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When providing palliative care, the nurse must keep in mind that the family may include which of the following? (Select all that apply.)
- A. Unmarried life partners of same sex
- B. Unmarried life partners of opposite sex
- C. Roommates
- D. Close friends
Correct Answer: A
Rationale: The correct answer is A: Unmarried life partners of same sex. When providing palliative care, it's crucial to recognize and respect diverse family structures. Unmarried life partners of the same sex may form a significant familial bond, requiring support and involvement in care decisions. This choice aligns with the principles of inclusivity and non-discrimination in palliative care.
Incorrect choices:
B: Unmarried life partners of the opposite sex - This choice is incorrect as it limits the definition of family to only opposite-sex partners, excluding same-sex couples.
C: Roommates - While roommates may provide support, they do not necessarily have the same level of emotional and decision-making involvement as family members or life partners.
D: Close friends - While close friends can be important sources of support, they do not necessarily have the same legal or emotional ties as a life partner.
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The nurse is caring for a critically ill patient who can speak. The nurse notices that the patient is demonstrating behaviors indicative of anxiety but is silent. What nursing strategy would give the nurse the most information about the patients feelings?
- A. Explain procedures to the patient and family.
- B. Ask the patient to share his or her internal dialogue.
- C. Encourage the patient to nap before visiting hours.
- D. Ensure that the patient has adequate pain control.
Correct Answer: B
Rationale: The correct answer is B because asking the patient to share his or her internal dialogue can provide direct insight into the patient's thoughts and feelings, allowing the nurse to address specific anxieties. This approach promotes open communication and understanding. Choice A focuses on providing information but may not directly address the patient's feelings. Choice C is unrelated to addressing the patient's anxiety. Choice D addresses pain control, which is important but not directly related to exploring the patient's emotions. Therefore, option B is the most effective strategy for gaining insight into the patient's feelings in this scenario.
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.
Warning signs that can assist the critical care nurse in reco gnizing that an ethical dilemma may exist include which of the following? (Select all that apply.)
- A. Family members are confused about what is happening to the patient.
- B. Family members are in conflict as to the best treatmen t options. They disagree with each other and cannot come to consensus.
- C. The family asks that the patient not be told of treatmenatb iprbl.aconms./t est
- D. The patient’s condition has changed dramatically for the worse and is not responding to conventional treatment.
Correct Answer: A
Rationale: The correct answer is A because when family members are confused about the patient's condition or treatment, it can indicate a lack of communication or understanding, leading to a potential ethical dilemma. This confusion may result in conflicting views on what is best for the patient, potentially leading to disagreements and ethical conflicts.
Choice B is incorrect because although family conflict can lead to ethical dilemmas, it is not a direct warning sign that an ethical dilemma exists.
Choice C is incorrect because the family asking not to inform the patient about treatment is more related to communication preferences rather than a clear indication of an ethical dilemma.
Choice D is incorrect because a deteriorating patient condition, while concerning, does not directly signal an ethical dilemma unless there are specific ethical considerations involved in the treatment decisions.
The nurse is discharging a patient home following treatment for community-acquired pneumonia. As part of the discharge teaching, the nurse sh ould provide instruction?
- A. “If you get the pneumococcal vaccine, you’ll never get pneumonia again.”
- B. “It is important for you to get an annual influenza shot to reduce your risk of pneumonia.”
- C. “Stay away from cold, drafty places because that incre ases your risk of pneumonia when you get home.”
- D. “Since you have been treated for pneumonia, you now have immunity from getting it in the future.”
Correct Answer: B
Rationale: Step 1: Influenza can lead to pneumonia as a complication, so getting an annual flu shot can reduce the risk of pneumonia.
Step 2: Providing education on the importance of prevention aligns with discharge teaching goals.
Step 3: Option A is incorrect as the pneumococcal vaccine doesn't guarantee immunity from all causes of pneumonia.
Step 4: Option C is incorrect as cold or drafty places do not directly cause pneumonia.
Step 5: Option D is incorrect as having pneumonia once does not confer permanent immunity.
A patient who is unconscious after a fall from a ladder is transported to the emergency department by emergency medical personnel. During the primary survey of the patient, the nurse should:
- A. Obtain a complete set of vital signs.
- B. Obtain a Glasgow Coma Scale score.
- C. Ask about chronic medical conditions.
- D. Attach a cardiac electrocardiogram monitor.
Correct Answer: B
Rationale: The correct answer is B: Obtain a Glasgow Coma Scale score. During the primary survey, assessing the patient's level of consciousness is crucial as it helps determine the severity of the injury and guides further management. The Glasgow Coma Scale is a standardized tool used to assess the level of consciousness based on eye opening, verbal response, and motor response. It provides valuable information about the patient's neurological status.
A: Obtaining a complete set of vital signs is important but assessing the level of consciousness takes priority in this scenario.
C: Asking about chronic medical conditions is important but not as critical as assessing the patient's level of consciousness during the primary survey.
D: Attaching a cardiac electrocardiogram monitor is not necessary during the primary survey unless there are specific indications of cardiac issues, which are not evident in this case.
In summary, obtaining a Glasgow Coma Scale score is essential for assessing the patient's level of consciousness and determining the severity of the injury during the primary survey.