Correct Answer: B

Rationale: The correct answer is B: Futility. In this scenario, the primary care provider suggests making the patient a "do not resuscitate" status because further medical treatment is deemed futile. Futility refers to situations where medical interventions are unlikely to achieve the desired outcome. This decision is made when the benefits of continuing treatment do not outweigh the burdens on the patient. Summary: A: Brain death does not apply here as the patient is not brain dead. C: Incompetence refers to the patient's ability to make decisions, not the medical concept being illustrated. D: Life-prolonging procedures are not being discussed; the focus is on the futility of further treatment.

Correct Answer: B

Rationale: The correct answer is B. Increased peak inspiratory pressure on the ventilator would cue the nurse to the potential of ARDS in a patient with respiratory distress. ARDS is characterized by severe respiratory failure with bilateral pulmonary infiltrates. An increase in peak inspiratory pressure on the ventilator indicates that the lungs are becoming stiffer, which is a common finding in ARDS due to increased inflammation and fluid accumulation in the alveoli. This finding alerts the nurse to the possibility of ARDS and the need for further assessment and intervention. Summary of other choices: A: Increased oxygen saturation via pulse oximetry is a nonspecific finding and may not specifically indicate ARDS. C: Normal chest radiograph with enlarged cardiac structures is more indicative of heart failure rather than ARDS. D: PaO2/FiO2 ratio > 300 is a criterion used to diagnose ARDS, but a value higher than 300 actually indicates mild ARDS, so it would not necessarily cue the nurse

Correct Answer: C

Rationale: The correct answer is C because the healthcare surrogate should base decisions on recommendations of the physician and healthcare team who have the expertise to provide medical advice. They are best positioned to understand the patient's condition and treatment options. Personal beliefs (A) may not align with medical best practices. Family and friends' recommendations (B) may not be informed by medical knowledge. Wishes previously expressed by the patient (D) are important but may need to be interpreted in the context of the current medical situation, which healthcare professionals can provide.

Correct Answer: D

Rationale: The correct action is D: Manually ventilate the patient with 100% oxygen. This is crucial to ensure adequate oxygenation and prevent hypoxia. Holding the ET tube can lead to extubation and airway compromise. Activating the rapid response team (A) may delay immediate intervention. Providing reassurance (B) is important but not the priority in this situation. Calling the health care provider (C) to reinsert the tube would also lead to a delay in providing essential respiratory support.

Correct Answer: D

Rationale: The correct answer is D: A patient with paradoxical chest movements. This indicates flail chest, a life-threatening condition where a segment of the chest wall moves independently from the rest. 1. Flail chest can lead to respiratory compromise and potential respiratory failure. 2. Immediate intervention is needed to stabilize the chest wall and support breathing. 3. Without prompt treatment, the patient can develop hypoxia and potentially progress to cardiac arrest. Summary: - Choice A: No pedal pulses may indicate vascular compromise but does not pose an immediate threat to life. - Choice B: Open femur fracture requires urgent treatment but does not have the same immediate life-threatening implications as flail chest. - Choice C: Bleeding facial lacerations can be managed after addressing more critical injuries like flail chest.