A nurse is assisting with the care of a client.

Π

Nurses' Notes 1000:

The client states, "I am tired of undergoing treatment because it doesn't seem to be working." The client states, "I hope I am just constipated." Appendectomy scar on the right lower quadrant. The abdomen is soft, and tender in the right lower quadrant, bowel sounds present in all four quadrants.

1200:

The surgeon has notified the client that surgical removal of the mass is advisable due to the client's history of metastasis and ongoing treatment failure. The client and their partner want to discuss end-of-life care. The client states, "I am unsure what it means to have a living will or a do not resuscitate order." The client's partner states, "I don't understand what power of attorney means." Both client and partner indicate that they might wish to decline further treatment as well as further lifesaving measures should they become necessary. The partner states, "How can we be sure that our decision about care will be honored?"

Select the responsibilities the nurse has in relation to the client's advance directives.

Provide the client with written information about advance directives.

Document that the provider discussed do not resuscitate status with the client. Inform the client that an advance directive discontinues further care.

Communicate advance directives status via the medical record and shift report. Instruct the client that an advance directive is a legal document and must be honored by care providers.

Initiate a power of attorney for health care documents.

Answer and Explanation

Correct Answer : A,C,D

A.   The nurse should provide the client with written information about advance directives to ensure that the client fully understands their options and can make informed decisions about their healthcare wishes.
B.   Not a correct option because it inaccurately states that an advance directive discontinues further care. An advance directive guides the type of care a patient wants or does not want, but it does not automatically discontinue all care.
C.   The nurse should communicate the client's advance directives status to other members of the healthcare team through documentation and shift reports. The nurse should also educate the client that an advance directive is a legal document that guides healthcare decisions and must be respected by care providers.
D.   The nurse can assist the client in initiating a power of attorney for health care document, which designates a trusted person to make healthcare decisions on behalf of the client if they become unable to make decisions for themselves.

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Correct Answer is D

Explanation

A. Incorrect. While monitoring dietary potassium might be relevant for some clients on certain medications, it is not the primary action for addressing syncope related to enalapril.
B. Incorrect. Withholding the medication based solely on pulse rate is not an appropriate action.
The nurse should provide guidance on appropriate management.
C. Incorrect. Decreasing daily fluid intake is not likely to address the syncope related to enalapril.
D. Correct. Enalapril is an ACE inhibitor, and syncope can be a side effect due to changes in blood pressure. Advising the client to rise slowly from a sitting position can help prevent sudden drops in blood pressure and decrease the risk of syncope.

A. Ensure that the client gave informed consent. B. Administer an oral contrast solution. C. Ensure that the client's bladder is full. D. Inform the client the procedure will take 60 min.

Correct Answer is A

Explanation

A. Correct. Ensuring informed consent is a critical step before any procedure.
B. Incorrect. An oral contrast solution is not typically required for an esophagogastroduodenoscopy.
C. Incorrect. A full bladder is not necessary for this procedure.
D. Incorrect. Informing the client about the procedure duration is important, but ensuring informed consent takes priority.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse at an outpatient clinic receives a call from a client who reports experiencing syncope after starting a new prescription for enalapril. Which of the following instructions should the nurse give the client?

Correct Answer is D

Explanation

A nurse is caring for a client who has peptic ulcer disease and is scheduled to undergo an esophagogastroduodenoscopy. Which of the following actions should the nurse take prior to the procedure?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with new parents about car seat safety. Which of the following instructions should the nurse include?

A nurse is reinforcing teaching with a client who is scheduled for an Intravenous pyelogram. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is applying a belt restraint to a client who has become physically aggressive. Which of the following actions should the nurse take?

A nurse is helping to place a client into the prone position. The nurse should use a small pillow to relieve pressure from which of the following areas of the client's body?

A nurse is reinforcing teaching with a client who is postoperative following a laparoscopic cholecystectomy. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is reinforcing teaching with a client who is dependent on nicotine and wishes to discontinue smoking. The nurse should inform the client that which of the following is a manifestation of nicotine withdrawal?

A nurse is providing change of shift report for a client. Which of the following information should the nurse include in the report?

A nurse is reinforcing discharge teaching with a client who has stable angina pectoris. Which of the following statements by the client indicates an understanding of what to do when chest pain occurs?