A nurse is caring for a client who has a living will which states Do Not Resuscitate (DNR), but whose children have decided that their parent should be a full code.

The client has coded twice.

The other nurses do not seem to have any issues with the situation, but the nurse feels distressed. What best describes this source of conflict?

Ethical conflict.

Scarcity, safety, and security.

Competition between groups.

Cultural differences.

Answer and Explanation

The Correct Answer is A

Choice A rationale
This situation represents an ethical conflict. The nurse is faced with a dilemma where the children’s wishes for their parent to be a full code contradict the client’s expressed wish in their living will for Do Not Resuscitate (DNR)2. Ethical conflicts often arise in healthcare when there are differing opinions about the right course of action.
Choice B rationale
Scarcity, safety, and security are not the primary sources of conflict in this situation. While these factors can contribute to conflict in certain contexts, they do not directly apply to the ethical dilemma presented in this scenario.
Choice C rationale
Competition between groups is not evident in this situation. The conflict arises from differing views on the appropriate course of action for the client’s care, not from competition.
Choice D rationale
Cultural differences are not the main source of conflict in this scenario. The conflict arises from an ethical issue related to the client’s end-of-life care, not from cultural differences.

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Correct Answer is A

Explanation

Choice A rationale
Auscultating the lungs for the presence of breath sounds is a priority action following endotracheal intubation. This helps to confirm correct tube placement and assess for complications such as a pneumothorax.
Choice B rationale
While it is important to ensure that the pulse oximetry is greater than 95% to confirm adequate oxygenation, this is not the priority action. The nurse should first confirm correct tube placement by auscultating lung sounds.
Choice C rationale
Assessing the baseline level of consciousness is important, but it is not the priority action following endotracheal intubation.
Choice D rationale
Assessing for the presence of circumoral cyanosis can indicate hypoxia, but it is not the priority action. The nurse should first confirm correct tube placement by auscultating lung sounds.

A. Implement ventilator-weaning protocols. B. Provide frequent oral care. C. Suction the patient every hour. D. Position the patient in a prone position. E. Avoid suctioning the patient.

Correct Answer is ["A","B","D"]

Explanation

Choice A rationale
Implementing ventilator-weaning protocols is a crucial intervention in the care plan for a patient on a ventilator to prevent ventilator-associated pneumonia. These protocols aim to minimize the patient’s exposure to mechanical ventilation, which is a significant risk factor for developing ventilator-associated pneumonia. By systematically reducing the level of ventilatory support, these protocols facilitate the earliest possible liberation from mechanical ventilation, thereby reducing the risk of ventilator-associated pneumonia.
Choice B rationale
Providing frequent oral care is another essential intervention in preventing ventilator- associated pneumonia. Oral health can quickly deteriorate in mechanically ventilated patients, leading to an increased risk of ventilator-associated pneumonia. Regular oral care, including the use of antiseptics, can help reduce the number of potential respiratory pathogens in the oral cavity and prevent their aspiration into the lower respiratory tract.
Choice C rationale
Suctioning the patient every hour is not typically recommended as a standard intervention to prevent ventilator-associated pneumonia. Over-suctioning can lead to trauma and inflammation in the airway, potentially increasing the risk of infection. Suctioning should be performed based on the patient’s needs and clinical signs, rather than on a fixed schedule.
Choice D rationale
Positioning the patient in a semi-upright position (30 to 45 degrees), rather than a prone position, is recommended to prevent ventilator-associated pneumonia. This position helps to reduce the risk of aspiration, which is a major risk factor for ventilator-associated pneumonia.
Choice E rationale
Avoiding suctioning the patient is not a recommended strategy for preventing ventilator- associated pneumonia. Suctioning is necessary to clear secretions from the airway, and its omission could potentially increase the risk of infection. However, as mentioned earlier, suctioning should be performed based on the patient’s needs and clinical signs, rather than on a fixed schedule.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient immediately following endotracheal intubation. Which of the following actions should the nurse prioritize to assess the patient for complications?

Correct Answer is A

Explanation

In the context of developing a care plan for a patient on a ventilator to prevent ventilator-associated pneumonia, which interventions should be included? Select all that apply.

Correct Answer is ["A","B","D"]

Explanation

A nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD). Which precaution should the nurse prioritize when administering nasal oxygen therapy to the client?

A nurse is part of a Continuous Quality Improvement (CQI) committee tasked with developing a program to decrease medication administration errors following a sentinel event. Which strategy should the committee consider implementing first?

A nurse is working with a colleague who frequently interrupts and dominates during patient care discussions. The nurse wants to address this behavior assertively to ensure effective teamwork. Which response by the nurse demonstrates assertive behavior?

A nurse on a quality control committee is evaluating the effectiveness of recently implemented measures aimed at reducing medication errors. Which methods should the nurse use to evaluate the success of the changes?

A nurse is caring for a client newly diagnosed with a pulmonary embolism (PE). Which of the following is the initial assessment finding in the client diagnosed with PE?

A nurse is preparing to discharge a patient who is post-operative following a laryngectomy. The nurse should recognize which of the following discharge teaching as the highest priority?