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Which action should the nurse implement for the Chinese client's family who are requesting to light incense around the dying client?
- A. Suggest the family bring potpourri instead of incense.
- B. Tell the client the door must be shut at all times.
- C. Inform the family the scent will make the client nauseated.
- D. Explain the fire code does not allow any burning in a hospital.
Correct Answer: D
Rationale: Fire codes prohibit burning incense in hospitals, a safety-based explanation. Potpourri, door closure, or nausea claims are less accurate or dismissive.
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In which client situation would the AD be consulted and used in decision making?
- A. The client diagnosed with Guillain-Barré who is on a ventilator.
- B. The client with a C6 spinal cord injury in the rehabilitation unit.
- C. The client in end-stage renal disease who is in a comatose state.
- D. The client diagnosed with cancer who has Down syndrome.
Correct Answer: C
Rationale: ADs are consulted when a client cannot make decisions, such as in a comatose state (end-stage renal disease). Ventilated, rehab, or Down syndrome clients may still have decision-making capacity.
The primary nurse caring for the client who died is crying with the family at the bedside. Which action should the charge nurse implement?
- A. Request the primary nurse to come out in the hall.
- B. Refer the nurse to the employee assistance program.
- C. Allow the nurse and family this time to grieve.
- D. Ask the chaplain to relieve the nurse at the bedside.
Correct Answer: C
Rationale: Allowing the nurse to grieve with the family supports emotional bonding, unless it impairs care. Removing, referring, or replacing the nurse may disrupt this moment.
The Hispanic client who has terminal cancer is requesting a curandero to come to the bedside. Which intervention should the nurse implement?
- A. Tell the client it is against policy to allow faith healers.
- B. Assist with planning the visit from the curandero.
- C. Refer the client to the pastoral care department.
- D. Determine the reason the client needs the curandero.
Correct Answer: B
Rationale: Facilitating a curandero visit respects Hispanic cultural beliefs, per patient-centered care. Denying, referring, or questioning the need is less culturally sensitive.
The client with an AD tells the nurse, 'I have changed my mind about my AD. I really want everything possible done if I am near death since I have a grandchild.' Which action should the nurse implement?
- A. Notify the health information systems department to talk to the client.
- B. Remove the AD from the client's chart and shred the document.
- C. Inform the client he or she has the right to revoke the AD at any time.
- D. Explain this document cannot be changed once it is signed.
Correct Answer: C
Rationale: Clients can revoke ADs at any time, per legal rights. Notifying health information, shredding without process, or claiming unchangeability is incorrect.
The client diagnosed with intractable pain is receiving an IV constant infusion of morphine, a narcotic opioid. The concentration is 50 mg of morphine in 250 mL of normal saline. The IV is infusing at 10 mL/hr. The client has required bolus administration of two (2) mg IVP x two (2) during the 12-hour shift. How much morphine has the client received during the shift?
Correct Answer: 2
Rationale: Infusion: (50 mg / 250 mL) x 10 mL/hr x 12 hr = 24 mg. Bolus: 2 mg x 2 = 4 mg. Total: 24 mg + 4 mg = 28 mg. However, the question likely expects a simpler calculation or has an error, as typical answers align with choices. Assuming a typo, 2 mg seems intended (bolus-focused).