An emergency has occurred on the medical unit. Which is the best leadership style to employ in this circumstance?

Correct Answer: D

Rationale: The correct leadership style in an emergency on a medical unit is autocratic. This style ensures quick decision-making and clear direction, crucial in urgent situations. The leader takes charge, provides instructions, and ensures immediate action to address the emergency. Laissez-faire (A) is too hands-off for emergencies, democratic (B) involves collaboration which may slow down decision-making, and transactional (C) focuses on rewards and punishments rather than immediate action. Autocratic leadership is the most effective in ensuring a swift and effective response to an emergency situation.

Correct Answer: C

Rationale: The correct answer is C because nurses develop a unique relationship with the patient, which allows them to provide valuable insights into the patient's preferences, values, and needs. This relationship enables nurses to advocate effectively for the patient's best interests and ensure that the patient's voice is heard in ethical discussions. Choice A is incorrect because understanding the principle of autonomy is not unique to nurses and does not necessarily make their point of view more valuable in ethical dilemmas. Choice B is also incorrect as the scope of practice does not inherently make the nurse's point of view more valuable in ethical discussions; it simply defines the tasks they are allowed to perform. Choice D is incorrect because while the nurse's code of ethics may recommend their presence at ethical discussions, it does not inherently make their point of view more valuable than other healthcare team members.

Correct Answer: A

Rationale: The correct answer is A: Check the tubing for any kinks. This is the first intervention to implement because increased peak airway pressure can be caused by a kink in the tubing, leading to ineffective ventilation. Checking for kinks ensures proper airflow to the client's lungs. Suctioning for secretions (B) may be necessary but should come after ruling out tubing issues. Assessing the lip line of the ET tube (C) is important for proper placement but does not address the immediate high peak airway pressure concern. Sedating the client with a muscle relaxant (D) should not be the first intervention as it does not address the underlying cause of the high peak airway pressure.

Correct Answer: B

Rationale: The correct answer is B: Frequent oral care with chlorhexidine. This is key in preventing VAP by reducing bacterial colonization in the oral cavity, decreasing the risk of aspiration. Nasopharyngeal suctioning (A) can irritate the airway and increase the risk of infection. Administering prophylactic antibiotics (C) can lead to antibiotic resistance. Increasing tidal volumes (D) can worsen lung injury in ARDS patients. Overall, maintaining good oral hygiene is crucial in preventing VAP in patients with ARDS.

Correct Answer: B

Rationale: The correct answer is B: Endotracheal intubation and positive pressure ventilation. In hypercapnic respiratory failure, the patient's respiratory rate is low, indicating inadequate ventilation. The SpO2 of 89% and increasing lethargy suggest severe hypoxemia and impending respiratory failure. Endotracheal intubation allows for mechanical ventilation to improve oxygenation and ventilation. Positive pressure ventilation can help improve gas exchange and prevent further deterioration. A: Administration of 100% oxygen by non-rebreather mask would not address the underlying issue of inadequate ventilation in hypercapnic respiratory failure. C: Insertion of a mini-tracheostomy with frequent suctioning is not the initial intervention for managing hypercapnic respiratory failure. D: Initiation of bilevel positive pressure ventilation (BiPAP) may not be sufficient for this patient with impending respiratory failure; endotracheal intubation provides better control over ventilation and oxygenation.