A patient nearing death experiences increased secretions and noisy breathing. What is the nurse’s priority intervention?

Correct Answer: B

Rationale: The correct answer is B: Administer anticholinergic medications as prescribed. Anticholinergic medications can help dry up secretions and improve breathing in a patient nearing death. This intervention targets the underlying cause of increased secretions. Suctioning (choice A) may provide temporary relief but does not address the root issue. Elevating the head of the bed and repositioning (choice C) can help with comfort but do not directly address the secretions. Restricting oral intake (choice D) may lead to dehydration and discomfort without effectively managing the secretions. Administering anticholinergic medications is the priority as it directly targets the symptom of increased secretions, improving the patient's comfort and quality of life.

Correct Answer: D

Rationale: The correct answer is D because it accurately states that withholding "extraordinary" resuscitation is legal and should be based on specified criteria in advance directives and physician orders. This is in line with medical ethics and patient autonomy. A is incorrect because family presence during resuscitation can be beneficial for emotional support and decision-making. B is incorrect as it is still necessary for a physician to document "do not resuscitate" orders even with a healthcare surrogate. C is incorrect as "slow codes" are not ethical and go against the principle of beneficence.

Correct Answer: A

Rationale: The correct answer is A: Diminished breath sounds over the left lung field. This finding could indicate a pneumothorax, a serious complication of subclavian CVC insertion. Immediate action is required to prevent respiratory distress. Incorrect answers: B: Localized pain at insertion site is common post-procedure and may not indicate a serious issue. C: A central venous pressure of 5 mm Hg is within the normal range and does not require immediate action. D: Slight bloody drainage is expected initially and can be managed with routine care.

Correct Answer: D

Rationale: Rationale: The correct answer is D because the purpose of the healthcare system in the United States is primarily focused on disease prevention and symptom management. This aligns with societal views as healthcare is geared towards improving health outcomes and quality of life. Incorrect choices: A: Dying is not viewed as a failure of the system or providers, rather as a natural part of life. B: Most Americans prefer to die at home or in hospice care rather than in a hospital. C: Illnesses are not always curable, and death can result from various complex conditions beyond treatment.

Correct Answer: B

Rationale: The correct answer is B: Explaining all procedures in easy-to-understand terms. This intervention is appropriate as it helps reduce the patient's anxiety by providing clear information about what to expect during their stay in the critical care unit. This promotes a sense of control and understanding, which can positively impact the patient's coping mechanisms. A: Allowing unrestricted visiting by several family members at one time may overwhelm the patient and interfere with their rest and recovery. C: Providing back massage and mouth care may be beneficial but may not directly address the patient's need for information and understanding. D: Turning down the alarm volume on the cardiac monitor may provide a more comfortable environment but does not address the patient's emotional and psychological needs related to coping with admission to the critical care unit.

Correct Answer: C

Rationale: Step-by-step rationale: 1. The Synergy Model emphasizes matching nurse competencies with patient needs. 2. A male nurse may not be culturally appropriate for a Muslim female patient due to religious beliefs. 3. Gender segregation is important in Islamic culture, especially concerning intimate care. 4. Therefore, assigning a new graduate male nurse to care for a Muslim female patient in critical condition is the most inappropriate choice. Summary: - Choice A is incorrect because being a new graduate does not impact cultural competence. - Choice B is incorrect as experience does not necessarily make a nurse the best fit for a specific patient. - Choice D is incorrect as postpartum experience is relevant, but cultural considerations are more critical in this scenario.

Correct Answer: A

Rationale: The correct answer is A. The nurse should suggest that the father contact his spiritual leader for counseling. This option is appropriate as it recognizes the importance of spirituality in coping with difficult situations. It offers emotional support and guidance to the father and his son during a time of crisis. Option B is incorrect as the nurse sharing her own religious beliefs may not align with the father's beliefs, potentially causing confusion or discomfort. Option C is not the best intervention, as the doctor's role is primarily medical, and explaining the odds of survival may not address the emotional and spiritual needs of the family. Option D is also incorrect as leaving the father and son to grieve alone does not provide them with the necessary support and guidance during such a challenging time.

Correct Answer: A

Rationale: The correct answer is A: Burn units. Burn units were identified as the first critical care units due to the complex and intensive care required by burn patients. These units were established to provide specialized care for burn victims, including wound management, infection control, and fluid resuscitation. Summary: - Burn units were the first critical care units due to the specialized care needed for burn patients. - Coronary care units focus on cardiac conditions, not the first identified critical care units. - Recovery rooms are for post-operative care, not specifically for critical care. - Neonatal intensive care units are specialized for newborns, not the first critical care units.

Correct Answer: B

Rationale: The correct answer is B: Mechanical ventilation via an endotracheal tube. In acute respiratory failure, especially in the setting of pneumonia and COPD, mechanical ventilation is often necessary to support breathing. Endotracheal intubation allows for precise control of airway patency, oxygenation, and ventilation. Emergency tracheostomy (choice A) is typically reserved for long-term ventilatory support. Noninvasive positive-pressure ventilation (choice C) may not provide sufficient support in severe cases. Oxygen via bag-valve-mask (choice D) may not be adequate for ventilatory support in acute respiratory failure.