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A patient on mechanical ventilation is experiencing severe agitation due to being on the ventilator. Which nursing intervention would be best?
- A. Performing breathing exercises with the patient
- B. Offering the patient a patient-controlled analgesic device
- C. Asking the physician to prescribe an antianxiety medication
- D. Offering the patient the patients own MP3 player to listen to
Correct Answer: B
Rationale: The correct answer is B: Offering the patient a patient-controlled analgesic device. This intervention allows the patient to self-administer pain relief, which can help alleviate discomfort associated with mechanical ventilation and reduce agitation. Breathing exercises (choice A) may not address the root cause of agitation. Asking for antianxiety medication (choice C) may not be immediate or ideal due to potential side effects. Offering an MP3 player (choice D) may provide distraction but may not effectively address the agitation caused by the ventilator.
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A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min. Spontaneous reabsiprbi.rcaotmio/tensst are 12 breaths/min. After receiving a dose of morphine sulfate, respirations decrease to 4 breaths/min. Which acid-base disturbance will likely occur?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: D
Rationale: The correct answer is D (Respiratory alkalosis). Morphine sulfate can cause respiratory depression, leading to decreased respiratory rate. In this case, the patient's breaths decrease from 12 to 4 breaths/min, indicating hypoventilation. With decreased ventilation, there is less CO2 elimination, resulting in respiratory alkalosis. The other choices can be ruled out: A (Metabolic acidosis) and B (Metabolic alkalosis) are less likely caused by morphine sulfate, and C (Respiratory acidosis) is incorrect because the scenario describes hypoventilation, not hyperventilation.
The nurse is caring for a patient with a left radial arterial lianbierb, .caonmd/t eas tp ulmonary artery catheter inserted into the right subclavian vein. Which action by th e nurse best ensures the safety of the patient being monitored with invasive hemodynamic moni toring lines?
- A. Document all waveform values.
- B. Limit the pressure tubing length.
- C. Zero reference the system daily.
- D. Ensure alarm limits are turned on.
Correct Answer: C
Rationale: The correct answer is C: Zero reference the system daily. Zero referencing ensures accuracy and calibration of pressure monitoring system by setting the baseline pressure to zero. This is crucial to prevent inaccuracies in measurements. Choice A is important but doesn't directly address the accuracy of the monitoring system. Choice B may help in preventing errors but doesn't address the accuracy of pressure measurement. Choice D is important for alerting the nurse but doesn't directly relate to the accuracy of hemodynamic monitoring.
A nurse has achieved certification in critical care nursing. What is the most important effect that this certification will have on the nurses practice?
- A. Recognition by peers
- B. Increase in salary and rank
- C. More flexibility in seeking employment
- D. Increased confidence in critical thinking
Correct Answer: D
Rationale: The correct answer is D: Increased confidence in critical thinking. Achieving certification in critical care nursing validates the nurse's expertise and knowledge in this specialized area, leading to increased confidence in their ability to critically think through complex patient situations. This confidence translates into improved clinical decision-making and patient outcomes.
A: Recognition by peers - While recognition by peers is important for professional growth, the primary benefit of certification is enhancing clinical skills.
B: Increase in salary and rank - While certification may lead to salary increases in some cases, the most significant impact is on improving clinical skills.
C: More flexibility in seeking employment - While certification may enhance employability, the focus is on improving critical thinking skills rather than employment opportunities.
When it is noted that a patient’s endotracheal tube is not se cured tightened, he respiratory care practitioner assists the nurse in taping the tube. After the tu be is retaped, the nurse auscultates the patient’s lungs and notes that the breath sounds over the left lung fields are absent. The nurse suspects is the cause of this finding?
- A. The endotracheal tube is in the right mainstem bronchus.
- B. The patient has a left pneumothorax.
- C. The patient has aspirated secretions during the proceduarbeir.b .com/test
- D. The stethoscope earpiece is clogged with wax.
Correct Answer: A
Rationale: The correct answer is A: The endotracheal tube is in the right mainstem bronchus. When the endotracheal tube is not secured properly and is retaped, there is a possibility that it may have migrated into the right mainstem bronchus, leading to absent breath sounds in the left lung fields. This condition is known as endobronchial intubation. In such cases, ventilation primarily occurs in the right lung, resulting in decreased or absent breath sounds on the contralateral side. Choices B, C, and D are incorrect as they do not explain the absence of breath sounds over the left lung fields in this specific scenario.
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.