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Which intervention should the nurse implement to provide culturally sensitive health care to the European-American Caucasian elderly client who is terminal?
- A. Discuss health-care issues with the oldest male child.
- B. Determine if the client will be cremated or have an earth burial.
- C. Do not talk about death and dying in front of the client.
- D. Encourage the client's autonomy and answer questions truthfully.
Correct Answer: D
Rationale: Encouraging autonomy and honesty respects individual preferences, common in European-American culture, per patient-centered care. Family roles, burial plans, or avoiding death talk are less universal.
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The client has just signed an AD at the bedside. Which intervention should the nurse implement first?
- A. Notify the client's health-care provider about the AD.
- B. Instruct the client to discuss the AD with significant others.
- C. Place a copy of the advance directive in the client's chart.
- D. Give the original advance directive to the client.
Correct Answer: C
Rationale: Placing a copy in the chart ensures the AD is accessible for care decisions, the first priority. Notifying HCP, discussing with others, or giving the original follows.
The client diagnosed with chronic back pain is being placed on a transcutaneous electrical nerve stimulation (TENS) unit. Which information should the nurse teach?
- A. The TENS unit will deaden the nerve endings, and the client will not feel pain.
- B. The TENS unit could cause paralysis if the client gets the unit wet.
- C. The TENS unit stimulates the nerves in the area, blocking the pain sensation.
- D. The TENS unit should be left on for an hour, and then taken off for an hour.
Correct Answer: C
Rationale: TENS units stimulate nerves to block pain signals, per gate control theory. Deadening nerves, paralysis, or specific on/off cycles are inaccurate.
Which document is the best professional source to provide direction for a nurse when addressing ethical issues and behavior?
- A. The Hippocratic Oath.
- B. The Nuremberg Code.
- C. Home Health Care Bill of Rights.
- D. ANA Code of Ethics.
Correct Answer: D
Rationale: The ANA Code of Ethics guides nurses on ethical behavior and decision-making, specific to nursing practice. Other documents are less relevant or outdated.
The hospice care nurse is conducting a spiritual care assessment. Which statement is the scientific rationale for this intervention?
- A. The client will ask all of his or her spiritual questions and get answers.
- B. The nurse is able to explain to the client how death will affect the spirit.
- C. Spirituality provides a sense of meaning and purpose for many clients.
- D. The nurse is the expert when assisting the client with spiritual matters.
Correct Answer: C
Rationale: Spirituality offers meaning and purpose, supporting holistic hospice care. Clients may not ask all questions, nurses aren’t spiritual experts, and death’s spiritual impact is subjective.
The mother of a 20-year-old African American male client receiving dialysis asks the nurse, 'My son has been on the transplant list longer than that white woman. Why did she get the kidney?' Which statement is the nurse's best response?
- A. The woman was famous, and so more people will donate organs now.
- B. I understand you are upset your son is ill. Would you like to talk?
- C. No one knows who gets an organ. You just have to wait and pray.
- D. The tissues must match or the body will reject the kidney and it will be wasted.
Correct Answer: D
Rationale: Tissue matching (HLA compatibility) determines transplant priority, preventing rejection, per UNOS guidelines. Fame, empathy, or fatalism are inappropriate responses.