A nurse is caring for a client who has a living will which states Do Not Resuscitate (DNR), but whose children have decided that their parent should be a full code.

The client has coded twice.

The other nurses do not seem to have any issues with the situation, but the nurse feels distressed. What best describes this source of conflict?

Ethical conflict.

Scarcity, safety, and security.

Competition between groups.

Cultural differences.

Answer and Explanation

The Correct Answer is A

Choice A rationale
This situation represents an ethical conflict. The nurse is faced with a dilemma where the children’s wishes for their parent to be a full code contradict the client’s expressed wish in their living will for Do Not Resuscitate (DNR)2. Ethical conflicts often arise in healthcare when there are differing opinions about the right course of action.
Choice B rationale
Scarcity, safety, and security are not the primary sources of conflict in this situation. While these factors can contribute to conflict in certain contexts, they do not directly apply to the ethical dilemma presented in this scenario.
Choice C rationale
Competition between groups is not evident in this situation. The conflict arises from differing views on the appropriate course of action for the client’s care, not from competition.
Choice D rationale
Cultural differences are not the main source of conflict in this scenario. The conflict arises from an ethical issue related to the client’s end-of-life care, not from cultural differences.

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Correct Answer is A

Explanation

Choice A rationale
Offering high-protein and high-carbohydrate foods frequently is an important intervention for a client who has acute respiratory distress syndrome (ARDS)4. These nutrients can provide the energy needed for the increased metabolic demands of ARDS and support the healing process.
Choice B rationale
Administering low-flow oxygen continuously via nasal cannula is not typically the main treatment for ARDS5. ARDS is a severe condition that often requires high levels of supplemental oxygen delivered through methods that can provide higher concentrations of oxygen than a nasal cannula.
Choice C rationale
Encouraging oral intake of at least 3,000 mL of fluids per day is not a typical intervention for a client with ARDS4. While adequate hydration is important, too much fluid can worsen lung function in clients with ARDS4. Fluid management in ARDS is typically carefully controlled and may involve diuretics to remove excess fluid.
Choice D rationale
Repositioning and placing the client in a prone position is not a typical intervention for all clients with ARDS4. While some clients with severe ARDS may benefit from prone positioning, this is not a standard intervention for all clients with ARDS4.

A. The client appears restless. B. The client’s SaO2 is 92% on 40% humidified oxygen via tracheostomy collar. C. The client’s lung fields have scattered rhonchi throughout. D. The client’s tracheostomy was suctioned for thin clear secretions.

Correct Answer is A

Explanation

Choice A rationale
Restlessness in a client with a tracheostomy could indicate respiratory distress or hypoxia. It’s important for the nurse to further assess the client’s vital signs, oxygen saturation, and overall appearance.
Choice B rationale
A SaO2 of 92% on 40% humidified oxygen via tracheostomy collar is within the acceptable range for a client with a tracheostomy. However, it’s important to consider the client’s baseline SaO2 and any changes in their condition.
Choice C rationale
Scattered rhonchi throughout the lung fields could indicate secretions in the airways. However, this finding alone does not necessarily indicate a problem with the tracheostomy.
Choice D rationale
Suctioning of thin clear secretions from a tracheostomy is a routine part of tracheostomy care. This finding does not necessarily indicate a problem with the tracheostomy.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who has acute respiratory distress syndrome (ARDS). Which of the following interventions should the nurse include in the plan of care?

Correct Answer is A

Explanation

A nurse is caring for a client who has a tracheostomy. Based on the Nurses Notes and Diagnostic Results, which of the following is a manifestation in the client?

Correct Answer is A

Explanation

A patient with lung cancer confides in the nurse, expressing fear about the disease and guilt for smoking in the past. Which response from the nurse would be most appropriate?

A nurse instructor is teaching nursing students about safety, quality, and patient-centered care. What recommendations should the students recognize that promote safe, quality, patient-centered care? Select all that apply.

A nurse is educating a client after surgery for laryngeal cancer about a full liquid diet. What selection made by a client indicates to a nurse that the teaching was effective?

A nurse is reviewing incident reports submitted during the previous month. The nurse should identify which of the following as a problem that should be reported to the risk manager?

A client has been diagnosed in the Emergency Department with acute respiratory distress syndrome (ARDS). Which of the following actions should a nurse perform first?

An employee asks the occupational health nurse about measures to prevent inhalation exposure of job-related substances. Which of the following explanations should the nurse include?

A nurse is caring for a patient who reports experiencing an alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the patient’s concern through which of the following responses?

A patient is being treated for bacterial pharyngitis. Which of the following should a nurse recommend to promote the patient’s nutrition during treatment?