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What outcome of being truthful about a terminal illness enhances the nurse-client relationship?
- A. The client’s autonomy and right to determine how to spend the rest of their life is upheld.
- B. Meaningful communication between clients and family members is promoted.
- C. The nurse-client relationship is based on honesty rather than false pretenses.
- D. Clients can use inner resources and determination to survive and prolong life.
Correct Answer: A
Rationale: Truthfulness empowers clients to make informed decisions about their remaining time, reinforcing trust and respect.
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Why would a client’s recovery from shock be tenuous?
- A. Increased urine output
- B. Edema
- C. Hypertension
- D. Hypernatremia
Correct Answer: B
Rationale: Edema occurs due to excess fluid accumulation in the interstitial spaces, commonly seen in conditions like heart failure and kidney disease.
A client is 4 hours postoperative following abdominal surgery. The client's blood pressure has dropped from 120/80 mm Hg to 90/60 mm Hg. What action should the nurse take first?
- A. Administer an IV fluid bolus.
- B. Check the surgical site for bleeding.
- C. Place the client in a Trendelenburg position.
- D. Notify the healthcare provider.
Correct Answer: B
Rationale: The correct answer is B: Check the surgical site for bleeding. This is the first action the nurse should take as a sudden drop in blood pressure postoperatively could indicate internal bleeding, a common complication after abdominal surgery. By assessing the surgical site for bleeding, the nurse can identify and address the source of the hypotension promptly. Administering IV fluids (choice A) may be necessary but should come after determining the cause. Placing the client in Trendelenburg position (choice C) is not recommended as it can worsen venous return and increase intracranial pressure. Notifying the healthcare provider (choice D) should be done after the nurse has assessed the situation and taken immediate action.
A client is hospitalized with a second episode of pulmonary embolism (PE). Recent genetic testing reveals the client has an alteration in the gene CYP2C19. What action by the nurse is best?
- A. Instruct the client to eliminate all vitamin K from the diet.
- B. Prepare preoperative teaching for an inferior vena cava (IVC) filter.
- C. Refer the client to a chronic illness support group.
- D. Teach the client to use a soft-bristled toothbrush.
Correct Answer: B
Rationale: The correct answer is B: Prepare preoperative teaching for an inferior vena cava (IVC) filter. In the context of a client with an alteration in the gene CYP2C19 and recurrent pulmonary embolism, the use of an IVC filter helps prevent blood clots from traveling to the lungs. This intervention is crucial in managing the risk of further pulmonary embolism. Teaching the client about the purpose, care, and potential complications of the IVC filter is essential for their understanding and cooperation in the treatment plan.
Incorrect Choices:
A: Instruct the client to eliminate all vitamin K from the diet. This choice is not relevant to the management of recurrent pulmonary embolism associated with a genetic alteration.
C: Refer the client to a chronic illness support group. While support is important, it is not the immediate priority in this case of managing a recurrent PE.
D: Teach the client to use a soft-bristled toothbrush. This recommendation is not directly
A patient with end-stage liver failure tells the nurse, “If I can just live to see my first grandchild who is expected in 5 months, then I can die happy.” The nurse recognizes that the patient is demonstrating which of the following stages of grieving?
- A. Prolonged grief disorder
- B. Kübler-Ross’s stage of bargaining
- C. Kübler-Ross’s stage of depression
- D. The new normal stage of the Grief Wheel.
Correct Answer: B
Rationale: The patient is expressing a desire to delay death in exchange for a significant event, characteristic of the bargaining stage in Kübler-Ross's model of grief.
A healthcare professional wishes to provide client-centered care in all interactions. Which action by the healthcare professional best demonstrates this concept?
- A. Assesses for cultural influences affecting healthcare
- B. Ensures that all the client's basic needs are met
- C. Informs the client and family about all upcoming tests
- D. Thoroughly orients the client and family to the room
Correct Answer: A
Rationale: The correct answer is A because assessing for cultural influences affecting healthcare aligns with client-centered care by recognizing the individual's unique beliefs and values. This action promotes respect, understanding, and tailored care. Choice B might address physical needs but not necessarily emotional or cultural aspects. Choice C focuses on information sharing rather than understanding the client's perspective. Choice D, while important, does not directly address individualized care based on cultural factors.