Correct Answer: D

Rationale: The correct answer is D. The patient receiving IV heparin with a PTT of 98 seconds is at risk for bleeding due to the therapeutic range of 60-80 seconds. Assessing this patient first is crucial to prevent potential bleeding complications. A high PTT indicates the blood is not clotting properly, increasing the risk of bleeding. Prompt assessment and possible adjustment of heparin infusion are needed.

A: The patient with a temperature of 101.4°F may have a fever but is not at immediate risk compared to the patient with a high PTT.
B: The patient on BiPAP with a respiratory rate of 16 is stable and does not require immediate assessment.
C: The patient post-percutaneous coronary intervention needing to void is a routine need and does not require immediate attention compared to the patient with a critical lab value.

Correct Answer: B

Rationale: The correct answer is B: Improvement in symptoms and quality of life. In palliative care, the primary focus is on enhancing the patient's quality of life by managing symptoms and providing comfort. This is achieved through effective symptom control, psychosocial support, and improving overall well-being. Complete resolution of the underlying disease (
A) is often not possible in palliative care as the focus shifts from curative treatments to comfort care. Increased adherence to curative treatments (
C) may not be the main goal in palliative care, as the emphasis is on improving the patient's comfort rather than prolonging life. Achievement of long-term survival goals (
D) is not typically the primary outcome in palliative care, as the focus is on providing support and care for patients with life-limiting illnesses.

Correct Answer: A

Rationale: The correct answer is A: Bilateral infiltrates on chest x-ray study. ARDS diagnosis requires bilateral infiltrates on chest x-ray, indicative of non-cardiogenic pulmonary edema.
Choice B, decreased cardiac output, is not a diagnostic criterion for ARDS.
Choice C, PaO2/FiO2 ratio of less than 200, is a key diagnostic criteria for ARDS, indicating severe hypoxemia.
Choice D, PAOP of more than 18 mm Hg, is used to differentiate between cardiogenic and non-cardiogenic causes of pulmonary edema, but it is not a direct diagnostic criterion for ARDS.

Correct Answer: D

Rationale: The correct answer is D. The first step in endotracheal intubation is to insert the endotracheal tube with a laryngoscope and blade to visualize the vocal cords and guide the tube into the trachea. This ensures proper placement of the tube for effective ventilation. Assessing the balloon symmetry (
Choice
A) and lung fields (
Choice
B) would come after the tube is successfully inserted. Inflating the balloon of the endotracheal tube (
Choice
C) should be the last step to secure the tube in place.

Correct Answer: B

Rationale:
Step 1: Start with Background - statement B provides relevant background information about the patient's current condition and why there is a need for communication.

Step 2: Move on to Situation - statement D sets the current situation where the nurse expresses concern about the patient's symptom.

Step 3: Next is Assessment - statement C details the nurse's assessment findings, highlighting the critical aspects of the patient's condition.

Step 4: End with Recommendation - statement A suggests the necessary action to be taken based on the assessment findings. This order ensures a clear and structured communication process.

Summary:
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Choice A is incorrect as the recommendation should come after providing background, situation, and assessment.
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Choice C is incorrect as assessment details should precede the patient's critical condition.
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Choice D is incorrect as the situation should be explained before expressing concern.