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Which interventions should the nurse implement at the time of a client's death? Select all that apply.
- A. Allow gaps in the conversation at the client's bedside.
- B. Avoid giving the family advice about how to grieve.
- C. Tell the family the nurse understands their feelings.
- D. Explain this is God's will to prevent further suffering.
- E. Allow the family time with the body in private.
Correct Answer: A,B,E
Rationale: Allowing silence, avoiding prescriptive grief advice, and providing private time support family grieving. Claiming understanding or invoking God’s will may alienate or presume.
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The nurse is obtaining the client’s signature on a surgical permit form. The nurse determines the client does not understand the surgical procedure and possible risks. Which action should the nurse take first?
- A. Notify the client's surgeon.
- B. Document the information in the chart.
- C. Contact the operating room staff.
- D. Explain the procedure to the client.
Correct Answer: A
Rationale: Notifying the surgeon ensures informed consent, as the surgeon must clarify risks and procedures. Documentation, OR contact, or nurse explanation is secondary.
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.
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 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.