Nokea
The male client asks the nurse, 'Should I designate my wife as durable power of attorney for health care?' Which statement would be the nurse's best response?
- A. Yes, she should be because she is your next of kin.
- B. Most people don't allow their spouse to do this.
- C. Will your wife be able to support your wishes?
- D. Your children are probably the best ones for the job.
Correct Answer: C
Rationale: Choosing a proxy involves ensuring they’ll honor the client’s wishes, a key consideration. Kinship, rarity, or children are less relevant without this focus.
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Which action by the primary nurse would require the unit manager to intervene?
- A. The nurse uses a correction fluid to correct a charting mistake.
- B. The nurse is shredding the worksheet at the end of the shift.
- C. The nurse circles an omitted medication time on the MAR.
- D. The nurse documents narcotic wastage with another nurse.
Correct Answer: A
Rationale: Using correction fluid obscures records, violating charting standards, requiring intervention. Shredding worksheets, circling omissions, or documenting wastage is appropriate.
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 received a liver transplant and is preparing for discharge. Which discharge instruction should the nurse teach?
- A. The immune-suppressant drugs must be tapered off when discontinuing them.
- B. There may be slight foul-smelling drainage on the dressing for a few days.
- C. Notify the HCP immediately if a cough or fever develops.
- D. The skin will turn yellow from the antirejection drugs.
Correct Answer: C
Rationale: Cough or fever may indicate infection, critical post-transplant due to immunosuppression. Tapering drugs, foul drainage, or jaundice are incorrect or misleading.
The 38-year-old client was brought to the emergency department with CPR in progress and expired 15 minutes after arrival. Which intervention should the nurse implement for postmortem care?
- A. Do not allow significant others to see the body.
- B. Do not remove any tubes from the body.
- C. Prepare the body for the funeral home.
- D. Send the client's clothing to the hospital laundry.
Correct Answer: C
Rationale: Preparing the body (e.g., cleaning, positioning) respects dignity and funeral home needs. Denying family access, leaving tubes, or laundering clothes is inappropriate.
The wife of a client receiving hospice care being cared for at home calls the nurse to report the client is restless and agitated. Which interventions should the nurse implement? List in order of priority.
- A. Request an order from the health-care provider for antianxiety medications.
- B. Call the medical equipment company and request oxygen for the client.
- C. Go to the home and assess the client and address the wife's concerns.
- D. Reassure and calm the wife over the telephone.
- E. Notify the chaplain about the client's change in status.
Correct Answer: C,D,A,B,E
Rationale: 1) Assess client at home (determine cause of agitation); 2) Reassure wife (immediate support); 3) Request antianxiety medication (if indicated); 4) Request oxygen (if hypoxia present); 5) Notify chaplain (spiritual support).