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In-home hospice care is arranged for a client with stage 4 lung cancer. While the palliative care nurse is arranging for discharge, the client verbalizes concerns about pain. Which action should the nurse implement?
- A. Recommend asking the healthcare professional for a patient-controlled analgesia (PCA) pump.
- B. Explain the respiratory problems that can occur with morphine use.
- C. Teach family how to evaluate the effectiveness of analgesics.
- D. Provide client with a schedule of around-the-clock prescribed analgesic use.
Correct Answer: D
Rationale: Scheduled analgesics ensure consistent pain relief.
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The nurse receives a new prescription to administer oxygen at 3 L/minute via a nasal cannula to maintain an oxygen saturation between 90 and 100% for an adult client. The nurse obtains an oxygen saturation reading of 85% and, after repositioning the oximeter on a different finger, obtains a second reading of 87%. Which action should the nurse take next?
- A. Place the client in a Trendelenburg position.
- B. Document the second reading in the client record.
- C. Securely place the prongs of the cannula in the nostrils.
- D. Place the pulse oximeter on the client's earlobe.
Correct Answer: C
Rationale: Proper cannula placement ensures effective oxygen delivery.
The healthcare provider prescribes nasogastric tube (NGT) insertion for a client with a postoperative ileus. During insertion, the client begins to gag. Which action should the nurse take?
- A. Use firm pressure to pass the tube through the glottis.
- B. Have the client tilt head backward to open the passage.
- C. Give the client a few sips of water to drink.
- D. Remove the tube and attempt reinsertion.
Correct Answer: D
Rationale: Removing and reinserting prevents discomfort and harm.
Prior to receiving a 120 mL hypertonic enema, an ambulatory female client tells the nurse that she does not believe that she can walk all the way to the bathroom without expelling the enema. Which intervention is best for the nurse to implement?
- A. Ask an unlicensed assistive personnel to stay with the client.
- B. Place the bedpan within the reach of the client.
- C. Obtain a bedside commode for the client to use.
- D. Notify the healthcare provider of the client's concerns.
Correct Answer: C
Rationale: Commode prevents enema expulsion accidents.
The nurse learns that members of the nursing staff are uncomfortable with responding to client family members who are angry. While designing a teaching session to help the staff respond more effectively in these situations, which instructional strategy is best for the nurse to use?
- A. Journaling
- B. Return demonstration.
- C. Role playing.
- D. Analogies.
Correct Answer: C
Rationale: Role-playing builds confidence in handling anger.
The nurse retrieves hydromorphone 4 mg/mL from an automated dispensing system, for a client who is receiving hydromorphone 3 mg IM every 6 hours PRN for severe pain. How many mL should the nurse administer to the client? (Enter the numerical value only. If rounding is required, round to the nearest tenth.)
Correct Answer: 0.8
Rationale: 3 mg ÷ 4 mg/mL = 0.75 mL, rounded to 0.8 mL.