A nurse is caring for an older adult client who has a terminal illness and is ventilator dependent. The client is alert and oriented and he wants to discontinue use of the ventilator. The nurse should be aware that continued treatment against the client’s wishes is a violation of which of the following ethical principles?

Justice

Veracity

Fidelity

Autonomy

Answer and Explanation

The Correct Answer is D

Choice A reason: Justice. This answer is incorrect because justice is the ethical principle that ensures fair and equal treatment for all clients, regardless of their personal or social characteristics. Justice does not apply to this situation, as the client is not being discriminated against or denied any resources.

Choice B reason: Veracity. This answer is incorrect because veracity is the ethical principle that requires honesty and truthfulness from the provider and the nurse in providing information and education to the client. Veracity does not apply to this situation, as the client is not being deceived or misled about their condition or treatment options.

Choice C reason: Fidelity. This answer is incorrect because fidelity is the ethical principle that obligates the provider and the nurse to be faithful and loyal to the client and to honor their commitments and promises. Fidelity does not apply to this situation, as the client is not being abandoned or betrayed by the provider or the nurse.

Choice D reason: Autonomy. This answer is correct because autonomy is the ethical principle that respects the client's right to make their own decisions about their health care, even if they are different from the provider's or the nurse's recommendations. Autonomy applies to this situation, as the client is expressing their preference to discontinue the ventilator, which is a life sustaining treatment.

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Correct Answer is D

Explanation

Choice A reason: Blood glucose levels are not a necessary laboratory test for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Blood glucose levels measure the amount of sugar in the blood and are used to diagnose and monitor diabetes. Rifampin and pyrazinamide do not affect blood glucose levels directly, but they may interact with some medications used to treat diabetes, such as sulfonylureas or metformin. The nurse should advise the client to monitor their blood glucose levels regularly and report any changes to the provider.

Choice B reason: Thyroid function studies are not a required laboratory test for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Thyroid function studies measure the levels of thyroid hormones and thyroid stimulating hormone in the blood and are used to diagnose and monitor thyroid disorders. Rifampin and pyrazinamide do not affect thyroid function directly, but they may interact with some medications used to treat thyroid disorders, such as levothyroxine or propylthiouracil. The nurse should advise the client to take their thyroid medication at least 4 hours before or after rifampin and pyrazinamide and report any symptoms of thyroid imbalance to the provider.

Choice C reason: Gallbladder studies are not a relevant laboratory test for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Gallbladder studies include ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) scans of the gallbladder and are used to diagnose and monitor gallstones or gallbladder inflammation. Rifampin and pyrazinamide do not affect the gallbladder directly, but they may cause side effects such as nausea, vomiting, or abdominal pain, which can mimic gallbladder problems. The nurse should assess the client for signs of hepatotoxicity, such as jaundice, dark urine, or clay colored stools, and report any findings to the provider.

Choice D reason: Liver function tests are a vital laboratory test for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Liver function tests measure the levels of enzymes, proteins, and bilirubin in the blood and are used to diagnose and monitor liver damage or disease. Rifampin and pyrazinamide are both hepatotoxic drugs, which means they can cause liver injury or failure. The nurse should instruct the client to have liver function tests done before starting the medication regimen and periodically during the treatment. The nurse should also educate the client about the signs and symptoms of hepatotoxicity, such as fatigue, loss of appetite, nausea, vomiting, or yellowing of the skin or eyes, and advise them to stop taking the medication and seek medical attention if they occur.

A. Impaired sense of humor B. Poor judgment C. Intellectual impairment D. Loss of depth perception

Correct Answer is C

Explanation

Choice A reason: Impaired sense of humor is not a common finding for a client who had a stroke involving the left cerebral hemisphere. Impaired sense of humor is more likely to occur after a stroke involving the right cerebral hemisphere, which is responsible for processing humor, irony, and sarcasm.

Choice B reason: Poor judgment is not a typical finding for a client who had a stroke involving the left cerebral hemisphere. Poor judgment is more likely to occur after a stroke involving the frontal lobe, which is involved in executive functions, such as planning, reasoning, and decision making.

Choice C reason: Intellectual impairment is a possible finding for a client who had a stroke involving the left cerebral hemisphere. The left cerebral hemisphere is dominant for language and analytical thinking in most people. A stroke affecting this hemisphere can impair the ability to speak, read, write, calculate, and comprehend information.

Choice D reason: Loss of depth perception is not a frequent finding for a client who had a stroke involving the left cerebral hemisphere. Loss of depth perception is more likely to occur after a stroke involving the occipital lobe, which is involved in visual processing, or the parietal lobe, which is involved in spatial awareness.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Which of the following laboratory tests should the nurse instruct the client will be required while on this medication regimen?

Correct Answer is D

Explanation

A nurse is caring for a client who had a stroke involving the left cerebral hemisphere. The nurse should monitor for which of the following findings?

Correct Answer is C

Explanation

A nurse is assessing a client who has asthma. Which of the following areas should the nurse evaluate as the most reliable indicator of central cyanosis?

A nurse is caring for a client who has aphasia following a stroke. A family member asks the nurse how she should communicate with the client. Which of the following responses by the nurse is appropriate?

A nurse in a provider’s office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching?

A nurse is caring for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Which of the following actions should the nurse take?

A nurse is admitting a client who has tuberculosis and a productive cough. Which of the following types of isolation precautions should the nurse initiate for the client?

A nurse in a long-term care facility is caring for an older adult client who had a stroke 4 weeks ago and who is unable to move independently. The nurse should monitor for which of the following complications of immobility?