The nurse is caring for a client who is suffering from multiple organ dysfunction syndrome (MODS). What does the nursing plan of care focus on?

Encouraging the family to stay hopeful because in most cases, the prognosis is good

Promoting communication with the client and family along with addressing end-of-life issues

Encouraging the family to take time for themselves, MODS clients may live for years

Discussing organ donation on a number of different occasions to allow the family time to adjust to the idea

Answer and Explanation

The Correct Answer is B

Choice A reason: Multiple organ dysfunction syndrome carries an extremely high mortality rate, often exceeding 70% to 90% as the number of failing organ systems increases. Providing a "good" prognosis is clinically inaccurate and offers false hope, which can hinder the family’s ability to make informed medical decisions.

Choice B reason: MODS represents the terminal stage of the shock continuum where homeostasis cannot be maintained. The nursing priority shifts toward holistic support, ensuring the family understands the gravity of the situation and facilitating discussions regarding goals of care, palliative measures, and potentially the withdrawal of life support.

Choice C reason: MODS is an acute, critical condition characterized by rapid physiological decline. It is not a chronic state; patients do not "live for years" with multiple failing organs. The clinical course is typically measured in days or weeks, requiring intensive, minute-to-minute medical and nursing interventions.

Choice D reason: While organ donation is a valid consideration in end-of-life care, it is generally not the primary focus of the nursing plan of care for a MODS patient. Furthermore, the systemic inflammatory process and underlying infection that usually trigger MODS often render the patient’s organs unsuitable for transplantation.

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Correct Answer is A

Explanation

Choice A reason: Burn dressing changes are notoriously painful due to the exposure of raw tissue and mechanical debridement. Pre-medicating the client 20 to 30 minutes prior to the procedure ensures therapeutic drug levels are reached, facilitating client cooperation and preventing the physiological stress response associated with severe pain.

Choice B reason: Removing the old dressing is a necessary step, but it must occur after pain management has been addressed. If the nurse removes the dressing without prior medication, the client may experience excruciating pain, making it difficult to complete the sterile portion of the procedure safely.

Choice C reason: Preparing equipment at the bedside is a logistical requirement for any procedure. While important for efficiency, it does not take priority over the ethical and clinical necessity of ensuring the client is comfortable and physiologically prepared for a painful intervention.

Choice D reason: Placing a sterile glove is one of the final steps in the actual dressing application process. It occurs long after the initial assessment, pain management, and removal of the old dressing. Proper sequencing ensures that the sterile field remains uncontaminated throughout the procedure.

A. A client three hours post-myocardial infarction B. A client with trauma related blood loss C. A client with a tension pneumothorax D. A client with positive blood cultures

Correct Answer is A

Explanation

Choice A reason: Cardiogenic shock occurs when the heart’s muscular wall fails to pump effectively. A myocardial infarction (MI) causes necrosis of the cardiac tissue; if more than 40% of the left ventricle is damaged, the heart cannot maintain adequate cardiac output, leading directly to cardiogenic shock.

Choice B reason: A client with trauma-related blood loss is at risk for hypovolemic shock. This type of shock is caused by a lack of intravascular volume rather than a primary failure of the heart muscle itself, distinguishing it from the pump-failure mechanism of cardiogenic shock.

Choice C reason: A tension pneumothorax causes obstructive shock. The high pressure in the thoracic cavity shifts the mediastinum and compresses the great vessels (superior and inferior vena cava), physically preventing blood from returning to the heart, which is different from a primary muscular failure.

Choice D reason: A client with positive blood cultures is at risk for septic shock. This is a form of distributive shock caused by systemic vasodilation and increased capillary permeability in response to an overwhelming infection, rather than an initial failure of the cardiac pump.

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The nurse is caring for a client who is suffering from multiple organ dysfunction syndrome (MODS). What does the nursing plan of care focus on?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to perform a sterile dressing change on a client who obtained full-thickness burns on the right leg one week ago. Which intervention would the nurse implement first?

Correct Answer is A

Explanation

Which client is at the greatest risk of developing cardiogenic shock?

Correct Answer is A

Explanation

A client suffered a 45 percent total body surface area (TBSA) burn and was intubated. Twelve hours later, bowel sounds are absent in all four abdominal quadrants. Which is the nurse's best action?

Which client does the nurse assess most carefully for obstructive shock?

The nurse is assessing clients in the emergency department. Which client is at highest risk for developing septic shock?

The nurse assesses a client who is admitted after a thermal burn injury to 60 percent of their body. Which action does the nurse take first?

A nurse cares for a client placed in skeletal traction. The client asks, “What is the main purpose of this type of traction?” How would the nurse respond?

A nurse is caring for a client during the first few hours post-admission to the burn unit with partial-thickness burns of the trunk and head. Which potential problem is the least concern for the nurse during the emergent phase of the burn injury?

The nurse is caring for a client who was in a house fire. The nurse notes that the hairs on the client's face are singed. Based on this assessment finding, the nurse monitors the client closely for which complications?