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How should the nurse interprets these blood gas values? 2 3
- A. Compensated metabolic alkalosis
- B. Normal values
- C. Uncompensated respiratory acidosis
- D. Uncompensated respiratory alkalosis
Correct Answer: C
Rationale: The correct interpretation is uncompensated respiratory acidosis (Choice C) based on the values. Step 1: Evaluate pH - pH is <7.35, indicating acidosis. Step 2: Determine PaCO2 - PaCO2 is >45 mmHg, indicating respiratory cause. Step 3: Check HCO3- - HCO3- is within normal range, indicating uncompensated state. Choices A, B, and D are incorrect because they do not align with the given blood gas values.
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Which statement reflects adherence to current recommendations concerning open visitation policies?
- A. Allowing animals on the unit; however, these can only be “therapy” animals through the hospital’s pet therapy program.
- B. Allowing family visitation throughout the day except a t change of shift and during rounds.
- C. Determining, in collaboration with the patient and famaiblyirb, .cwomho/te csta n visit and when.
- D. Permitting open visitation by adults 18 years of age and older; limit visits of children to 1 hour.
Correct Answer: C
Rationale: The correct answer is C because it reflects patient-centered care by involving patients and families in decision-making. Collaborating with them on visitation preferences promotes a supportive environment. Choice A restricts animal visitation, not addressing human visitors. Choice B limits visitation during specific times, not individualized. Choice D imposes restrictions based on age, not on patient/family preferences. Therefore, Choice C is the most aligned with current recommendations for open visitation policies.
The nurse cites evidence-based practice as a rationale for a patient care decision. What isthe best description of evidence-based practice?
- A. Decisions based on expert legal testimony
- B. Use of best available research data
- C. Evolution of nursing practice over time
- D. Individual optimization of patient outcomes
Correct Answer: B
Rationale: The correct answer is B: Use of best available research data. Evidence-based practice involves integrating the best available research evidence with clinical expertise and patient values to make informed decisions about patient care. It emphasizes using scientifically proven data to guide practice and improve patient outcomes. Expert legal testimony (A) is not necessarily evidence-based. Evolution of nursing practice over time (C) does not specifically focus on research data. Individual optimization of patient outcomes (D) is a goal of evidence-based practice, but it does not fully encompass the concept.
A mode of pressure-targeted ventilation that provides posiatbivirbe. cporme/tsessut re to decrease the workload of spontaneous breathing through what action by the endotracheal tube?
- A. Continuous positive airway pressure
- B. Positive end-expiratory pressure
- C. Pressure support ventilation
- D. T-piece adapter
Correct Answer: C
Rationale: The correct answer is C: Pressure support ventilation. This mode delivers a set pressure to support each spontaneous breath, decreasing the workload of breathing. Pressure support ventilation assists the patient's inspiratory efforts without providing a set tidal volume like in volume-targeted ventilation. Continuous positive airway pressure (Choice A) maintains a constant level of positive pressure throughout the respiratory cycle but does not actively support spontaneous breathing efforts. Positive end-expiratory pressure (Choice B) maintains positive pressure at the end of expiration to prevent alveolar collapse but does not directly support spontaneous breathing. T-piece adapter (Choice D) is a weaning device that allows the patient to breathe spontaneously without ventilatory support.
Which of the following are physiological effects of positive end-expiratory pressure (PEEP) used in the treatment of acute respiratory distress syndrom e (ARDS)? (Select all that apply.)
- A. Increase functional residual capacity
- B. Prevent collapse of unstable alveoli
- C. Improve arterial oxygenation
- D. Open collapsed alveoli
Correct Answer: A
Rationale: The correct answer is A: Increase functional residual capacity. Positive end-expiratory pressure (PEEP) helps increase the functional residual capacity by keeping the alveoli open at the end of expiration. This prevents alveolar collapse, improves ventilation-perfusion matching, and enhances oxygenation.
B: Prevent collapse of unstable alveoli - This is incorrect because PEEP actually helps prevent the collapse of all alveoli, not just unstable ones.
C: Improve arterial oxygenation - This is partially correct, but the primary mechanism through which PEEP improves oxygenation is by increasing functional residual capacity.
D: Open collapsed alveoli - This is incorrect because PEEP helps prevent alveolar collapse rather than actively opening already collapsed alveoli.
The nurse understands that many strategies are available to address ethical issues that may occur; these strategies include which of the following? (Select all that apply.)
- A. Change-of-shift report updates
- B. Ethics consultation services
- C. Formal multiprofessional ethics committees
- D. Pastoral care services
Correct Answer: B
Rationale: The correct answer is B: Ethics consultation services. These services involve seeking guidance from experts to navigate complex ethical dilemmas. They provide in-depth analysis and recommendations based on ethical principles, helping healthcare professionals make informed decisions. Change-of-shift report updates (A) are essential for continuity of care but do not directly address ethical issues. Formal multiprofessional ethics committees (C) are valuable for reviewing policies and addressing systemic ethical concerns but may not be readily available for immediate guidance. Pastoral care services (D) offer spiritual support but may not always have the expertise to handle complex ethical dilemmas. Ethics consultation services (B) are the most suitable option for addressing specific ethical issues promptly and effectively.