A client with a right hemisphere stroke is eating lunch.
The nurse notes the client is only eating food from the right side of the tray and is unaware of food remaining on the left side. What is the nurse's priority action?

Providing post-mortem care requires knowledge of legal requirements, hospital protocols, and psychosocial support. The nurse must apply principles of cultural sensitivity and respect for the deceased while ensuring that administrative and physical care tasks align with the specific circumstances of death.

Choice A rationale

While a physician or authorized practitioner must pronounce death and sign the certificate, it is not the immediate responsibility of the nurse to ensure the signature is completed before beginning initial post-mortem nursing care.

Choice B rationale

Removing tubes is often prohibited if an autopsy is required, especially in sudden or suspicious deaths. The nurse must first verify the cause of death and institutional policy before disturbing any medical devices or invasive lines.

Choice C rationale

Removing the body immediately is insensitive and may interfere with the grieving process. Families should be given adequate time to spend with the deceased to begin their emotional processing and perform any necessary rituals.

Choice D rationale

Allowing for religious and cultural customs is a core component of holistic nursing care. This respects the dignity of the deceased and supports the family's coping mechanisms during the immediate period following a significant loss.

Choice E rationale

Providing privacy is essential for the family to express grief without observation. This therapeutic environment allows for intimate goodbyes and facilitates the beginning of the mourning process in a respectful and safe hospital or hospice setting.

Evaluating pulmonary embolism in patients with renal impairment requires knowledge of contrast-induced nephropathy risks. One must apply understanding of different imaging modalities to select a test that provides diagnostic clarity without using nephrotoxic agents that would worsen kidney failure.

Choice A rationale

Pulmonary angiography is an invasive procedure requiring a large bolus of iodinated contrast. In a client with chronic kidney disease and recent nephropathy, this would likely cause further irreversible damage to the remaining renal function.

Choice B rationale

D-dimer is a screening tool with high sensitivity but low specificity. While it does not require contrast, it cannot definitively diagnose a PE. It is used to rule out PE in low-risk patients rather than confirm.

Choice C rationale

A ventilation-perfusion scan uses radioactive isotopes rather than iodinated contrast. It is the preferred diagnostic test for patients with renal failure because it avoids the risk of contrast-induced nephropathy while effectively assessing for V/Q mismatch.

Choice D rationale

A chest X-ray is useful for ruling out other causes of respiratory distress like pneumonia or pneumothorax, but it is not sensitive or specific enough to diagnose a pulmonary embolism. Most PE patients have normal X-rays..