Nokea
You are caring for a 33-year-old male client at the end of life. This married client has two children; the son is 14-years-old and the daughter is 8-years-old. Both of these children are being prepared for their father's imminent death. Which consideration should be incorporated into your explanations of death with these children?
- A. Children before the age of 12 view death as terrifying so the nurse should not discuss death with these young children.
- B. Children before the age of 12 do not have any perspectives about death, its meaning, and its finality or lack thereof.
- C. The cognitive development of young children impacts their understanding of death.
- D. The cognitive development of young children before 12 has no impact on their understanding of death
Correct Answer: C
Rationale: Cognitive development (C) influences how children, like the 8-year-old, understand death. Younger children may view death as reversible or temporary, while adolescents, like the 14-year-old, grasp its finality. Tailoring explanations to their developmental stage is essential. Options A and B are incorrect as children do have perspectives, and avoiding discussion (A) is unhelpful. Option D contradicts developmental psychology.
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The nurse is planning to interview a client interested in establishing care with a primary healthcare provider (PHCP). The nurse should initially
- A. obtain the client's vital signs.
- B. identify the client's chief complaint.
- C. provide a private area for the interview.
- D. inquire about the client's allergies.
Correct Answer: C
Rationale: Providing a private area (C) ensures confidentiality and comfort, the initial step for an interview. Chief complaint (B), allergies (D), and vital signs (A) follow after establishing privacy.
The nurse is caring for the following assigned clients. It would be a priority to follow up with a client who
- A. is being treated for acute glomerulonephritis (AGN) and has periorbital edema.
- B. has urolithiasis and reports persistent nausea.
- C. is receiving continuous bladder irrigation and reports the need to void.
- D. just returned from a hemodialysis session and reports dizziness.
Correct Answer: D
Rationale: Dizziness post-hemodialysis (D) suggests hypotension or fluid shifts, a life-threatening complication requiring immediate follow-up. Edema in AGN (A), nausea with urolithiasis (B), and voiding sensation with irrigation (C) are less urgent.
The nurse is providing care for a patient recently transferred from the post-anesthesia care unit [PACU]. The chart indicates that the patient was medicated for pain 1 hour ago, yet the patient reports that he is experiencing extreme pain. He is not due for further medication until another 2 hours. How might the nurse intervene as a patient advocate?
- A. Contact the physician regarding the need for more effective pain management.
- B. Assist the patient to use non-pharmacological pain management strategies.
- C. Explain to the patient that giving the pain medication too soon can be dangerous.
- D. Provide a quiet environment to help the patient rest and cope with his pain level.
Correct Answer: A
Rationale: Contacting the physician (A) advocates for the patient by addressing uncontrolled pain, potentially adjusting the regimen. Non-pharmacological strategies (B), explaining risks (C), or providing a quiet environment (D) are supportive but do not directly address the need for better pain control.
The nurse has received the following information about assigned clients. The nurse should initially assess the client who is at
- A. 15 weeks gestation who reports not feeling any fetal movement.
- B. 28 weeks gestation who reports swollen feet and ankles.
- C. 36 weeks gestation who reports contractions that are irregular.
- D. 37 weeks gestation experiencing variable decelerations.
Correct Answer: D
Rationale: Variable decelerations at 37 weeks (D) indicate possible umbilical cord compression, a fetal emergency requiring immediate assessment. No fetal movement at 15 weeks (A) is normal, edema at 28 weeks (B) is common, and irregular contractions at 36 weeks (C) are non-urgent.
The nurse is preparing to insert an indwelling urinary catheter. Which action may be delegated to the unlicensed assistive personnel (UAP)?
- A. Set up the sterile field
- B. Palpate the bladder for distention
- C. Explain the procedure to the client
- D. Place the urinary catheter kit at the bedside
Correct Answer: D
Rationale: Placing the catheter kit at the bedside (D) is a non-clinical task suitable for a UAP. Setting up a sterile field (A), palpating the bladder (B), and explaining the procedure (C) require clinical judgment or training beyond UAP scope.