A patient was admitted several weeks ago with an acute myocardial infarction and subsequently underwent coronary artery bypass grafting surgery. Since a cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram shows no meaningful brain activity. The patient does not have an advance directive. Which statement would be the best way to approach the family regarding ongoing care?
“I will refer this case to the hospital ethics committee, and they will contact you when they have a decision.”
“What do you want to do about the patient’s care at this point?”
“Dr. Smith believes that there is no hope at this point and recommends do-not-resuscitate status.”
“What would the patient want if he knew he were in this situation?”
The Correct Answer is D
Choice A reason: Referring to the ethics committee is premature without discussing the patient’s wishes with the family. Asking about the patient’s preferences respects autonomy, making this incorrect, as it bypasses the family’s role in decision-making for the unresponsive patient.
Choice B reason: Asking what the family wants is vague and may pressure them without context. Inquiring about the patient’s wishes guides ethical decisions, making this incorrect, as it’s less focused than the nurse’s approach to honor the patient’s likely preferences.
Choice C reason: Stating the doctor’s recommendation may bias the family and doesn’t explore the patient’s wishes. Asking what the patient would want is more patient-centered, making this incorrect, as it’s less collaborative in discussing ongoing care options.
Choice D reason: Asking what the patient would want respects autonomy and guides family decision-making in the absence of an advance directive. This aligns with ethical principles, making it the correct approach for the nurse to discuss ongoing care with the family.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Initiating antibiotics is critical but follows cultures to identify the causative organism. Obtaining cultures first ensures accurate treatment, making this incorrect, as it risks altering culture results if antibiotics are given before sampling in the pneumonia client.
Choice B reason: Obtaining blood and sputum cultures first identifies the pneumonia-causing organism, guiding effective antibiotic therapy. This aligns with infection management protocols, making it the correct initial order to implement for the client admitted with pneumonia to ensure accurate treatment.
Choice C reason: Airborne precautions are needed for specific pneumonias (e.g., tuberculosis), but most require droplet precautions. Cultures guide treatment, making this incorrect, as it’s less urgent than obtaining cultures first to confirm the pathogen in the client with pneumonia.
Choice D reason: An indwelling catheter is unnecessary for pneumonia unless urinary retention is present. Obtaining cultures is the priority, making this incorrect, as it’s irrelevant to the immediate management of the client’s infection compared to identifying the causative organism.
Correct Answer is B
Explanation
Choice A reason: Shortness of breath is a heart failure symptom, not a furosemide side effect, which causes diuresis. Lightheadedness from hypotension is common, making this incorrect, as it confuses disease symptoms with medication effects in the nurse’s monitoring plan for furosemide.
Choice B reason: Lightheadedness is a common furosemide adverse effect due to hypotension or electrolyte imbalances from diuresis. This aligns with pharmacological monitoring for heart failure treatment, making it the correct effect the nurse should plan to monitor in the client.
Choice C reason: Dry cough is associated with ACE inhibitors, not furosemide, a diuretic causing hypotension. Lightheadedness is a furosemide effect, making this incorrect, as it misattributes a side effect to the wrong medication in the nurse’s monitoring for heart failure treatment.
Choice D reason: Bitter taste is not a typical furosemide side effect; it’s more linked to medications like antibiotics. Lightheadedness is relevant, making this incorrect, as it does not reflect the expected adverse effects the nurse should monitor with furosemide administration.
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