A nurse is caring for a client who is in the late stage of the dying process.
Which of the following interventions should the nurse perform for this client? Select all that apply.
Place client in supine position with foot of bed elevated.
Place ice chips in mouth as needed.
Apply lubricating [LW1] ophthalmic drops PRN.
Administer furosemide 40 mg orally.
Administer albuterol nebulizer treatments 10 mg every 1 to 4 hr PRN.
Swab mouth with moisturizer as needed.
Correct Answer : B,C,F
A. Supine with foot of bed elevated
Can worsen respiratory effort in dying clients.
B. Place ice chips in mouth
Helps soothe dry mouth and maintain comfort.
C. Lubricating eye drops PRN
Maintains moisture and prevents eye irritation when blinking diminishes.
D. Administer furosemide
Not indicated in comfort care/DNR-focus is not on aggressive fluid removal.
E. Albuterol every 1–4 hr
Not typically part of end-of-life comfort care unless specifically needed for comfort.
F. Swab mouth with moisturizer
Prevents dryness, cracking-important for comfort in the dying process.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Adolescent with sickle cell pain (7/10)
Needs prompt treatment, but not as life-threatening as airway obstruction.
B. Toddler with asthma and SpO₂ 95% on 2L O₂
Stable oxygenation; not an immediate emergency.
C. Toddler with otitis media and fever
Infection is concerning but not life-threatening.
D. Child with acute epiglottitis, drooling, no cough
These are classic signs of airway obstruction. Airway management is the priority—this is life-threatening.
Correct Answer is A
Explanation
A. Troponin
Troponin is the most specific and sensitive marker for myocardial injury. Levels rise within 3–6 hours of an MI.
B. C-reactive protein
CRP indicates inflammation and is nonspecific. It is not diagnostic for acute MI.
C. Brain natriuretic peptide (BNP)
BNP is used to evaluate heart failure, not primarily to diagnose MI.
D. Creatinine kinase (CK)
CK is a general marker of muscle injury; CK-MB is more specific for cardiac damage but is less accurate than troponin.
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