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The nurse is aware the Patient Self-Determination Act of 1991 requires the health-care facility to implement which action?
- A. Make available an AD on admission to the facility.
- B. Assist the client with legally completing a will.
- C. Provide ethically and morally competent care to the client.
- D. Discuss the importance of understanding consent forms.
Correct Answer: A
Rationale: The Patient Self-Determination Act mandates offering AD information on admission for Medicare/Medicaid facilities. Wills, ethical care, and consent forms are unrelated.
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The nurse and an unlicensed assistive personnel (UAP) are caring for a group of clients in a pain clinic. Which intervention would be inappropriate to delegate to the UAP?
- A. Assist the client diagnosed with intractable pain to the bathroom.
- B. Elevate the head of the bed for a client diagnosed with back pain.
- C. Perform passive range of motion for a client who is bedfast.
- D. Monitor the potassium levels on a client about to receive medication.
Correct Answer: D
Rationale: Monitoring potassium levels requires nursing judgment, outside UAP scope. Assisting to bathroom, elevating bed, and range of motion are within UAP capabilities.
The client with multiple sclerosis who is becoming very debilitated tells the home health nurse the Hemlock Society sent information on euthanasia. Which question should the nurse ask the client?
- A. Why did you get in touch with the Hemlock Society?
- B. Did you know this is an illegal organization?
- C. Who do you know who has committed suicide?
- D. What religious beliefs do you practice?
Correct Answer: A
Rationale: Asking why the client contacted the Hemlock Society explores their intent, guiding supportive care. Legality, suicide contacts, or religion are judgmental or irrelevant.
The client who is terminally ill called the significant others to the room and said goodbye, then dismissed them and now lies quietly and refuses to eat. The nurse understands the client is in what stage of the grieving process?
- A. Denial.
- B. Anger.
- C. Bargaining.
- D. Acceptance.
Correct Answer: D
Rationale: Saying goodbye and withdrawing quietly reflect acceptance in Kübler-Ross’s grief stages, common in terminal illness.
The nurse writes a client problem of 'spiritual distress' for the client who is dying. Which statement is an appropriate goal?
- A. The client will reconcile self and the higher power of his or her beliefs.
- B. The client will be able to express anger at the terminal diagnosis.
- C. The client will reconcile self to estranged members of the family.
- D. The client will have a dignified and pain-free death.
Correct Answer: A
Rationale: Spiritual distress goals focus on reconciling with beliefs or higher power, addressing the distress. Anger expression, family reconciliation, or pain-free death are separate issues.
The nurse is caring for a client who is confused and fell trying to get out of bed. There is no family at the client's bedside. Which action should the nurse implement first?
- A. Contact a family member to come and stay with the client.
- B. Administer a sedative medication to the client.
- C. Place the client in a chair with a sheet tied around him or her.
- D. Notify the health-care provider to obtain a restraint order.
Correct Answer: D
Rationale: Notifying the HCP for a restraint order ensures safety and legal compliance for a confused client at risk of falls. Family contact, sedation, or makeshift restraints are unsafe or secondary.