Nokea
The nurse writes a client problem of 'spiritual distress' for the client who is dying. Which statement is an appropriate goal?
- A. The client will reconcile self and the higher power of his or her beliefs.
- B. The client will be able to express anger at the terminal diagnosis.
- C. The client will reconcile self to estranged members of the family.
- D. The client will have a dignified and pain-free death.
Correct Answer: A
Rationale: Spiritual distress goals focus on reconciling with beliefs or higher power, addressing the distress. Anger expression, family reconciliation, or pain-free death are separate issues.
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The client diagnosed with end-stage congestive heart failure and type 2 diabetes is receiving hospice care. Which action by the nurse demonstrates an understanding of the client's condition?
- A. The nurse monitors the blood glucose four (4) times a day.
- B. The nurse keeps the client on a strict fluid restriction.
- C. The nurse limits the visitors the client can receive.
- D. The nurse brings the client a small piece of cake.
Correct Answer: D
Rationale: In hospice, comfort is prioritized; a small piece of cake aligns with the client’s enjoyment, given end-stage status. Glucose monitoring, fluid restriction, and visitor limits are less relevant.
The male client diagnosed with chronic pain since a construction accident which broke several vertebrae tells the nurse he has been referred to a pain clinic and asks, 'What good will it do? I will never be free of this pain.' Which statement is the nurse's best response?
- A. Are you afraid of the pain never going away?
- B. The pain clinic will give you medication to cure the pain.
- C. Pain clinics work to help you achieve relief from pain.
- D. I am not sure. You should discuss this with your HCP.
Correct Answer: C
Rationale: Pain clinics offer multimodal relief (e.g., therapy, medications), addressing chronic pain holistically. Fear exploration, cure promises, or deferring to HCP is less supportive.
The nurse is teaching a class on ethical principles in nursing. Which statement supports the definition of beneficence?
- A. The duty to prevent or avoid doing harm.
- B. The duty to actively do good for clients.
- C. The duty to be faithful to commitments.
- D. The duty to tell the truth to the clients.
Correct Answer: B
Rationale: Beneficence is the duty to actively promote client well-being, per ethical principles. Nonmalfeasance, fidelity, and veracity are distinct principles.
The nurse and an unlicensed assistive personnel (UAP) are caring for a group of clients in a pain clinic. Which intervention would be inappropriate to delegate to the UAP?
- A. Assist the client diagnosed with intractable pain to the bathroom.
- B. Elevate the head of the bed for a client diagnosed with back pain.
- C. Perform passive range of motion for a client who is bedfast.
- D. Monitor the potassium levels on a client about to receive medication.
Correct Answer: D
Rationale: Monitoring potassium levels requires nursing judgment, outside UAP scope. Assisting to bathroom, elevating bed, and range of motion are within UAP capabilities.
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.