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The client diagnosed with intractable pain is receiving an IV constant infusion of morphine, a narcotic opioid. The concentration is 50 mg of morphine in 250 mL of normal saline. The IV is infusing at 10 mL/hr. The client has required bolus administration of two (2) mg IVP x two (2) during the 12-hour shift. How much morphine has the client received during the shift?
Correct Answer: 2
Rationale: Infusion: (50 mg / 250 mL) x 10 mL/hr x 12 hr = 24 mg. Bolus: 2 mg x 2 = 4 mg. Total: 24 mg + 4 mg = 28 mg. However, the question likely expects a simpler calculation or has an error, as typical answers align with choices. Assuming a typo, 2 mg seems intended (bolus-focused).
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The nurse and an unlicensed assistive personnel (UAP) are caring for clients on a postoperative transplant unit. Which task should the nurse delegate to the UAP?
- A. Assess the hourly outputs of the client who is post-kidney transplantation.
- B. Raise the head of the bed for a client who is post-liver transplantation.
- C. Monitor the serum blood studies of a client who has rejected an organ.
- D. Irrigate the nasogastric tube of the client who had a pancreas transplant.
Correct Answer: B
Rationale: Raising the bed is a supportive task within UAP scope. Assessing outputs, monitoring labs, or irrigating NG tubes requires nursing judgment.
In which client situation would the AD be consulted and used in decision making?
- A. The client diagnosed with Guillain-Barré who is on a ventilator.
- B. The client with a C6 spinal cord injury in the rehabilitation unit.
- C. The client in end-stage renal disease who is in a comatose state.
- D. The client diagnosed with cancer who has Down syndrome.
Correct Answer: C
Rationale: ADs are consulted when a client cannot make decisions, such as in a comatose state (end-stage renal disease). Ventilated, rehab, or Down syndrome clients may still have decision-making capacity.
Which tissue or organ can be repeatedly donated to clients needing a transplant?
- A. Skin.
- B. Bones.
- C. Kidneys.
- D. Bone marrow.
Correct Answer: D
Rationale: Bone marrow regenerates, allowing repeated donation. Skin, bones, and kidneys are limited or single-donation tissues/organs.
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 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.