A patient with terminal illness expresses fear and anxiety about dying alone. What intervention should the palliative nurse prioritize to address the patient's concerns?

Correct Answer: A

Rationale: The most appropriate intervention for the palliative nurse to prioritize in this situation is to arrange for family members or loved ones to be present at the patient's bedside. Having loved ones nearby can provide emotional support, comfort, and reassurance to the patient during their final moments. This can help alleviate the fear and anxiety the patient is experiencing about dying alone. Additionally, it can contribute to a sense of connectedness and peace for both the patient and their loved ones during this challenging time. Offering practical solutions to address the patient's emotional needs is key in providing holistic palliative care.

Correct Answer: A

Rationale: Ventilator-associated pneumonia (VAP) is a serious complication in patients receiving mechanical ventilation in the ICU. The priority intervention to manage respiratory infection in a patient with VAP is the administration of appropriate antibiotics to target and eliminate the causative pathogens. Broad-spectrum antibiotics are usually initiated empirically to cover a wide range of potential pathogens commonly associated with VAP, such as Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter species. Timely initiation of antibiotic therapy is crucial in improving outcomes and reducing morbidity and mortality associated with VAP. Other interventions like endotracheal suctioning, oral hygiene measures, and early mobilization are also important in preventing complications and promoting recovery, but the primary focus should be on treating the infection with antibiotics.

Correct Answer: A

Rationale: In the scenario described, the patient is experiencing refractory hypotension despite adequate fluid resuscitation, indicating the presence of septic shock. In septic shock, systemic vasodilation and vascular hyporesponsiveness contribute to hypotension. Therefore, the primary management approach is to restore vascular tone and blood pressure to maintain organ perfusion. Administering vasopressor medications (Choice A) is the crucial intervention to achieve this goal. Vasopressors, such as norepinephrine or vasopressin, constrict blood vessels and increase blood pressure, helping to stabilize the patient in septic shock. While options B and C (performing blood cultures and initiating broad-spectrum antibiotics) are important for identifying the causative pathogen and treating the infection, they are secondary to the immediate need for hemodynamic support in septic shock. Prophylactic anticoagulation (Choice D) is not the primary intervention for

Correct Answer: A

Rationale: The most important intervention for managing ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a patient undergoing mechanical ventilation in the ICU is to start appropriate antimicrobial therapy targeting MRSA. Vancomycin or linezolid are commonly used antibiotics for MRSA infections. These medications are effective against MRSA and can help in treating the infection and preventing further complications. It is crucial to initiate antimicrobial therapy promptly once the diagnosis of VAP caused by MRSA is suspected or confirmed to improve patient outcomes. Other interventions such as bronchoalveolar lavage for diagnostic purposes, contact precautions, or antifungal therapy may be relevant but the priority is to start effective antibiotic therapy to target the specific pathogen causing the infection.

Correct Answer: C

Rationale: Bursitis is characterized by inflammation of the bursa, which is a small, fluid-filled sac that cushions and reduces friction between bones, tendons, and muscles near joints. In the shoulder, bursitis commonly affects the subacromial bursa, located between the rotator cuff tendons and the top of the shoulder blade. The inflammation of this bursa can lead to pain and restricted movement around the shoulder joint.