Nokea
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.
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The nurse is discussing placing the client diagnosed with chronic obstructive pulmonary disease (COPD) in hospice care. Which prognosis must be determined to place the client in hospice care?
- A. The client is doing well but could benefit from the added care by hospice.
- B. The client has a life expectancy of six (6) months or less.
- C. The client will live for about one (1) to two (2) more years.
- D. The client has about eight (8) weeks to live and needs pain control.
Correct Answer: B
Rationale: Hospice eligibility requires a prognosis of six months or less, per Medicare guidelines. Other options do not meet this criterion.
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.
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 teaching a class on chronic pain to new graduates. Which information is most important for the nurse to discuss?
- A. The nurse must believe the client's report of pain.
- B. Clients in chronic pain may not show objective signs.
- C. Alternate pain-control therapies are used for chronic pain.
- D. Referral to a pain clinic may be necessary.
Correct Answer: A
Rationale: Believing the client’s pain report is critical, as pain is subjective, per pain management guidelines. Objective signs, therapies, or referrals are secondary.
The HCP has notified the family of a client in a persistent vegetative state on a ventilator of the need to 'pull the plug.' The client does not have an AD or a durable power of attorney for health care, and the family does not want their loved one removed from the ventilator. Which action should the nurse implement?
- A. Refer the case to the hospital ethics committee.
- B. Tell the family they must do what the HCP orders.
- C. Follow the HCP's order and 'pull the plug.'
- D. Determine why the client did not complete an AD.
Correct Answer: A
Rationale: Without an AD or proxy, disagreements between family and HCP require ethics committee review for resolution. Forcing compliance, following orders against family wishes, or investigating AD absence is inappropriate.