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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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

A. This is not be the most appropriate question to start with as it does not directly address the client's health concerns or reasons for seeking care.
B. This question It allows the client to identify their primary reason for seeking care and provides the nurse with essential information to guide the health history assessment. Starting with the client's major health concern helps to prioritize the assessment and address the client's immediate needs.
C. This question is broad and open-ended, which may lead to a vague or general response. Starting with a more focused question about the client's specific health concerns can provide more relevant information.
D. This is not appropriate for initiating the health history assessment. It may come across as confrontational or directive, which is not conducive to establishing rapport or gathering information about the client's health concerns.

A. "Do you have family who can help you when you get home?" B. "Has anything stressful happened recently?" C. "You really do need to stop smoking: your kids need you." D. How would you describe your feelings about the procedure?

Correct Answer is ["A","B","D"]

Explanation

A. This statement is non-judgmental. It focuses on assessing the patient's support system and potential resources for assistance after surgery without implying any judgment about the patient's circumstances.
B. This statement is non-judgmental. It aims to assess the patient's current stressors or life events that may impact her emotional well-being and coping abilities without implying any judgment.
C. This statement is judgmental. It conveys a directive and implies criticism or disapproval of the patient's smoking habit. It may also imply blame for the patient's health condition, which can be counterproductive and may cause the patient to feel defensive or discouraged.
D. This statement is non-judgmental. It encourages the patient to express her thoughts and emotions about the upcoming procedure without imposing any judgment or criticism.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

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.)

Correct Answer is ["A","B","D"]

Explanation

A nurse is assessing a client who has malnutrition. Which of the following findings should the nurse expect?

The nurse is completing an assessment of a client who was sexually assaulted. What assessment should the nurse conduct last?

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?

A nurse in an emergency department often sees victims of intimate partner violence. Which of the following actions should the nurse take when caring for victims of violence?

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 is developing the plan of care for a client who does not speak the same language as the nurse. Which of the following interventions should the nurse include?

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?

A nurse is teaching a client who is lactose intolerant. Which of the following statements regarding lactose intolerance should the nurse include in the teaching plan?