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The nurse is aware the Patient Self-Determination Act of 1991 requires the health-care facility to implement which action?
- A. Make available an AD on admission to the facility.
- B. Assist the client with legally completing a will.
- C. Provide ethically and morally competent care to the client.
- D. Discuss the importance of understanding consent forms.
Correct Answer: A
Rationale: The Patient Self-Determination Act mandates offering AD information on admission for Medicare/Medicaid facilities. Wills, ethical care, and consent forms are unrelated.
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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 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.
Which tissue or organ can be repeatedly donated to clients needing a transplant?
- A. Skin.
- B. Bones.
- C. Kidneys.
- D. Bone marrow.
Correct Answer: D
Rationale: Bone marrow regenerates, allowing repeated donation. Skin, bones, and kidneys are limited or single-donation tissues/organs.
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.
Which action should the nurse implement for the Chinese client's family who are requesting to light incense around the dying client?
- A. Suggest the family bring potpourri instead of incense.
- B. Tell the client the door must be shut at all times.
- C. Inform the family the scent will make the client nauseated.
- D. Explain the fire code does not allow any burning in a hospital.
Correct Answer: D
Rationale: Fire codes prohibit burning incense in hospitals, a safety-based explanation. Potpourri, door closure, or nausea claims are less accurate or dismissive.