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What is the treatment for an acute exacerbation of asthma?
- A. Corticosteroids and theophylline by mouth
- B. Inhaled bronchodilators and intravenous corticosteroids
- C. Prone positioning or continuous lateral rotation
- D. Sedation and inhaled bronchodilators
Correct Answer: B
Rationale: The correct answer is B: Inhaled bronchodilators and intravenous corticosteroids. Bronchodilators help to quickly open up the airways during an asthma exacerbation, providing immediate relief. Intravenous corticosteroids help reduce airway inflammation and prevent further worsening of symptoms. Corticosteroids by mouth (Choice A) are not as effective as intravenous administration during an acute exacerbation. Prone positioning or continuous lateral rotation (Choice C) is not a recommended treatment for asthma exacerbation. Sedation and inhaled bronchodilators (Choice D) are not appropriate as sedation can depress respiratory function and worsen the condition.
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The nurse aware that a shortage of organs exists knows that which statement is true?
- A. Anyone who is comfortable approaching the family sh ould discuss the option of organ donation.
- B. Brain death determination is required before organs ca n be retrieved for transplant.
- C. Donation of selected organs after cardiac death is ethically acceptable.
- D. Family members should consider withdrawing life supapboirbrt.c osmo /ttehsat t the patient can become an organ donor.
Correct Answer: B
Rationale: Rationale for Correct Answer (B - Brain death determination is required before organs can be retrieved for transplant):
1. Brain death determination is a medical necessity to ensure the organs are viable for transplant.
2. Organs must be retrieved promptly after brain death to maintain their functionality.
3. Brain death criteria ensure that the donor is truly deceased before organ retrieval.
Summary of Why Other Choices are Incorrect:
A: While discussing organ donation is important, comfort level is not the main factor in organ shortage awareness.
C: Donation after cardiac death is ethically acceptable, but it is not directly related to the need for brain death determination.
D: Withdrawing life support solely to become an organ donor is ethically questionable and not a necessary step in organ donation.
The nurse is developing a teaching plan for an adolescent with a Milwaukee brace. Which instruction should the nurse include?
- A. Wear the brace over a T-shirt 23 hours per day.
- B. Dress with the brace over regular clothing.
- C. Shower with the brace directly against the skin.
- D. Remove the brace just before going to bed.
Correct Answer: A
Rationale: The correct answer is A because wearing the Milwaukee brace over a T-shirt ensures proper skin protection and ventilation. This helps prevent skin irritation and allows for comfortable wearing for long periods. Choice B may cause skin issues due to friction. Choice C is incorrect as moisture from showering can lead to skin problems. Choice D is incorrect as consistent wear is crucial for brace effectiveness.
The nurse is assessing a patient with a new arteriovenous fistula, but does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable. The nurse should
- A. reassess the patient in an hour.
- B. raise the arm above the level of the patient’s heart.
- C. notify the provider immediately.
- D. apply warm packs to the fistula site and reassess.
Correct Answer: C
Rationale: The correct answer is C: notify the provider immediately. The absence of bruit, thrill, and palpable distal pulses in a new arteriovenous fistula suggests potential complications like thrombosis or stenosis, requiring urgent intervention. Notifying the provider promptly allows for timely assessment and appropriate management to prevent further complications.
Summary:
A: Reassessing the patient in an hour may delay necessary intervention for a potentially serious issue.
B: Raising the arm above the level of the patient’s heart does not address the underlying problem and may not improve the situation.
D: Applying warm packs to the fistula site is not the appropriate intervention for the absence of bruit and thrill and may not address the underlying cause.
In which situation would a healthcare surrogate or proxy a ssume the end-of-life decision-making role for a patient?
- A. When a dying patient requires extensive heavy sedatioanb,i rbs.ucocmh/ taesst benzodiazepines and narcotics, to control distressing symptoms
- B. When a dying patient who is competent requests to wi thdraw treatment against the wishes of the family
- C. When a dying patient who is competent requests to con tinue treatment against the recommendations of the healthcare team
- D. When a dying patient who is competent is receiving pr n treatment for pain and anxiety
Correct Answer: A
Rationale: The correct answer is A because in this situation, the patient is no longer able to make decisions for themselves due to being heavily sedated. The healthcare surrogate or proxy steps in to make decisions on behalf of the patient to ensure their comfort and well-being.
Choice B is incorrect because the patient is competent and able to make their own decisions, so there is no need for a surrogate to take over decision-making.
Choice C is incorrect because the patient is competent and has the right to make decisions about their own treatment, even if they go against medical recommendations.
Choice D is incorrect because the patient is competent and receiving appropriate treatment for their pain and anxiety, so there is no need for a surrogate to intervene in this scenario.
Which scenarios contribute to effective handoff communicaabitribo.cno ma/tte csth ange of shift? (Select all that apply.)
- A. The nephrology consultant physician is making rounds and asks the nurse to provide an update on the patient’s status and assist in p lacing a central line for hemodialysis.
- B. The noise level is high because twice as many staff me mbers are present and everyone is giving report in the nurse’s station.
- C. The unit has decided to use a standardized checklist/toaobli rbfo.cro mc/hteasnt ge-of-shift reports and patient transfers.
- D. Both the off-going and the oncoming nurses conduct a standardized report at the patient’s bedside and review key assessment findings.
Correct Answer: A
Rationale: The correct answer is A because it demonstrates effective handoff communication by involving key stakeholders (nephrology consultant physician), requesting specific patient updates, and collaborating on patient care tasks (placing a central line). This scenario promotes continuity of care and ensures important information is shared.
Explanation for why other choices are incorrect:
B: High noise level disrupts communication and can lead to errors or omissions in handoff information.
C: While using a standardized checklist can be beneficial, it alone does not guarantee effective communication if not utilized properly or if key information is missed.
D: Conducting reports at the patient's bedside is beneficial for patient involvement but may not address the need for involving relevant healthcare providers like the consultant physician in the handoff process.