A hospice nurse is visiting with the son of a client who has terminal cancer. The son reports sleeping very little during the past week due to caring for his mother. Which of the following responses should the nurse make?

"I can give you information about respite care if you are interested."

"I am sure you're doing a great job taking care of your mother."

"You should consider taking a sleeping pill before bed each night."

"It is always difficult caring for someone who is terminally ill."

Answer and Explanation

The Correct Answer is A

A. Correct. Offering information about respite care provides the son with an option to take a break and get some rest while ensuring his mother's care is still managed by professionals.

B. Incorrect. While supportive, this statement does not offer a solution to the son's sleep deprivation.

C. Incorrect. Suggesting a sleeping pill might not address the underlying issue of the son's caregiving responsibilities.

D. Incorrect. While empathetic, this statement does not offer a practical solution or support for the son's situation.

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Correct Answer is C

Explanation

A. Incorrect. A residual of 65 mL may indicate delayed gastric emptying, but it alone does not directly correlate with an increased risk of aspiration unless it leads to significant overdistension or the client is unable to tolerate further feedings.

B. Incorrect. Sitting in high Fowler's position during feeding is actually a preventive measure against aspiration.

C. Correct. his factor increases the risk for aspiration. Clients with gastroesophageal reflux disease (GERD) are more prone to refluxing contents from the stomach into the esophagus, which can lead to aspiration, especially during or after feedings.

D. Incorrect. The osmolarity of the formula might affect tolerance but is not directly related to aspiration risk.

A. "Store unused patches in the refrigerator.” B. "Apply the patch prior to traveling.” C. "Place the patch on your upper arm.” D. "Replace a dislodged patch onto the same location.”

Correct Answer is B

Explanation

Choice A rationale:

Storing unused patches in the refrigerator is not necessary for transdermal scopolamine patches. Refrigeration is not a requirement for their storage.

Choice B rationale:

Applying the patch prior to traveling is the correct choice. Transdermal scopolamine patches are used to prevent motion sickness. Applying the patch before the journey allows the medication to be absorbed before exposure to motion, ensuring its effectiveness during travel.

Choice C rationale:

Placing the patch on the upper arm is a specific and correct instruction for applying transdermal scopolamine patches. The patch should be placed on a clean, dry, and hairless area of the skin, preferably behind the ear or on the upper arm.

Choice D rationale:

Replacing a dislodged patch onto the same location is incorrect. If the patch becomes dislodged, it should be replaced with a new patch on a different, clean, and dry area of the skin. Reapplying a dislodged patch to the same spot may result in uneven absorption and reduced effectiveness.

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A hospice nurse is visiting with the son of a client who has terminal cancer. The son reports sleeping very little during the past week due to caring for his mother. Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following factors places the client at risk for aspiration?

Correct Answer is C

Explanation

A nurse is teaching a client about using transdermal scopolamine to treat motion sickness.Which of the following instructions should the nurse include?

Correct Answer is B

Explanation

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