A nurse is planning care for a client who has terminal cancer and is nearing the end of life. Which of the following interventions should the nurse include?

Place the client in a supine position.

Remind the client to eat scheduled meals daily.

Speak in a loud tone when addressing the client.

Offer the client a blanket to keep warm.

Answer and Explanation

The Correct Answer is D

Rationale:

A. Place the client in a supine position: The supine position may impair respiratory function and increase discomfort, especially in terminal clients who may experience dyspnea. A semi-Fowler’s or side-lying position is often preferred for comfort and easier breathing.

B. Remind the client to eat scheduled meals daily: For clients nearing end of life, appetite naturally decreases, and forcing meals can cause distress. Care should focus on comfort, allowing the client to eat only if and when they desire rather than adhering to structured meal times.

C. Speak in a loud tone when addressing the client: Loud speech is not appropriate unless the client has documented hearing impairment. A calm, soft tone is more comforting and respectful, especially in the emotionally sensitive context of end-of-life care.

D. Offer the client a blanket to keep warm: Clients nearing the end of life often experience poor circulation and may feel cold. Providing a blanket is a comfort-focused, non-invasive intervention that promotes warmth and dignity during this phase.

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Correct Answer is B

Explanation

Rationale:

A. Use Leopold maneuvers to determine the fetal position: Leopold maneuvers are not appropriate as an immediate response to sudden nausea. The priority is to relieve the symptom, which may be related to positional compression of major blood vessels.

B. Position the client on her side: At 36 weeks gestation, the gravid uterus can compress the inferior vena cava when lying supine, leading to supine hypotensive syndrome. Symptoms like nausea, dizziness, and hypotension can occur. Side-lying positioning relieves the pressure and restores venous return and cardiac output.

C. Administer propranolol IV to the client: Propranolol is not indicated for treating pregnancy-related nausea or hypotension. Using it without a cardiovascular diagnosis would be inappropriate and could worsen hypotensive symptoms.

D. Ask the client to increase her daily calcium intake: While calcium is essential in pregnancy, especially for fetal bone development, increasing calcium intake has no immediate impact on sudden nausea or circulatory symptoms linked to maternal positioning.

A. Set up the sterile field 5 cm (2 in) below waist level. B. Place the cap from the solution sterile side up on a clean surface: C. Open the outermost flap of the sterile kit toward the body. D. Place the sterile dressing within 125 cm (0.5in) of the ledge of the sterile field.

Correct Answer is B

Explanation

Rationale:

A. Set up the sterile field 5 cm (2 in) below waist level: Sterile fields must be at or above waist level to maintain sterility. Anything below the waist is considered contaminated because it is out of the nurse’s visual field and control.

B. Place the cap from the solution sterile side up on a clean surface: The inside of the cap must face up to avoid contamination. Placing it on a clean surface with the sterile side up preserves sterility for recapping the solution if needed.

C. Open the outermost flap of the sterile kit toward the body: The first flap should be opened away from the body to prevent reaching over the sterile field, which increases the risk of contamination.

D. Place the sterile dressing within 1.25 cm (0.5 in) of the ledge of the sterile field: Items must be placed at least 2.5 cm (1 in) from the edge of the sterile field. The outer 1 inch is considered non-sterile and any item placed within this margin is no longer sterile.

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A nurse is planning care for a client who has terminal cancer and is nearing the end of life. Which of the following interventions should the nurse include?

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