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When planning the response to the potential use of smallpox as an agent of terrorism, the emergency department (ED) nurse manager will plan to obtain adequate quantities of:
- A. Vaccine.
- B. Atropine.
- C. Antibiotics.
- D. Whole blood.
Correct Answer: A
Rationale: The correct answer is A: Vaccine. Smallpox is a contagious and potentially deadly disease caused by the variola virus. The smallpox vaccine is the most effective way to prevent and control the spread of smallpox. By obtaining adequate quantities of the smallpox vaccine, the ED nurse manager can protect healthcare workers and the public from contracting the virus in case of a smallpox bioterrorism event. Atropine (B) is used to treat certain types of nerve agent poisoning, not smallpox. Antibiotics (C) are ineffective against viruses like smallpox. Whole blood (D) is not specifically needed for smallpox treatment.
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What nursing strategies help families cope with the stress of critical illness? (Select all that apply.)
- A. Asking the family to leave during the morning bath to promote the patient’s privacy.
- B. Encouraging family members to make notes of questio ns they have for the physician during family rounds.
- C. When possible, providing continuity of nursing care.
- D. Providing a daily update of the patient’s condition to the family spokesperson.
Correct Answer: B
Rationale: The correct answer is B: Encouraging family members to make notes of questions they have for the physician during family rounds. This strategy helps families cope with the stress of critical illness by empowering them to stay informed and actively participate in the patient's care. By encouraging them to make notes, it promotes effective communication with the healthcare team and ensures that their concerns and questions are addressed promptly.
Other choices are incorrect:
A: Asking the family to leave during the morning bath to promote the patient’s privacy is not a helpful strategy for coping with stress as it may lead to feelings of isolation and lack of involvement in the patient's care.
C: Providing continuity of nursing care is important but may not directly address the family's coping mechanisms during a critical illness.
D: Providing a daily update of the patient’s condition to the family spokesperson is valuable but may not fully address the family's need for active participation and communication with the healthcare team.
Sleep often is disrupted for critically ill patients. Which nu rsing intervention is most appropriate to promote sleep and rest?
- A. Consult with the pharmacist to adjust medication times to allow periods of sleep or rest between intervals.
- B. Encourage family members to talk with the patient wh enever they are present in the room.
- C. Keep the television on to provide “white” noise and di straction.
- D. Leave the lights on in the room so that the patient is no t frightened of his or her surroundings.
Correct Answer: A
Rationale: The correct answer is A: Consult with the pharmacist to adjust medication times to allow periods of sleep or rest between intervals. This is the most appropriate intervention as medication timings can significantly impact sleep patterns of critically ill patients. Adjusting medication times can help synchronize rest periods, promoting uninterrupted sleep.
Choice B is incorrect as encouraging constant conversation can disrupt sleep. Choice C is incorrect as the television noise can be stimulating and hinder rest. Choice D is incorrect as leaving the lights on can disrupt the patient's circadian rhythm and negatively impact sleep quality.
The nurse is concerned about the risk of alcohol withdraw al syndrome in a 45-year-old postoperative patient. Which statement indicates an unders tanding of management of this patient?
- A. “Alcohol withdrawal is common; we see it all of the tiambierb .icno mth/tees tt rauma unit.”
- B. “There is no way to assess for alcohol withdrawal.”
- C. “This patient will require less pain medication.”
- D. “We have initiated the alcohol withdrawal protocol.”
Correct Answer: D
Rationale: The correct answer is D because initiating the alcohol withdrawal protocol shows an understanding of managing a patient at risk for alcohol withdrawal syndrome. This protocol involves carefully monitoring the patient's symptoms, providing appropriate medications, and ensuring a safe environment. Option A is incorrect as it downplays the seriousness of alcohol withdrawal. Option B is incorrect as there are assessment tools available for identifying alcohol withdrawal. Option C is incorrect as pain management should be tailored to the individual's needs, not necessarily lessened due to alcohol withdrawal risk.
The spouse of a patient with terminal cancer visits daily and cheerfully talks with the patient about wedding anniversary plans for the next year. When the nurse asks about any concerns, the spouse says, 'I’m busy at work, but otherwise, things are fine.' Which nursing diagnosis is most appropriate?
- A. Ineffective coping related to lack of grieving.
- B. Anxiety related to the complicated grieving process.
- C. Caregiver role strain related to feeling overwhelmed.
- D. Hopelessness related to knowledge deficit about cancer.
Correct Answer: A
Rationale: The correct answer is A: Ineffective coping related to lack of grieving. The spouse's behavior of avoiding the reality of the terminal illness and focusing on future plans indicates maladaptive coping. The cheerfulness and denial suggest a lack of acceptance and processing of the impending loss. This can lead to emotional distress and hinder the grieving process.
Choice B (Anxiety related to the complicated grieving process) is incorrect because the spouse's behavior does not exhibit signs of anxiety but rather avoidance and denial. Choice C (Caregiver role strain related to feeling overwhelmed) is incorrect as the spouse does not express feeling overwhelmed but instead deflects by focusing on work. Choice D (Hopelessness related to knowledge deficit about cancer) is incorrect because the spouse's behavior does not indicate hopelessness or lack of understanding about cancer, but rather an avoidance of facing the reality of the situation.
The nurse caring for a mechanically ventilated patient prepares to include which strategies to prevent ventilator-associated pneumonia should be into the patient’s plan of care? (Select all that apply.)
- A. Drain condensate from the ventilator tubing away from the patient.
- B. Elevate the head of the bed 30 to 45 degrees.
- C. Instill normal saline as part of the suctioning procedure.
- D. Perform regular oral care with chlorhexidine.
Correct Answer: A
Rationale: The correct answer is A: Drain condensate from the ventilator tubing away from the patient. This is crucial to prevent ventilator-associated pneumonia as stagnant condensate can harbor harmful bacteria. By draining it away from the patient, the risk of bacterial growth and subsequent aspiration is minimized. Elevating the head of the bed (choice B) helps prevent aspiration but is not specific to preventing ventilator-associated pneumonia. Instilling normal saline during suctioning (choice C) can increase the risk of infection. Performing regular oral care with chlorhexidine (choice D) is important for oral hygiene but not directly related to preventing ventilator-associated pneumonia.