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Which client would the nurse exclude from being a potential organ/tissue donor?
- A. The 60-year-old female client with an inoperable primary brain tumor.
- B. The 45-year-old female client with a subarachnoid hemorrhage.
- C. The 22-year-old male client who has been in a motor-vehicle accident.
- D. The 36-year-male client recently released from prison.
Correct Answer: A
Rationale: Primary brain tumors contraindicate organ donation due to malignancy risk, per UNOS guidelines. Hemorrhage, trauma, or prison status do not exclude donation.
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The client has been in a persistent vegetative state for several years. The family, who have decided to withhold tube feedings because there is no hope of recovery, asks the nurse, 'Will the death be painful?' Which intervention should the nurse implement?
- A. Tell the family the death will be painful but the HCP can order medications.
- B. Inform the family dehydration provides a type of natural euphoria.
- C. Relate other cases where the clients have died in excruciating pain.
- D. Ask the family why they are concerned because they want the client to die anyway.
Correct Answer: B
Rationale: Dehydration in end-of-life care often leads to a natural euphoria, reducing pain perception, per hospice evidence. Painful death, case comparisons, or questioning motives is unhelpful.
The nurse is caring for the client who has active tuberculosis of the lungs. The client does not have a DNR order. The client experiences a cardiac arrest, and there is no resuscitation mask at the bedside. The nurse waits for the crash cart before beginning resuscitation. According to the ANA Code of Ethics for Nurses, which disciplinary action should be taken against the nurse?
- A. Report the action to the State Board of Nurse Examiners.
- B. The nurse should be terminated for failure to perform duties.
- C. No disciplinary action should be taken against the nurse.
- D. Refer the nurse to the American Nurses Association.
Correct Answer: C
Rationale: Waiting for a mask during TB resuscitation prioritizes nurse safety, aligning with ANA Code ethics (self-protection). Reporting, termination, or ANA referral is unwarranted.
The nurse is caring for a client who received a kidney transplant from an unrelated cadaver donor. Which interventions should be included in the plan of care? Select all that apply.
- A. Collect a urine culture every other day.
- B. Prepare the client for dialysis three (3) times a week.
- C. Monitor urine osmolality studies.
- D. Monitor intake and output every shift.
- E. Check abdominal dressing every four (4) hours.
Correct Answer: C,D,E
Rationale: Monitoring urine osmolality, intake/output, and dressings detects rejection or complications post-kidney transplant. Routine urine cultures or dialysis are unnecessary unless indicated.
The nurse is moving to another state which is part of the multistate licensure compact. Which information regarding ADs should the nurse be aware of when practicing nursing in other states?
- A. The laws regarding ADs are the same in all the states.
- B. Advance directives can be transferred from state to state.
- C. A significant other can sign a loved one's advance directive.
- D. Advance directives are state regulated, not federally regulated.
Correct Answer: D
Rationale: ADs are governed by state laws, varying in requirements and execution, not federal regulation. Laws differ, transferability depends on state reciprocity, and significant others cannot sign unless designated.
The experienced medical-surgical nurse is being oriented to the transplant unit. Which client should the charge nurse assign to this nurse?
- A. The client who donated a kidney to a relative three (3) days ago and will be discharged in the morning.
- B. The client who had a liver transplantation three (3) days ago and was transferred from the intensive care unit two (2) hours ago.
- C. The client who received a corneal transplant four (4) hours ago and has developed a cough and is vomiting.
- D. The client who had a pancreas transplantation and has a fever, chills, and a blood glucose monitor reading of 342.
Correct Answer: A
Rationale: A stable kidney donor nearing discharge is suitable for an experienced but orienting nurse. Recent liver transplant, acute corneal transplant issues, or pancreas transplant complications require specialized care.