Correct Answer: D

Rationale: The correct answer is D: Maintaining a quiet environment during hours of sleep. This action is directed at reducing environmental stress in the critical care unit because noise and disturbances during sleep can negatively impact patients' rest and recovery. By ensuring a quiet environment, patients can have uninterrupted sleep, which is crucial for healing. Rationale: 1. Constant expert evaluation of patient status (A) may be important but does not directly address environmental stress. 2. Limiting visits to immediate family (B) may hinder patients' emotional support and can be stressful for families. 3. Bathing all patients during hours of sleep (C) may disrupt patients' rest and increase stress levels rather than reduce it.

Correct Answer: C

Rationale: The correct answer is C: Damage to the type II pneumocytes, which produce surfactant. Acute respiratory distress syndrome (ARDS) is characterized by damage to the alveolar epithelium, including type II pneumocytes responsible for producing surfactant. Surfactant reduces surface tension in the alveoli, preventing collapse. Damage to type II pneumocytes impairs surfactant production, leading to alveolar collapse and impaired gas exchange. Choices A, B, and D are incorrect because ARDS is not primarily caused by a decrease in white blood cells, damage to the right mainstem bronchus, or decreased capillary permeability.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Bladder catheterization helps relieve urinary obstruction, a common postrenal cause of acute kidney injury. 2. By draining urine from the bladder, it prevents further damage to the kidneys. 3. This intervention addresses the underlying cause of the kidney injury, leading to improvement. Summary: - Choice A is correct as it directly addresses the postrenal cause by relieving urinary obstruction. - Choices B, C, and D are incorrect as they do not target the specific postrenal cause of acute kidney injury.

Correct Answer: C

Rationale: The correct answer is C because a pulmonary artery occlusion pressure of 25 mm Hg indicates possible fluid overload or cardiac issue requiring urgent evaluation. This value is high, suggesting increased pressure in the left side of the heart. Additionally, the oxygen saturation of 89% on 3 L of oxygen indicates potential respiratory compromise. This patient needs immediate assessment and intervention to prevent worsening of their condition. Choice A is incorrect as a central venous pressure of 6 mm Hg is within normal limits, and the urine output is adequate. Choice B is incorrect as a BP of 110/60 mm Hg is acceptable, and a slightly dampened arterial waveform is not an immediate concern. Choice D is incorrect as a pulmonary artery pressure of 25/10 mm Hg is within normal range, and an oxygen saturation of 94% on 2 L of oxygen is acceptable.

Correct Answer: C

Rationale: The correct answer is C because the SUPPORT study revealed disparities between patients' care preferences and the actual care provided. This is supported by the findings that many patients did not receive treatments aligned with their preferences. Choice A is incorrect because the study actually highlighted communication challenges between patients and healthcare providers. Choice B is incorrect as the study showed that critical care units often do not meet the needs of dying patients and their families. Choice D is incorrect as the study found that pain and suffering of patients at the end of life are not always well controlled in hospitals.