Nokea
The client diagnosed with cancer is experiencing severe pain. Which regimen would the nurse teach the client about to control the pain?
- A. Nonsteroidal anti-inflammatory drugs (NSAIDs) around the clock with narcotics used for severe pain.
- B. Morphine sustained release, a narcotic, routinely with a liquid morphine preparation for breakthrough pain.
- C. Extra-Strength Tylenol, a nonnarcotic analgesic, plus therapy to learn alternative methods of pain control.
- D. Demerol, an opioid narcotic, every six (6) hours orally with a suppository when the pain is not controlled.
Correct Answer: B
Rationale: Sustained-release morphine with breakthrough doses is standard for cancer pain, per WHO pain ladder. NSAIDs, Tylenol, or Demerol regimens are less effective or outdated.
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Which client would the nurse exclude from being a potential organ/tissue donor?
- A. The 60-year-old female client with an inoperable primary brain tumor.
- B. The 45-year-old female client with a subarachnoid hemorrhage.
- C. The 22-year-old male client who has been in a motor-vehicle accident.
- D. The 36-year-male client recently released from prison.
Correct Answer: A
Rationale: Primary brain tumors contraindicate organ donation due to malignancy risk, per UNOS guidelines. Hemorrhage, trauma, or prison status do not exclude donation.
The male client requested a DNR per the AD, and the HCP wrote the order. The client's death is imminent and the client's wife tells the nurse, 'Help him please. Do something. I am not ready to let him go.' Which action should the nurse take?
- A. Ask the wife if she would like to revoke her husband's AD.
- B. Leave the wife at the bedside and notify the hospital chaplain.
- C. Sit with the wife at the bedside and encourage her to say good-bye.
- D. Request the client to tell the wife he is ready to die, and don't do anything.
Correct Answer: C
Rationale: Sitting with the wife and encouraging closure supports her emotionally while respecting the DNR. Revoking AD, notifying chaplain, or requesting client communication is inappropriate.
The client diagnosed with chronic back pain is being placed on a transcutaneous electrical nerve stimulation (TENS) unit. Which information should the nurse teach?
- A. The TENS unit will deaden the nerve endings, and the client will not feel pain.
- B. The TENS unit could cause paralysis if the client gets the unit wet.
- C. The TENS unit stimulates the nerves in the area, blocking the pain sensation.
- D. The TENS unit should be left on for an hour, and then taken off for an hour.
Correct Answer: C
Rationale: TENS units stimulate nerves to block pain signals, per gate control theory. Deadening nerves, paralysis, or specific on/off cycles are inaccurate.
The male client who has made himself a do not resuscitate (DNR) order is in pain. The client's vital signs are P 88, R 8, and BP 108/70. Which intervention should be the nurse's priority action?
- A. Refuse to give the medication because it could kill the client.
- B. Administer the medication as ordered and assess for relief from pain.
- C. Wait until the client' respirations improve and then administer the medication.
- D. Notify the HCP the client is unstable and pain medication is being held.
Correct Answer: B
Rationale: Pain relief is a priority, even with DNR; administering medication as ordered with assessment is safe, despite low respirations. Refusing, delaying, or notifying HCP delays care.
The spouse of a client dying from lung cancer states, 'I don't understand this death rattle. She has not had anything to drink in days. Where is the fluid coming from?' Which is the hospice care nurse's best response?
- A. The body produces about two (2) teaspoons of fluid every minute on its own.
- B. Are you sure someone is not putting ice chips in her mouth?
- C. There is no reason for this, but it does happen from time to time.
- D. I can administer a patch to her skin to dry up the secretions if you wish.
Correct Answer: C
Rationale: The death rattle results from accumulated secretions in the throat, a normal end-of-life phenomenon, not fluid intake. Teaspoon estimates, ice chips, or patches are inaccurate or premature.