The physician orders a maintenance dose of 5,000 units of subcutaneous heparin (an anticoagulant) daily. Nursing responsibilities for Mrs. Mitchell now include:

Correct Answer: D

Rationale: The correct answer is D. When a physician orders a maintenance dose of subcutaneous heparin, nursing responsibilities include reviewing daily activated partial thromboplastin time (APTT) and prothrombin time to monitor the patient's coagulation status, reporting an APTT above 45 seconds to the physician as it may indicate a risk of bleeding, and assessing the patient for signs and symptoms of frank and occult bleeding, which are potential adverse effects of anticoagulant therapy. Therefore, all the options listed are essential nursing responsibilities when a patient is on subcutaneous heparin therapy.

Correct Answer: D

Rationale: In Maslow's hierarchy of needs, physiological needs form the base of the pyramid, representing the most fundamental requirements for human survival. These needs must be met before higher-level needs (such as safety, love, or esteem) can be addressed. Among physiological needs, *oxygen* (D) is the most critical because the human body can only survive for *minutes* without it. Cellular respiration, which provides energy for all bodily functions, depends entirely on oxygen. Without it, brain function ceases rapidly, leading to irreversible damage or death. This immediacy of oxygen's necessity makes it the highest priority. *Nutrition* (C) is essential for sustaining life, but the body can survive for *weeks* without food. While prolonged lack of nutrition leads to organ failure, the timeline for survival without food is far longer than without oxygen. Similarly, *elimination* (B), the removal of waste, is vital for maintaining homeostasis, but the body can endure *days* without proper waste elimination before severe complications arise. Both nutrition and elimination are undeniably important but are secondary to oxygen due to the difference in survival timelines. *Love* (A) is incorrect because it belongs to Maslow's third tier (social needs) and is not a physiological requirement for survival. While emotional connections contribute to mental well-being, they are irrelevant in immediate survival scenarios. A person deprived of love may suffer psychologically but will not die from it, unlike deprivation of oxygen. The prioritization of these needs aligns with biological imperatives: oxygen sustains cellular processes in real-time, while other needs become urgent only after longer periods of deprivation. This hierarchy reflects the body's adaptive mechanisms, where systems shut down in a predictable order when resources are scarce. Thus, oxygen's non-negotiable role in immediate survival makes it the need of greatest priority in Maslow's physiological tier.

Correct Answer: B

Rationale: When a family is open to organ donation after a loved one has been declared brain-dead, the nurse's role is to provide compassionate, honest, and non-coercive support while addressing their concerns. The correct choice (B) emphasizes active listening and truthful communication, which is critical in this sensitive situation. Families need accurate information to make an informed decision, and the nurse must create a safe space for them to express doubts, fears, or questions without pressure. This approach respects their autonomy, acknowledges their grief, and ensures they understand the process, including the medical and ethical aspects of organ donation. Choice (A) is incorrect because delaying the decision until grief eases is medically impractical. Organ donation must occur promptly after brain death to ensure the viability of organs for transplantation. Postponing the discussion risks the loss of life-saving opportunities for recipients. While grief is a significant factor, the nurse’s responsibility is to guide the family through the decision-making process with empathy, not defer it indefinitely. Choice (C) is inappropriate as it pressures the family into a quick decision without adequate time for reflection or discussion. Organ donation is a deeply personal choice, and rushing the family could lead to regret or resentment. Ethical practice requires ensuring the family fully comprehends the implications of donation and consents voluntarily, not under duress or haste. Choice (D) is misleading and factually incorrect. Organ donation does not preclude the possibility of a wake or funeral. The surgical recovery of organs is performed with respect for the donor’s body, and funeral arrangements can proceed as planned. Providing inaccurate information could unnecessarily distress the family or dissuade them from considering donation. Transparency about the process, including how the body will be treated, is essential to maintaining trust. The nurse’s primary responsibilities in this scenario are to educate, support, and advocate for the family while upholding ethical standards. By listening attentively and answering questions honestly (B), the nurse helps the family navigate this difficult decision with clarity and dignity, ensuring their choice aligns with their values and the patient’s wishes.

Correct Answer: C

Rationale: In this scenario, the new head nurse should discuss the problem with her supervisor. This is the most appropriate action as the supervisor is in a position to address staffing concerns effectively and make necessary changes. Complaining to fellow nurses may not lead to a solution, waiting may exacerbate the issue, and demanding staff rotation without proper discussion is not a collaborative approach to resolving the problem.

Correct Answer: C

Rationale: Primary nursing care units have been proven to be highly satisfying for both patients and nurses. This model promotes a consistent and continuous relationship between a patient and a primary nurse, leading to improved communication, personalized care, and overall satisfaction for both parties involved.