An elderly male patient in his early 70s is admitted to the emergency department due to a COPD exacerbation.
The patient is having difficulty breathing and the healthcare team is preparing for endotracheal intubation.
The patient’s wife, who is 30 years younger, asks the nurse to halt the procedure and presents the nurse with a copy of the patient’s living will.
What should the nurse’s next step be?

Place a certified copy of the living will in the patient’s record.

Inform the healthcare provider of the patient’s wishes.

Arrange a family meeting with the palliative care team.

Notify the nursing staff of the patient’s do not resuscitate status.

Answer and Explanation

The Correct Answer is B

Choice A rationale

While placing a certified copy of the living will in the patient’s record is important, it is not the immediate next step. The living will should be acknowledged, but the healthcare provider needs to be informed immediately.

Choice B rationale

Informing the healthcare provider of the patient’s wishes is the most appropriate next step. The healthcare provider can then make decisions based on the patient’s expressed wishes.

Choice C rationale

Arranging a family meeting with the palliative care team may be beneficial, but it is not the immediate next step. The healthcare provider needs to be informed first.

Choice D rationale

Notifying the nursing staff of the patient’s do not resuscitate status is important, but it is not the immediate next step. The healthcare provider needs to be informed first.

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Free Nursing Study Resources

Correct Answer is ["21"]

Explanation

Step 1 is: Convert 12 hours into minutes. 12 hours × 60 minutes/hour = 720 minutes.

Step 2 is: Calculate the infusion rate. (1000 mL ÷ 720 minutes) × 15 gtt/mL = 20.83 gtt/min. Therefore, the infusion rate should be approximately 21 gtt/min when rounded to the nearest whole number.

A. Set up supplemental oxygen delivery B. Increase the fraction of inspired oxygen C. Gather supplies for extubation D. Place a nasogastric tube E. Offer the client ice chips F. Suggest a different ventilator mode to the provider G. Set the ventilator to give mandatory breaths

Correct Answer is ["A","C","E"]

Explanation

A. Set up supplemental oxygen delivery- This could be necessary as the client is being weaned off the ventilator and may require additional oxygen support.
C. Gather supplies for extubation- As the client is being weaned off the ventilator and the pressure support has been decreased to 0 cm H2O, extubation may be imminent.
E. Offer the client ice chips- Once extubated, the client may have a dry mouth and throat from the intubation tube. Ice chips can help soothe the throat and keep the mouth moist.

B. Increase the fraction of inspired oxygen- This action is not indicated based on the information provided. The client’s oxygen saturation is within normal range and there’s no indication that the client is experiencing difficulty breathing or hypoxia.
D. Place a nasogastric tube- There’s no indication in the scenario that the client has a need for a nasogastric tube. This procedure is typically done for clients who have difficulty swallowing or need help with feeding, neither of which is mentioned in the scenario.
F. Suggest a different ventilator mode to the provider- The client is already being successfully weaned off the ventilator, as indicated by the decreasing pressure support. There’s no indication in the scenario that a different ventilator mode is needed.
G. Set the ventilator to give mandatory breaths- This action would be counterproductive to the weaning process. The client is already on a ventilator mode with no mandatory breaths and is being successfully weaned off the ventilator.

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Naxlex Comprehensive Predictor Exams

A patient has been prescribed 1 L of Lactated Ringer’s IV to be infused over a 12-hour period. The IV administration set delivers 15 gtt/mL. What should be the infusion rate in gtt/min? (Provide a numerical value only. If rounding is required, round to the nearest whole number.)

Correct Answer is ["21"]

Explanation

Exhibits The nurse notifies the healthcare provider of the client’s status. The healthcare provider comes to the bedside to evaluate the client. Which should the nurse do? Select all that apply. Potential Actions

Correct Answer is ["A","C","E"]

Explanation

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