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While caring for a critically ill patient, the nurse knows that fostering patient control over the environment is a method for stress reduction. What nursing intervention gives the patient the most environmental control while still adhering to best practice principles?
- A. Ask the patient whether he or she wants to get out of bed.
- B. Give the patients bath at the same time every day.
- C. Explain painful procedures only after giving pain medication.
- D. Choose menu items for the patient to ensure a balanced diet.
Correct Answer: A
Rationale: Step 1: Asking the patient whether he or she wants to get out of bed allows the patient to make a decision regarding their immediate environment, promoting autonomy and control.
Step 2: This intervention respects the patient's preferences and fosters a sense of dignity and empowerment, reducing stress.
Step 3: Best practice principles in nursing emphasize patient-centered care and promoting patient autonomy.
Summary:
Choice A is correct as it directly involves the patient in decision-making, enhancing their sense of control. Choices B, C, and D do not provide the same level of autonomy and control to the patient, making them less effective in reducing stress and promoting patient well-being.
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A nurse who works in an intermediate care unit has experienced high nursing turnover. The nurse manager is often considered to be an autocratic leade r by staff members and that leadership style is contributing to turnover. The nurse asks to be involved in developing new guidelines to prevent pressure ulcers in the patient populat ion. The nurse manager suggests that the nurse has not yet had enough experience to be on tahbierb p.croemv/teenstt ion task force. This situation and setting is an example of what form of ineffec tive leadership?
- A. Creating a barrier to inter-staff communication.
- B. Supporting a work environment that is unhealthy.
- C. Displaying ineffective decision making.
- D. Demonstrating nursing practice that is not evidence-based.
Correct Answer: C
Rationale: The correct answer is C: Displaying ineffective decision making. In this scenario, the nurse manager's decision to exclude the nurse from participating in developing new guidelines is an example of ineffective decision making. By dismissing the nurse's request based on lack of experience rather than considering their input and involvement, the manager is not utilizing the nurse's expertise and potentially missing out on valuable insights. This decision reflects a lack of inclusivity, collaboration, and respect for the nurse's professional growth and potential contributions. The other choices are not directly applicable in this context as the core issue lies in the manager's decision-making process.
Which statement is a likely response from someone who h as survived a stay in the critical care unit?
- A. “I don’t remember much about being in the ICU, but if I had to be treated there again, it would be okay. I’m glad I can see my grandchildren again.”
- B. “If I get that sick again, do not take me to the hospital. I would rather die than go through having a breathing tube put in again.”
- C. “My family is thrilled that I am home. I know I need some extra attention, but my children have rearranged their schedules to help me ou t.”
- D. “Since I have been transferred out of the ICU, I cannot get enough to eat. They didn’t let me eat in the ICU, so I’m making up for it no w.”
Correct Answer: A
Rationale: Rationale: Choice A is the correct answer because it reflects a positive attitude towards potential future treatments in the critical care unit and gratitude for being able to see family again. The survivor acknowledges the past experience but remains optimistic.
Summary:
- Choice B is incorrect as it shows a strong aversion to hospital care, indicating a preference for death over treatment.
- Choice C is incorrect as it focuses on the family's reaction and not the survivor's personal experience or perspective.
- Choice D is incorrect as it highlights a trivial aspect (eating) rather than reflecting on the ICU experience or future treatments.
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.
A nurse who has been recently hired to manage the nursing staff of the ICU is concerned at the lack of evidence-based practice she sees among the staff. Which of the following would be the best step for her to take to promote incorporating evidence into clinical practice?
- A. Only hire nurses certified in critical care nursing.
- B. Leave copies of several different nursing journals in the nurses lounge.
- C. Demonstrate to the staff the best nursing-related search terms to use in Google orYahoo!
- D. Introduce the staff to the PubMed search engine and assign them topics to researchon it.
Correct Answer: D
Rationale: The correct answer is D because introducing the staff to the PubMed search engine and assigning them topics to research on it is the most effective way to promote evidence-based practice. PubMed is a reputable database that contains a vast collection of peer-reviewed articles and research studies, making it a reliable source for evidence. By assigning specific topics, the nurse can ensure that the staff is focusing on relevant and current information, fostering a deeper understanding of evidence-based practice.
Choice A is incorrect because certification in critical care nursing does not guarantee a commitment to evidence-based practice. Choice B is not as effective as it relies on passive exposure to journals rather than active engagement with specific research topics. Choice C is not the best option as using general search terms on search engines like Google or Yahoo may lead to unreliable or outdated information.
The nurse is caring for an older adult patient who is in card iogenic shock and has failed to respond to medical treatment. The primary care provider conducts a conference to explain that they have exhausted treatment options and suggest that the patient be made a “do not resuscitate” status. This scenario illustrates what medical concept?
- A. Brain death
- B. Futility
- C. Incompetence
- D. Life-prolonging procedures
Correct Answer: B
Rationale: The correct answer is B: Futility. In this scenario, the primary care provider suggests making the patient a "do not resuscitate" status because further medical treatment is deemed futile. Futility refers to situations where medical interventions are unlikely to achieve the desired outcome. This decision is made when the benefits of continuing treatment do not outweigh the burdens on the patient.
Summary:
A: Brain death does not apply here as the patient is not brain dead.
C: Incompetence refers to the patient's ability to make decisions, not the medical concept being illustrated.
D: Life-prolonging procedures are not being discussed; the focus is on the futility of further treatment.