A nurse is caring for a client who has a terminal illness and is in the active phase of dying. The client refuses further hydration and nourishment. What action should the nurse take?

Ask the client's healthcare surrogate for permission to withhold nourishment.

Request a prescription for IV fluids.

Explain the importance of oral hydration to the client.

Provide regular oral care for the client with a moist swab.

Answer and Explanation

The Correct Answer is D

The correct answer is choice D. Provide regular oral care for the client with a moist swab. When a client with a terminal illness and in the active phase of dying refuses further hydration and nourishment, the nurse should provide comfort measures such as regular oral care to prevent discomfort. The nurse should not force the client to eat or drink or request a prescription for IV fluids. The healthcare surrogate cannot be asked for permission to withhold nourishment as the client has the right to refuse nourishment.

Option A - The client has the right to refuse nourishment, and healthcare surrogate permission is not required.

Option B - Requesting a prescription for IV fluids is not an appropriate intervention as the client has the right to refuse nourishment.

Option C - Explaining the importance of oral hydration to the client is not an appropriate intervention as the client has the right to refuse nourishment.

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Correct Answer is D

Explanation

The correct answer is choice D, Describe the food placement as though the plate were a clock. When delivering the client's meal tray, the nurse should describe the food placement as though the plate were a clock to help the client know where the food is located. This helps the client be more independent and participate actively at mealtime. Choice A is incorrect because arranging for assistive personnel to feed the client may take away the client's independence. Choice B is incorrect because discouraging conversations during the client's mealtime may make the client feel isolated. Choice C is incorrect because providing the client with small-handled adaptive utensils may not help the client locate food on the plate.

Other choices:

A. Arrange for assistive personnel to feed the client: Arranging for assistive personnel to feed the client may take away the client's independence.

B. Discourage conversations during the client's mealtime: Discouraging conversations during the client's mealtime may make the client feel isolated.

B. Provide the client with small-handled adaptive utensils: Providing the client with small-handled adaptive utensils may not help the client locate food on the plate.

A. The client becomes exhausted while brushing her teeth. B. The client coughs while drinking from a straw. C. The client is unable to bear her full weight while walking. D. The client is having difficulty reading large print.

Correct Answer is A

No explanation

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A nurse is caring for a client who has a terminal illness and is in the active phase of dying. The client refuses further hydration and nourishment. What action should the nurse take?

Nursing Test Bank

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