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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason: Multiple facial lacerations, if not affecting airway or causing severe bleeding, are minor injuries in triage (green tag). These clients can wait for treatment without immediate risk, aligning with disaster triage principles, making this the correct classification.
Choice B reason: A puncture wound to the lung is life-threatening, potentially causing pneumothorax or hemothorax, requiring urgent intervention (red tag). This is not a minor injury, so it does not qualify for a green tag, making it incorrect.
Choice C reason: Full-thickness burns over the lower extremities are severe, requiring immediate fluid resuscitation and specialized care (red or yellow tag). These are not minor injuries, so this client does not fit green tag criteria, making it incorrect.
Choice D reason: An open compound fracture of the humerus is a significant injury with risks of infection and bleeding, requiring prompt surgical intervention (yellow or red tag). It is not minor, so it does not qualify for a green tag, making it incorrect.

A. Bilirubin B. Alkaline phosphatase C. Amylase D. Creatinine

Correct Answer is D

Explanation

Choice A reason: Bilirubin assesses liver function, not kidneys. Cyclosporine’s nephrotoxicity affects glomerular filtration, not heme metabolism. Monitoring bilirubin is irrelevant for renal function in transplant clients, as it reflects hepatic or hemolytic processes, not kidney health or drug toxicity.
Choice B reason: Alkaline phosphatase evaluates liver or bone health, not kidneys. Cyclosporine may cause hepatotoxicity, but renal monitoring is critical due to its nephrotoxic potential. Alkaline phosphatase does not reflect glomerular or tubular function, making it unsuitable for assessing renal impact.
Choice C reason: Amylase measures pancreatic function, not kidneys. Cyclosporine’s nephrotoxicity affects renal filtration, not pancreatic enzymes. Monitoring amylase is irrelevant for kidney transplant clients, as it does not indicate renal impairment or cyclosporine’s toxic effects on kidney function.
Choice D reason: Creatinine is a key renal function marker, reflecting glomerular filtration rate. Cyclosporine’s nephrotoxicity elevates creatinine, indicating kidney damage. Monitoring it with BUN ensures early detection of renal impairment, guiding dose adjustments to prevent further injury in transplant clients.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse has been assigned to an internal disaster drill team and is triaging clients. Which of the following clients should the nurse classify with a green tag?

Correct Answer is A

Explanation

A nurse is reviewing the BUN result of a client who is taking cyclosporine following a kidney transplant. Which of the following laboratory studies should the nurse recognize as another renal function study that should be monitored?

Correct Answer is D

Explanation

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