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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.
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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 client diagnosed with septicemia expired, and the family tells the nurse the client is an organ donor. Which intervention should the nurse implement?
- A. Notify the organ and tissue organizations to make the retrieval.
- B. Explain a systemic infection prevents the client from being a donor.
- C. Call and notify the health-care provider of the family's request.
- D. Take the body to the morgue until the organ bank makes a decision.
Correct Answer: B
Rationale: Systemic infections like septicemia contraindicate organ donation due to infection risk, per UNOS guidelines. Notification, HCP calls, or morgue transfer are premature.
The client has been declared brain dead and is an organ donor. The nurse is preparing the wife of the client to enter the room to say good-bye. Which information is most important for the nurse to discuss with the wife?
- A. Inform the wife the client will still be on the ventilator.
- B. Instruct the wife to only stay a few minutes at the bedside.
- C. Tell the wife it is all right to talk to the client.
- D. Allow another family member to go in with the wife.
Correct Answer: A
Rationale: Informing the wife about the ventilator prepares her for the client’s appearance, reducing distress, a priority for organ donors. Time limits, talking, or companions are secondary.
The nurse is aware the Patient Self-Determination Act of 1991 requires the health-care facility to implement which action?
- A. Make available an AD on admission to the facility.
- B. Assist the client with legally completing a will.
- C. Provide ethically and morally competent care to the client.
- D. Discuss the importance of understanding consent forms.
Correct Answer: A
Rationale: The Patient Self-Determination Act mandates offering AD information on admission for Medicare/Medicaid facilities. Wills, ethical care, and consent forms are unrelated.
The nurse is caring for an 82-year-old female client who is crying and asking for her mother to come to see her. Which statement represents the ethical principle of nonmalfeasance?
- A. You must miss your mother very much. Can you tell me about her?
- B. You are 82 years old. Your mother is dead and can't come see you.
- C. Why do you need your mother? Can I get something for you?
- D. Your mother would not want you to worry. I will tell her you want to see her.
Correct Answer: A
Rationale: Nonmalfeasance (do no harm) involves empathetic engagement, like discussing the mother, avoiding emotional harm. Blunt truth, questioning needs, or false promises may distress.