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The transplant clinic coordinator is evaluating relatives of a patient with end-stage renal disease, whose blood type is A positive, for suitability as aa bliirvb.icnogm /dteostn or for kidney transplantation. Which family member best qualifies for evaluation?
- A. A 65-year-old brother with a history of hypertension; b lood type A positive
- B. A 35-year-old female with a history of food allergies; blood type O negative
- C. A 14-year-old son, otherwise healthy with no history; blood type B negative
- D. A 70-year-old mother, with a history of sinus infection s; blood type A positive
Correct Answer: D
Rationale: The correct answer is D, the 70-year-old mother with blood type A positive. This choice is the best candidate for evaluation due to her blood type matching the patient's (A positive) for kidney transplantation. Age and medical history are also crucial factors in determining suitability. The 65-year-old brother (choice A) has hypertension, a significant risk factor. The 35-year-old female (choice B) with food allergies may have potential complications. The 14-year-old son (choice C) is underage and might not be a suitable donor due to age and the potential impact on his growth and development. In summary, choice D aligns with the matching blood type and age, making the mother the most suitable candidate for evaluation.
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During the primary survey of a patient with severe leg trauma, the nurse observes that the patient’s left pedal pulse is absent and the leg is swollen. Which action will the nurse take next?
- A. Send blood to the lab for a complete blood count.
- B. Assess further for a cause of the decreased circulation.
- C. Finish the airway, breathing, circulation, and disability survey.
- D. Start normal saline fluid infusion with a large-bore IV line.
Correct Answer: B
Rationale: The correct answer is B: Assess further for a cause of the decreased circulation. The nurse should prioritize assessing the cause of the absent left pedal pulse and leg swelling to address the severe leg trauma effectively. This step involves identifying potential vascular compromise or compartment syndrome, which are critical conditions requiring immediate intervention. Sending blood for a complete blood count (A) is not the priority in this situation. Finishing the primary survey (C) may delay addressing the circulation issue. Starting normal saline infusion (D) without addressing the circulation problem first could potentially worsen the condition. Therefore, assessing further for the cause of decreased circulation is the most appropriate next step to ensure timely and appropriate management of the patient's condition.
The nurse is assisting with endotracheal intubation and un derstands correct placement of the endotracheal tube in the trachea would be identified by which of the following? (Select all that apply.)
- A. Auscultation of air over the epigastrium
- B. Equal bilateral breath sounds upon auscultation
- C. Position above the carina verified by chest x-ray
- D. Positive detection of carbon dioxide (CO
Correct Answer: B
Rationale: The correct answer is B: Equal bilateral breath sounds upon auscultation. This indicates proper placement of the endotracheal tube in the trachea, ensuring both lungs are being ventilated equally.
Rationale:
1. Auscultation of air over the epigastrium (Choice A) is incorrect as it indicates esophageal intubation, not tracheal intubation.
2. Position above the carina verified by chest x-ray (Choice C) is incorrect as it does not confirm proper placement at the trachea.
3. Positive detection of carbon dioxide (CO2) (Choice D) is incorrect as it indicates the presence of exhaled CO2, but not necessarily proper placement in the trachea.
After attending an educational program, the nurse understaanbidrbs.c othma/tte swt hich the following situations would require an ethics consultation?
- A. Conflict has occurred between the primary care provid er and family regarding treatment decisions. A family conference is held, and the family and primary care provider agree to a treatment plan that includes aggres sive treatment for 24 hours followed by re-evaluation.
- B. Family members disagree as to a patient’s course of tre atment. The patient has designated a healthcare proxy and has a written advancaebi rdb.icroemc/tteivste .
- C. A postoperative coronary artery bypass surgery patient was successfully resuscitated after sustaining a cardiopulmonary arrest i n the operating room The patient who is now not responding to treatment has a written advance directive and has a life partner at the bedside.
- D. Patient with multiple trauma and is not responding to treatment. No family members are known, and care is considered futile.
Correct Answer: D
Rationale: Step 1: The correct answer is D because the situation involves a patient with multiple trauma who is not responding to treatment and has no known family members. This indicates a complex ethical dilemma where the medical team may be unsure about the appropriate course of action.
Step 2: In this scenario, an ethics consultation is necessary to help guide decision-making regarding the care of the patient. The lack of available family members complicates decision-making, and the consideration of care as futile adds another layer of complexity.
Step 3: An ethics consultation can provide a structured framework for evaluating the situation, considering ethical principles such as beneficence, non-maleficence, autonomy, and justice. It can help the healthcare team navigate the ethical considerations and make a well-informed decision in the best interest of the patient.
Summary:
Choice A: While conflicts between the primary care provider and family may warrant discussions, the agreement on a treatment plan does not necessarily require an ethics consultation.
Choice B: Disagreement
The nurse recommends that the family of a critically ill patient seek help from the Critical Care Family Assistance Program. What benefit for the family does the nurse anticipate?
- A. Reduction of health care cost
- B. More physical comfort
- C. Multidisciplinary support
- D. Health promotion information
Correct Answer: C
Rationale: The correct answer is C: Multidisciplinary support. The Critical Care Family Assistance Program offers a range of professionals such as social workers, counselors, and financial advisors to provide holistic support to the family. This helps address emotional, financial, and practical needs during a challenging time. Option A is incorrect because the program does not directly reduce healthcare costs. Option B is incorrect as the focus is not solely on physical comfort but on comprehensive support. Option D is incorrect as the primary aim is not health promotion but rather addressing the family's immediate concerns and needs.
The nurse wishes to assess the quality of a patient’s pain. Which questions is appropriate to obtain this assessment if the patient is able to give a verbal response?
- A. “Is the pain constant or intermittent?”
- B. “Is the pain sharp, dull, or crushing?”
- C. “What makes the pain better? Worse?”
- D. “When did the pain start?”
Correct Answer: B
Rationale: The correct answer is B because asking if the pain is sharp, dull, or crushing helps assess the quality of pain, providing specific information on the type of sensation felt. This is crucial for understanding the underlying cause and guiding appropriate treatment.
A: Asking about pain being constant or intermittent addresses duration, not quality.
C: Inquiring about what makes pain better or worse focuses on triggers, not quality.
D: Asking when the pain started addresses onset time, not quality.