Nokea
The female client in the oncology clinic tells the nurse she has a great deal of pain but does not like to take pain medication. Which action should the nurse implement first?
- A. Tell the client it is important for her to take her medication.
- B. Find out how the client has been dealing with the pain.
- C. Have the HCP tell the client to take the pain medications.
- D. Instruct the client not to worry-the pain will resolve itself.
Correct Answer: B
Rationale: Assessing coping strategies informs a tailored pain management plan, respecting client preferences. Forcing medication, HCP involvement, or dismissing pain is premature.
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The client diagnosed with end-stage congestive heart failure and type 2 diabetes is receiving hospice care. Which action by the nurse demonstrates an understanding of the client's condition?
- A. The nurse monitors the blood glucose four (4) times a day.
- B. The nurse keeps the client on a strict fluid restriction.
- C. The nurse limits the visitors the client can receive.
- D. The nurse brings the client a small piece of cake.
Correct Answer: D
Rationale: In hospice, comfort is prioritized; a small piece of cake aligns with the client’s enjoyment, given end-stage status. Glucose monitoring, fluid restriction, and visitor limits are less relevant.
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 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.
The nurse writes a client problem of 'spiritual distress' for the client who is dying. Which statement is an appropriate goal?
- A. The client will reconcile self and the higher power of his or her beliefs.
- B. The client will be able to express anger at the terminal diagnosis.
- C. The client will reconcile self to estranged members of the family.
- D. The client will have a dignified and pain-free death.
Correct Answer: A
Rationale: Spiritual distress goals focus on reconciling with beliefs or higher power, addressing the distress. Anger expression, family reconciliation, or pain-free death are separate issues.
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.