While neuromuscular blocking agents are used in the management of some ventilated patients what is their primary mode of action?

Correct Answer: C

Rationale: The correct answer is C: Paralysis. Neuromuscular blocking agents work by blocking the transmission of nerve impulses at the neuromuscular junction, leading to muscle paralysis. This is essential in ventilated patients to facilitate mechanical ventilation and prevent patient-ventilator dyssynchrony. Rationale: A: Analgesia - Neuromuscular blocking agents do not provide pain relief. They do not have any direct analgesic properties. B: Anticonvulsant - Neuromuscular blocking agents do not prevent or treat seizures. They do not have anticonvulsant effects. D: Sedation - While sedatives may be used in conjunction with neuromuscular blocking agents, the primary mode of action of these agents is muscle paralysis, not sedation.

Correct Answer: D

Rationale: Rationale: The correct answer is D because the purpose of the healthcare system in the United States is primarily focused on disease prevention and symptom management. This aligns with societal views as healthcare is geared towards improving health outcomes and quality of life. Incorrect choices: A: Dying is not viewed as a failure of the system or providers, rather as a natural part of life. B: Most Americans prefer to die at home or in hospice care rather than in a hospital. C: Illnesses are not always curable, and death can result from various complex conditions beyond treatment.

Correct Answer: B

Rationale: The correct answer is B: A deep vein thrombosis from lower extremities. Deep vein thrombosis (DVT) is the most common cause of a pulmonary embolus as a blood clot can dislodge from the veins, travel to the lungs, and block blood flow. An amniotic fluid embolus (Choice A) occurs during childbirth and is rare as a cause of pulmonary embolism. A fat embolus (Choice C) typically occurs after a long bone fracture and is more likely to cause issues in the lungs. Vegetation from an infected central venous catheter (Choice D) can cause septic pulmonary embolism, but it is not as common as DVT.

Correct Answer: B

Rationale: The correct answer is B: a normal serum creatinine level. In renal insufficiency, the kidneys are not able to filter waste products effectively, leading to an increase in serum creatinine levels. This is a common indicator of renal dysfunction. A: An increased GFR would not be expected in renal insufficiency, as it signifies improved kidney function. C: Increased ability to excrete drugs is not a typical finding in renal insufficiency, as impaired kidney function can lead to drug accumulation. D: Hypokalemia is not directly related to renal insufficiency. It is more commonly associated with factors like diuretic use or gastrointestinal losses.

Correct Answer: B

Rationale: The correct answer is B because it acknowledges and validates the patient's belief, showing empathy and support. By stating that the belief gives strength, the nurse facilitates a therapeutic relationship and promotes the patient's emotional well-being. Choice A is incorrect as it challenges the patient's belief system, potentially creating conflict. Choice C is inappropriate as it dismisses the patient's belief and could damage the nurse-patient relationship. Choice D is also incorrect as it invalidates the patient's belief and could harm trust and rapport.

Correct Answer: B

Rationale: Rationale: The correct action is to observe the patient's respiratory effort next. This step ensures that the patient's breathing remains stable and adequate. If respiratory effort is compromised, immediate intervention is required. Checking for bilateral pulses (A) is important but comes after ensuring respiratory status. Checking level of consciousness (C) is also crucial but not as immediate as monitoring breathing. Examining for external bleeding (D) is important but not the priority when airway and breathing are already determined to be clear.

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Acknowledges the child's distress and concerns. 2. Explains the concept of allowing natural death after serious injuries. 3. Helps the family understand the ethical and medical reasoning behind removing life support. 4. Shows empathy and provides education to address misconceptions. Summary of other choices: B: Incorrect - Avoids addressing the family's concerns and provides a vague response. C: Incorrect - Contains a typo and does not directly address the child's distress or misunderstanding. D: Incorrect - Irrelevant response that does not address the ethical dilemma at hand.

Correct Answer: D

Rationale: The correct answer is D because it accurately states that withholding "extraordinary" resuscitation is legal and should be based on specified criteria in advance directives and physician orders. This is in line with medical ethics and patient autonomy. A is incorrect because family presence during resuscitation can be beneficial for emotional support and decision-making. B is incorrect as it is still necessary for a physician to document "do not resuscitate" orders even with a healthcare surrogate. C is incorrect as "slow codes" are not ethical and go against the principle of beneficence.

Correct Answer: A

Rationale: The correct answer is A because slow continuous ultrafiltration removes excess plasma water in cases of volume overload by applying a pressure gradient across a semipermeable membrane. This process helps to achieve fluid balance without removing solutes. Choice B is incorrect because convection is not the primary mechanism of slow continuous ultrafiltration. Choice C is incorrect as dialysate is not added in slow continuous ultrafiltration. Choice D is incorrect as slow continuous ultrafiltration does not combine all three processes of ultrafiltration, convection, and dialysis.