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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Eat a light snack before bedtime: A light snack can prevent hunger from interfering with sleep and promote relaxation. Complex carbohydrates or small amounts of protein may help induce sleep without causing gastrointestinal discomfort.
B. Perform exercises prior to bedtime: Vigorous physical activity before bed can stimulate the body and make it harder to fall asleep. Exercise is beneficial when done earlier in the day, ideally several hours before bedtime.
C. Stay in bed at least 1 hr if unable to fall asleep: Staying in bed while unable to sleep can create negative associations with the bed and worsen insomnia. It's more effective to get up, engage in a quiet activity, and return to bed once sleepy.
D. Take a 1-hr nap during the day: Long daytime naps can reduce sleep pressure at night and interfere with falling or staying asleep. If needed, naps should be limited to 20–30 minutes and taken early in the day.
Correct Answer is C,D,A,B
Explanation
Rationale:
A. Close all nearby windows and doors: Containment helps prevent the spread of smoke and flames. Closing doors and windows minimizes oxygen supply to the fire and keeps it from moving into other areas.
B. Use the unit's fire extinguisher to attempt to put out the fire: The final step is to extinguish the fire, but only if it is safe to do so. The nurse should not attempt this before ensuring safety, alerting others, and containing the fire.
C. Transport the client to another area of the nursing unit: The first priority in a fire situation is rescue, removing anyone in immediate danger, especially vulnerable clients who cannot evacuate themselves.
D. Activate the facility's fire alarm system: Once the client is safe, the next step is to alarm the system to alert others in the facility and begin emergency response protocols.
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