Nokea
An Ethiopian man with AIDS has recently been admitted to the ICU with a case of pneumonia. The man is new to the U.S. and has no health insurance. He would likely be eligible for the states Medicaid coverage, but does not understand how to access this coverage. Which competency or competencies are most needed in this situation? Select all that apply.
- A. Clinical judgment
- B. Advocacy and moral agency
- C. Collaboration
- D. Systems thinking
Correct Answer: B
Rationale: The correct answer is B: Advocacy and moral agency. In this scenario, the Ethiopian man with AIDS is in a vulnerable position due to lack of health insurance and understanding of Medicaid coverage. Advocacy skills are crucial to help him navigate the complex healthcare system and access the necessary resources. Moral agency involves advocating for the patient's rights and well-being, ensuring that he receives appropriate care despite his socioeconomic status. Clinical judgment, collaboration, and systems thinking are important competencies but not as directly relevant in this specific situation of advocating for the patient's access to Medicaid coverage.
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The nurse is assisting with endotracheal intubation and un derstands correct placement of the endotracheal tube in the trachea would be identified by which of the following? (Select all that apply.)
- A. Auscultation of air over the epigastrium
- B. Equal bilateral breath sounds upon auscultation
- C. Position above the carina verified by chest x-ray
- D. Positive detection of carbon dioxide (CO
Correct Answer: B
Rationale: The correct answer is B: Equal bilateral breath sounds upon auscultation. This indicates proper placement of the endotracheal tube in the trachea, ensuring both lungs are being ventilated equally.
Rationale:
1. Auscultation of air over the epigastrium (Choice A) is incorrect as it indicates esophageal intubation, not tracheal intubation.
2. Position above the carina verified by chest x-ray (Choice C) is incorrect as it does not confirm proper placement at the trachea.
3. Positive detection of carbon dioxide (CO2) (Choice D) is incorrect as it indicates the presence of exhaled CO2, but not necessarily proper placement in the trachea.
The nurse is caring for a patient who is mechanically ventilated. The nurse understands that what statement should be considered when determining apapbrirob.pcormia/ttees tn ursing interventions?
- A. Communication with intubated patients is often difficult.
- B. Controlled ventilation is the preferred mode for most p atients.
- C. Patients with chronic obstructive pulmonary disease w ean easily from mechanical ventilation.
- D. Wrist restraints are applied to all patients to avoid self- extubation.
Correct Answer: A
Rationale: The correct answer is A because communication with intubated patients is often challenging due to the presence of an artificial airway, which hinders speech. This understanding is crucial when determining appropriate nursing interventions to ensure effective patient care.
Choice B is incorrect because different patients may require different modes of ventilation based on their specific condition, and controlled ventilation may not always be the preferred mode for all patients.
Choice C is incorrect as patients with chronic obstructive pulmonary disease often have difficulty weaning from mechanical ventilation due to their underlying respiratory condition.
Choice D is incorrect as wrist restraints are not applied to all patients on mechanical ventilation unless absolutely necessary for safety concerns, such as preventing self-extubation.
The nurse is discussing the role of hospice care with a patient and family. Which statement by the nurse accurately describes hospice care?
- A. Hospice care aims to cure serious illnesses through specialized treatments.
- B. Hospice care provides support and comfort for patients at the end of life.
- C. Hospice care is only for patients with cancer-related illnesses.
- D. Hospice care focuses primarily on extending life expectancy.
Correct Answer: B
Rationale: The correct answer is B because hospice care indeed focuses on providing support and comfort for patients at the end of life. This is achieved through pain management, emotional support, and enhancing quality of life. Choice A is incorrect because hospice care does not aim to cure serious illnesses but rather to provide comfort and care. Choice C is incorrect as hospice care is not limited to patients with cancer but is available to individuals with various terminal illnesses. Choice D is incorrect as hospice care does not focus on extending life expectancy but rather on improving the quality of life during the end-of-life period.
The emergency department (ED) triage nurse is assessing four victims involved in a motor vehicle collision. Which patient has the highest priority for treatment?
- A. A patient with no pedal pulses.
- B. A patient with an open femur fracture.
- C. A patient with bleeding facial lacerations.
- D. A patient with paradoxical chest movements.
Correct Answer: D
Rationale: The correct answer is D: A patient with paradoxical chest movements. This indicates flail chest, a life-threatening condition where a segment of the chest wall moves independently from the rest.
1. Flail chest can lead to respiratory compromise and potential respiratory failure.
2. Immediate intervention is needed to stabilize the chest wall and support breathing.
3. Without prompt treatment, the patient can develop hypoxia and potentially progress to cardiac arrest.
Summary:
- Choice A: No pedal pulses may indicate vascular compromise but does not pose an immediate threat to life.
- Choice B: Open femur fracture requires urgent treatment but does not have the same immediate life-threatening implications as flail chest.
- Choice C: Bleeding facial lacerations can be managed after addressing more critical injuries like flail chest.
Todays critical care nursing environment is constantly changing. What nursing behavior best illustrates awareness of current events affecting critical care nursing?
- A. Participating in the hospitals efforts to recruit new nurses
- B. Volunteering to serve on a disaster response planning committee
- C. Adhering to content taught in basic nursing program
- D. Attending hospital-mandated in-services without other education Answer Key
Correct Answer: B
Rationale: The correct answer is B because volunteering to serve on a disaster response planning committee demonstrates awareness of current events affecting critical care nursing. By actively participating in planning for potential disasters, the nurse shows a proactive approach to staying informed and prepared for emergencies. This behavior indicates a commitment to staying up-to-date with the evolving landscape of critical care nursing.
Choices A, C, and D are incorrect because:
A: Participating in recruitment efforts may be important but does not directly demonstrate awareness of current events affecting critical care nursing.
C: Adhering to basic nursing program content is necessary but does not show active engagement with current events in critical care nursing.
D: Attending hospital-mandated in-services is valuable, but without seeking additional education or involvement in current events, it does not illustrate awareness of the changing critical care nursing environment.