A nurse is preparing to administer gentamycin ordered for the patient at 3mg/kg/day divided equally every 8 hours.

The patient is 100kg.

How much should each dose be?

Choice A rationale

While it might seem natural to inquire about prior discussions, this response could induce guilt or regret in the spouse and doesn't directly address the current emotional distress and uncertainty about the spouse's wishes as explicitly stated in the advance directive. It shifts the focus to the past rather than the present need for clarification regarding the existing directive.

Choice B rationale

Although the primary care provider may indeed have the client's best interests in mind, this statement dismisses the spouse's expressed uncertainty and relies on an assumption about the PCP's motivations. It doesn't help the spouse understand or feel confident about the content of the advance directive, which is the core of their concern.

Choice C rationale

This statement, while true, places the burden of decision-making solely on the spouse without acknowledging the existence of the advance directive, which is meant to guide such decisions. It overlooks the possibility that the directive already contains the spouse's wishes and could offer clarity, thereby increasing the spouse's anxiety.

Choice D rationale

This response directly addresses the spouse's statement by reminding them that their spouse's wishes are likely documented in the advance directive. It encourages the spouse to review the directive, which is the most direct way to understand what their spouse wanted regarding medical interventions like a PEG tube, thus providing immediate and relevant support.

Choice A rationale

A colleague who graduated at the same time lacks the experience and established professional network necessary to provide effective mentorship. Mentorship involves guidance based on practical experience and insights gained over time, which a recent graduate, regardless of academic achievements, would not possess. A mentor should offer a more seasoned perspective on navigating career challenges and professional development.

Choice B rationale

While a personal friendship might offer emotional support, a unit manager who is primarily a friend may not possess the objectivity and focus required for professional mentorship. The managerial role involves administrative and supervisory responsibilities that might overshadow the specific developmental needs of a novice nurse. Furthermore, personal relationships can sometimes blur professional boundaries, hindering effective guidance.

Choice C rationale

An experienced nurse who previously served as a preceptor has demonstrated an ability to guide and educate new nurses in a clinical setting. This individual is likely familiar with the challenges faced by novice nurses and possesses the practical knowledge and teaching skills necessary for effective mentorship. Their prior experience in a similar role makes them well-suited to provide targeted support and professional guidance.

Choice D rationale

A nurse educator primarily focuses on formal education and training programs within the hospital. While they possess valuable knowledge and expertise, their role typically involves broader educational responsibilities rather than individualized, long-term mentorship. A mentor relationship often involves a more personal and ongoing connection focused on the mentee's specific career trajectory and professional growth, which may fall outside the scope of a nurse educator's primary duties.