Which action is best for the nurse to take to ensure culturally competent care for an alert, terminally ill Filipino patient?
- A. Ask the patient and family about their preferences for care during this time.
- B. Let the family decide whether to tell the patient about the terminal diagnosis.
- C. Obtain information from Filipino staff members about possible cultural needs.
- D. Remind family members that dying patients prefer to have someone at the bedside.
Correct Answer: A
Rationale: The correct answer is A because it promotes patient-centered care by involving the patient and family in decision-making, respecting their autonomy and preferences. This approach acknowledges the importance of cultural beliefs and values in end-of-life care. Choice B undermines patient autonomy by bypassing direct communication with the patient. Choice C assumes all Filipino individuals have the same cultural needs, which is not accurate. Choice D generalizes preferences without considering individual patient needs and wishes. Overall, choice A is the most appropriate as it aligns with the principles of patient-centered care and cultural competence.
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What were identified as the first critical care units? (Select all that apply.)
- A. Burn units.
- B. Coronary care units
- C. Recovery rooms.
- D. Neonatal intensive care units.
Correct Answer: A
Rationale: The correct answer is A: Burn units. Burn units were identified as the first critical care units due to the complex and intensive care required by burn patients. These units were established to provide specialized care for burn victims, including wound management, infection control, and fluid resuscitation.
Summary:
- Burn units were the first critical care units due to the specialized care needed for burn patients.
- Coronary care units focus on cardiac conditions, not the first identified critical care units.
- Recovery rooms are for post-operative care, not specifically for critical care.
- Neonatal intensive care units are specialized for newborns, not the first critical care units.
The nurse is caring for a patient with a subarachnoid hemorrhage who is intubated and placed on a mechanical ventilator with 10 cm H2O of peak end-expiratory pressure (PEEP). When monitoring the patient, the nurse will need to notify the healthcare provider immediately if the patient develops:
- A. Oxygen saturation of 93%.
- B. Respirations of 20 breaths/minute.
- C. Green nasogastric tube drainage.
- D. Increased jugular venous distention.
Correct Answer: D
Rationale: The correct answer is D: Increased jugular venous distention. In a patient with a subarachnoid hemorrhage and on mechanical ventilation, increased jugular venous distention can indicate increased intracranial pressure, which can be life-threatening. The nurse should notify the healthcare provider immediately as it may require urgent intervention to prevent further neurological deterioration.
A: Oxygen saturation of 93% is within the acceptable range for a patient on mechanical ventilation and may not require immediate notification.
B: Respirations of 20 breaths/minute are within normal limits for a ventilated patient and do not necessarily indicate a critical condition.
C: Green nasogastric tube drainage may indicate the presence of bile and could be related to gastrointestinal issues, but it does not pose an immediate threat to the patient's neurological status.
A nurse is weaning a 68-kg male patient who has chronic obstructive pulmonary disease (COPD) from mechanical ventilation. Which patient assessment finding indicates that the weaning protocol should be stopped?
- A. The patient’s heart rate is 97 beats/min.
- B. The patient’s oxygen saturation is 93%.
- C. The patient’s respiratory rate is 32 breaths/min.
- D. The patient’s spontaneous tidal volume is 450 mL.
Correct Answer: C
Rationale: The correct answer is C because a respiratory rate of 32 breaths/min indicates increased work of breathing, which could be a sign of respiratory distress. In a patient being weaned from mechanical ventilation, an elevated respiratory rate suggests that the patient may not be able to sustain adequate ventilation on their own. This warrants stopping the weaning protocol to prevent respiratory failure.
Choice A is incorrect because a heart rate of 97 beats/min is within normal range for an adult. Choice B is incorrect because an oxygen saturation of 93% is acceptable for a patient with COPD. Choice D is incorrect because a tidal volume of 450 mL is adequate for a patient weaning from mechanical ventilation.
A patient presents to the emergency department in acute re spiratory failure secondary to community-acquired pneumonia. The patient has a history of chronic obstructive pulmonary disease. The nurse anticipates which treatment to facilitate ventilation?
- A. Emergency tracheostomy and mechanical ventilation
- B. Mechanical ventilation via an endotracheal tube
- C. Noninvasive positive-pressure ventilation (NPPV)
- D. Oxygen at 100% via bag-valve-mask device
Correct Answer: B
Rationale: The correct answer is B: Mechanical ventilation via an endotracheal tube. In acute respiratory failure, especially in the setting of pneumonia and COPD, mechanical ventilation is often necessary to support breathing. Endotracheal intubation allows for precise control of airway patency, oxygenation, and ventilation. Emergency tracheostomy (choice A) is typically reserved for long-term ventilatory support. Noninvasive positive-pressure ventilation (choice C) may not provide sufficient support in severe cases. Oxygen via bag-valve-mask (choice D) may not be adequate for ventilatory support in acute respiratory failure.
The American Nurses Credential Center Magnet Recognition Program supports many actions to ensure that nurses are engaged and empowered to participate in ethical decision making. Which of the following would assist nurses in being involvabeirdb .icnom r/etesset arch studies?
- A. Education on protection of human subjects
- B. Participation of staff nurses on ethics committees
- C. Written descriptions of how nurses participate in ethic s programs
- D. Written policies and procedures related to response to ethical issues
Correct Answer: A
Rationale: Rationale:
A: Education on protection of human subjects is crucial for nurses to understand ethical principles when conducting research studies. It ensures compliance with ethical guidelines and protection of research participants.
B: Participation of staff nurses on ethics committees is not directly related to conducting research studies and may not specifically involve protection of human subjects.
C: Written descriptions of how nurses participate in ethics programs do not necessarily focus on research studies and may not cover the specific ethical considerations required in research.
D: Written policies and procedures related to response to ethical issues are important but may not provide the necessary knowledge on protection of human subjects for conducting research studies.