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Which statement regarding ethical concepts is true?
- A. A living will is the same as a healthcare proxy.
- B. A signed donor card ensures that organ donation will o ccur in the event of brain death.
- C. A surrogate is a competent adult designated by a perso n to make healthcare decisions in the event the person is incapacitated.
- D. A persistent vegetative state is the same as brain deatha ibnir bm.cooms/tt esstt ates.
Correct Answer: C
Rationale: Rationale: Choice C is correct because a surrogate is indeed a competent adult designated to make healthcare decisions for an incapacitated person. This individual is typically chosen by the person themselves through a legal document like a healthcare proxy. This ensures that someone trusted can make important decisions when the person is unable to do so. Choices A, B, and D are incorrect because a living will and healthcare proxy serve different purposes, a signed donor card does not guarantee organ donation in the event of brain death (medical criteria are also required), and a persistent vegetative state is different from brain death (brain death implies irreversible cessation of brain function while a vegetative state involves some level of brain function).
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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.
The family members of a patient who has just been admitted to the intensive care unit (ICU) with multiple traumatic injuries have just arrived in the ICU waiting room. Which action should the nurse take next?
- A. Explain ICU visitation policies and encourage family visits.
- B. Immediately take the family members to the patient’s bedside.
- C. Describe the patient’s injuries and the care that is being provided.
- D. Invite the family to participate in a multidisciplinary care conference.
Correct Answer: A
Rationale: The correct answer is A: Explain ICU visitation policies and encourage family visits. This is the best course of action because it prioritizes the needs of the family members by providing them with information on visitation policies and encouraging them to visit the patient. This helps establish communication, support, and involvement in the patient's care. It also respects the family's emotional needs during a challenging time.
Choices B, C, and D are incorrect:
B: Immediately taking the family members to the patient's bedside may overwhelm them and disrupt the patient's care.
C: Describing the patient's injuries and care being provided should be done in a more controlled environment to ensure the family's understanding and emotional readiness.
D: Inviting the family to a multidisciplinary care conference may be premature without first addressing their immediate concerns and providing support.
A patient with terminal cancer reports a sudden onset of severe pain. Which intervention should the nurse implement first?
- A. Assess the patient’s pain using a standardized pain scale.
- B. Administer a PRN dose of prescribed analgesic.
- C. Notify the healthcare provider about the patient’s pain.
- D. Reposition the patient to enhance comfort.
Correct Answer: A
Rationale: The correct answer is A: Assess the patient’s pain using a standardized pain scale. The first step is to assess the severity and nature of the pain to determine the appropriate intervention. This allows the nurse to understand the pain intensity and characteristics, which guides the choice of analgesic and dosing. Administering analgesics (B) without proper assessment can lead to inappropriate treatment. Notifying the healthcare provider (C) is important but assessing the pain should come first. Repositioning the patient (D) may provide comfort but addressing the pain directly is the priority.
A patient is being mechanically ventilated in the synchronized intermittent mandatory ventilation mode at a rate of 4 breaths/min. Spontaneous re spirations are 12 breaths/min. The patient receives a dose of morphine sulfate, and now respi rations decrease to 4 breaths/min. What adjustments may need to be made to the patient’s ve ntilator settings?
- A. Add positive end-expiratory pressure (PEEP).
- B. Add pressure support.
- C. Change to assist/control ventilation at a rate of 4 breathabsi/rmb.cionm. /test
- D. Increase the synchronized intermittent mandatory ventilation respiratory rate.
Correct Answer: C
Rationale: The correct answer is C: Change to assist/control ventilation at a rate of 4 breaths/min. When the patient's spontaneous respirations decrease to match the ventilator rate, it indicates that the patient is not actively participating in breathing. Changing to assist/control ventilation allows the patient to trigger breaths when they desire, ensuring a more synchronized and comfortable breathing pattern.
A: Adding PEEP may help improve oxygenation but is not directly related to the issue of decreased spontaneous respirations.
B: Adding pressure support provides additional support during inspiration but does not address the underlying issue of decreased spontaneous respirations.
D: Increasing the SIMV respiratory rate would not address the patient's decreased spontaneous respirations and could potentially lead to overventilation.
The patient has a temporary percutaneous catheter in place for treatment of acute kidney injury. The catheter has been in place for 5 days. The nurse should
- A. prepare to assist with a routine dialysis catheter change.
- B. evaluate the patient for signs and symptoms of infection.
- C. teach the patient that the catheter is designed for long-term use.
- D. use one of the three lumens for fluid administration.
Correct Answer: B
Rationale: The correct answer is B because after 5 days, the risk of infection increases. Evaluating the patient for signs and symptoms of infection is crucial for early detection and treatment. Choice A is incorrect because routine dialysis catheter changes are not necessary after only 5 days. Choice C is incorrect as percutaneous catheters are for short-term use. Choice D is incorrect as using the catheter for fluid administration may increase the risk of infection.