Nokea
The client has been in a persistent vegetative state for several years. The family, who have decided to withhold tube feedings because there is no hope of recovery, asks the nurse, 'Will the death be painful?' Which intervention should the nurse implement?
- A. Tell the family the death will be painful but the HCP can order medications.
- B. Inform the family dehydration provides a type of natural euphoria.
- C. Relate other cases where the clients have died in excruciating pain.
- D. Ask the family why they are concerned because they want the client to die anyway.
Correct Answer: B
Rationale: Dehydration in end-of-life care often leads to a natural euphoria, reducing pain perception, per hospice evidence. Painful death, case comparisons, or questioning motives is unhelpful.
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The nurse is giving an in-service on end-of-life issues. Which activity should the nurse encourage the participants to perform?
- A. Discuss with another participant the death of a client.
- B. Review the hospital postmortem care policy.
- C. Justify not putting the client in a shroud after dying.
- D. Write down their own beliefs about death and dying.
Correct Answer: D
Rationale: Writing personal beliefs fosters self-awareness, enhancing end-of-life care competence. Client death discussions, policy review, or shroud justification are less introspective.
The mother of a 20-year-old African American male client receiving dialysis asks the nurse, 'My son has been on the transplant list longer than that white woman. Why did she get the kidney?' Which statement is the nurse's best response?
- A. The woman was famous, and so more people will donate organs now.
- B. I understand you are upset your son is ill. Would you like to talk?
- C. No one knows who gets an organ. You just have to wait and pray.
- D. The tissues must match or the body will reject the kidney and it will be wasted.
Correct Answer: D
Rationale: Tissue matching (HLA compatibility) determines transplant priority, preventing rejection, per UNOS guidelines. Fame, empathy, or fatalism are inappropriate responses.
Which intervention should the nurse implement to provide culturally sensitive health care to the European-American Caucasian elderly client who is terminal?
- A. Discuss health-care issues with the oldest male child.
- B. Determine if the client will be cremated or have an earth burial.
- C. Do not talk about death and dying in front of the client.
- D. Encourage the client's autonomy and answer questions truthfully.
Correct Answer: D
Rationale: Encouraging autonomy and honesty respects individual preferences, common in European-American culture, per patient-centered care. Family roles, burial plans, or avoiding death talk are less universal.
The experienced medical-surgical nurse is being oriented to the transplant unit. Which client should the charge nurse assign to this nurse?
- A. The client who donated a kidney to a relative three (3) days ago and will be discharged in the morning.
- B. The client who had a liver transplantation three (3) days ago and was transferred from the intensive care unit two (2) hours ago.
- C. The client who received a corneal transplant four (4) hours ago and has developed a cough and is vomiting.
- D. The client who had a pancreas transplantation and has a fever, chills, and a blood glucose monitor reading of 342.
Correct Answer: A
Rationale: A stable kidney donor nearing discharge is suitable for an experienced but orienting nurse. Recent liver transplant, acute corneal transplant issues, or pancreas transplant complications require specialized care.
Which action by the unlicensed assistive personnel (UAP) would warrant immediate intervention by the nurse?
- A. The UAP is holding the phone to the ear of a client who is a quadriplegic.
- B. The UAP refuses to discuss the client's condition with the visitor in the room.
- C. The UAP put a vest restraint on an elderly client found wandering in the hall.
- D. The UAP is assisting the client with arthritis to open up personal mail.
Correct Answer: C
Rationale: Applying restraints without a physician’s order violates safety and legal standards, requiring intervention. Other actions are appropriate UAP tasks.