A nurse is caring for a client whose family just learned that he has terminal pancreatic cancer. The family requests the diagnosis be withheld from the client. Which of the following actions should the nurse take first?

Assist the client to make autonomous decisions about his treatment options.

Reflect on her own opinion about withholding the diagnosis from him.

Inform the family that he has a legal right to be informed of his diagnosis.

Determine the family's reasons for not telling him about his diagnosis.

Answer and Explanation

The Correct Answer is D

A. Assist the client to make autonomous decisions about his treatment options. Assisting the client to make autonomous decisions is important, but it cannot be done effectively until the client is aware of his diagnosis. This action would follow once the client is informed.
B. Reflect on her own opinion about withholding the diagnosis from him. Reflecting on her own opinion can help the nurse understand her biases but does not directly address the family's request or the client's immediate needs.
C. Inform the family that he has a legal right to be informed of his diagnosis. Informing the family about the client's legal right is essential, but first, the nurse should understand the family's perspective and concerns.
D. Determine the family's reasons for not telling him about his diagnosis. This is correct. Understanding the family's reasons provides context and helps the nurse address their concerns appropriately while advocating for the client’s right to know his diagnosis.

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Correct Answer is B

Explanation

A. Provide an analgesic for pain. Administering medication is important but should be done after assessing the pain.
B. Obtain a self-report from the client. The client's self-report is the most reliable indicator of pain and should be obtained first.
C. Observe the client's behaviors. Observing behaviors is helpful but should follow the self-report to validate the client's experience.
D. Develop a behavioral pain score. This can be useful for non-verbal clients, but the self-report is the primary method of assessment for verbal clients.

A. Keep the collection bag below the level of the bladder. B. Irrigate the catheter routinely with sterile water every other day. C. Use an antiseptic to cleanse the periurethral area twice each day. D. Disconnect the catheter from the drainage tubing to collect urine specimens.

Correct Answer is A

Explanation

A. Keep the collection bag below the level of the bladder. This prevents backflow of urine, which can introduce bacteria into the bladder and cause infection.
B. Irrigate the catheter routinely with sterile water every other day. Routine irrigation is not recommended as it can introduce pathogens and increase the risk of infection.
C. Use an antiseptic to cleanse the periurethral area twice each day. Cleansing with soap and water is recommended; frequent antiseptic use can irritate the skin and is not necessary.
D. Disconnect the catheter from the drainage tubing to collect urine specimens. Disconnecting the catheter can introduce bacteria and increase the risk of infection. Specimens should be collected using a sterile technique without disconnecting the system.

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A nurse is caring for a client whose family just learned that he has terminal pancreatic cancer. The family requests the diagnosis be withheld from the client. Which of the following actions should the nurse take first?

Nursing Test Bank

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