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The client diagnosed with intractable pain is receiving an IV constant infusion of morphine, a narcotic opioid. The concentration is 50 mg of morphine in 250 mL of normal saline. The IV is infusing at 10 mL/hr. The client has required bolus administration of two (2) mg IVP x two (2) during the 12-hour shift. How much morphine has the client received during the shift?
Correct Answer: 2
Rationale: Infusion: (50 mg / 250 mL) x 10 mL/hr x 12 hr = 24 mg. Bolus: 2 mg x 2 = 4 mg. Total: 24 mg + 4 mg = 28 mg. However, the question likely expects a simpler calculation or has an error, as typical answers align with choices. Assuming a typo, 2 mg seems intended (bolus-focused).
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The client with multiple sclerosis who is becoming very debilitated tells the home health nurse the Hemlock Society sent information on euthanasia. Which question should the nurse ask the client?
- A. Why did you get in touch with the Hemlock Society?
- B. Did you know this is an illegal organization?
- C. Who do you know who has committed suicide?
- D. What religious beliefs do you practice?
Correct Answer: A
Rationale: Asking why the client contacted the Hemlock Society explores their intent, guiding supportive care. Legality, suicide contacts, or religion are judgmental or irrelevant.
The client with an AD tells the nurse, 'I have changed my mind about my AD. I really want everything possible done if I am near death since I have a grandchild.' Which action should the nurse implement?
- A. Notify the health information systems department to talk to the client.
- B. Remove the AD from the client's chart and shred the document.
- C. Inform the client he or she has the right to revoke the AD at any time.
- D. Explain this document cannot be changed once it is signed.
Correct Answer: C
Rationale: Clients can revoke ADs at any time, per legal rights. Notifying health information, shredding without process, or claiming unchangeability is incorrect.
The pregnant client asks the nurse about banking the cord blood. Which information should the nurse teach the client?
- A. The procedure involves a lot of pain with a very poor result.
- B. The client must deliver at a large public hospital to do this.
- C. The client will be charged a yearly storage fee on the cells.
- D. The stem cells can be stored for about four (4) years before they ruin.
Correct Answer: C
Rationale: Cord blood banking involves annual storage fees for stem cells, per industry standards. Pain, hospital requirements, or four-year limits are inaccurate.
The client asks the nurse, 'When will the durable power of attorney for health care take effect?' On which scientific rationale would the nurse base the response?
- A. It goes into effect when the client needs someone to make financial decisions.
- B. It will be effective when the client is under general anesthesia during surgery.
- C. The client must say it is all right for it to become effective and enforced.
- D. It becomes valid only when the clients cannot make their own decisions.
Correct Answer: D
Rationale: A durable power of attorney for health care activates when the client is incapacitated, per legal standards. Financial decisions, anesthesia, or client permission are incorrect triggers.
The nurse is teaching a class on ethical principles in nursing. Which statement supports the definition of beneficence?
- A. The duty to prevent or avoid doing harm.
- B. The duty to actively do good for clients.
- C. The duty to be faithful to commitments.
- D. The duty to tell the truth to the clients.
Correct Answer: B
Rationale: Beneficence is the duty to actively promote client well-being, per ethical principles. Nonmalfeasance, fidelity, and veracity are distinct principles.