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Upon entering the room of a patient with a right radial arte rial line, the nurse assesses the waveform to be slightly dampened and notices blood to bea bbirabc.ckoemd/te ustp into the pressure tubing. What is the best action by the nurse?
- A. Check the inflation volume of the flush system pressur e bag.
- B. Disconnect the flush system from the arterial line catheter.
- C. Zero reference the transducer system at the phlebostati c axis. WWWWWW ..TTHHEENNUURRSSIINNGGMMAASSTTEERRYY..CCOOMM
- D. Reduce the number of stopcocks in the flush system tubing.
Correct Answer: B
Rationale: The correct answer is B: Disconnect the flush system from the arterial line catheter. This action is necessary to prevent air from entering the patient's bloodstream, which can lead to air embolism. By disconnecting the flush system, the nurse stops the flow of air and ensures patient safety. Checking the inflation volume of the pressurized bag (A) is not the immediate concern in this situation. Zero referencing the transducer system (C) is unrelated to the issue of air entering the arterial line. Reducing the number of stopcocks in the flush system tubing (D) does not address the immediate risk of air embolism.
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Gastric lavage and administration of activated charcoal are ordered for an unconscious patient who has been admitted to the emergency department (ED) after ingesting 30 lorazepam (Ativan) tablets. Which action should the nurse plan to do first?
- A. Insert a large-bore orogastric tube.
- B. Assist with the intubation of the patient.
- C. Prepare a 60-mL syringe with saline.
- D. Give the first dose of activated charcoal.
Correct Answer: B
Rationale: The correct answer is B: Assist with the intubation of the patient. In this scenario, the patient is unconscious and has ingested a potentially harmful substance. Intubation is the first priority to maintain the patient's airway and ensure adequate oxygenation. This step is crucial in preventing aspiration of gastric contents and securing the patient's respiratory status. Inserting a large-bore orogastric tube (choice A) is not the priority as airway management takes precedence. Preparing a syringe with saline (choice C) is unnecessary at this stage. Giving the first dose of activated charcoal (choice D) should only be done after securing the airway to prevent aspiration.
Which strategy is important to addressing issues associated with the aging workforce? (Select all that apply.)
- A. Allowing nurses to work flexible shift durations
- B. Encouraging older nurses to transfer to an outpatient se tting that is less stressful
- C. Hiring nurse technicians that are available to assist wit h patient care, such as turning the patient
- D. Developing a staffing model that accurately reflects th e unit’s needs.
Correct Answer: A
Rationale: The correct answer is A: Allowing nurses to work flexible shift durations. This strategy is important in addressing issues associated with the aging workforce because it acknowledges the changing needs and preferences of older nurses. By offering flexible shift durations, older nurses can better manage their work-life balance, reduce physical strain, and continue contributing to the workforce effectively.
Choices B, C, and D are incorrect because they do not directly address the specific needs of the aging workforce. Encouraging older nurses to transfer to a less stressful outpatient setting may not align with their career goals. Hiring nurse technicians to assist with patient care may not address the unique experience and expertise of older nurses. Developing a staffing model, while important, does not specifically cater to the needs of aging nurses in terms of flexibility and support.
A nurse is the only one in the ICU who has not achieved certification in critical care nursing. She often will ask her fellow nurses what to do in caring for a patient because she doubts the accuracy of her knowledge and her intuition. She loves her work but wishes she could do it with a greater level of competence. What is the most important effect that obtaining certification would likely have on the nurses practice?
- A. Recognition by peers
- B. Increase in salary and rank
- C. More flexibility in seeking employment
- D. Increased confidence in making decisions
Correct Answer: D
Rationale: The correct answer is D: Increased confidence in making decisions. Obtaining certification in critical care nursing would likely enhance the nurse's knowledge and skills, leading to increased confidence in making clinical decisions. This confidence would stem from the rigorous training and education required to achieve certification, as well as the validation of her expertise in critical care nursing. With increased confidence, the nurse would be more self-assured in her abilities, leading to improved patient care outcomes.
Choice A: Recognition by peers is not the most important effect because while recognition is a positive outcome, it may not directly impact the nurse's ability to provide better patient care.
Choice B: Increase in salary and rank is not the most important effect because while financial benefits are important, the primary focus of obtaining certification should be on improving competence and patient care.
Choice C: More flexibility in seeking employment is not the most important effect because while certification may open up more job opportunities, the main benefit should be on enhancing the nurse's skills and confidence in providing quality
Which statement is true regarding the impact of culture on end-of-life decision making?
- A. African-Americans prefer more conservative, less invaasbiirvbe.c ocma/rtees to ptions during the end of life.
- B. Caucasians prefer aggressive and more invasive care options during the end of life.
- C. Culture and religious beliefs may affect end-of-life decision making.
- D. Perspectives regarding end-of-life care are similar betwabeirebn.c oamn/dte swt ithin religious groups.
Correct Answer: C
Rationale: Rationale:
1. Culture and religious beliefs can significantly impact end-of-life decision making by influencing values, beliefs, and preferences.
2. These factors may affect choices related to treatment options, quality of life, and spiritual aspects.
3. Different cultural backgrounds may lead to varying perspectives on autonomy, family involvement, and medical interventions.
4. Option A and B make generalizations based on race, which is not accurate as preferences can vary widely within any racial group.
5. Option D is incorrect as perspectives on end-of-life care can vary even within the same religious group due to individual beliefs and interpretations.
The nurse observes that an elderly woman, whose granddaughter has been admitted to theICU, is struggling to manage her two great-grandsons, who are toddlers, in the waiting room. What is the most likely explanation for the womans inability to manage the children in this situation?
- A. She is senile.
- B. She is in the exhaustion stage of the general adaptation syndrome to stress.
- C. She is assuming the role of caregiver in place of the patient, a role she is not used to.
- D. She has macular degeneration and cannot see well.
Correct Answer: B
Rationale: The correct answer is B: She is in the exhaustion stage of the general adaptation syndrome to stress.
Rationale:
1. In the exhaustion stage, the body's resources are depleted due to prolonged stress, leading to fatigue and reduced ability to cope.
2. The elderly woman is likely experiencing high levels of stress due to her granddaughter's critical condition.
3. Managing toddlers while dealing with the emotional distress of a loved one in the ICU can be overwhelming, causing exhaustion.
4. This explanation aligns with the symptoms of fatigue and difficulty managing the children observed by the nurse.
Summary:
A: Incorrect. Senility is a cognitive condition unrelated to the stress of the situation.
C: Incorrect. Assuming a caregiver role can be stressful, but it does not explain the observed exhaustion.
D: Incorrect. Macular degeneration affects vision, not the ability to manage stress and children.