Ideally, by whom and when should an advance directive be developed?

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Critical Care Nursing NCLEX Questions Questions

Question 1 of 5

Ideally, by whom and when should an advance directive be developed?

Correct Answer: C

Rationale: Step-by-step rationale for choice C: 1. Advance directives should be made by the patient to reflect their wishes. 2. Developing it before illness ensures clarity and avoids confusion. 3. Patients may not be able to make informed decisions in critical conditions. 4. Family or surrogates may not accurately represent the patient's wishes. Summary: A - Family in critical condition may not know the patient's wishes. B - Hospital admission process may be too late for clear decision-making. D - Healthcare surrogate may not fully understand the patient's preferences.

Question 2 of 5

The nurse is caring for a critically ill patient with terminal cancer. The monitor alarms and shows ventricular tachycardia. The patient does not have a “do not resuscitate” order written on the chart. What is the appropriate nursing action?

Correct Answer: D

Rationale: The correct answer is D: Initiate CPR and call a code. In this scenario, the patient is critically ill with ventricular tachycardia, a life-threatening arrhythmia. Since there is no "do not resuscitate" order, the appropriate nursing action is to initiate CPR immediately to attempt to restore the patient's cardiac function and circulation. Calling a code will ensure that a team of healthcare providers can respond promptly with necessary interventions. Options A and B involve unnecessary delays in potentially life-saving interventions. Option C is incorrect as withholding intubation can compromise the patient's airway and oxygenation. Thus, option D is the most appropriate action to prioritize the patient's safety and well-being in this critical situation.

Question 3 of 5

Warning signs that can assist the critical care nurse in reco gnizing that an ethical dilemma may exist include which of the following? (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A because when family members are confused about the patient's condition or treatment, it can indicate a lack of communication or understanding, leading to a potential ethical dilemma. This confusion may result in conflicting views on what is best for the patient, potentially leading to disagreements and ethical conflicts. Choice B is incorrect because although family conflict can lead to ethical dilemmas, it is not a direct warning sign that an ethical dilemma exists. Choice C is incorrect because the family asking not to inform the patient about treatment is more related to communication preferences rather than a clear indication of an ethical dilemma. Choice D is incorrect because a deteriorating patient condition, while concerning, does not directly signal an ethical dilemma unless there are specific ethical considerations involved in the treatment decisions.

Question 4 of 5

A 75-year-old patient, who suffered a massive stroke 3 weeks ago, has been unresponsive and

Correct Answer: E

Rationale: Step 1: The scenario describes a decision made based on the patient's previously expressed wishes. Step 2: The decision aligns with the principle of respecting patient autonomy. Step 3: The term that best describes this situation is "Advance Directive." Summary: - A: Incorrect, as it involves actively ending the patient's life without their consent. - B: Incorrect, as euthanasia involves intentionally causing death to relieve suffering. - C: Incorrect, as palliative care focuses on improving quality of life for the patient. - D: Incorrect, as withdrawal of life support involves discontinuing medical interventions, not honoring the patient's wishes.

Question 5 of 5

Which statement is true regarding the impact of culture on end-of-life decision making?

Correct Answer: C

Rationale: Rationale: 1. Culture and religious beliefs can significantly impact end-of-life decision making by influencing values, beliefs, and preferences. 2. These factors may affect choices related to treatment options, quality of life, and spiritual aspects. 3. Different cultural backgrounds may lead to varying perspectives on autonomy, family involvement, and medical interventions. 4. Option A and B make generalizations based on race, which is not accurate as preferences can vary widely within any racial group. 5. Option D is incorrect as perspectives on end-of-life care can vary even within the same religious group due to individual beliefs and interpretations.

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