The male client diagnosed with chronic pain since a construction accident which broke several vertebrae tells the nurse he has been referred to a pain clinic and asks, 'What good will it do? I will never be free of this pain.' Which statement is the nurse's best response?
- A. Are you afraid of the pain never going away?
- B. The pain clinic will give you medication to cure the pain.
- C. Pain clinics work to help you achieve relief from pain.
- D. I am not sure. You should discuss this with your HCP.
Correct Answer: C
Rationale: Pain clinics offer multimodal relief (e.g., therapy, medications), addressing chronic pain holistically. Fear exploration, cure promises, or deferring to HCP is less supportive.
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The nurse is caring for a client who is confused and fell trying to get out of bed. There is no family at the client's bedside. Which action should the nurse implement first?
- A. Contact a family member to come and stay with the client.
- B. Administer a sedative medication to the client.
- C. Place the client in a chair with a sheet tied around him or her.
- D. Notify the health-care provider to obtain a restraint order.
Correct Answer: D
Rationale: Notifying the HCP for a restraint order ensures safety and legal compliance for a confused client at risk of falls. Family contact, sedation, or makeshift restraints are unsafe or secondary.
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 receiving dialysis for end-stage renal disease wants to quit dialysis and die. Which ethical principle supports the client's right to die?
- A. Autonomy.
- B. Self-determination.
- C. Beneficence.
- D. Justice.
Correct Answer: A
Rationale: Autonomy supports a client’s right to make decisions, including refusing treatment, per ethical standards. Self-determination is synonymous, but autonomy is the precise term.
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 primary nurse caring for the client who died is crying with the family at the bedside. Which action should the charge nurse implement?
- A. Request the primary nurse to come out in the hall.
- B. Refer the nurse to the employee assistance program.
- C. Allow the nurse and family this time to grieve.
- D. Ask the chaplain to relieve the nurse at the bedside.
Correct Answer: C
Rationale: Allowing the nurse to grieve with the family supports emotional bonding, unless it impairs care. Removing, referring, or replacing the nurse may disrupt this moment.