Nokea
The hospice nurse is making the final visit to the wife whose husband died a little more than a year ago. The nurse realizes the husband's clothes are still in the closet and chest of drawers. Which action should the nurse implement first?
- A. Discuss what the wife is going to do with the clothes.
- B. Refer the wife to a grief recovery support group.
- C. Do not take any action because this is normal grieving.
- D. Remove the clothes from the house and dispose of them.
Correct Answer: C
Rationale: Keeping clothes is a normal part of grieving, requiring no immediate action. Discussing plans, referring to support, or removing clothes may rush or distress the widow.
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The nurse is discussing malpractice issues in an in-service class. Which situation is an example of malpractice?
- A. The nurse fails to report a neighbor who is abusing his two children.
- B. The nurse does not intervene in a client who has a BP of 80/50 and AP of 122.
- C. The nurse is suspected of taking narcotics prescribed for a client.
- D. The nurse falsifies vital signs in the client's medical records.
Correct Answer: B
Rationale: Malpractice involves breaching the standard of care causing harm, like ignoring hypotension and tachycardia. Child abuse reporting, narcotic theft, or falsification are ethical/legal issues, not malpractice.
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.
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.
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 male client in the long-term care facility has been told that he will not live for many more months. The client has been estranged from his daughter for years. He tells the nurse that he could die a happy man if he could talk to his daughter just one more time. Which statement is the nurse's best response?
- A. You should not feel bad. Things will work out for the best before your death.
- B. What did you do to make your daughter not talk to you all this time?
- C. If you would like I can try to contact your daughter and ask her to come see you.
- D. Tell me more about being unhappy that you don't have a relationship with your daughter.
Correct Answer: C
Rationale: Offering to contact the daughter supports the client’s wish, per patient-centered care. Minimizing feelings, blaming, or exploring unhappiness is less actionable.