Which statement is true regarding the impact of culture on end-of-life decision making?

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Critical Care Nursing NCLEX Questions Questions

Question 1 of 9

Which statement is true regarding the impact of culture on end-of-life decision making?

Correct Answer: C

Rationale: Rationale: 1. Culture and religious beliefs can significantly impact end-of-life decision making by influencing values, beliefs, and preferences. 2. These factors may affect choices related to treatment options, quality of life, and spiritual aspects. 3. Different cultural backgrounds may lead to varying perspectives on autonomy, family involvement, and medical interventions. 4. Option A and B make generalizations based on race, which is not accurate as preferences can vary widely within any racial group. 5. Option D is incorrect as perspectives on end-of-life care can vary even within the same religious group due to individual beliefs and interpretations.

Question 2 of 9

What is true regarding pain and anxiety in the healthy individual? (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A because pain and anxiety trigger the sympathetic nervous system's fight-or-flight response, increasing heart rate, blood pressure, and stress hormones to prepare the body for potential danger. This physiological response helps the individual respond to perceived threats. Choices B, C, and D are incorrect because pain and anxiety typically increase stress levels, do not necessarily remove one from harm, and can hinder rather than enhance performance due to distraction and decreased focus.

Question 3 of 9

The nurse is caring for a mechanically ventilated patient. T he primary care providers are considering performing a tracheostomy because the patienatb iirsb .hcoamv/itensgt difficulty weaning from mechanical ventilation. Related to tracheostomy, the nurse understands which of the following?

Correct Answer: C

Rationale: The correct answer is C: Procedures performed in the operating room are associated with fewer complications. This is because performing a tracheostomy in the operating room allows for better control of the environment, equipment, and expertise of the surgical team. In this setting, the risk of complications such as bleeding, infection, and injury to surrounding structures is minimized. Choices A, B, and D are incorrect: A: Patient outcomes are better if the tracheostomy is done within a week of intubation - This statement is not universally true and depends on individual patient factors. Timing of tracheostomy should be based on the patient's clinical condition and not a set timeline. B: Percutaneous tracheostomy can be done safely at the bedside by the respiratory therapist - While percutaneous tracheostomy can be performed at the bedside, it is typically done by a trained physician or surgeon due to the potential risks and complications involved. D: The greatest risk after a per

Question 4 of 9

A 75-year-old patient, who suffered a massive stroke 3 weeks ago, has been unresponsive and

Correct Answer: E

Rationale: Step 1: The scenario describes a decision made based on the patient's previously expressed wishes. Step 2: The decision aligns with the principle of respecting patient autonomy. Step 3: The term that best describes this situation is "Advance Directive." Summary: - A: Incorrect, as it involves actively ending the patient's life without their consent. - B: Incorrect, as euthanasia involves intentionally causing death to relieve suffering. - C: Incorrect, as palliative care focuses on improving quality of life for the patient. - D: Incorrect, as withdrawal of life support involves discontinuing medical interventions, not honoring the patient's wishes.

Question 5 of 9

The nurse is caring for a patient who has undergone major abdominal surgery. The nurse notices that the patient’s urine output has been less than 20 mL/hour for the past 2 hours. The patient’s blood pressure is 100/60 mm Hg, and the pulse is 110 beats/min. Previously, the pulse was 90 beats/min with a blood pressure of 120/80 mm Hg. The nurse should

Correct Answer: A

Rationale: The correct answer is A: contact the provider and expect a prescription for a normal saline bolus. The patient is showing signs of hypovolemia with decreased urine output, low blood pressure, and elevated heart rate. This indicates inadequate perfusion and potential hypovolemic shock. Administering a normal saline bolus will help restore intravascular volume and improve perfusion. Waiting for the provider to make rounds (option B) could delay necessary intervention. Continuing to evaluate urine output for 2 more hours (option C) is not appropriate given the patient's current condition. Ignoring the urine output (option D) is dangerous as it could lead to further complications.

Question 6 of 9

Which hemodynamic parameter is most appropriate for the nurse to monitor to determine the effectiveness of medications given to a patient to reduce left ventricular afterload?

Correct Answer: B

Rationale: The correct answer is B: Systemic vascular resistance (SVR). SVR reflects the resistance the heart must overcome to pump blood into the systemic circulation. By monitoring SVR, the nurse can assess the effectiveness of medications aimed at reducing left ventricular afterload, as these medications work by dilating blood vessels and reducing resistance. An effective reduction in afterload would lead to a decrease in SVR. A: Mean arterial pressure (MAP) is an indicator of perfusion pressure but may not directly reflect changes in afterload. C: Pulmonary vascular resistance (PVR) is specific to the pulmonary circulation and not directly related to left ventricular afterload. D: Pulmonary artery wedge pressure (PAWP) is a measure of left ventricular preload and filling pressures, not afterload.

Question 7 of 9

A PaCO 2 of 48 mm Hg is associated with what outcome?

Correct Answer: B

Rationale: The correct answer is B: Hypoventilation. A PaCO2 of 48 mm Hg indicates an elevated level of carbon dioxide in the blood, which is typically seen in hypoventilation where the lungs are not effectively removing CO2. Hypoventilation leads to respiratory acidosis. Option A is incorrect because hyperventilation would decrease PaCO2 levels. Option C is incorrect as it does not directly relate to PaCO2 levels. Option D is incorrect as increased excretion of HCO3- would not directly affect PaCO2 levels.

Question 8 of 9

The removal of plasma water and some low–molecular weight particles by using a pressure or osmotic gradient is known as

Correct Answer: D

Rationale: Ultrafiltration is the correct answer because it involves the removal of plasma water and low-molecular weight particles by using a pressure or osmotic gradient. During ultrafiltration, the pressure gradient pushes the fluid through a semipermeable membrane, separating the substances based on their molecular size. This process allows for the selective removal of unwanted substances while retaining essential components. Dialysis (choice A) involves the removal of waste products from the blood, but it does not specifically target plasma water and low-molecular weight particles. Diffusion (choice B) is the passive movement of particles from an area of higher concentration to an area of lower concentration and is not specific to the removal of plasma water. Clearance (choice C) refers to the rate at which a substance is removed from the blood and does not involve the mechanism of pressure or osmotic gradient utilized in ultrafiltration.

Question 9 of 9

The nurse is caring for a terminally ill patient who has chosen palliative care. Which goal should the nurse prioritize when planning care?

Correct Answer: B

Rationale: The correct answer is B: Manage the patient's pain and symptoms. In palliative care, the primary goal is to provide comfort and improve quality of life for terminally ill patients. Managing pain and symptoms is crucial in achieving this goal. By addressing pain and symptoms, the nurse can help enhance the patient's comfort and well-being. Other choices are incorrect because palliative care focuses on improving quality of life rather than curing the underlying disease (A), prolonging life expectancy (C), or primarily addressing family concerns (D). Prioritizing pain and symptom management aligns with the holistic approach of palliative care.

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