Nokea
A client with cancer tells the nurse that he would like to make out a living will. The nurse knows that a living will provides documentation of:
- A. The client's desire to receive all means of assistance to sustain life.
- B. The client's desire to allow another to make decisions regarding his care.
- C. The client's wish to die without life-prolonging interventions.
- D. The client's desire to have his life terminated by active euthanasia.
Correct Answer: C
Rationale: A living will documents a client's wish to avoid life-prolonging interventions in terminal conditions. It does not mandate all assistance, delegate decisions, or support euthanasia.
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Laboratory results
Hematocrit
Male: 42%-52%
(0.42-0.52)
Female: 37%-47%
(0.37-0.47) 29%
(0.29)
Hemoglobin
Male: 14-18 g/dL
(140-180 g/L)
Female: 12-16 g/dL
(120-160 g/L) 9.7 g/dL
97 (g/L)
The nurse is caring for a client with chronic kidney disease who is scheduled to receive recombinant human erythropoietin and iron sucrose. Which of the following actions should the nurse take?
- A. Administer erythropoietin in the client's ventrogluteal muscle.
- B. Check the client's blood pressure prior to administering erythropoietin.
- C. Contact the health care provider to clarify the prescription for iron sucrose.
- D. Hold erythropoietin and inform the health care provider of the laboratory test results.
Correct Answer: B
Rationale: Erythropoietin can increase blood pressure, so checking BP is essential. It's given IV or SC, not IM . Iron sucrose is standard , and holding erythropoietin requires lab evidence.
Laboratory reference ranges
BUN
10-20 mg/dL
(3.6-7.1 mmol/L)
An 80-year-old client is receiving amikacin, an aminoglycoside antibiotic, IVPB every 12 hours. Which of the following data obtained
by the practical nurse is most important to report to the registered nurse before the client receives the next dose?
- A. client reports tinnitus
- B. Blood pressure 104/60 mm Hg
- C. urine output of 400 mL since last dose
Correct Answer: A
Rationale: Tinnitus may indicate ototoxicity, requiring immediate reporting. Low BP and urine output are less urgent without context of medication.
The nurse reinforces discharge teaching to a client who had a total knee replacement 4 days ago. Which client statement indicates the need for additional teaching?
- A. I have to give myself shots in the belly because my spouse is afraid of needles?
- B. I have to use a walker because I cant bear any weight on this knee yet.
- C. I will call my health care provider if I get short of breath or sore or swollen below my knee
- D. The raised toilet seat makes it easier for me to get on and off the toilet by myself.
Correct Answer: A
Rationale: Self-administered anticoagulant injections require confirmation of correct technique, not spousal fear, indicating misunderstanding. Walker use , symptom reporting , and toilet aids are correct.
A client with paranoid thoughts refuses to eat because of the belief that the food is poisoned. The appropriate statement at this time for the nurse to say is
- A. Here, I will pour a little of the juice in a medicine cup to drink it to show you that it is OK.'
- B. The food has been prepared in our kitchen and is not poisoned.'
- C. Let's see if your partner could bring food from home.'
- D. If you don't eat, I will have to suggest for you to be tube fed.'
Correct Answer: C
Rationale: Reassurance is ineffective when a client is actively delusional. This option avoids both arguing with the client and agreeing with the delusional premise.
The practical nurse is collaborating with the registered nurse to develop a care plan for a homeless client just brought into the emergency department with frostbite to the fingers and toes. The client is experiencing numbness, and assessment shows mottled skin. Which interventions should be included in the client's plan of care? Select all that apply.
- A. Apply occlusive dressings after rewarming
- B. Elevate affected extremities after rewarming
- C. Massage the areas to increase circulation
- D. Provide adequate analgesia
- E. Provide continuous warm water soaks
Correct Answer: B,D
Rationale: Elevation reduces swelling post-rewarming. Analgesia manages pain. Occlusive dressings trap moisture, massaging risks tissue damage, and continuous soaks may cause maceration.