Nokea
The mother of a 20-year-old African American male client receiving dialysis asks the nurse, 'My son has been on the transplant list longer than that white woman. Why did she get the kidney?' Which statement is the nurse's best response?
- A. The woman was famous, and so more people will donate organs now.
- B. I understand you are upset your son is ill. Would you like to talk?
- C. No one knows who gets an organ. You just have to wait and pray.
- D. The tissues must match or the body will reject the kidney and it will be wasted.
Correct Answer: D
Rationale: Tissue matching (HLA compatibility) determines transplant priority, preventing rejection, per UNOS guidelines. Fame, empathy, or fatalism are inappropriate responses.
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The hospice care nurse is planning the care of an elderly client diagnosed with end-stage renal disease. Which interventions should be included in the plan of care? Select all that apply.
- A. Discuss financial concerns.
- B. Assess any comorbid conditions.
- C. Monitor increased visual or auditory abilities.
- D. Note any spiritual distress.
- E. Encourage euphoria at the time of death.
Correct Answer: A,B,D
Rationale: Financial concerns, comorbidities, and spiritual distress are relevant for holistic hospice care in end-stage renal disease. Visual/auditory increases or euphoria are not typical interventions.
The nurse is obtaining the client’s signature on a surgical permit form. The nurse determines the client does not understand the surgical procedure and possible risks. Which action should the nurse take first?
- A. Notify the client's surgeon.
- B. Document the information in the chart.
- C. Contact the operating room staff.
- D. Explain the procedure to the client.
Correct Answer: A
Rationale: Notifying the surgeon ensures informed consent, as the surgeon must clarify risks and procedures. Documentation, OR contact, or nurse explanation is secondary.
Which interventions should the nurse implement at the time of a client's death? Select all that apply.
- A. Allow gaps in the conversation at the client's bedside.
- B. Avoid giving the family advice about how to grieve.
- C. Tell the family the nurse understands their feelings.
- D. Explain this is God's will to prevent further suffering.
- E. Allow the family time with the body in private.
Correct Answer: A,B,E
Rationale: Allowing silence, avoiding prescriptive grief advice, and providing private time support family grieving. Claiming understanding or invoking God’s will may alienate or presume.
The nurse is teaching an in-service on legal issues in nursing. Which situation is an example of battery, an intentional tort?
- A. The nurse threatens the client who is refusing to take a hypnotic medication.
- B. The nurse forcibly inserts a Foley catheter in a client who refused it.
- C. The nurse tells the client a nasogastric tube insertion is not painful.
- D. The nurse gives confidential information over the telephone.
Correct Answer: B
Rationale: Battery involves nonconsensual physical contact, like forcible catheter insertion. Threats (assault), misrepresentation (negligence), or confidentiality breaches are not battery.
The client has been in a persistent vegetative state for several years. The family, who have decided to withhold tube feedings because there is no hope of recovery, asks the nurse, 'Will the death be painful?' Which intervention should the nurse implement?
- A. Tell the family the death will be painful but the HCP can order medications.
- B. Inform the family dehydration provides a type of natural euphoria.
- C. Relate other cases where the clients have died in excruciating pain.
- D. Ask the family why they are concerned because they want the client to die anyway.
Correct Answer: B
Rationale: Dehydration in end-of-life care often leads to a natural euphoria, reducing pain perception, per hospice evidence. Painful death, case comparisons, or questioning motives is unhelpful.