Correct Answer: D

Rationale: The correct answer is D, Living will. A living will is a legal document that outlines a person's preferences for medical treatment if they become unable to communicate their wishes. It specifically addresses life-prolonging procedures. Option A, Do not resuscitate order, is a specific directive to not perform CPR in case of cardiac arrest, not a comprehensive medical care directive. Option B, Healthcare proxy, is a person designated to make medical decisions on behalf of a patient who is unable to do so, not the specific directive itself. Option C, Informed consent, refers to the process of obtaining permission from a patient before conducting a healthcare intervention, not a directive for life-prolonging procedures.

Correct Answer: A

Rationale: The correct answer is A: Apply wet sheets and a fan to the patient. This is the initial treatment for hyperthermia to aid in lowering the body temperature. Wet sheets help in evaporative cooling, while a fan enhances heat loss through convection. This approach is crucial in managing heat-related illnesses quickly. Choices B, C, and D are incorrect as they do not directly address the urgent need to reduce the patient's elevated core temperature. Providing O2, IV fluids, or acetaminophen can be considered later in the management, but the priority is to rapidly lower the body temperature in a hyperthermic patient to prevent further complications.

Correct Answer: A

Rationale: The correct answer is A: Kidney, ureter, bladder (KUB) x-ray. This procedure is noninvasive and commonly used to assess kidney function by visualizing the size, shape, and position of the kidneys. Renal ultrasound is also noninvasive and can provide detailed images of the kidneys. However, MRI and IVP are more invasive procedures that involve the use of contrast agents and are not typically used solely for diagnostic purposes to assess kidney function. Overall, KUB x-ray and renal ultrasound are the preferred noninvasive options for evaluating kidney function.

Correct Answer: C

Rationale: The correct answer is C: Neuromuscular blockade. 1. Neuromuscular blockade helps to achieve optimal ventilator synchrony by reducing patient-ventilator asynchrony and improving oxygenation in patients with acute respiratory distress syndrome (ARDS). 2. Despite sedation, the patient's restlessness and discomfort suggest inadequate ventilator synchrony, which can be addressed by neuromuscular blockade. 3. Continuous lateral rotation therapy (A) and prone positioning (D) are interventions for improving ventilation and oxygenation in ARDS but do not directly address patient-ventilator synchrony. 4. Guided imagery (B) is a non-pharmacological technique for relaxation and pain management, which may not address the underlying issue of ventilator synchrony in this case.

Correct Answer: A

Rationale: The correct answer is A: Difficulty communicating. When a patient undergoes endotracheal intubation and mechanical ventilation, they are unable to speak normally. This leads to frustration and anxiety due to the inability to communicate effectively with healthcare providers and loved ones. The lack of communication can also impact their emotional well-being. Choices B, C, and D are less likely as the most common recollection because patients might not remember feeling uncomfortable, experiencing pain, or having sleep disruption during sedation and ventilation. Additionally, the inability to communicate is a primary concern for patients in this situation.