A nurse is caring for a client who has end-stage kidney disease and refuses further hemodialysis treatments. The client has advance directives that indicate no life-sustaining treatments. Which of the following actions should the nurse take?
Encourage the client to complete a final hemodialysis treatment.
Contact the client’s family to discuss the decision.
Discuss future treatment options with the client’s health care surrogate.
Discuss possible options for discharge with the client.
The Correct Answer is D
Choice A reason: Encouraging a final hemodialysis treatment contradicts the client’s advance directives, which refuse life-sustaining treatments. Respecting autonomy is paramount, and persuading the client undermines their decision, making this action unethical and inappropriate in this end-of-life scenario.
Choice B reason: Contacting the family to discuss the decision is unnecessary unless the client is incapacitated, which is not indicated. The client’s advance directives guide care, and family input is secondary to the client’s wishes, making this action incorrect and irrelevant.
Choice C reason: Discussing treatment options with the surrogate is inappropriate, as the client is competent and has clear advance directives refusing treatment. The surrogate’s role applies only if the client cannot decide, making this action misaligned with the client’s autonomy and directives.
Choice D reason: Discussing discharge options respects the client’s refusal of treatment and advance directives, focusing on palliative care or home arrangements. This supports autonomy and aligns with end-of-life care principles, ensuring comfort and dignity, making it the correct action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Changing the stoma pouch 30 minutes after meals is not recommended, as meal timing does not dictate pouch changes. Pouches are typically changed every 3-7 days or if leaking, to prevent skin irritation. This statement reflects a misunderstanding, as it suggests an incorrect schedule unrelated to stoma care needs.
Choice B reason: Cutting the pouch opening 1/8 inch larger than the stoma ensures a snug fit, preventing leakage while protecting peristomal skin from irritation by digestive enzymes. Proper sizing maintains skin integrity and pouch adherence, supporting effective ostomy management. This statement demonstrates correct understanding of stoma care techniques.
Choice C reason: Cleaning the stoma with moisturizing soap is incorrect, as soaps with oils or fragrances can irritate peristomal skin and impair pouch adhesion. Mild, non-residue soap and water are recommended to maintain skin integrity. This statement indicates a misunderstanding of proper stoma cleaning practices.
Choice D reason: Expecting the stoma to be blistered is incorrect, as a healthy stoma should be pink, moist, and free of irritation. Blistering indicates complications like infection or poor pouch fit. This statement reflects a misunderstanding of normal stoma appearance and care, suggesting potential issues requiring intervention.
Correct Answer is C
Explanation
Choice A reason: Dehydration is not directly associated with gastroesophageal reflux, which involves gastric acid backflow. Dehydration affects fluid balance, not reflux mechanisms, so this statement is inaccurate and irrelevant to preterm contractions, making it incorrect.
Choice B reason: Dehydration is not caused by decreased hemoglobin and hematocrit; rather, it may elevate these due to hemoconcentration. This statement reverses the relationship, making it factually incorrect and unrelated to preterm labor risks.
Choice C reason: Dehydration can increase preterm labor risk by reducing uterine blood flow and triggering contractions via oxytocin release. This evidence-based link supports hydration as a preventive measure, making it the correct statement for teaching in this scenario.
Choice D reason: Dehydration is treated with fluid replacement, not calcium supplements, which address bone health or specific deficiencies. This treatment is irrelevant to dehydration or preterm labor, making it an incorrect and inappropriate recommendation.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.