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.

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Correct Answer is B

Explanation

This question is more focused and directly addresses the reason for the client's current admission. It prompts the client to discuss their chief complaint or presenting symptoms, which is essential information for the nurse to gather during the health history interview.
A. This question is too broad and may overwhelm the client, especially during the initial stages of the health history interview.
C. While discussing the client's feelings about hospitalization is important for providing emotional support and understanding their perspective, this question may not directly promote the discussion of health history data.
D. This question invites the client to share their perspective and provides an opportunity for them to express any immediate health issues or worries they may have. However, it is too broad.

A. "I don't like it when you address me with that tone of voice." B. "I know you can, but are you going to read it or not?" C. "Fine. Here is the schedule, and I will expect you to be on time to your therapies. D. "We do this every day. Why are you so angry with me this morning?"

Correct Answer is A

Explanation

This response addresses the client's disrespectful tone and sets a boundary regarding acceptable communication. It promotes respect and professionalism in the nurse-client relationship while addressing the immediate behavior.

B. It maintains a neutral tone and encourages cooperation without escalating the conflict. However, it may come across as slightly confrontational and could potentially provoke further resistance from the client.

C. This response accommodates the client's request to have the schedule provided without further interaction. However, it may reinforce the client's dismissive and disrespectful behavior by complying with their demands without addressing the underlying communication issue.

D. It encourages the client to reflect on their feelings and provides an opportunity for open communication about any issues or concerns they may have. However, it may not be the most effective response in the moment as it could potentially escalate the conflict or lead to further defensiveness from the client.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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 nurse on an inpatient mental health unit is caring for a client who has major depressive disorder and malnutrition. Which of the following actions should the nurse take to improve the client's nutritional status?

A nurse has just finished a wound irrigation for a client who requires contact precautions. Which of the following pieces of personal protective equipment (PPE) should the nurse remove first?

A nurse is taking a new client's health history at a clinic. Which question should the nurse begin with to obtain the health history?

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 frequent vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect? (Select all that apply.)

A nurse is assessing a toddler at a well-child visit. At what point in the physical examination should the nurse examine the child's tympanic membrane?