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The client is on the ventilator and has been declared brain dead. The spouse refuses to allow the ventilator to be discontinued. Which collaborative action by the nurse is most appropriate?
- A. Discuss referral of the case to the ethics committee.
- B. Pull the plug when the spouse is not in the room.
- C. Ask the HCP to discuss the futile situation with the spouse.
- D. Inform the spouse what is happening is cruel.
Correct Answer: A
Rationale: Ethics committee referral addresses conflicts over futile care, respecting family wishes and legal standards. Unilateral action, HCP discussion, or calling it cruel is inappropriate.
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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 Hispanic client who has terminal cancer is requesting a curandero to come to the bedside. Which intervention should the nurse implement?
- A. Tell the client it is against policy to allow faith healers.
- B. Assist with planning the visit from the curandero.
- C. Refer the client to the pastoral care department.
- D. Determine the reason the client needs the curandero.
Correct Answer: B
Rationale: Facilitating a curandero visit respects Hispanic cultural beliefs, per patient-centered care. Denying, referring, or questioning the need is less culturally sensitive.
The client receiving dialysis for end-stage renal disease wants to quit dialysis and die. Which ethical principle supports the client's right to die?
- A. Autonomy.
- B. Self-determination.
- C. Beneficence.
- D. Justice.
Correct Answer: A
Rationale: Autonomy supports a client’s right to make decisions, including refusing treatment, per ethical standards. Self-determination is synonymous, but autonomy is the precise term.
The client who is terminally ill called the significant others to the room and said goodbye, then dismissed them and now lies quietly and refuses to eat. The nurse understands the client is in what stage of the grieving process?
- A. Denial.
- B. Anger.
- C. Bargaining.
- D. Acceptance.
Correct Answer: D
Rationale: Saying goodbye and withdrawing quietly reflect acceptance in Kübler-Ross’s grief stages, common in terminal illness.
The client with chronic low back pain is having trouble sleeping at night. Which nonpharmacological therapy should the nurse teach the client?
- A. Acupuncture.
- B. Massage therapy.
- C. Herbal remedies.
- D. Progressive relaxation techniques.
Correct Answer: D
Rationale: Progressive relaxation reduces muscle tension and promotes sleep, a safe nonpharmacological option. Acupuncture, massage, or herbs are less directly linked to sleep.