A nurse is caring for a client in the emergency department who is actively dying from a catastrophic injury. Which of the following is the priority in planning care for this client?

Discussing organ donation with the family

Communicating sensitively with the client and family

Creating a plan for pain relief, nutrition, and hydration

Contacting the family's spiritual advisor

Answer and Explanation

The Correct Answer is B

A. "Discussing organ donation with the family": While organ donation is important, it is not the priority in the setting of an actively dying client. The primary concern at this stage should be addressing the immediate needs of the client and their family, focusing on emotional support and comfort.
B. "Communicating sensitively with the client and family.": When caring for a client who is actively dying, providing emotional support and clear communication with the family is critical. Sensitively addressing the family’s concerns and the client’s comfort is essential in this stage of care.
C. "Creating a plan for pain relief, nutrition, and hydration.": While ensuring pain relief is important, in the context of an actively dying patient, the focus should primarily be on comfort rather than ongoing interventions like nutrition and hydration, which may no longer be beneficial.
D. "Contacting the family's spiritual advisor.": While spiritual support is valuable, it should not be the first priority. Ensuring the client’s comfort and providing emotional support to the family should be prioritized initially, and the spiritual advisor can be contacted afterward if desired.

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Correct Answer is A

Explanation

A. Respiratory acidosis: Clients with COPD have chronic difficulty exhaling carbon dioxide due to airflow obstruction, leading to CO₂ retention. This accumulation of carbon dioxide causes a drop in blood pH, resulting in respiratory acidosis, a common acid-base imbalance in COPD patients.
B. Metabolic acidosis: Metabolic acidosis results from increased acid production or loss of bicarbonate through the kidneys or gastrointestinal tract, such as in diabetic ketoacidosis or severe diarrhea. It is not typically associated with impaired ventilation or chronic lung disease like COPD.
C. Respiratory alkalosis: Respiratory alkalosis occurs when there is excessive loss of carbon dioxide due to hyperventilation. Clients with COPD generally hypoventilate rather than hyperventilate, making this acid-base imbalance unlikely in this case.
D. Metabolic alkalosis: Metabolic alkalosis is typically caused by loss of hydrogen ions through vomiting or diuretic use, or excessive bicarbonate intake. It is unrelated to the impaired gas exchange and CO₂ retention seen in clients with COPD.

A. Chronic pulmonary disease B. Rheumatic fever C. Body mass index of 35 D. History of venous thrombosis

Correct Answer is C

Explanation

A. Chronic pulmonary disease: Chronic pulmonary disease, such as COPD, affects the lungs and respiratory system but is not a primary risk factor for peripheral artery disease (PAD), which is caused by atherosclerosis affecting peripheral circulation.
B. Rheumatic fever: Rheumatic fever is associated with inflammatory damage to the heart valves due to a streptococcal infection, but it does not increase the risk of developing PAD, which is vascular in nature and primarily driven by atherosclerotic risk factors.
C. Body mass index of 35: A BMI of 35 indicates obesity, which significantly increases the risk for atherosclerosis and related conditions like PAD. Obesity contributes to poor lipid profiles, hypertension, and insulin resistance, all of which promote arterial narrowing and plaque buildup.
D. History of venous thrombosis: Venous thrombosis affects the venous system and is different from arterial disease. While it may signal vascular issues, it is not considered a direct risk factor for PAD, which involves arterial—not venous—occlusion.

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A nurse is caring for a client in the emergency department who is actively dying from a catastrophic injury. Which of the following is the priority in planning care for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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