A male client with a chronic medical condition tells the practical nurse (PN) that he wants no heroics to prolong his life if anything should happen to him. Which action should the PN take?
Place a "Do Not Resuscitate" sign outside the client's door and at the bedside.
Reassure the client that life-saving measures will not be taken without consent.
Complete an advance directive form and place it in the medical record.
Notify the client's healthcare provider of the client's wishes as soon as possible.
The Correct Answer is D
A. "Place a 'Do Not Resuscitate' sign outside the client's door and at the bedside."
A DNR order must be written by the healthcare provider and documented in the medical record. A sign alone is not sufficient to ensure the client’s wishes are followed.
B. "Reassure the client that life-saving measures will not be taken without consent."
While reassuring the client is important, the client’s wishes must be documented formally through an advance directive, which is legally binding and ensures that medical staff are aware of and follow the client’s instructions.
C. "Complete an advance directive form and place it in the medical record."
While completing an advance directive is important, the first priority is notifying the healthcare provider so that the client’s wishes can be documented and the proper legal forms can be completed.
D. "Notify the client's healthcare provider of the client's wishes as soon as possible."
The nurse should immediately notify the healthcare provider of the client’s wishes. The healthcare provider can then initiate the appropriate legal documentation, such as a DNR order or an advance directive, ensuring the client’s wishes are respected in the future. This is the first step in ensuring that the client’s preferences are followed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E"]
Explanation
C. Regularly selects salty snacks to eat in the evening: Consuming excessive amounts of sodium (found in salty snacks) can increase blood pressure and contribute to the development of hypertension.
E. Chews tobacco while playing baseball every weekend: Tobacco use, including chewing tobacco, is associated with an increased risk of hypertension and other cardiovascular diseases.
The other choices are incorrect because they do not directly contribute to an increased risk of hypertension:
A. Drinks a protein supplement for breakfast every day: Consuming a protein supplement for breakfast does not necessarily increase the risk of hypertension. However, it is important to note that some protein supplements may contain added sodium, which can contribute to hypertension if consumed in excessive amounts.
B. Eats eight ounces of nonfat yogurt for lunch daily: Eating nonfat yogurt is generally considered a healthy food choice. However, unless the yogurt is high in added sodium, it would not significantly increase the risk of hypertension.
D. Walks briskly for two miles every day after work: Regular exercise, such as brisk walking, is generally beneficial for cardiovascular health and can help lower blood pressure. It is unlikely to increase the risk of hypertension.
Correct Answer is A
Explanation
Log-rolling is a technique used to safely turn a client who requires immobilization of the spine or has limited mobility. After log-rolling the client to a lateral position, it is important to maintain proper alignment to prevent injury and promote comfort. Placing pillows strategically can help support and maintain the client's alignment in the lateral position.
The other options mentioned are not the immediate interventions following log-rolling:
B. Raising the head of the bed 30 degrees may be indicated for specific medical conditions or interventions, but it is not the immediate intervention after log-rolling.
C. Flexing the legs and placing a blanket between them is a positioning technique used for preventing skin breakdown and pressure ulcers, but it is not the immediate intervention after log-rolling.
D. Measuring the blood pressure and pulse rate is an important nursing assessment, but it is not the immediate intervention after log-rolling.
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