Nokea
The 6-year-old client diagnosed with cystic fibrosis (CF) needs a lung transplant. Which individual would be the best donor for the client?
- A. The 20-year-old brother who does not have cystic fibrosis.
- B. The 45-year-old father who carries the cystic fibrosis gene.
- C. The 18-year-old who died in an MVA who matches on four (4) points.
- D. The 18-year-old drowning victim who is a three (3)-point match.
Correct Answer: A
Rationale: A healthy sibling (20-year-old brother) offers the best HLA match and living donor potential, minimizing rejection. Carrier status or partial matches are less optimal.
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The client who is of the Jewish faith died during the night. The nurse notified the family, who do not want to come to the hospital. Which intervention should the nurse implement to address the family's behavior?
- A. Take no further action because this is an accepted cultural practice.
- B. Notify the hospital supervisor and report the situation immediately.
- C. Call the local synagogue and request the rabbi go to the family's home.
- D. Assume the family does not care about the client and follow hospital protocol.
Correct Answer: A
Rationale: In Jewish tradition, some families avoid hospital visits post-death, delegating care to professionals, a cultural norm. Supervisor reports, rabbi involvement, or assumptions are inappropriate.
The client is dying and wants to talk to the nurse about heaven. Which is the nurse's best nursing action?
- A. Make a referral to the chaplain to come to see the client.
- B. Tell the client that nurses are not allowed to discuss spiritual matters.
- C. Ask the client to describe heaven and hell.
- D. Allow the client to discuss the beliefs about heaven.
Correct Answer: D
Rationale: Allowing discussion of heaven respects client spirituality, per holistic care. Chaplain referral, prohibiting discussion, or prompting hell discussion is less supportive.
The client is three (3) hours post-heart transplantation. Which data would support a complication of this procedure?
- A. The client has nausea after taking the oral antirejection medication.
- B. The client has difficulty coming off the heart-lung bypass machine.
- C. The client has saturated three (3) ABD dressing pads in one (1) hour.
- D. The client complains of pain at a '6' on a 1-to-10 scale.
Correct Answer: C
Rationale: Excessive bleeding (saturated dressings) indicates a surgical complication, requiring urgent intervention. Nausea, bypass difficulty, or moderate pain are less immediate.
Which element is not necessary to prove nursing malpractice?
- A. Breach of duty.
- B. Identify the ethical issues.
- C. Injury to the client.
- D. Proximate cause.
Correct Answer: B
Rationale: Malpractice requires duty, breach, injury, and causation. Identifying ethical issues is not a legal element, though relevant to ethics.
The nurse is discussing the HCP's recommendation for removal of life support with the client's family. Which information concerning brain death should the nurse teach the family?
- A. Positive waves on the electroencephalogram (EEG) mean the brain is dead and any further treatment is futile.
- B. When putting cold water in the ear, if the client reacts by pulling away, this demonstrates brain death.
- C. Tests will be done to determine if any brain activity exists before the machines are turned off.
- D. Although the blood flow studies don't indicate activity, the client can still come out of the coma.
Correct Answer: C
Rationale: Brain death requires tests (e.g., EEG, apnea test) to confirm no brain activity, per medical standards. Positive EEG waves, caloric reflex, or coma recovery are incorrect.