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Peritoneal dialysis is different from hemodialysis in that peritoneal dialysis
- A. is more frequently used for acute kidney injury.
- B. uses the patient’s own semipermeable membrane (peritoneal membrane).
- C. is not useful in cases of drug overdose or electrolyte imbalance.
- D. is not indicated in cases of water intoxication.
Correct Answer: B
Rationale: The correct answer is B because peritoneal dialysis utilizes the patient's own semipermeable membrane, the peritoneal membrane, as the filtration surface. This allows for the exchange of waste products and excess fluids without the need for external dialysis equipment. Choice A is incorrect as peritoneal dialysis can be used for both acute and chronic kidney injury. Choice C is incorrect as peritoneal dialysis can help manage drug overdose and electrolyte imbalances. Choice D is incorrect as peritoneal dialysis can be used in cases of water intoxication to help remove excess fluids.
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The patient is in need of immediate hemodialysis, but has no vascular access. The nurse prepares the patient for insertion of
- A. a percutaneous catheter at the bedside.
- B. a percutaneous tunneled catheter at the bedside.
- C. an arteriovenous fistula.
- D. an arteriovenous graft.
Correct Answer: A
Rationale: The correct answer is A: a percutaneous catheter at the bedside. This is the most appropriate option for immediate hemodialysis when the patient has no vascular access. A percutaneous catheter can be quickly inserted at the bedside, allowing for immediate initiation of hemodialysis.
Choice B, a percutaneous tunneled catheter, involves a more complex insertion process and is not typically done at the bedside. Choices C and D, arteriovenous fistula and arteriovenous graft, require advanced planning and surgical procedures, making them unsuitable for immediate hemodialysis in this scenario.
Which of the following is a National Patient Safety Goal? a(bSirebl.ceocmt /taelslt that apply.)
- A. Accurately identify patients.
- B. Eliminate use of patient restraints.
- C. Reconcile medications across the continuum of care.
- D. Reduce risks of healthcare-acquired infection.
Correct Answer: A
Rationale: Rationale: Accurately identifying patients is a National Patient Safety Goal to prevent errors in patient care. Proper patient identification ensures correct treatments and medications are given, reducing harm. Restraint elimination, medication reconciliation, and infection reduction are important goals but not specific National Patient Safety Goals. Accurate patient identification directly addresses patient safety concerns.
The condition of a critically ill patient with a living will has deteriorated. The patient’s partner wants “everything done,” regardless of the patient’s wishe s. Which ethical principle is the partner violating?
- A. Autonomy
- B. Beneficence
- C. Justice
- D. Nonmaleficence
Correct Answer: A
Rationale: The correct answer is A: Autonomy. Autonomy is the ethical principle that respects an individual's right to make decisions about their own care and treatment. In this scenario, the partner wanting "everything done" regardless of the patient's wishes violates the patient's autonomy by not honoring their previously expressed wishes outlined in the living will. This decision disregards the patient's right to make choices about their own healthcare. Choices B, C, and D are incorrect because:
B: Beneficence focuses on doing good for the patient, but in this case, the partner's actions are not necessarily in the patient's best interest.
C: Justice pertains to fairness and equal treatment, which is not directly relevant to the situation described.
D: Nonmaleficence is the principle of doing no harm, but in this scenario, the harm is not necessarily physical but rather a violation of the patient's autonomy.
After coronary artery bypass graft surgery a patient is transported to the surgical intensive care unit at noon and placed on mechanical ventilation. How sh ould the nurse interpret the patient’s initial arterial blood gas levels? pH 7.31 PaCO 48 mm Hg Bicarbonate 22 mEq/L PaO 115 mm Hg O saturation 99%
- A. Normal arterial blood gas levels with a high oxygen le vel
- B. Partly compensated respiratory acidosis, normal oxygen
- C. Uncompensated metabolic acidosis with high oxygen laebvirbe.lcso m/test
- D. Uncompensated respiratory acidosis; hyperoxygenated
Correct Answer: B
Rationale: The correct answer is B: Partly compensated respiratory acidosis, normal oxygen. The pH of 7.31 indicates acidosis, the PaCO2 of 48 mm Hg shows respiratory acidosis, and the bicarbonate level of 22 mEq/L is slightly elevated, indicating the kidneys are compensating. The PaO2 of 115 mm Hg and oxygen saturation of 99% are normal, ruling out hypoxemia. Therefore, the patient is experiencing partly compensated respiratory acidosis.
A: Normal arterial blood gas levels with a high oxygen level - Incorrect. The pH is low, indicating acidosis, which is not normal.
C: Uncompensated metabolic acidosis with high oxygen level - Incorrect. Metabolic acidosis would have a primary issue with bicarbonate levels, which is not the case here.
D: Uncompensated respiratory acidosis; hyperoxygenated - Incorrect. The oxygen levels are normal, ruling out hyperoxygenation.
The nurse is assessing an older client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding?
- A. A nystagmus on the left.
- B. Exophthalmos on the right.
- C. Ptosis on the left eyelid.
- D. Astigmatism on the right.
Correct Answer: C
Rationale: The correct answer is C: Ptosis on the left eyelid. Ptosis refers to drooping of the eyelid, which is a common condition in older adults. In this scenario, the nurse should document the finding as ptosis on the left eyelid because the client's left upper eyelid is drooping, covering more of the iris than the right eyelid.
Explanation: Nystagmus (A) is an involuntary eye movement, not related to eyelid drooping. Exophthalmos (B) is the protrusion of the eyeball and not relevant to this scenario. Astigmatism (D) refers to a refractive error of the eye and does not cause eyelid drooping. Therefore, the correct choice is C as it accurately describes the client's condition.