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The nurse is discussing advance directives with the client. The client asks the nurse, 'Why is this so important to do?' Which statement would be the nurse's best response?
- A. The federal government mandates this form must be completed by you.
- B. This will make sure your family does what you want them to do.
- C. Don't you think it is important to let everyone know your final wishes?
- D. Because of technology, there are many options for end-of-life care.
Correct Answer: D
Rationale: ADs address varied end-of-life options due to medical technology, ensuring client wishes are followed. Federal mandates, family compliance, or rhetorical questions are less accurate.
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The client has just signed an AD at the bedside. Which intervention should the nurse implement first?
- A. Notify the client's health-care provider about the AD.
- B. Instruct the client to discuss the AD with significant others.
- C. Place a copy of the advance directive in the client's chart.
- D. Give the original advance directive to the client.
Correct Answer: C
Rationale: Placing a copy in the chart ensures the AD is accessible for care decisions, the first priority. Notifying HCP, discussing with others, or giving the original follows.
The hospice care nurse is conducting a spiritual care assessment. Which statement is the scientific rationale for this intervention?
- A. The client will ask all of his or her spiritual questions and get answers.
- B. The nurse is able to explain to the client how death will affect the spirit.
- C. Spirituality provides a sense of meaning and purpose for many clients.
- D. The nurse is the expert when assisting the client with spiritual matters.
Correct Answer: C
Rationale: Spirituality offers meaning and purpose, supporting holistic hospice care. Clients may not ask all questions, nurses aren’t spiritual experts, and death’s spiritual impact is subjective.
The client diagnosed with cancer is experiencing severe pain. Which regimen would the nurse teach the client about to control the pain?
- A. Nonsteroidal anti-inflammatory drugs (NSAIDs) around the clock with narcotics used for severe pain.
- B. Morphine sustained release, a narcotic, routinely with a liquid morphine preparation for breakthrough pain.
- C. Extra-Strength Tylenol, a nonnarcotic analgesic, plus therapy to learn alternative methods of pain control.
- D. Demerol, an opioid narcotic, every six (6) hours orally with a suppository when the pain is not controlled.
Correct Answer: B
Rationale: Sustained-release morphine with breakthrough doses is standard for cancer pain, per WHO pain ladder. NSAIDs, Tylenol, or Demerol regimens are less effective or outdated.
The client diagnosed with chronic back pain is being placed on a transcutaneous electrical nerve stimulation (TENS) unit. Which information should the nurse teach?
- A. The TENS unit will deaden the nerve endings, and the client will not feel pain.
- B. The TENS unit could cause paralysis if the client gets the unit wet.
- C. The TENS unit stimulates the nerves in the area, blocking the pain sensation.
- D. The TENS unit should be left on for an hour, and then taken off for an hour.
Correct Answer: C
Rationale: TENS units stimulate nerves to block pain signals, per gate control theory. Deadening nerves, paralysis, or specific on/off cycles are inaccurate.
The nurse is caring for the family of the client who has just died. Which is the nurse's priority action?
- A. Be with the family.
- B. Call the funeral home.
- C. Notify the minister.
- D. Fill out the death certificate.
Correct Answer: A
Rationale: Being with the family provides immediate emotional support, a nursing priority post-death. Funeral, minister, or certificate tasks are secondary.