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A 42-year-old husband and father of a 7-year-old girl and a 10-year-old boy is concerned about what he should tell his children regarding his wife's impending death from aggressive breast cancer. The nurse should:
- A. Refer the family to pastoral care services.
- B. Encourage the husband to come to terms with his own grief first.
- C. Suggest that the children be told nothing until after death occurs.
- D. Begin education about strategies for communication with his children.
Correct Answer: D
Rationale: Educating the husband on communication strategies helps him prepare his children for their mother's death, fostering understanding and emotional support.
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On admission to same-day surgery, the nurse reviews the chart to verify the client's identification documentation. Which of the following is most important?
- A. Admitting record.
- B. Addressograph labels.
- C. Identification bracelet.
- D. Location of family.
Correct Answer: C
Rationale: The identification bracelet is the most reliable method to verify client identity, ensuring safety and preventing errors in same-day surgery.
A client post-hemodialysis reports dizziness. The nurse should:
- A. Check blood pressure.
- B. Administer fluids.
- C. Encourage eating.
- D. Increase dialysis time.
Correct Answer: A
Rationale: Dizziness may indicate hypotension, a common post-dialysis issue.
If a client is receiving rescue breaths and the chest wall fails to rise during cardiopulmonary resuscitation, the rescuer should first:
- A. Try using an ambu bag.
- B. Decrease the rate of compressions.
- C. Intubate the client.
- D. Reposition the airway.
Correct Answer: D
Rationale: Failure of the chest to rise during rescue breaths suggests airway obstruction or improper positioning. Repositioning the airway (e.g., head-tilt-chin-lift) is the first step.
A 60-year-old client with acute myeloid leukemia (AML) states that he overheard one of the other clients say that AML had a very poor prognosis. The client explains to the nurse that he had understood his doctor to say that he had a relatively good prognosis. Which is the nurse's best response?
- A. You must have misunderstood. Whom did you hear that from?'
- B. AML does have a very poor prognosis for poorly differentiated cells.'
- C. AML is the most common nonlymphocytic leukemia.'
- D. Your doctor stated your prognosis based on the differentiation of your cells.'
Correct Answer: D
Rationale: The prognosis for AML varies based on factors like cell differentiation, age, and genetics. The nurse should clarify that the doctor's prognosis was specific to the client's cell differentiation, reassuring him without dismissing his concerns. The other responses are either confrontational, overly general, or irrelevant.
The nurse formulates a nursing diagnosis of Spiritual distress related to advanced cancer disease. An appropriate goal for the client would be to:
- A. Start attending church or chapel services once a week.
- B. Call a chaplain and set up an appointment for spiritual guidance.
- C. Reflect on past accomplishments.
- D. Participate in spiritual activities of the client's choice.
Correct Answer: D
Rationale: Participating in spiritual activities of the client's choice respects their individual beliefs and supports resolution of spiritual distress.