A family requested a visit from a hospice nurse as they think the client appears to be nearing the end of life. The nurse assesses the client.

Which of the following signs indicate that the client is near death?

Decreased muscle tone, relaxed jaw muscles, sagging mouth.

Urine output is clear yellow.

Altered breathing (apnea, labored or irregular breathing, Cheyne-Stokes pattern).

Congestion/increased pulmonary secretions; noisy respirations (death rattle).

Answer and Explanation

Correct Answer : A,C,D

Choice A rationale
Decreased muscle tone, relaxed jaw muscles, and a sagging mouth are common signs that indicate a client is near death. These changes occur as the body begins to shut down and muscle control diminishes.
Choice B rationale
Clear yellow urine output is not typically associated with the end-of-life stage. As death approaches, urine output usually decreases and may become darker in color.
Choice C rationale
Altered breathing patterns, such as apnea, labored or irregular breathing, and Cheyne-Stokes respiration, are common signs that a client is nearing death. These changes in breathing patterns are due to the body’s decreasing ability to regulate respiratory function.
Choice D rationale
Congestion and increased pulmonary secretions, often referred to as the “death rattle,” are common signs that a client is near death. These noisy respirations occur as the body’s ability to clear secretions diminishes.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A rationale
Inspecting crutches to ensure rubber tips are intact is important for safety, but it does not indicate an understanding of proper crutch walking technique. Proper crutch walking involves more than just equipment inspection.
Choice B rationale
Practicing bicep and triceps isometric exercises can help strengthen the muscles needed for crutch walking, but it does not directly demonstrate an understanding of the correct crutch gait. The focus should be on the actual technique of using the crutches.
Choice C rationale
Bearing body weight on the palms of hands during the crutch gait is the correct behavior that indicates an understanding of proper crutch walking. This technique helps distribute weight appropriately and prevents strain on the underarms, which can cause nerve damage and discomfort.
Choice D rationale
Progressing to foot touchdown and weight bearing of the affected leg is not appropriate for a three-point gait, which is used when the client should not bear any weight on the affected leg. This choice indicates a misunderstanding of the correct crutch walking technique for this specific gait.

A. “The healthcare provider will share this information with you.”. B. “I’m sorry, but your child’s medical information is none of your business.”. C. “I can give you those results as soon as I get them back from the laboratory.”. D. “I can only give medical information to your child because they are legally an adult.”.

Correct Answer is D

Explanation

Choice A rationale
Stating that the healthcare provider will share the information does not address the legal status of the emancipated minor and may delay the communication of important information.
Choice B rationale
Telling the parents that their child’s medical information is none of their business is not respectful and does not provide a clear explanation of the legal situation.
Choice C rationale
Offering to give the results to the parents as soon as they are available does not respect the legal autonomy of the emancipated minor.
Choice D rationale
Explaining that medical information can only be given to the client because they are legally an adult is the best response. It respects the legal status of the emancipated minor and their right to make their own healthcare decisions.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A family requested a visit from a hospice nurse as they think the client appears to be nearing the end of life. The nurse assesses the client. Which of the following signs indicate that the client is near death?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is demonstrating three-point gait crutch walking to an older adult client who broke a foot while playing soccer with the grandchildren. Which behavior indicates that the client understands proper crutch walking?

Correct Answer is C

Explanation

A 16-year-old emancipated client is being seen in the emergency department following a minor automobile accident. The client’s parents arrive and are asking querry about the client’s laboratory results.Which response is best for the nurse to provide?

Correct Answer is D

Explanation

When assessing a client with a serum potassium level of 7.5 mEq/L (7.5 mmol/L), which intervention is most important for the nurse to implement?

A child has experienced several episodes of vomiting. After the nurse reviews the need to provide only clear liquids, the parent of the child reports making clear liquid popsicles out of flavored gelatin for the child. Which information should the nurse obtain about the popsicles?

The nurse assesses an older adult client’s ability to perform activities of daily living (ADLs). When observing the client ambulate, the nurse notes that the client’s posture is upright, and the gait is smooth and steady. Which action should the nurse take next?

The nurse is interviewing a client with lower abdominal pain and dysuria, and needs to the client about sexual activity. Which approach is best for the nurse to use?

A confused older adult client is having trouble sleeping at night and is sometimes found wandering in the hallway. Which nursing intervention should the nurse implement first?

The nurse attaches a pulse oximeter to a client’s finger and obtains an oxygen saturation reading of 91%. Which assessment finding most likely contributes to this reading?

The nurse is preparing to administer lorazepam 1.5 mg IV to an anxious preoperative client. The medication is available in a 2 mg/mL vial. Which action should the nurse perform with the remainder of the medication?

A nurse is reviewing error prevention techniques that would have helped to avoid a medication error. Which technique is most effective?

A family requested a visit from a hospice nurse as they think the client appears to be nearing the end of life. The nurse assesses the client.

Which of the following signs indicate that the client is near death?