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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 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.
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 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 has been declared brain dead and is an organ donor. The nurse is preparing the wife of the client to enter the room to say good-bye. Which information is most important for the nurse to discuss with the wife?
- A. Inform the wife the client will still be on the ventilator.
- B. Instruct the wife to only stay a few minutes at the bedside.
- C. Tell the wife it is all right to talk to the client.
- D. Allow another family member to go in with the wife.
Correct Answer: A
Rationale: Informing the wife about the ventilator prepares her for the client’s appearance, reducing distress, a priority for organ donors. Time limits, talking, or companions are secondary.
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.