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When a client is comatose and has advance directives stating a desire to avoid life-sustaining measures, but the family wants these measures, what action should the nurse take?
- A. Arrange for an ethics committee meeting to address the family's concerns.
- B. Support the family's decision and initiate life-sustaining measures.
- C. Complete an incident report.
- D. Encourage the family to contact an attorney.
Correct Answer: A
Rationale: In this scenario, the nurse should prioritize the client's wishes as outlined in the advance directives. By arranging for an ethics committee meeting, the nurse can facilitate discussions between the family and healthcare team to ensure that the client's wishes are respected while addressing the concerns of the family. This approach promotes ethical decision-making and collaborative communication among all involved parties, ultimately aiming to provide the best possible care for the client while considering their autonomy and preferences.
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A healthcare professional in an emergency department is assessing a newly admitted client who is experiencing drooling and hoarseness following a burn injury. Which of the following actions should the healthcare professional take first?
- A. Obtain a baseline ECG.
- B. Obtain a blood specimen for ABG analysis.
- C. Insert an 18-gauge IV catheter.
- D. Administer 100% humidified oxygen.
Correct Answer: D
Rationale: In a client experiencing drooling and hoarseness following a burn injury, airway compromise is a critical concern. Administering 100% humidified oxygen is the priority to ensure adequate oxygenation. This intervention takes precedence over obtaining baseline ECG, obtaining blood specimens, or inserting an IV catheter, as airway management and oxygenation are fundamental in the initial assessment and management of a client with potential airway compromise.
A client requests the creation of a living will. Which of the following actions should the nurse take?
- A. Schedule a meeting between the hospital ethics committee and the client.
- B. Evaluate the client's understanding of life-sustaining measures.
- C. Determine the client's preferences about post-mortem care.
- D. Request a conference with the client's family
Correct Answer: B
Rationale: When a client requests the creation of a living will, the nurse's priority is to evaluate the client's understanding of life-sustaining measures. This involves ensuring that the client comprehends the implications of various life-sustaining interventions and can make informed decisions about their care preferences in the event they are unable to communicate them later. It is crucial for the nurse to assess the client's comprehension to ensure that the living will accurately reflects the client's wishes and values.
A client with heart failure has a new prescription for furosemide. Which of the following statements should the nurse make?
- A. Taking furosemide can cause your potassium levels to be high
- B. Eat foods that are high in sodium
- C. Rise slowly when getting out of bed
- D. Taking furosemide can cause you to be overhydrated
Correct Answer: C
Rationale: Educating the client on the importance of rising slowly when getting out of bed is crucial due to the risk of orthostatic hypotension associated with furosemide use. This precaution helps prevent dizziness and falls. Options A and D are incorrect as furosemide commonly causes hypokalemia and dehydration, respectively, rather than high potassium levels or overhydration. Option B is inaccurate as clients on furosemide need to reduce sodium intake to manage fluid retention.
A healthcare professional is caring for a client who is newly diagnosed with pancreatic cancer and has questions about the disease. To research, the healthcare professional should identify that which of the following electronic databases has the most comprehensive collection of nursing articles?
- A. MEDLINE
- B. CINAHL
- C. ProQuest
- D. Health Source
Correct Answer: B
Rationale: CINAHL (Cumulative Index to Nursing and Allied Health Literature) is a comprehensive database that specializes in nursing and allied health literature. It is a valuable resource for healthcare professionals seeking nursing-related articles, making it the most appropriate option for the nurse caring for a client with questions about pancreatic cancer.
During the assessment of a client receiving packed RBCs, which finding indicates fluid overload?
- A. Low back pain.
- B. Dyspnea.
- C. Hypotension.
- D. Thready pulse.
Correct Answer: B
Rationale: Dyspnea is a key finding indicating fluid overload in a client receiving packed RBCs. Fluid overload can lead to pulmonary edema, causing difficulty breathing or shortness of breath (dyspnea). Low back pain is not typically associated with fluid overload but can be more related to musculoskeletal issues. Hypotension and thready pulse are more indicative of hypovolemia (low fluid volume), not fluid overload.