A nurse is caring for a client who has severe head injuries and is declared brain dead. The transplant coordinator has spoken with the client's family about organ donation. The client's spouse states she is confused and does not know what she should do. Which of the following responses by the nurse is appropriate?

"Most religions support organ donation, so don't let that stand in the way."

"There is such a shortage of organs in this country, so I think you should go ahead and consent to donate your spouse's organs."

"Don't you think you will feel a little better about the situation if you donate your spouse's organs?"

"What do you think your spouse would have wanted?"

Answer and Explanation

The Correct Answer is D

A. This response may make the spouse feel pressured by implying that religion should not be a concern, which may not be respectful of the spouse's beliefs.

B. This statement is coercive, focusing on the shortage of organs rather than on the spouse's feelings and the wishes of the deceased.

C. Suggesting that donating organs will make the spouse feel better can be seen as manipulative and may not truly address the spouse's confusion or emotions.

D. Asking what the spouse thinks the deceased would have wanted is appropriate, as it centers on the values and wishes of the deceased, which can guide the spouse in making an informed decision.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A. Thrombolytic therapy is the priority in managing an ST-elevated myocardial infarction (STEMI) when percutaneous coronary intervention (PCI) is not available. It helps dissolve the blood clot causing the blockage in the coronary artery.

B. Maintaining oxygen saturation is important, but the priority is to restore coronary blood flow.

C. The focus should be on stabilizing the heart rhythm, not specifically maintaining a high heart rate.

D. Diuretics are important in managing heart failure but are not the priority in acute STEMI management.

A. Call the provider for a stat DNR order. B. Start CPR and call the emergency response team. C. Seek immediate help from the risk manager. D. Respect the family's wishes and do nothing.

Correct Answer is B

Explanation

A. There is no time to wait for a DNR order in an emergency; immediate action is needed.

B. Without a written DNR order, the nurse is legally and ethically obligated to initiate CPR and call the emergency response team to attempt to save the client’s life.

C. Contacting the risk manager is not an immediate action that would benefit the patient in this emergency situation.

D. The family’s wishes cannot be respected in this scenario without a formal DNR order in place; thus, the nurse must perform CPR.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse enters a client's room and finds the client pulseless. The family has requested a do-not-resuscitate (DNR) order from the provider, but he has not written the order yet. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level?

The nurse is caring for a patient with a left subclavian central venous catheter (CVC) and a left radial arterial line. Which assessment finding by the nurse requires immediate action?

The main purpose of critical care certification is to

The nurse is educating a patient's family member about a central venous pressure catheter (CVP). Which statement by the family member best indicates understanding of the purpose of the CVP?

A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apneic. Which of the following actions is the nurse's priority?

While close family members are visiting, a patient has a respiratory arrest, and resuscitation is started. Which action by the nurse is best?

The patient is admitted with a suspected acute myocardial infarction (AMI). In assessing the 12-lead electrocardiogram (ECG) changes, which findings would indicate to the nurse that the patient is in the process of a myocardial infarction (MI)?