Nokea
A community health nurse is caring for a group of homeless people. What is the most immediate concern when planning for the potential needs of this group?
- A. Finding affordable housing for the group
- B. Setting up a 24-hour crisis center and hotline
- C. Providing peer support through structured support groups
- D. Ensuring that adequate food, shelter, and clothing are available
Correct Answer: D
Rationale: The question asks about the situation's most immediate concern. The initial community health concern is always attending to people's basic physiological needs of food, shelter, and clothing. Finding affordable housing and providing crisis intervention and peer support are meaningful interventions that may be completed at a later time.
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The nurse is interacting with the family of a client who is unconscious as a result of a head injury. Which approach should the nurse use to help the family cope with their concerns?
- A. Explain equipment and procedures on an ongoing basis.
- B. Discuss displaying their grief only when not in the room with the client.
- C. Discourage them from touching the client in order to minimize stimulation.
- D. Explain that they need their rest so they should adhere to regular visiting hours.
Correct Answer: A
Rationale: Families often need assistance to cope with the sudden severe illness of a loved one. The nurse should explain all equipment, treatments, and procedures, and he or she should supplement or reinforce the information given by the primary health care provider. Displaying grief is a normal process and should not be discouraged. The family should be encouraged to touch and speak to the client and become involved in the client's care in some way if they are comfortable with doing so. The nurse should allow the family to stay with the client whenever possible. This is important for both the client and the family.
The nurse is caring for a depressed, withdrawn client who was responsible for an automobile accident that recently resulted in the death of a child. What is the nurse's initial action?
- A. Allow the client to have some time alone to grieve over the loss.
- B. Reinforce to the client that the child's death was a result of an accident.
- C. Communicate in a manner that acknowledges and respects the client's depressed state.
- D. Inform the primary health care provider of the client's possible need for medication to cope.
Correct Answer: C
Rationale: The nurse's initial intervention is to encourage the client to express feelings, which is facilitated by establishing a nurse-client relationship that is based upon respect. The correct option validates the perception that the client is depressed. This action also allows the nurse to assess the situation. Options 1, 2, and 4 address interventions before assessing the situation and identifying the client's actual needs.
When a client is dead on arrival (DOA) to the emergency department, the family states that they do not want an autopsy performed. Which statement should the nurse make in response to the family?
- A. Autopsies are mandatory for clients who are DOA.'
- B. Federal law requires autopsies for clients who are DOA.'
- C. The medical examiner makes the decision about autopsies.'
- D. I will make sure the medical examiner is aware of your request.'
Correct Answer: D
Rationale: The nurse should notify the medical examiner or the coroner when a family wishes to avoid having an autopsy on a deceased family member. Normally the medical examiner will honor the family request unless there is a state law requiring the autopsy. Depending on the state, it is not mandatory for every client who is DOA to have an autopsy. However, many states require an autopsy in specific circumstances, including sudden death, a suspicious death, and death within 24 hours of admission to the hospital. Autopsy is not a requirement under federal law.
The nurse cared for a client who died a few minutes ago. Which event supports the nurse's belief that the client died with dignity?
- A. The family thanks the nurse for facilitating such a peaceful death.
- B. The nurse states that it is difficult to give that kind of care to a dying client.
- C. The primary health care provider acknowledges that all of the prescriptions were carried out.
- D. The nurse kept the client's last hours comfortable with increasing doses of pain medication.
Correct Answer: A
Rationale: The family response is an external perception, and it is extremely important. Families derive a great deal of comfort from knowing that their loved one received the best care possible. The correct option provides external validation that the client received comprehensive, quality care. Option 2 focuses on the feelings of the nurse, who may be expressing his or her own anxiety. Option 3 focuses on the provider's prescriptions rather than client care. Option 4 reflects on only one aspect of the care of a dying client.
A client diagnosed with incurable cancer has a life expectancy of a few weeks. Which response indicates that the client's partner is reacting with an expected coping response?
- A. Refusing to visit the client
- B. Expresses anger with his God
- C. Not allowing the death to occur at home
- D. Sending the children to live with relatives
Correct Answer: B
Rationale: Anger is a normal stage of the grieving process and is an expected coping response when facing the imminent loss of a loved one. Expressing anger toward a spiritual entity, such as God, is a common way for individuals to process their grief. Refusing to visit the client indicates avoidance or denial, which may not be constructive. Not allowing the death to occur at home or sending children to live with relatives may reflect practical decisions but do not directly indicate an expected emotional coping response related to grief.