Nokea
The nurse is caring for the client who has active tuberculosis of the lungs. The client does not have a DNR order. The client experiences a cardiac arrest, and there is no resuscitation mask at the bedside. The nurse waits for the crash cart before beginning resuscitation. According to the ANA Code of Ethics for Nurses, which disciplinary action should be taken against the nurse?
- A. Report the action to the State Board of Nurse Examiners.
- B. The nurse should be terminated for failure to perform duties.
- C. No disciplinary action should be taken against the nurse.
- D. Refer the nurse to the American Nurses Association.
Correct Answer: C
Rationale: Waiting for a mask during TB resuscitation prioritizes nurse safety, aligning with ANA Code ethics (self-protection). Reporting, termination, or ANA referral is unwarranted.
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Which intervention should the nurse implement to provide culturally sensitive health care to the European-American Caucasian elderly client who is terminal?
- A. Discuss health-care issues with the oldest male child.
- B. Determine if the client will be cremated or have an earth burial.
- C. Do not talk about death and dying in front of the client.
- D. Encourage the client's autonomy and answer questions truthfully.
Correct Answer: D
Rationale: Encouraging autonomy and honesty respects individual preferences, common in European-American culture, per patient-centered care. Family roles, burial plans, or avoiding death talk are less universal.
The client tells the nurse, 'Every time I come in the hospital you hand me one of these advance directives (AD). Why should I fill one of these out?' Which statement by the nurse is most appropriate?
- A. You must fill out this form because Medicare laws require it.
- B. An AD lets you participate in decisions about your health care.
- C. This paper will ensure no one can override your decisions.
- D. It is part of the hospital admission packet and I have to give it to you.
Correct Answer: B
Rationale: Advance directives allow clients to specify their health care preferences, ensuring participation in decisions, per the Patient Self-Determination Act. Medicare requires offering, not completing, ADs; no document guarantees non-override; and packet inclusion is procedural, not the reason.
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 admitting a client to the medical surgical unit. Which is required to be offered to the client if the hospital accepts Medicare reimbursement?
- A. The opportunity to make an advance directive.
- B. The client must be referred to a case manager.
- C. The client must apply for a Medicare supplement insurance.
- D. The opportunity to discuss end-of-life issues.
Correct Answer: A
Rationale: The Patient Self-Determination Act mandates offering ADs on admission for Medicare-funded hospitals. Case management, insurance, or end-of-life discussions are not required.
The client has received a kidney transplant. Which assessment would warrant immediate intervention by the nurse?
- A. Fever and decreased urine output.
- B. Decreased creatinine and BUN levels.
- C. Decreased serum potassium and calcium.
- D. Bradycardia and hypotension.
Correct Answer: A
Rationale: Fever and decreased urine output suggest infection or rejection, requiring immediate action post-transplant. Decreased labs are expected, and vital signs are less specific.