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What risk is the rationale for the recommendation of endot racheal rather than nasotracheal intubation?
- A. Basilar skull fracture
- B. Cervical hyperextension
- C. Impaired ability to "mouth" words
- D. Sinusitis and infection
Correct Answer: A
Rationale: The correct answer is A: Basilar skull fracture. Endotracheal intubation is recommended over nasotracheal intubation to avoid the risk of further damaging a basilar skull fracture. Nasotracheal intubation can potentially cause further injury due to the passage of the tube through the nasal cavity, which could exacerbate a basilar skull fracture.
Summary of other choices:
B: Cervical hyperextension - Not directly related to the choice between endotracheal and nasotracheal intubation.
C: Impaired ability to "mouth" words - Not a significant factor in determining the choice of intubation method.
D: Sinusitis and infection - While nasotracheal intubation can potentially lead to sinusitis and infection, the primary concern in this scenario is the risk of aggravating a basilar skull fracture.
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Many critically ill patients experience anxiety. The nurse can reduce anxiety with which approach?
- A. Asking family members to limit their visitation to 2-hour periods in morning, afternoon, and evening. You know that this is the best approach to ensure uninterrupted rest time for the patient. Tell the patient, “Your family is in the waiting room. They will be permitted to come in at 2:0 0 PM after you take a short nap.”
- B. Explaining the unit routine. “Assessments are done every 4 hours; patients are bathed on the night shift around 5:00 AM; family memabbierbr.sc oamr/ete spt ermitted to visit you after the physicians make their morning rounds. They can spend the day. Lights are out every night at 10:00 PM.”
- C. Stating, “It’s time to turn you. I am going to ask another nurse to come in and help me. We will turn you to your left side. During the turn , I’m going to inspect the skin on your back and rub some lotion on your back. T his should help to make you feel better.”
- D. Suctioning the endotracheal tube immediately when thaeb iprba.ctoiemn/tte sst tarts to cough. Sharing, “Your tube needs suctioned; you should feel better after I’m done.”
Correct Answer: C
Rationale: The correct answer is C because it addresses the patient's anxiety by providing clear communication and involving the patient in the care process. By explaining the turning procedure, inspecting the skin, and providing comfort through lotion application, the nurse establishes trust and promotes a sense of control for the patient. This approach helps alleviate anxiety by keeping the patient informed and engaged in their care.
Choice A is incorrect because limiting family visitation may not directly address the patient's anxiety. Choice B is incorrect as it focuses on routine information rather than directly addressing the patient's anxiety. Choice D is incorrect because suctioning the endotracheal tube may cause discomfort and does not address the underlying anxiety issue.
Which treatment can be used to dissolve a thrombus that is lodged in the pulmonary artery?
- A. Aspirin
- B. Embolectomy
- C. Heparin
- D. Thrombolytics
Correct Answer: D
Rationale: The correct answer is D: Thrombolytics. Thrombolytics are medications that can dissolve blood clots, making them effective in treating a thrombus lodged in the pulmonary artery. They work by activating the body's natural clot-dissolving system. Aspirin (A) is an antiplatelet drug and may prevent further clot formation but cannot dissolve an existing thrombus. Embolectomy (B) is a surgical procedure to remove a clot and is invasive, usually reserved for cases where thrombolytics are contraindicated. Heparin (C) is an anticoagulant that prevents clot formation but does not dissolve existing clots like thrombolytics do.
The nurse is assessing pain levels in a critically ill patient . The nurse recognizes that which patient action as indicatin g the greatest level of pain?
- A. Brow lowering
- B. Eyelid closing
- C. Grimacing
- D. Staring
Correct Answer: C
Rationale: Correct Answer: C (Grimacing)
Rationale:
1. Grimacing is a universal nonverbal sign of pain.
2. It involves facial muscles, indicating a high level of discomfort.
3. Brow lowering and eyelid closing are subtle signs, less indicative of severe pain.
4. Staring may signify concentration, not necessarily pain.
Summary:
Grimacing is the correct choice as it directly correlates with pain intensity, unlike the other options which are less specific or relevant indicators of severe pain.
A patient with hypotension and an elevated temperature after working outside on a hot day is treated in the emergency department (ED). The nurse determines that discharge teaching has been effective when the patient makes which statement?
- A. I will take salt tablets when I work outdoors in the summer.
- B. I should take acetaminophen (Tylenol) if I start to feel too warm.
- C. I should drink sports drinks when working outside in hot weather.
- D. I will move to a cool environment if I notice that I am feeling confused.
Correct Answer: C
Rationale: The correct answer is C: "I should drink sports drinks when working outside in hot weather." This statement is correct because hypotension and elevated temperature could indicate dehydration and electrolyte imbalance due to excessive sweating in hot weather. Drinking sports drinks can help replenish electrolytes lost through sweating and prevent dehydration.
Incorrect choices:
A: Taking salt tablets can lead to an imbalance in electrolytes and worsen the condition.
B: Acetaminophen can lower fever but does not address dehydration or electrolyte imbalance.
D: Moving to a cool environment when feeling confused is important but does not address the underlying issue of dehydration and electrolyte imbalance.
Which statement is consistent with societal views of dying in the United States?
- A. Dying is viewed as a failure on the part of the system and providers.
- B. Most Americans would prefer to die in a hospital to spaabrireb .lcoomve/teds to nes the burden of care.
- C. People die of indistinct, complex illness for which a cu re is always possible.
- D. The purpose of the healthcare system is to prevent dise ase and treat symptoms.
Correct Answer: D
Rationale: Rationale: The correct answer is D because the purpose of the healthcare system in the United States is primarily focused on disease prevention and symptom management. This aligns with societal views as healthcare is geared towards improving health outcomes and quality of life.
Incorrect choices:
A: Dying is not viewed as a failure of the system or providers, rather as a natural part of life.
B: Most Americans prefer to die at home or in hospice care rather than in a hospital.
C: Illnesses are not always curable, and death can result from various complex conditions beyond treatment.