Nokea
Which client would be most likely to complete an advance directive?
- A. A 55-year-old Caucasian person who is a bank president.
- B. A 34-year-old Asian licensed practical nurse.
- C. A 22-year-old Hispanic lawn care worker.
- D. A 65-year-old African American retired cook.
Correct Answer: D
Rationale: Older adults (e.g., 65-year-old) are more likely to complete ADs due to increased awareness of mortality and health issues, regardless of ethnicity or profession.
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The client received a liver transplant and is preparing for discharge. Which discharge instruction should the nurse teach?
- A. The immune-suppressant drugs must be tapered off when discontinuing them.
- B. There may be slight foul-smelling drainage on the dressing for a few days.
- C. Notify the HCP immediately if a cough or fever develops.
- D. The skin will turn yellow from the antirejection drugs.
Correct Answer: C
Rationale: Cough or fever may indicate infection, critical post-transplant due to immunosuppression. Tapering drugs, foul drainage, or jaundice are incorrect or misleading.
The nurse is presenting an in-service discussing do not resuscitate (DNR) orders and advance directives. Which statement should the nurse discuss with the class?
- A. Advance directives must be notarized by a notary public.
- B. The client must use an attorney to complete the advanced directive.
- C. Once the DNR is written, it can be used for every hospital admission.
- D. The health-care provider must write the DNR order in the client's chart.
Correct Answer: D
Rationale: A DNR order requires a physician's written order in the chart to be actionable, per hospital policy. Notarization and attorneys are not required, and DNRs are typically re-evaluated per admission.
The 78-year-old Catholic client is in end-stage congestive heart failure and has a DNR order. The client has AP 50, RR 10, and BP 80/50, and Cheyne-Stokes respirations. Which action should the nurse implement?
- A. Bring the crash cart to the bedside.
- B. Apply oxygen via nasal cannula.
- C. Notify a priest for last rites.
- D. Turn the bed to face the sunset.
Correct Answer: C
Rationale: Notifying a priest for last rites respects Catholic end-of-life practices, a priority with imminent death. Crash cart violates DNR, oxygen is less critical, and bed orientation is irrelevant.
Which element is not necessary to prove nursing malpractice?
- A. Breach of duty.
- B. Identify the ethical issues.
- C. Injury to the client.
- D. Proximate cause.
Correct Answer: B
Rationale: Malpractice requires duty, breach, injury, and causation. Identifying ethical issues is not a legal element, though relevant to ethics.
The nurse pronounced Dr. Smith's client to be clinically dead. Which should the nurse document on the client's chart?
- A. Brain scan indicates no brain wave activity, client pronounced deceased. Family refuses to talk with organ bank.
- B. Cardiac arrest noted, CPR initiated but unsuccessful. Pronounced dead.
- C. Pulse, respirations, and blood pressure absent at 0900, pronounced dead. Dr. Smith to sign death certificate.
- D. Client found without pulse, body cold to touch. Pronounced deceased at 0900.
Correct Answer: C
Rationale: Documentation should include objective findings (absent vital signs), time, and physician’s role, per legal standards. Brain scan or CPR details are specific, and cold body is insufficient.