Nokea
Which client would be most likely to complete an advance directive?
- A. A 55-year-old Caucasian person who is a bank president.
- B. A 34-year-old Asian licensed practical nurse.
- C. A 22-year-old Hispanic lawn care worker.
- D. A 65-year-old African American retired cook.
Correct Answer: D
Rationale: Older adults (e.g., 65-year-old) are more likely to complete ADs due to increased awareness of mortality and health issues, regardless of ethnicity or profession.
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The nurse is discussing the HCP's recommendation for removal of life support with the client's family. Which information concerning brain death should the nurse teach the family?
- A. Positive waves on the electroencephalogram (EEG) mean the brain is dead and any further treatment is futile.
- B. When putting cold water in the ear, if the client reacts by pulling away, this demonstrates brain death.
- C. Tests will be done to determine if any brain activity exists before the machines are turned off.
- D. Although the blood flow studies don't indicate activity, the client can still come out of the coma.
Correct Answer: C
Rationale: Brain death requires tests (e.g., EEG, apnea test) to confirm no brain activity, per medical standards. Positive EEG waves, caloric reflex, or coma recovery are incorrect.
The 38-year-old client was brought to the emergency department with CPR in progress and expired 15 minutes after arrival. Which intervention should the nurse implement for postmortem care?
- A. Do not allow significant others to see the body.
- B. Do not remove any tubes from the body.
- C. Prepare the body for the funeral home.
- D. Send the client's clothing to the hospital laundry.
Correct Answer: C
Rationale: Preparing the body (e.g., cleaning, positioning) respects dignity and funeral home needs. Denying family access, leaving tubes, or laundering clothes is inappropriate.
The client had a mastectomy and lymph node dissection three (3) years ago and has experienced postmastectomy pain (PMP) since. Which intervention should the nurse implement?
- A. Have the client see a psychologist because the pain is not real.
- B. Tell the client the pain is the cancer coming back.
- C. Refer the client to a physical therapist to prevent a frozen shoulder.
- D. Discuss changing the client to a more potent narcotic medication.
Correct Answer: C
Rationale: PMP can lead to shoulder immobility; physical therapy prevents frozen shoulder, per evidence-based practice. Psychological dismissal, cancer assumptions, or narcotics are inappropriate.
The 78-year-old Catholic client is in end-stage congestive heart failure and has a DNR order. The client has AP 50, RR 10, and BP 80/50, and Cheyne-Stokes respirations. Which action should the nurse implement?
- A. Bring the crash cart to the bedside.
- B. Apply oxygen via nasal cannula.
- C. Notify a priest for last rites.
- D. Turn the bed to face the sunset.
Correct Answer: C
Rationale: Notifying a priest for last rites respects Catholic end-of-life practices, a priority with imminent death. Crash cart violates DNR, oxygen is less critical, and bed orientation is irrelevant.
The HCP has notified the family of a client in a persistent vegetative state on a ventilator of the need to 'pull the plug.' The client does not have an AD or a durable power of attorney for health care, and the family does not want their loved one removed from the ventilator. Which action should the nurse implement?
- A. Refer the case to the hospital ethics committee.
- B. Tell the family they must do what the HCP orders.
- C. Follow the HCP's order and 'pull the plug.'
- D. Determine why the client did not complete an AD.
Correct Answer: A
Rationale: Without an AD or proxy, disagreements between family and HCP require ethics committee review for resolution. Forcing compliance, following orders against family wishes, or investigating AD absence is inappropriate.