Nokea
A nurse is caring for a client who has advanced lung cancer. The client's provider has recommended hospice services for the client. Which of the following statements by the client indicates a correct understanding of hospice care?
- A. My oncologist will continue to look for a cure for my cancer while I am receiving hospice care.
- B. I should expect the hospice team to help me manage my dyspnea.
- C. Hospice care services are available to patients who are terminally ill regardless of their life expectancy.
- D. I will have to be admitted to a long-term care facility in order to receive hospice care.
Correct Answer: B
Rationale: The correct answer is B: "I should expect the hospice team to help me manage my dyspnea." This statement indicates a correct understanding of hospice care because managing symptoms like dyspnea (difficulty breathing) is a primary goal of hospice care. Hospice focuses on providing comfort and quality of life for terminally ill patients, rather than pursuing aggressive treatments or searching for a cure.
The other choices are incorrect because:
A: This statement is incorrect as hospice care is focused on palliative care and quality of life, not curative treatments.
C: This statement is incorrect because hospice care is typically provided to patients with a life expectancy of six months or less.
D: This statement is incorrect as hospice care can be provided in various settings, including the patient's own home, not just in long-term care facilities.
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A nurse in the emergency department is caring for a client who has a compression fracture of a spinal vertebra. During transport to the facility, the client was medicated with intravenous morphine. On arrival, the neurosurgeon determined urgent surgical intervention is indicated for the fracture. Staff members have been unable to reach the client's family. Which of the following actions should the nurse anticipate the neurosurgeon taking?
- A. Prescribing naloxone to reverse the effects of the morphine
- B. Asking the client to sign the surgical consent form
- C. Delaying the surgery until a member of the client's family is reached
- D. Invoking implied consent
Correct Answer: D
Rationale: The correct answer is D: Invoking implied consent. Implied consent allows healthcare providers to proceed with urgent treatment when a patient is unable to provide informed consent and there is an immediate threat to the patient's life or health. In this scenario, the client requires urgent surgical intervention for a compression fracture, and the family cannot be reached. Therefore, the neurosurgeon may invoke implied consent to proceed with the surgery to prevent further harm to the client.
A: Prescribing naloxone to reverse the effects of the morphine is not necessary in this case as the morphine was given for pain management and does not interfere with the need for urgent surgical intervention.
B: Asking the client to sign the surgical consent form is not appropriate as the client may not be in a condition to provide informed consent due to the urgent nature of the surgery and the effects of the medication.
C: Delaying the surgery until a member of the client's family is reached may not be feasible if there
A nurse is caring for four clients who are postoperative from surgery 24 hr ago. At 1200 the nurse assesses the clients. Which of the following clients is the nurse's priority?
- A. A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6
- B. A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous
- C. A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL
- D. A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg
Correct Answer: D
Rationale: The correct answer is D because a significant drop in blood pressure from 138/86 mm Hg at 0800 to 106/60 mm Hg at 1200 indicates potential hypotension, which could be a sign of hemorrhage or shock postoperatively. Hypotension can lead to inadequate tissue perfusion and organ damage. Monitoring and addressing the client's blood pressure promptly is crucial to prevent further complications.
Choice A is not the priority because an increase in pain from 4 to 6 is significant but does not indicate as immediate risk as hypotension. Choice B, a change in wound drainage consistency, may require monitoring but is not as urgent as addressing hypotension. Choice C, an increase in post-meal blood glucose, is important but does not pose an immediate threat to the client's life compared to hypotension in Choice D.
A charge nurse is evaluating the performance of an assistive personnel (AP). Which of the following actions by the AP indicates a need for further education?
- A. The AP reports a client's temperature of 38.5°C to the nurse.
- B. The AP assists a client with turning every 2 hours.
- C. The AP leaves a client's meal tray out of reach after delivery.
- D. The AP uses a gait belt when ambulating a client.
Correct Answer: C
Rationale: Leaving the meal tray out of reach prevents the client from eating, indicating a need for further education on client-centered care. The other actions are appropriate.
A nurse is preparing to discharge a client who has a new prescription for warfarin. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?
- A. Teach the client about dietary restrictions with warfarin.
- B. Provide the client with written discharge instructions.
- C. Assist the client with packing personal belongings.
- D. Schedule a follow-up appointment for the client.
Correct Answer: C
Rationale: Assisting the client with packing personal belongings is a non-clinical task within the AP's scope of practice. Teaching, providing instructions, and scheduling appointments require nursing expertise.
A nurse manager observes an unknown man in a laboratory coat making copies of a client's medical record. Which of the following actions should the nurse plan to take first?
- A. Report the observation to the nurse caring for that client.
- B. Inform the nursing supervisor.
- C. Approach the man and ask why he is making copies.
- D. Notify hospital security.
Correct Answer: C
Rationale: The correct answer is C: Approach the man and ask why he is making copies. This is the first action the nurse should take to gather information and assess the situation. By directly addressing the man, the nurse can determine his intentions and potentially stop any unauthorized activity. Reporting to the nurse caring for the client (A) may lead to delays in addressing the issue directly. Informing the nursing supervisor (B) is important, but immediate action is needed. Notifying hospital security (D) should be done after gathering more information.