A hospice nurse is caring for a patient who has terminal cancer and is receiving hospice care for stage 4 metastatic breast cancer.
The patient experiences excruciating pain and is scheduled for morphine 10mg IM every 6 hours. The patient is sleeping, and the medication is due.

What action should the nurse take?

Hold the pain medication until the patient wakes up.

The patient should be given the scheduled pain medication.

Call the family and ask if the patient would like to be woken up to have their pain medication.

The patient has become addicted to the medication and is sleeping the last dose off.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Holding the pain medication until the patient wakes up is not the best choice. Pain can disrupt sleep, and it’s important to keep the patient as comfortable as possible. If the patient is sleeping, it may be because the pain is well-controlled, and delaying the medication could lead to a return of pain.
Choice B rationale
The patient should be given the scheduled pain medication. This is the best choice because it ensures that the patient’s pain is managed effectively. Even if the patient is sleeping, the medication should be given to prevent the pain from returning.
Choice C rationale
Calling the family and asking if the patient would like to be woken up to have their pain medication is not the best choice. The nurse should make this decision based on the patient’s pain level and the medication schedule, not on the family’s preferences.
Choice D rationale
The statement that the patient has become addicted to the medication and is sleeping the last dose off is not accurate. Addiction is a complex condition characterized by compulsive drug use despite harmful consequences. In this case, the patient is receiving the medication for a legitimate medical reason, and there is no indication of addiction.

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Free Nursing Study Resources

Correct Answer is ["A","C"]

Explanation

Choice A rationale
Mottling of the skin, especially in the lower extremities, is a common sign of impending death. This is due to decreased blood flow and can be a sign that the body is starting to shut down.
Choice B rationale
This statement is incorrect. As a person nears death, their blood pressure typically decreases, not increases.
Choice C rationale
Cheyne-Stokes breathing, which is characterized by a pattern of increasing and decreasing respiration with periods of apnea, is a common symptom in the final stages of life.
Choice D rationale
This statement is incorrect. As a person nears death, their skin may become cool to the touch and may appear pale or mottled.
Choice E rationale
Regular respiration is not typically a sign of impending death. In fact, changes in breathing patterns, such as Cheyne-Stokes breathing, are more common.

A. Glucose level B. Metformin C. Smoking history D. WBC count E. Type 2 diabetes mellitus.

Correct Answer is ["A","B","C","D","E"]

Explanation

Choice A rationale
High glucose levels can indicate uncontrolled diabetes, which can increase the risk of surgical complications such as infection and poor wound healing.
Choice B rationale
Metformin is a medication used to treat type 2 diabetes. It can increase the risk of lactic acidosis, especially in patients undergoing procedures that involve the use of contrast dye.
Choice C rationale
A history of smoking can increase the risk of surgical complications, including poor wound healing, infection, and lung problems.
Choice D rationale
An elevated white blood cell (WBC) count can indicate an infection or inflammation in the body, which can increase the risk of surgical complications.
Choice E rationale
Type 2 diabetes mellitus can increase the risk of surgical complications, including infection, poor wound healing, and cardiovascular complications.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a patient who is in the active stage of dying. What are the signs and symptoms of impending death? (Select all that apply)

Correct Answer is ["A","C"]

Explanation

A nurse is caring for a patient who is scheduled for a surgical procedure. The nurse is reviewing the patient’s electronic medical record. Which of the following findings places the patient at risk for a surgical complication? Select all that apply.

Correct Answer is ["A","B","C","D","E"]

Explanation

a nurse is teaching a class about physical manifestations associated with the fight-or-flight response to stress. Which of the following manifestations should the nurse include?

A nurse is caring for a patient with moderate vision impairment. What actions should the nurse take?

A nurse is conducting a class on stress. Which of the following would the nurse include as an example of acute stress?

A nurse is admitting a client diagnosed with herpes simplex virus encephalitis. Which medication would the nurse anticipate the healthcare provider to order for treatment?

A client is newly diagnosed with relapsing-remitting multiple sclerosis (RRMS). What instruction should the nurse provide?

A nurse is teaching a class about the stages of the general adaptive syndrome (GAS). The nurse should include that which of the following is the first physiological response that occurs during GAS?