therefore, PEEP may cause low cardiac output due to increased intrathoracic pressure.
Summary of Incorrect Choices:
A. Fluid overload is not directly related to PEEP but more to fluid administration or kidney function.
B. High cardiac index is unlikely as PEEP can decrease cardiac output.
C. Hypoxemia is not a direct result of PEEP but may occur due to other factors like inadequate ventilation or oxygenation settings.