The nurse is caring for a client who has stage 3 lung cancer and is in renal failure. The client indicates that he does not wish to have life-sustaining treatment and wants to die a natural death. What document does the nurse anticipate this client completing? Fill in the blank.
- A. Durable Power of Attorney for Healthcare
- B. Living Will
- C. Do Not Resuscitate Order
- D. Medical Power of Attorney
Correct Answer: B
Rationale: Living Will (B) is the correct answer, as it documents a client’s preferences for medical treatment, such as refusing life-sustaining measures, aligning with the client’s wish to die naturally without such interventions.
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Which play activity is best suited to the gross motor skills of the toddler?
- A. Coloring book and crayons
- B. Ball
- C. Building cubes
- D. Swing set
Correct Answer: B
Rationale: Playing with a ball encourages gross motor skills like kicking and throwing, suitable for a toddler's developmental stage.
Which of the following best describes the language of a 24-month-old?
- A. Doesn't understand yes and no
- B. Understands the meaning of words
- C. Able to verbalize needs
- D. Asks 'why?' to most statements
Correct Answer: C
Rationale: A 24-month-old can verbalize needs using simple words or phrases, reflecting their developing language skills.
To reduce the possibility of having a baby with a neural tube defect, the client should be told to increase her intake of folic acid. Dietary sources of folic acid include:
- A. Meat, liver, eggs
- B. Pork, fish, chicken
- C. Spinach, beets, cantaloupe
- D. Dried beans, sweet potatoes, Brussels sprouts
Correct Answer: D
Rationale: Folic acid is found in foods like dried beans, sweet potatoes, and Brussels sprouts. These help reduce the risk of neural tube defects like spina bifida when consumed before and during early pregnancy.
The nurse is caring for a client with a history of breast cancer who is receiving tamoxifen (Nolvadex). The nurse should instruct the client to report which of the following side effects?
- A. Mild nausea.
- B. Hot flashes.
- C. Vaginal bleeding.
- D. Hair thinning.
Correct Answer: C
Rationale: vaginal bleeding is a serious side effect of tamoxifen, as it may indicate endometrial cancer
The nurse notes variable decelerations on the fetal monitor strip. The most appropriate initial action would be to:
- A. Notify her.Concurrent doctor
- B. Increase the rate of IV fluid
- C. Reposition the client
- D. Readjust the monitor
Correct Answer: C
Rationale: Repositioning the client can relieve umbilical cord compression, the common cause of variable decelerations.
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