What term is used to describe a specific request made by a competent person that directs medical care related to life-prolonging procedures if the pa tient loses capacity to make decisions?

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Question 1 of 9

What term is used to describe a specific request made by a competent person that directs medical care related to life-prolonging procedures if the pa tient loses capacity to make decisions?

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.

Question 2 of 9

The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period of time. Which of the following nursing interventions would improve the patient’s well-being and reduce anxiety the most?

Correct Answer: B

Rationale: The correct answer is B because pet therapy has been shown to reduce anxiety and improve well-being in hospitalized patients. Interacting with therapy dogs can provide comfort, companionship, and a distraction from the hospital environment. Bringing in a therapy dog can help the trauma patient feel more relaxed and supported during their extended hospital stay. Choice A may be comforting but does not address the therapeutic benefits of pet therapy. Choice C may provide soothing music, but pet therapy has been specifically proven to reduce anxiety in patients. Choice D, observing fish in an aquarium, may be calming but does not involve the interactive benefits of pet therapy.

Question 3 of 9

The nurse is caring for a patient with an admitting diagnosis of congestive failure. While attempting to obtain a pulmonary artery occlusion pressure in the supine position, the patient becomes anxious and tachypneic. What is the best action by the nurse?

Correct Answer: D

Rationale: The correct answer is D: Elevate the head of the bed 45 degrees while recording pressures. Rationale: 1. Elevating the head of the bed will help improve the patient's breathing by reducing the pressure on the diaphragm. 2. This position will also help alleviate the patient's anxiety and tachypnea, promoting better oxygenation. 3. Recording pressures in this position will provide accurate data for monitoring the patient's condition. Summary: A: Limiting the supine position to 10 seconds does not address the underlying issues causing the patient's anxiety and tachypnea. B: Administering anxiety medications without addressing the positioning issue may not effectively manage the patient's symptoms. C: Encouraging the patient to take slow deep breaths is helpful, but changing the position of the patient is more crucial in this situation.

Question 4 of 9

Which interventions may be included during “terminal we aning”? (Select all that apply.)

Correct Answer: B

Rationale: The correct answer is B because during terminal weaning, the artificial ventilation is discontinued while maintaining the artificial airway to ensure comfort and support. This allows the patient to breathe on their own with support as needed. Explanation: 1. Option A: Complete extubation following ventilator withdrawal may not be suitable during terminal weaning as it involves removing the breathing tube entirely. 2. Option C: Discontinuation of anxiolytic and pain medications may not always be appropriate during terminal weaning as it depends on the patient's comfort needs. 3. Option D: Titration of ventilator support based on blood gas determinations is not typically done during terminal weaning as the focus is on gradual withdrawal of ventilation support while maintaining comfort.

Question 5 of 9

Which nursing strategies help the patient to feel safe in the critical care setting? (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A because allowing family members to remain at the bedside can provide emotional support and comfort to the patient, helping them feel safe in the critical care setting. Family presence can also facilitate communication and understanding between the healthcare team and the patient. Choice B is incorrect because consulting with the charge nurse before making patient care decisions may not directly contribute to the patient feeling safe. Choice C is incorrect because providing informal conversation about work-related topics may not address the patient's need for safety and security in the critical care setting. Choice D is incorrect because explaining how to communicate for assistance is important for patient care but may not directly contribute to the patient's sense of safety in the critical care setting.

Question 6 of 9

A patient with respiratory failure has arterial pressure-based cardiac output (APCO) monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 12 cm H2O. Which information indicates that a change in the ventilator settings may be required?

Correct Answer: A

Rationale: The correct answer is A. A decrease in the arterial pressure (hypotension) with a low diastolic pressure (46 mmHg) may indicate inadequate perfusion, possibly due to inadequate cardiac output from the mechanical ventilation. This suggests that a change in ventilator settings may be required to improve oxygenation and perfusion. Option B is incorrect because a heart rate of 58 beats/minute alone does not provide direct information on the patient's hemodynamic status. Option C is incorrect as an increased stroke volume would usually be a positive indicator; it does not necessarily indicate a need for changing the ventilator settings. Option D is incorrect as a stroke volume variation of 12% is within normal limits and does not necessarily require a change in ventilator settings.

Question 7 of 9

Which of the following professional organizations best supports critical care nursing practice?

Correct Answer: A

Rationale: The correct answer is A: American Association of Critical-Care Nurses (AACN). This organization focuses exclusively on critical care nursing, offering specialized education, resources, and certifications for critical care nurses. AACN advocates for high standards of care in critical care settings. The other choices do not specifically cater to critical care nursing practice. The American Heart Association focuses on cardiovascular health, the American Nurses Association is a general nursing organization, and the Society of Critical Care Medicine is more physician-centric. Therefore, A is the best choice for supporting critical care nursing practice.

Question 8 of 9

assessment, the patient is restless, heart rate has increased to 110 beats/min, respirat ions are 36 breaths/min, and blood pressure is 156/98 mm Hg. The cardiac monitor shows sin us tachycardia with 10 premature ventricular contractions (PVCs) per minute. Pulmonary artery pressures are elevated. The nurse suctions the patient and obtains pink, frothy secretio ns. Loud crackles are audible throughout lung fields. The nurse notifies the physician, who orders an ABG analysis, electrolyte levels, and a portable chest x-ray study. In comambirubn.ciocma/tteinstg with the physician, which statement indicates the nurse understands what is likely occurring with the patient?

Correct Answer: B

Rationale: The correct answer is B: “My assessment indicates potential fluid overload.” The patient is showing signs of fluid overload, such as increased heart rate, respiratory rate, elevated blood pressure, pulmonary artery pressures, frothy secretions, and crackles in lung fields. These symptoms suggest fluid is accumulating in the lungs, causing pulmonary congestion. This can lead to impaired gas exchange and respiratory distress. The nurse's recognition of these signs is crucial for prompt intervention to prevent further complications. Other choices are incorrect because there are no indications of a myocardial infarction, PVCs compromising cardiac output, or a hypertensive crisis based on the given information.

Question 9 of 9

A client who has active tuberculosis (TB) is admitted to the medical unit. What action is most important for the nurse to implement?

Correct Answer: B

Rationale: The correct answer is B: Assign the client to a negative air-flow room. This is crucial to prevent the spread of TB to other patients and healthcare workers. Negative air-flow rooms help contain airborne pathogens. Option A is not sufficient as it only protects the client, not others. Option C is important for infection control but not the priority in this situation. Option D is not as effective as placing the client in a negative air-flow room. Overall, option B is the best choice to ensure the safety of everyone in the unit.

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