A nurse is planning care for a client who has terminal cancer and is nearing the end of life. Which the following interventions should the nurse include?
Remind the client to eat scheduled meals daily.
Place the client in a supine position.
Offer the client a blanket to keep warm.
Speak in a loud tone when addressing the client.
The Correct Answer is C
A. Remind the client to eat scheduled meals daily: Clients nearing the end of life often have a decreased appetite and may be unable or unwilling to eat. Forcing meals can cause discomfort and is not a priority at this stage.
B. Place the client in a supine position: Lying flat can increase the risk of aspiration and respiratory discomfort. Positioning the client for comfort, often semi-Fowler’s or side-lying, is preferred.
C. Offer the client a blanket to keep warm: Clients near the end of life may experience chills or cool extremities due to decreased circulation. Providing a blanket helps maintain comfort and dignity, which is a primary goal of end-of-life care.
D. Speak in a loud tone when addressing the client: Speaking loudly is unnecessary unless the client has hearing impairment. Communication should remain calm, gentle, and respectful to provide reassurance and maintain comfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. The child believes the person will return: Preschoolers view death as temporary and reversible due to their developmental stage and limited understanding of permanence. Magical thinking often leads them to expect the deceased person to come back.
B. The child focuses on his own mortality: This is more typical of older school-age children or adolescents, who have a more developed understanding of death’s permanence and may begin to consider their own vulnerability.
C. The child refuses to talk about the death: Avoidance can occur at any age, but it is not the primary expected response in preschoolers. At this stage, they may ask repetitive questions or make statements that suggest misunderstanding, rather than complete refusal to talk.
D. The child expresses curiosity about the death process: Curiosity about death’s physical aspects is more common in school-age children, who have greater cognitive ability to think concretely about biological processes.
Correct Answer is C
Explanation
A. Apply lidocaine gel around the incision: Topical lidocaine is generally used for localized superficial pain, not for deep postoperative pain following major joint surgery. Its effectiveness for a knee arthroplasty incision is limited.
B. Attach a transcutaneous electrical nerve stimulation unit around the incision: TENS units can help with some types of pain but are more effective for chronic musculoskeletal pain rather than acute postoperative pain.
C. Place a cold pack over the incision: Cold therapy reduces inflammation, swelling, and pain in the immediate postoperative period. It is a safe and effective nonpharmacological intervention for mild to moderate pain following knee arthroplasty.
D. Assist the client for a walk in the hallway: Early ambulation is important for preventing complications and promoting recovery, but it may initially increase pain when the client is only 4 hours post-surgery. Cold therapy is more appropriate for immediate pain relief.
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