A nurse is setting goals for a patient who has Stage 4 Breast cancer, is in hospice care, and is at the end of life.
Which of the following are realistic goals?
The patient will increase attendance at community social activities.
The patient will receive medication to minimize episodes of breakthrough pain.
The patient will experience a weight gain of one to two pounds per week.
The patient will verbalize an understanding of the mode of disease transmission.
The Correct Answer is B
Choice A rationale
Increasing attendance at community social activities may not be a realistic goal for a patient in hospice care with Stage 4 breast cancer. The patient’s physical condition and energy levels may limit their ability to participate in such activities.
Choice B rationale
Receiving medication to minimize episodes of breakthrough pain is a realistic and important goal for a patient in hospice care. Effective pain management is a key aspect of end-of-life care.
Choice C rationale
Experiencing a weight gain of one to two pounds per week may not be a realistic goal for a patient in hospice care with Stage 4 breast cancer. Patients at this stage of illness often experience weight loss, not gain.
Choice D rationale
Verbalizing an understanding of the mode of disease transmission may not be a relevant goal for a patient in hospice care with Stage 4 breast cancer. The focus of care at this stage is typically on comfort and quality of life, rather than disease education.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Academic pressure is a psychological stressor, not a physiological one. It involves mental or emotional strain or tension resulting from adverse or demanding circumstances, in this case, related to academic performance.
Choice B rationale
A burn injury is an example of a physiological stressor. Physiological stressors are related to physical or biological factors that strain the body’s resources. A burn injury places physical stress on the body as it tries to heal and recover.
Choice C rationale
Financial difficulties are a type of environmental stressor, not a physiological one. They involve external factors in a person’s environment that cause stress, such as financial problems or jobrelated stress.
Choice D rationale
A change in marital status is a type of psychosocial stressor, not a physiological one. It involves both psychological factors (such as emotions and behavior) and social factors (such as relationships and social interactions).
Correct Answer is A
Explanation
Choice A rationale
Before repositioning a patient, the nurse should first elevate the height of the patient’s bed. This allows the nurse to work at a comfortable height and reduces the risk of injury.
Choice B rationale
While tightening the abdominal muscles can help with lifting and moving, it is not the first action the nurse should take when preparing to reposition a patient.
Choice C rationale
Positioning the feet in line with the shoulders can provide a stable base of support when moving or lifting. However, this is not the first action the nurse should take when preparing to reposition a patient.
Choice D rationale
Pivoting the feet in the direction of the move can help with turning and moving. However, this is not the first action the nurse should take when preparing to reposition a patient.
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