A nurse is developing a care plan for Mrs. Thompson who is in the end-of-life stage. After assessing the client, the nurse has identified several potential problems. Which of the following hypotheses should the nurse prioritize when planning care for this client?

The client may benefit from additional laboratory tests to monitor disease progression.

The client may experience pain and discomfort due to the progression of their illness.

The client may need increased physical therapy sessions to maintain mobility.

The client may have elevated blood pressure due to an acute exacerbation of their condition.

Answer and Explanation

The Correct Answer is B

A. Additional laboratory tests: While monitoring is essential, at this stage, the priority is comfort, not disease progression.

B. Pain and discomfort: Mrs. Thompson is nearing the end of life and likely experiencing pain due to her advanced metastatic cancer. Pain management should always be a priority in palliative care.

C. Physical therapy: Physical therapy is not typically a priority in the end-of-life stage where the focus is on comfort rather than mobility.

D. Elevated blood pressure: This is unlikely to be the primary concern at this stage. Blood pressure is usually low, and interventions should be focused on comfort and symptom relief.

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Correct Answer is A

Explanation

A. Level of sedation. Assessing sedation is the priority because excessive sedation could indicate opioid toxicity, which may precede respiratory depression.

B. Pain level. While assessing pain is essential, it is not the priority when evaluating the safety of opioid administration.

C. Pulse oximetry. Monitoring oxygenation is critical but follows the assessment of sedation, which directly relates to the risk of respiratory depression.

D. Blood pressure. Blood pressure monitoring is important but not as immediate a concern as sedation and respiratory function.

A. Asking the client to rate the pain B. Having the client perform range-of-motion of the affected arm C. Monitoring the client's pulse rate D. Inspecting the site for reduced swelling

Correct Answer is A

Explanation

A. Asking the client to rate the pain: Pain rating provides a subjective measure of the intervention’s effectiveness in reducing discomfort.

B. Having the client perform range-of-motion of the affected arm: This assessment is not specific to determining the effectiveness of cold therapy; it is more related to mobility or rehabilitation.

C. Monitoring the client's pulse rate: While pain can affect pulse rate, this is an indirect and nonspecific measure of pain or swelling reduction.

D. Inspecting the site for reduced swelling: Swelling reduction can be an indicator of decreased inflammation, but it does not provide a direct assessment of the client’s pain levels.

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A nurse is developing a care plan for Mrs. Thompson who is in the end-of-life stage. After assessing the client, the nurse has identified several potential problems. Which of the following hypotheses should the nurse prioritize when planning care for this client?

Nursing Test Bank

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