Correct Answer: C

Rationale: The correct answer is C because providing specific information such as descending trends in parameters helps the family understand the patient's condition objectively. This allows them to prepare emotionally and make informed decisions. Option A is incorrect because false hope should not be given. Option B is not the best approach as the nurse should still provide some information to the family. Option D is inappropriate and insensitive as it focuses on funeral arrangements rather than addressing the family's concerns about the patient's condition.

Correct Answer: B

Rationale: The correct answer is B: Administration of morphine, 5 mg IV bolus, and initiation of a continuous morphine infusion. Morphine is the preferred pharmacological management for severe dyspnea in end-stage heart failure due to its potent analgesic and anxiolytic properties. Step-by-step rationale: 1. Morphine is a potent opioid that helps relieve dyspnea by reducing anxiety, decreasing respiratory drive, and improving overall comfort. 2. The initial IV bolus of 5 mg provides rapid relief of dyspnea. 3. Initiating a continuous morphine infusion ensures sustained relief of dyspnea. 4. Midazolam (choice A) is a benzodiazepine used for sedation and anxiety, but it is not the first-line treatment for dyspnea in this scenario. 5. Increasing the midazolam (choice C) or morphine (choice D) infusions by 100% dose increments hourly is not appropriate as

Correct Answer: D

Rationale: The correct answer is D because using an end-tidal CO2 monitor is the most reliable method to confirm correct endotracheal tube placement in the trachea. This method detects exhaled CO2, indicating proper tube placement in the trachea. It is a quick and efficient way to confirm placement without delay, reducing the risk of complications. A: Auscultating for bilateral breath sounds is not as reliable because breath sounds may be heard even if the tube is misplaced. B: Obtaining a portable chest x-ray is not the best initial action as it takes time and delays confirming tube placement. C: Observing chest movement may not provide conclusive evidence of proper tube placement and can lead to misinterpretation. In summary, using an end-tidal CO2 monitor is the most accurate and efficient method to verify correct endotracheal tube placement compared to the other options.

Correct Answer: B

Rationale: The correct answer is B because providing a daily update of the patient's progress and facilitating communication with the intensivist directly addresses the family members' need for information in a timely and personalized manner. This intervention ensures that the family is kept informed about the patient's condition and treatment plan, fostering transparency and trust. It also allows for any questions or concerns to be addressed promptly, aiding in the family's understanding and involvement in the patient's care. Now, let's summarize why the other choices are incorrect: A: Handing out a pamphlet may provide information, but it lacks the personalized touch and real-time updates that are crucial for meeting the family's need for information. C: Restricting information and only allowing family members to be present at specific times may create frustration and hinder communication, not effectively meeting their information needs. D: Providing a list of medications is helpful, but it does not offer a comprehensive update on the patient's progress or facilitate direct communication with the medical team, which are

Correct Answer: C

Rationale: The correct answer is C because it explains that the decision to remove life-sustaining treatments is based on the fact that these treatments are not helping the patient and may actually be causing discomfort. This rationale aligns with the principle of beneficence, which emphasizes doing good and avoiding harm to the patient. It also respects the patient's autonomy by prioritizing their well-being and quality of life. Choice A is incorrect as it focuses on financial reasons rather than the patient's best interest. Choice B is incorrect because it prioritizes hospital resources over individual patient care. Choice D is incorrect as it lacks clarity and may come across as insensitive to the significant other's concerns.