Family presence is encouraged during resuscitation and invasive procedures. Which findings about this practice have been reported in the literature? (Select all that apply.)

Presence reduces nurses' involvement in explaining things to the family.

Families report that staff conversations during this time were distressing.

Families report reduced anxiety and fear about what is being done to the patient.

Presence encourages family members to seek litigation for improper care.

Families benefit by witnessing that everything possible was done.

Answer and Explanation

Correct Answer : B,C,E

A. Family presence does not reduce nurses’ responsibilities; rather, nurses often need to provide additional explanations and emotional support during resuscitation or procedures. Effective communication remains essential.

B. Studies indicate that families may overhear clinical conversations or technical language that can be upsetting. Awareness of this helps staff maintain professional and clear communication while family members are present.

C. Literature shows that witnessing resuscitation or invasive procedures can decrease uncertainty and fear, as families see the care being provided firsthand and feel more informed about the patient’s condition.

D. Research does not support increased litigation due to family presence. In fact, witnessing care can increase trust in healthcare providers and improve family satisfaction with care.

E. Being present allows families to observe the medical team’s efforts, which can provide reassurance that all interventions were carried out appropriately and can facilitate the grieving process if the outcome is poor.

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Correct Answer is A

Explanation

A. Bronchodilators, such as short-acting beta-agonists (e.g., albuterol), relax airway smooth muscles, reduce bronchospasm, and improve airflow. This is the primary intervention for acute exacerbations of COPD, as it immediately helps relieve dyspnea, improve oxygenation, and decrease the work of breathing. Administering therapy as prescribed is essential for stabilizing respiratory status.

B. Supine positioning can worsen dyspnea in patients with COPD because it restricts diaphragmatic movement and lung expansion. Patients often feel more comfortable sitting upright or in a tripod position, which facilitates better ventilation and oxygenation.

C. Similar to option B, lying flat increases respiratory effort and can decrease oxygen saturation. Encouraging an upright or semi-Fowler’s position supports effective breathing mechanics and reduces the sensation of shortness of breath.

D. There is no immediate indication to restrict fluids in acute COPD exacerbation unless the patient has a coexisting condition (e.g., heart failure). Proper hydration is important to help thin secretions, making airway clearance easier. Fluid restriction would not improve acute dyspnea.

A. Looks a lot like failure, both left and right, 53, crackles, hypertension. JVD, edema B. Hypertension, 54, tracheal deviation, edema C. Diuretics, insulin, ARBS D. IV vasodilators (preload and afterload) E. Positive inotropes to contractility F. Circulatory assist devices

Correct Answer is ["A","D","E","F"]

Explanation

A. Cardiogenic shock results from severe pump failure and presents with signs of both left- and right-sided heart failure. Left-sided failure leads to pulmonary congestion, manifested by crackles and dyspnea, while right-sided failure causes systemic venous congestion, including JVD and peripheral edema. Hypotension and poor perfusion develop as shock progresses. Early recognition of these signs allows prompt intervention.

B. Tracheal deviation is not associated with cardiogenic shock; it indicates tension pneumothorax or large pleural effusion. Hypertension alone is not typical of cardiogenic shock, which usually presents with hypotension and low cardiac output.

C. While diuretics and ARBs are part of chronic heart failure management, they are not first-line treatments for acute cardiogenic shock. Insulin is unrelated unless the patient has diabetes. Acute shock management requires hemodynamic support rather than standard outpatient medications.

D. IV vasodilators, such as nitroprusside or nitroglycerin, reduce preload and afterload, improving cardiac output and tissue perfusion in cardiogenic shock. Careful monitoring is needed to prevent hypotension.

E. Positive inotropes, like dobutamine or milrinone, increase myocardial contractility, improving cardiac output in cardiogenic shock. They are often used in combination with vasodilators or mechanical support for optimal hemodynamic stabilization.

F. Mechanical support devices, such as intra-aortic balloon pumps (IABP) or ventricular assist devices (VADs), can be used in refractory cardiogenic shock to improve perfusion, reduce cardiac workload, and stabilize the patient until recovery or definitive therapy.

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Family presence is encouraged during resuscitation and invasive procedures. Which findings about this practice have been reported in the literature? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

One of the complications we might see of heart failure is cardiogenic shock. What kinds of signs and symptoms might you see and how do we treat? (Select all that apply)

Correct Answer is ["A","D","E","F"]

Explanation

The nurse is caring for a patient who has a chest tube. Attached to the top of the patient's bed are two hemostats. In which situations would these be used? (Select all that apply.)

Of the following responses, what would you expect to see in left sided heart failure? (Select all that apply)

The nurse notices ventricular tachycardia on the heart monitor. When the patient is assessed, the patient is found to be unresponsive with no pulse. The nurse should:

The nurse is caring for a recently admitted patient and notes the following priority intervention?

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The nurse is caring for a patient whose ventilator settings include 15 cm H2O of positive end- expiratory pressure (PEEP). The nurse understands that although beneficial, PEEP may result in:

Family presence is encouraged during resuscitation and invasive procedures. Which findings about this practice have been reported in the literature? (Select all that apply.)