In which situation would a healthcare surrogate or proxy a ssume the end-of-life decision-making role for a patient?

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Question 1 of 9

In which situation would a healthcare surrogate or proxy a ssume the end-of-life decision-making role for a patient?

Correct Answer: A

Rationale: The correct answer is A because in this situation, the patient is no longer able to make decisions for themselves due to being heavily sedated. The healthcare surrogate or proxy steps in to make decisions on behalf of the patient to ensure their comfort and well-being. Choice B is incorrect because the patient is competent and able to make their own decisions, so there is no need for a surrogate to take over decision-making. Choice C is incorrect because the patient is competent and has the right to make decisions about their own treatment, even if they go against medical recommendations. Choice D is incorrect because the patient is competent and receiving appropriate treatment for their pain and anxiety, so there is no need for a surrogate to intervene in this scenario.

Question 2 of 9

After the return of spontaneous circulation following the resuscitation of a patient who had a cardiac arrest, therapeutic hypothermia is ordered. Which action will the nurse include in the plan of care?

Correct Answer: A

Rationale: The correct answer is A: Apply external cooling device. Therapeutic hypothermia is a treatment used to protect the brain after cardiac arrest by lowering the body temperature. The nurse should use external cooling devices, such as cooling blankets or ice packs, to achieve and maintain the desired temperature. This method allows for precise temperature control and monitoring. Checking mental status every 15 minutes (choice B) is not the priority as maintaining the temperature is crucial. Avoiding sedative medications (choice C) may be necessary to accurately assess the patient's neurological status. Rewarming if the temperature is <91°F (32.8°C) (choice D) is incorrect as the goal is to maintain hypothermia for a specific duration before gradual rewarming.

Question 3 of 9

Which scenarios contribute to effective handoff communicaabitribo.cno ma/tte csth ange of shift? (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A because it demonstrates effective handoff communication by involving key stakeholders (nephrology consultant physician), requesting specific patient updates, and collaborating on patient care tasks (placing a central line). This scenario promotes continuity of care and ensures important information is shared. Explanation for why other choices are incorrect: B: High noise level disrupts communication and can lead to errors or omissions in handoff information. C: While using a standardized checklist can be beneficial, it alone does not guarantee effective communication if not utilized properly or if key information is missed. D: Conducting reports at the patient's bedside is beneficial for patient involvement but may not address the need for involving relevant healthcare providers like the consultant physician in the handoff process.

Question 4 of 9

The nurse notes that a patient’s endotracheal tube (ET), which was at the 22 cm mark, is now at the 25 cm mark and the patient is anxious and restless. Which action should the nurse take next?

Correct Answer: C

Rationale: The correct answer is C: Listen to the patient’s breath sounds. Moving from 22 cm to 25 cm may indicate ET tube migration. Checking breath sounds can confirm proper tube placement. A may not address the underlying issue. B could worsen the situation if the tube is misplaced. D is not urgent compared to assessing airway integrity.

Question 5 of 9

The nurse has identified an increase in medication errors in the critical care unit over the past several months. What aspect of medication procedures should be evaluated first?

Correct Answer: A

Rationale: The correct answer is A: Adherence to procedures by nursing staff. This should be evaluated first because medication errors are often caused by human factors such as staff not following proper procedures. By assessing adherence, the root cause of errors can be identified and addressed. Choice B: Clarity of interdisciplinary communication may contribute to errors but doesn't directly address staff adherence to procedures. Choice C: Number of new employees could be a factor, but focusing on adherence to procedures is more crucial. Choice D: Changes in administration procedures may impact errors, but evaluating staff adherence is more immediate and directly related to errors.

Question 6 of 9

The nurse is preparing for insertion of a pulmonary artery acbairtbh.ceotme/rte (sPt AC). During insertion of the catheter, what are the priority nursing actions? (Select all that apply.)

Correct Answer: B

Rationale: The correct answer is B: Ensure that a sterile field is maintained during the insertion procedure. This is the priority nursing action because maintaining a sterile field is crucial to prevent infection during the invasive procedure. The nurse must follow strict aseptic technique to reduce the risk of introducing bacteria into the patient's bloodstream. All other choices are incorrect: A: Addressing the patient's anxiety is important but not the priority during the insertion procedure. C: Inflating the balloon is a specific action that should be performed by the physician, not the nurse. D: While monitoring the patient's cardiac rhythm is important, ensuring the sterile field takes precedence to prevent complications.

Question 7 of 9

What is the treatment for an acute exacerbation of asthma?

Correct Answer: B

Rationale: The correct answer is B: Inhaled bronchodilators and intravenous corticosteroids. Bronchodilators help to quickly open up the airways during an asthma exacerbation, providing immediate relief. Intravenous corticosteroids help reduce airway inflammation and prevent further worsening of symptoms. Corticosteroids by mouth (Choice A) are not as effective as intravenous administration during an acute exacerbation. Prone positioning or continuous lateral rotation (Choice C) is not a recommended treatment for asthma exacerbation. Sedation and inhaled bronchodilators (Choice D) are not appropriate as sedation can depress respiratory function and worsen the condition.

Question 8 of 9

The nurse is caring for a patient who is being evaluated clianbiircba.clolmy/ tfeostr brain death by a primary care provider. Which assessment findings by the nurse sup port brain death?

Correct Answer: A

Rationale: The correct answer is A, absence of a corneal reflex, because in brain death, all brainstem reflexes, including the corneal reflex, are absent. This indicates complete loss of brain function. Choice B, unequal reactive pupils, is incorrect as it suggests some level of brainstem function. Choice C, withdrawal from painful stimuli, is also incorrect as it is a spinal reflex and can occur even in the absence of brain function. Choice D, core temperature of 100.8° F, is irrelevant to assessing brain death.

Question 9 of 9

Which statement about family assessment is false?

Correct Answer: A

Rationale: The correct answer is A because assessing the structure of the family (who comprises the family) is not the last step in family assessment. The rationale is that understanding the family structure is essential at the beginning of the assessment process to identify key relationships and support systems. Assessing interaction among family members helps to understand dynamics and relationships within the family. Assessing communication is crucial to identify roles and patterns of interaction. Ongoing assessment is necessary as family dynamics can evolve throughout the illness. Therefore, A is false as family structure assessment is an important initial step, not the last step.

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