A client on the cardiac telemetry unit unexpectedly begins manifesting ventricular fibrillation and the advanced cardiac life support (ACLS) team defibrillates the client, restoring a normal sinus rhythm. Later in the day, a family member questions why the code was called, telling the nurse that the client has a living will. How should the nurse respond?
Schedule a client and family conference to review the plan of care.
Seek clarification of the type of advance directive the client has.
Check the client's arm for a "Do Not Resuscitate" (DNR) bracelet.
Explain that living wills cannot be followed by emergency personnel.
The Correct Answer is B
A. While scheduling a client and family conference may be necessary to discuss the plan of care, the immediate concern is to determine the type of advance directive the client has and whether it includes preferences regarding resuscitation.
B. This is the most appropriate action because it addresses the family member's concern and ensures that the client's wishes regarding resuscitation are understood and followed.
C. While checking for a DNR bracelet is important, it does not address the family member's question about why the code was called despite the client having a living will.
D. This statement is incorrect. Living wills can guide decision-making regarding end-of-life care, including resuscitation, depending on the legal requirements and documentation in place.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Aching leg. Aching leg is not a commonly occurring problem after gastric endoscopy. It may be related to positioning during the procedure or another unrelated issue.
B. Nausea. Nausea is a potential side effect of the anesthesia or sedation used during the procedure. However, it is not as commonly occurring as a sore throat after gastric endoscopy.
C. Sore throat. Sore throat is a commonly occurring problem after gastric endoscopy due to
irritation of the throat by the endoscope. It is often caused by the insertion and manipulation of the scope during the procedure.
D. Headache. While headache can occur as a side effect of anesthesia or sedation, it is not as commonly associated with gastric endoscopy as a sore throat.
Correct Answer is B
Explanation
A. Gained 10 lb (4.5 kg) within one month. Weight gain is not typically associated with the onset of type 1 diabetes. In fact, weight loss is more common due to the body's inability to use glucose properly.
B. Drinks more fluids than previously. Increased thirst (polydipsia) is a classic symptom of type 1 diabetes due to high blood sugar levels causing dehydration.
C. Voids only one or two times per day. Increased urination (polyuria) is a common symptom of type 1 diabetes as the body attempts to excrete excess glucose, so decreased urination is unlikely.
D. Refuses to eat favorite meals at home. While changes in appetite can occur, it is not a primary symptom of type 1 diabetes. Increased hunger (polyphagia) is more typical.
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