Nokea
A nurse is reinforcing teaching about advance directives with a client who has terminal colorectal cancer. Which of the following statements by the client indicates an understanding of the teaching?
- A. I'm glad to have the opportunity to choose what kind of care I receive while I still can.
- B. If I want life support, I'll need to sign a separate consent form first.
- C. I can't change my mind about the care I will receive once I sign my living will.
- D. Once I fill out my living will, there will be a 1-month delay before it is legally binding.
Correct Answer: A
Rationale: Advance directives allow clients to specify care preferences, reflecting autonomy.
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A nurse is assisting with scoliosis screenings for students at a public school. Which of the following findings should the nurse recognize as an indication of scoliosis?
- A. Unequal height of the shoulders
- B. Expansion of the upper intercostal spaces
- C. Increased convex curve of the cervical spine
- D. Increased concave curve of the thoracic spine
Correct Answer: A
Rationale: Unequal shoulder height is a classic sign of scoliosis due to spinal curvature.
A nurse is planning to obtain a client's oxygen saturation. Which of the following might influence the result of this test?
- A. The client has a fever.
- B. The client has an elevated hemoglobin level.
- C. The client is wearing a ring.
- D. The client is wearing nail polish.
Correct Answer: D
Rationale: Nail polish can interfere with pulse oximetry readings by absorbing light.
A nurse is planning to provide postmortem care for a client who requires an autopsy. Which of the following actions should the nurse plan to take?
- A. Place an identification tag on the outside of the client's shroud.
- B. Remove the client's dentures and give them to the client's family.
- C. Wear sterile gloves when cleaning the client's body.
- D. Ask the assistive personnel to document the client's time of death.
Correct Answer: A
Rationale: An ID tag on the shroud ensures proper identification for autopsy purposes.
A nurse is caring for a client who follows a lacto-vegetarian diet. Which of the following food choices should the nurse recommend?
- A. Tuna fish
- B. Clam chowder
- C. Cheese
- D. Chicken
Correct Answer: C
Rationale: Cheese fits a lacto-vegetarian diet, which includes dairy but excludes meat and fish.
A nurse is preparing to perform a fecal occult blood test of stool specimens for a client. Which of the following actions should the nurse plan to take?
- A. Ensure that the stool specimen does not contain urine.
- B. Repeat the test three times using the same stool specimen.
- C. Have the client defecate into a bedpan that contains a small amount of water.
- D. Wear sterile gloves when handling the stool specimen
Correct Answer: A
Rationale: Urine can contaminate the specimen and affect test accuracy.