A nurse is caring for a client who has ovarian cancer and is in the end stages of the dying process.

Provider Prescriptions

Admission: Do-not-resuscitate (DNR) prescription 0940:

Oxycodone acetaminophen 5 mg/325 mg one tablet every 6 hr PRN for pain 1550:

Proceed with withdrawal of mechanically administered nutrition and hydration (MANH)

A nurse is planning care for a client who has requested withdrawal of medically administered nutrition and hydration (MANH). Which of the following should the nurse include in the plan of care? Select all that apply.
(Select All that Apply.)

Support client-requested rituals.

Encourage family to be present for MANH.

Following withdrawal of MANH, offer mouth sponges with preferred flavors as needed.

Request spiritual advisor visit, if applicable

Following withdrawal of MANH, suction oral cavity for pooling of secretions as needed

Educate client on the steps of the dying process

Answer and Explanation

Correct Answer : A,B,C,D,E

Supporting the client's rituals can provide comfort and dignity during this challenging time. It honors their preferences and cultural or religious beliefs, contributing to their overall well-being.

Having loved ones present can offer emotional support to both the client and their family members during the withdrawal of MANH. It allows for meaningful connections and facilitates closure.

Providing mouth sponges with preferred flavors can help alleviate dryness and discomfort in the oral cavity that may occur after the withdrawal of MANH. It promotes comfort and enhances the client's quality of life.

Spiritual support can be valuable for clients and their families during the end-of-life process. If the client desires spiritual guidance or support, arranging for a visit from a spiritual advisor can address their spiritual needs and provide comfort.

Suctioning the oral cavity for pooling secretions can help maintain the client's comfort and prevent aspiration, particularly if the client is unable to swallow effectively. It supports respiratory hygiene and comfort.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is B

Explanation

Maintaining a nonjudgmental attitude allows the client to feel comfortable discussing their alcohol use without fear of criticism or condemnation. It also helps foster honest communication and promotes engagement in the treatment process.

A. It's important to balance sympathy with professionalism and maintain appropriate boundaries.

C. Expressing disapproval of the client's substance abuse can be counterproductive and may hinder the therapeutic relationship.

D. While it's important for the nurse to maintain professionalism and emotional boundaries, completely avoiding displaying any emotional response may come across as cold or detached.

A. "Holistic nursing care is not any different than any other nursing care. It is just a new term that is used since we started COVID-19 protocols." B. "Holistic nursing care means that you will have all members of the nursing staff working with you for each nursing action." C. "Holistic nursing care ensures all clients receive the same treatments." D. "Holistic nursing care involves viewing the client as a whole."

Correct Answer is D

Explanation

Holistic nursing care is centered around the concept of viewing the client as a whole person, rather than just focusing on their physical symptoms or specific health issues. It considers all aspects of the client's being, including their physical, emotional, social, spiritual, and cultural dimensions.
A. Holistic nursing goes beyond just addressing physical symptoms or illnesses and focuses on promoting healing and wellness in all aspects of the client's life.
B. While collaboration among members of the nursing staff may be part of holistic nursing care, it does not fully capture the essence of what holistic nursing care entails.
C. Holistic nursing care does not necessarily mean that all clients receive the same treatments. Instead, it emphasizes individualized care that considers each client's unique circumstances, preferences, and goals.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is interviewing a client during admission to an alcohol treatment center. Which of the following approaches should the nurse take?

Correct Answer is B

Explanation

A nurse is providing care to a client who asks, "What is the meaning of holistic nursing care?" The nurse should give which of the following responses?

Correct Answer is D

Explanation

A nurse is obtaining a health history from a client. Which of the following findings should the nurse identify as a non-modifiable risk factor for disease?

A 35-year-old woman has been admitted to the hospital for a hysterectomy secondary to uterine cancer caused by smoking, and the nurse is collecting subjective data prior to surgery. Which statements by the nurse could be construed as non-judgmental? (Select All that Apply.)

A nurse manager in a community clinic is planning an in-service to increase staff nurses' knowledge on cultural diversity in health care. Which of the following information should the nurse manager include in the presentation? (Select All that Apply)

A nurse is obtaining a health history from a client. Which of the following findings should the nurse identify as a modifiable risk factor for developing a disease?

A community health nurse is making efforts to expand their cultural competence when working with clients. To develop cultural competence, the nurse must appreciate understand which of the following characteristics of their clients?

A nurse is assessing a client who reports feeling stress and anxiety. The client appears restless and is pacing in the room. The client is alert and oriented to person, place, and time. Which of the following findings is subjective?

A nurse is preparing to collect health history data during a client's admission. Which of the following questions should the nurse use to promote this discussion?