A nurse is planning care for a client who is to begin receiving hospice care. Which of the following interventions should the nurse include in the plan?
Insert a peripheral catheter to deliver intravenous fluids.
Obtain a prescription for parenteral nutrition.
Offer the client massage therapy:
Initiate a referral for physical therapy.
The Correct Answer is C
A. Insert a peripheral catheter to deliver intravenous fluids: Routine IV fluid administration is not a standard intervention in hospice care unless specifically indicated for symptom management. The focus in hospice is on comfort and quality of life rather than aggressive interventions, so placing an IV line for routine hydration is generally avoided.
B. Obtain a prescription for parenteral nutrition: Parenteral nutrition is typically not initiated in hospice care because it does not improve comfort or quality of life and may cause discomfort or complications. Hospice care prioritizes symptom management, pain relief, and emotional support rather than aggressive nutritional interventions.
C. Offer the client massage therapy: Massage therapy is an appropriate intervention in hospice care as it promotes comfort, reduces pain, alleviates anxiety, and supports emotional well-being. Complementary therapies like massage are aligned with hospice goals of enhancing quality of life and providing holistic care for clients nearing the end of life.
D. Initiate a referral for physical therapy: Physical therapy in hospice is generally limited and focused only on maintaining comfort and safe mobility rather than improving function or strength. While referrals can be made if needed, massage therapy is a more direct intervention to address comfort and symptom management at this stage of care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. A client who has an open fracture of the tibia and reports pain as 5 on a scale of 0 to 10: While the open fracture requires prompt attention to prevent infection and manage pain, it is not immediately life-threatening. This client can be treated after more critical, unstable patients.
B. A client who has suspected appendicitis and reports severe lower right abdominal pain: Suspected appendicitis is urgent but not immediately life-threatening unless complications like rupture occur. This client’s condition is lower priority compared to airway or breathing compromise.
C. A client who has a penetrating head wound and fixed pupils: Fixed pupils suggest a non-survivable brain injury. In a mass casualty or disaster triage situation, this client is considered expectant and would not receive immediate intervention.
D. A client who has flail chest and a respiratory rate of 32/min: Flail chest with increased respiratory rate indicates respiratory compromise and potential hypoxia, which is life-threatening. Airway and breathing take priority, so this client requires immediate intervention to stabilize breathing and prevent rapid deterioration.
Correct Answer is B
Explanation
A. "You will have a urine test for the herpes simplex virus": Routine prenatal screening does not include urine testing for herpes simplex virus. Testing for HSV is typically done based on symptoms or history, not as a standard prenatal test.
B. "You will have a rectovaginal culture to test for group B streptococcus.": Group B streptococcus screening is a standard prenatal test performed between 35 and 37 weeks of gestation using a rectovaginal swab. Identifying colonization allows for intrapartum antibiotic prophylaxis to prevent neonatal infection.
C. "You will have a urine test to check for toxoplasmosis": Routine urine testing does not screen for toxoplasmosis. Testing for toxoplasmosis is usually done via blood tests in women at high risk, not standard urine tests.
D. "You will undergo amniotic fluid sampling to test for cytomegalovirus.": Amniocentesis for cytomegalovirus is not part of routine prenatal care and is typically only performed if there is a known risk or suspected fetal infection. Standard prenatal tests focus on more common conditions.
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