As part of the Synergy Model, the nurse has identified a patient characteristic of resiliency. What patient behavior demonstrates resiliency?

Correct Answer: B

Rationale: The correct answer is B because developing a list of questions for the physician shows active engagement in their healthcare, seeking information, and taking control of their situation, which are characteristics of resiliency. This behavior indicates the patient's willingness to understand and cope with their health condition. Choices A, C, and D are incorrect as they demonstrate maladaptive coping mechanisms such as dysfunctional grieving, denial, and blame assignment, which are not indicative of resiliency. Resiliency involves adaptability, problem-solving, and seeking support, which are better exemplified by choice B.

Correct Answer: A

Rationale: The correct answer is A: Assess the patient’s pain using a standardized pain scale. The first step is to assess the severity and nature of the pain to determine the appropriate intervention. This allows the nurse to understand the pain intensity and characteristics, which guides the choice of analgesic and dosing. Administering analgesics (B) without proper assessment can lead to inappropriate treatment. Notifying the healthcare provider (C) is important but assessing the pain should come first. Repositioning the patient (D) may provide comfort but addressing the pain directly is the priority.

Correct Answer: C

Rationale: The correct answer is C: Insertion of a vena cava filter. This is a strategy for preventing thromboembolism in patients at risk who cannot take anticoagulants. The vena cava filter prevents blood clots from traveling to the lungs by trapping them in the inferior vena cava. It is a mechanical device that does not interfere with the body's clotting process. Explanation of why other choices are incorrect: A: Administration of two aspirin tablets every 4 hours is not an effective strategy for preventing thromboembolism in high-risk patients. Aspirin is an antiplatelet agent and may not be sufficient for preventing blood clots in these patients. B: Infusion of thrombolytics is used for breaking down blood clots that have already formed, not for prevention. It is not a suitable option for preventing thromboembolism in at-risk patients. D: Subcutaneous heparin administration every 12

Correct Answer: D

Rationale: The correct answer is D: Synergy model of practice. The Synergy model emphasizes matching nurse competencies with patient needs for optimal outcomes. In this scenario, the charge nurse assigned the experienced, certified nurse to a complex patient requiring specialized care (sepsis, renal replacement therapy, ventilation), aligning with the model's principle of matching nurse expertise to patient acuity. Assigning the less experienced nurse to stable patients aligns with the model's focus on optimizing patient outcomes by matching nurse competencies appropriately. A: Crew resource management model focuses on teamwork and communication to enhance safety, not specifically on nurse-patient assignments. B: National Patient Safety Goals are broad guidelines for improving patient safety, not specific to nurse-patient assignments. C: Quality and Safety Education for Nurses (QSEN) model focuses on integrating quality and safety competencies into nursing education, not specifically on nurse-patient assignments.

Correct Answer: B

Rationale: The correct answer is B: a decreased risk of peritonitis exists. Peritoneal dialysis involves the insertion of a catheter into the peritoneal cavity, which can introduce bacteria and increase the risk of peritonitis. However, compared to hemodialysis, peritoneal dialysis has a lower risk of bloodstream infections and vascular access-related complications, leading to a decreased risk of peritonitis. This advantage makes peritoneal dialysis a favorable option for some patients. Incorrect choices: A: peritoneal dialysis is actually less time-intensive compared to hemodialysis. C: biochemical disturbances are corrected more gradually in peritoneal dialysis. D: the danger of hemorrhage is not specific to peritoneal dialysis.

Correct Answer: A

Rationale: The correct answer is A: Give N-acetylcysteine (Mucomyst). N-acetylcysteine is the antidote for acetaminophen overdose. It helps replenish glutathione, which is depleted by acetaminophen metabolism. This prevents liver damage. Choice B, chelation therapy, is not indicated for acetaminophen overdose. Choice C, oxygen therapy, is not directly related to acetaminophen overdose treatment. Choice D, drinking water, will not address the overdose and may not be safe in high doses. Therefore, the best course of action is to administer N-acetylcysteine to prevent liver damage in acetaminophen overdose.

Correct Answer: C

Rationale: The correct answer is C: The distal tip of the catheter is in the appropriate position. Rationale: 1. The superior vena cava is a desirable location for a central venous catheter tip placement as it is close to the heart for rapid medication delivery. 2. Catheter tip in the superior vena cava allows for proper venous return and minimizes the risk of complications. 3. The nurse does not need to remove or adjust the catheter if the tip is in the superior vena cava. 4. Advancing the catheter into the pulmonary artery (option D) would be incorrect as it can lead to serious complications. Incorrect choices: A: Incorrect because placement in the superior vena cava is acceptable. B: Incorrect as placement in the superior vena cava does not increase the risk of ventricular dysrhythmias. D: Incorrect as advancing the catheter into the pulmonary artery is unnecessary and risky.

Correct Answer: D

Rationale: The correct answer is D because CRRT removes solutes and water slowly, which is beneficial for hemodynamically unstable patients. This slow removal allows for gradual fluid and electrolyte balance adjustments, reducing the risk of hemodynamic instability. A: Incorrect - A hemofilter is indeed used in CRRT, but this choice does not highlight the key difference between CRRT and intermittent hemodialysis. B: Incorrect - CRRT actually provides slower solute and water removal compared to intermittent hemodialysis. C: Incorrect - Diffusion does occur in CRRT, as it is a key mechanism for solute removal in the process. In summary, the key difference between CRRT and intermittent hemodialysis is the slow removal of solutes and water in CRRT, making choice D the correct answer.

Correct Answer: A

Rationale: The correct answer is A because in ARDS, there is a severe impairment in gas exchange leading to hypoxemia. Decreasing PaO2 levels despite increased FiO2 administration indicate poor oxygenation, a hallmark of ARDS. Elevated alveolar surfactant levels (Choice B) do not directly correlate with ARDS pathophysiology. Increased lung compliance with increased FiO2 administration (Choice C) is not characteristic of ARDS, as ARDS leads to decreased lung compliance. Respiratory acidosis associated with hyperventilation (Choice D) is not a typical finding in ARDS, as hyperventilation is usually present in an attempt to compensate for hypoxemia.