Which of the following statements regarding pain and anxiety are true? (Select all that apply.)

Questions 81

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Critical Care Nursing Practice Questions Questions

Question 1 of 9

Which of the following statements regarding pain and anxiety are true? (Select all that apply.)

Correct Answer: A

Rationale: Rationale: A: Correct. Anxiety is characterized by apprehension, agitation, autonomic arousal, and fearful withdrawal, which are distinct from pain. B: Incorrect. Critically ill patients can experience both anxiety and pain, as pain is not exclusive to them. C: Incorrect. While pain and anxiety can be interrelated, they can be differentiated based on their unique physiological and behavioral manifestations. D: Incorrect. Pain is a subjective experience, but it is not solely defined by the individual; objective assessments are also important.

Question 2 of 9

While family members are visiting, a patient has a respiratory arrest and is being resuscitated. Which action by the nurse is best?

Correct Answer: A

Rationale: The correct answer is A because it respects the patient's right to privacy while also acknowledging the family's presence. By asking family members if they wish to remain in the room, the nurse allows them to make an informed decision based on their comfort level. This approach fosters open communication and shows respect for the family's emotions. Choice B is incorrect because abruptly removing family members can increase their distress and feelings of powerlessness. Choice C is incorrect as it places the burden of support solely on a staff member, potentially isolating the family from the situation. Choice D is incorrect as it assumes family members should stay without considering their preferences or emotional well-being.

Question 3 of 9

A patient who is orally intubated and receiving mechanical ventilation is anxious and is fighting the ventilator. Which action should the nurse take next?

Correct Answer: A

Rationale: The correct answer is A: Verbally coach the patient to breathe with the ventilator. This approach allows the nurse to address the patient's anxiety and help them synchronize their breathing with the ventilator, promoting better ventilation and oxygenation. It is important to first try non-invasive interventions before resorting to sedation or manual ventilation. Sedating the patient (B) should be a last resort to avoid potential complications. Manual ventilation (C) may disrupt the ventilator settings and cause respiratory distress. Increasing the rate of propofol infusion (D) is not indicated unless the patient's sedation level is inadequate.

Question 4 of 9

The nurse is caring for a terminally ill patient who has 20-second periods of apnea followed by periods of deep and rapid breathing. Which action by the nurse would be most appropriate?

Correct Answer: D

Rationale: The correct answer is D because the patient is exhibiting Cheyne-Stokes breathing pattern characterized by periods of apnea followed by deep and rapid breathing. The nurse should document this pattern accurately. Option A is incorrect as suctioning is not indicated. Option B may worsen the respiratory pattern. Option C is not specifically related to addressing the breathing pattern.

Question 5 of 9

A family member approaches the nurse caring for their gra vely ill son and states, “We want to donate our son’s organs.” What is the best action by the nu rse?

Correct Answer: C

Rationale: The correct answer is C: Notify the organ procurement organization (OPO). This is the best action because the OPO is responsible for coordinating organ donation and transplantation. By involving the OPO, the nurse ensures that the donation process is handled appropriately and ethically. Choice A: Arranging a multidisciplinary meeting with physicians may be necessary but should not be the first step in this situation. Choice B: Consulting the hospital’s ethics committee may be helpful, but the immediate priority is to involve the OPO to facilitate organ donation. Choice D: Obtaining family consent to withdraw life support is not the nurse’s role in this situation. The focus should be on organ donation to honor the family's wishes.

Question 6 of 9

An ICU nurse has provided excellent care for a 6-year-old girl who had been admitted to the ICU for a head injury. The nurse was attentive not only to the needs of the patient but also went out of her way to care for the needs of the girls family. According to research, which of the following forms of recognition would the nurse value the most?

Correct Answer: A

Rationale: Rationale: The correct answer is A: A card from the girl's family. The nurse would value this form of recognition the most because it directly reflects the impact of her care on the patient and her family. It is a personal, heartfelt gesture that acknowledges the nurse's compassion and dedication. A card from the family shows genuine appreciation and gratitude for the nurse's efforts, making it the most meaningful form of recognition. Summary: - Choice B: A plaque from the ICU physicians could be seen as a formal recognition but lacks the personal touch and direct impact of the nurse's care on the patient and family. - Choice C: A letter of commendation from the hospital's administration is a professional acknowledgment but may not capture the emotional connection and impact that the nurse had on the family. - Choice D: A bouquet of flowers from her supervisor is a nice gesture but does not necessarily reflect the specific impact of the nurse's care on the patient and family.

Question 7 of 9

What is the best way to monitor agitation and effectivenes s of treating it in the critically ill patient?

Correct Answer: D

Rationale: The correct answer is D: Richmond Agitation Sedation Scale (RASS). RASS is specifically designed to monitor agitation and sedation levels in critically ill patients, providing a standardized and objective assessment. It includes clear descriptors for different levels of agitation and sedation, allowing for consistent monitoring and treatment adjustments. CAM-ICU is mainly used for delirium assessment, not agitation. FACES assessment tool is more appropriate for pain assessment. Glasgow Coma Scale is focused on assessing level of consciousness, not agitation specifically. By using RASS, healthcare providers can accurately track agitation levels and evaluate the effectiveness of interventions in managing agitation in critically ill patients.

Question 8 of 9

What is the most critical element of effective early end-of-life decision making?

Correct Answer: B

Rationale: The correct answer is B because effective communication ensures that the patient's wishes and values are understood and respected, leading to informed decision-making. It also promotes shared decision-making among the patient, family, and healthcare team, enhancing the quality of care. Choices A, C, and D are incorrect because while they are important aspects of end-of-life care, they do not address the core element of communication in facilitating meaningful and informed decisions.

Question 9 of 9

Which of the following statements about comfort care is aacbcirubr.caotme/?te st

Correct Answer: C

Rationale: Step 1: Comfort care is focused on providing relief from suffering and improving quality of life. Step 2: Patient-centered care emphasizes the individual's preferences and values. Step 3: Patient autonomy is a fundamental principle in healthcare decision-making. Step 4: Patients have the right to determine what constitutes comfort care for themselves. Step 5: Therefore, statement C is correct as it aligns with the patient's autonomy and individualized care approach. Summary: - Choice A is incorrect because legal distinctions between withholding and withdrawing treatment may vary. - Choice B is incorrect as it focuses on evaluating procedures rather than the patient's preferences. - Choice D is incorrect as withdrawing life-sustaining treatments is not universally considered euthanasia.

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