Nokea
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.
You may also like to solve these questions
The primary health care provider writes an order to discon tinue a patient’s left radial arterial line. When discontinuing the patient’s invasive line, what is the priority nursing action?
- A. Apply an air occlusion dressing to insertion site.
- B. Apply pressure to the insertion site for 5 minutes.
- C. Elevate the affected limb on pillows for 24 hours.
- D. Keep the patient’s wrist in a neutral position.
Correct Answer: B
Rationale: The correct answer is B: Apply pressure to the insertion site for 5 minutes. This is the priority nursing action because it helps prevent bleeding and hematoma formation after removing the arterial line. Applying pressure for 5 minutes allows for adequate hemostasis.
A: Applying an air occlusion dressing to the insertion site is not the priority action. It does not address the immediate need to control bleeding.
C: Elevating the affected limb on pillows for 24 hours is not necessary and does not address the immediate need for hemostasis.
D: Keeping the patient's wrist in a neutral position is not the priority action when discontinuing an arterial line. It does not address the need for hemostasis and preventing bleeding.
The nurse is caring for a terminally ill patient who has 20-second periods of apnea followed by periods of deep and rapid breathing. Which action by the nurse would be most appropriate?
- A. Suction the patient.
- B. Administer oxygen via face mask.
- C. Place the patient in a high Fowler’s position.
- D. Document the respirations as Cheyne-Stokes.
Correct Answer: D
Rationale: The correct answer is D because the patient is exhibiting Cheyne-Stokes breathing pattern characterized by periods of apnea followed by deep and rapid breathing. The nurse should document this pattern accurately. Option A is incorrect as suctioning is not indicated. Option B may worsen the respiratory pattern. Option C is not specifically related to addressing the breathing pattern.
An 81-year-old patient who has been in the intensive care unit (ICU) for a week is now stable, and transfer to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset confusion. The nurse will plan to:
- A. Give PRN lorazepam (Ativan) and cancel the transfer.
- B. Inform the receiving nurse and then transfer the patient.
- C. Notify the health care provider and postpone the transfer.
- D. Obtain an order for restraints as needed and transfer the patient.
Correct Answer: C
Rationale: The correct answer is C: Notify the health care provider and postpone the transfer. The new onset confusion in an elderly patient in the ICU can be a sign of delirium, which is a serious condition that requires prompt evaluation and management. By notifying the healthcare provider, they can assess the patient's condition, order appropriate tests, and adjust the treatment plan as needed. Postponing the transfer allows for further observation and intervention to address the underlying cause of the confusion.
Choice A (Give PRN lorazepam and cancel the transfer) is incorrect because administering lorazepam may worsen the confusion in an elderly patient and should not be done without proper evaluation.
Choice B (Inform the receiving nurse and then transfer the patient) is incorrect because transferring the patient without addressing the new onset confusion can lead to potential complications and delay in appropriate management.
Choice D (Obtain an order for restraints as needed and transfer the patient) is incorrect because using restraints should only be considered as a
What is the basic underlying pathophysiology of acute respiratory distress syndrome?
- A. A decrease in the number of white blood cells availabl e.
- B. Damage to the right mainstem bronchus.
- C. Damage to the type II pneumocytes, which produce suarbfiarbc.tcaomnt/t.e st
- D. Decreased capillary permeability.
Correct Answer: C
Rationale: The correct answer is C: Damage to the type II pneumocytes, which produce surfactant. Acute respiratory distress syndrome (ARDS) is characterized by damage to the alveolar epithelium, including type II pneumocytes responsible for producing surfactant. Surfactant reduces surface tension in the alveoli, preventing collapse. Damage to type II pneumocytes impairs surfactant production, leading to alveolar collapse and impaired gas exchange. Choices A, B, and D are incorrect because ARDS is not primarily caused by a decrease in white blood cells, damage to the right mainstem bronchus, or decreased capillary permeability.
The charge nurse is supervising care for a group of patients monitored with a variety of invasive hemodynamic devices. Which patient should the charge nurse evaluate first?
- A. A patient with a central venous pressure (RAP/CVP) oafb i6rb .mcomm/ teHstg and 40 mL of urine output in the past hour
- B. A patient with a left radial arterial line with a BP of 11 0/60 mm Hg and slightly dampened arterial waveform
- C. A patient with a pulmonary artery occlusion pressure of 25 mm Hg and an oxygen saturation of 89% on 3 L of oxygen via nasal cannula
- D. A patient with a pulmonary artery pressure of 25/10 mm Hg and an oxygen saturation of 94% on 2 L of oxygen via nasal cannula
Correct Answer: C
Rationale: The correct answer is C because a pulmonary artery occlusion pressure of 25 mm Hg indicates possible fluid overload or cardiac issue requiring urgent evaluation. This value is high, suggesting increased pressure in the left side of the heart. Additionally, the oxygen saturation of 89% on 3 L of oxygen indicates potential respiratory compromise. This patient needs immediate assessment and intervention to prevent worsening of their condition.
Choice A is incorrect as a central venous pressure of 6 mm Hg is within normal limits, and the urine output is adequate. Choice B is incorrect as a BP of 110/60 mm Hg is acceptable, and a slightly dampened arterial waveform is not an immediate concern. Choice D is incorrect as a pulmonary artery pressure of 25/10 mm Hg is within normal range, and an oxygen saturation of 94% on 2 L of oxygen is acceptable.