Correct Answer: D

Rationale: The correct answer is D because after arteriovenous fistula implantation, it is essential to assess for the presence of a bruit (audible sound caused by turbulent blood flow) and thrill (vibratory sensation) in the access site, which indicates proper functioning of the fistula. This assessment ensures that blood is flowing adequately through the newly created access for dialysis or other procedures. Drawing blood or taking blood pressures from the fistula arm can lead to complications such as clot formation or damage to the fistula. Starting a new IV line in the same arm is contraindicated to avoid compromising the newly created fistula. Thus, auscultating for a bruit and palpating for a thrill are the appropriate nursing actions in this scenario.

Correct Answer: D

Rationale: Rationale for Correct Answer (D - Low cardiac output secondary to increased intrathoracic pressure): 1. PEEP increases intrathoracic pressure, which can impede venous return to the heart. 2. Impaired venous return reduces preload, leading to decreased cardiac output. 3. Decreased cardiac output can result in inadequate tissue perfusion and oxygenation. 4. Therefore, PEEP may cause low cardiac output due to increased intrathoracic pressure. Summary of Incorrect Choices: A. Fluid overload is not directly related to PEEP but more to fluid administration or kidney function. B. High cardiac index is unlikely as PEEP can decrease cardiac output. C. Hypoxemia is not a direct result of PEEP but may occur due to other factors like inadequate ventilation or oxygenation settings.

Correct Answer: D

Rationale: The correct answer is D: “Recovery is possible, but it may take several months.” This response is the best choice as it provides a balanced and accurate explanation to the patient. Here's the rationale: 1. Hemodialysis is often used as a temporary measure to support kidney function while allowing time for the kidneys to recover. 2. Acute kidney injury can be reversible in some cases, especially if the underlying cause is identified and treated promptly. 3. Recovery time varies for each individual, and it can indeed take several months for kidney function to improve. 4. Choices A, B, and C are incorrect: - A is overly pessimistic and does not consider the potential for recovery. - B provides a specific timeframe that may not be accurate for all patients. - C is not a reliable indicator of kidney function recovery and may lead to confusion.

Correct Answer: B

Rationale: The correct answer is B because volunteering to serve on a disaster response planning committee demonstrates awareness of current events affecting critical care nursing. By actively participating in planning for potential disasters, the nurse shows a proactive approach to staying informed and prepared for emergencies. This behavior indicates a commitment to staying up-to-date with the evolving landscape of critical care nursing. Choices A, C, and D are incorrect because: A: Participating in recruitment efforts may be important but does not directly demonstrate awareness of current events affecting critical care nursing. C: Adhering to basic nursing program content is necessary but does not show active engagement with current events in critical care nursing. D: Attending hospital-mandated in-services is valuable, but without seeking additional education or involvement in current events, it does not illustrate awareness of the changing critical care nursing environment.

Correct Answer: C

Rationale: Rationale for Correct Answer C: Endotracheal suctioning should be done as indicated by patient assessment because not all patients require routine suctioning. Performing unnecessary suctioning can lead to potential complications such as mucosal damage and increased risk of infection. Therefore, the nurse must assess the patient's respiratory status, auscultate lung sounds, monitor oxygen saturation levels, and observe for signs of increased secretions before deciding to perform suctioning. Summary of Incorrect Choices: A: Endotracheal suctioning does not directly impact intracranial pressure. It is primarily focused on maintaining airway patency and removing respiratory secretions. B: While endotracheal suctioning may temporarily suppress the cough reflex during the procedure, its primary purpose is to clear airway secretions to prevent complications such as atelectasis and respiratory distress. D: Saline instillation before suctioning is not recommended as it can lead to negative outcomes such as dehydration, mucosal damage, and increased risk of infection