A nurse provides care to an older hospitalized client who is newly admitted for advanced liver failure. The client states, "I've told my doctor to let me die if my heart stops beating or if I quit breathing. I do not want to be revived." To best ensure the client's request is honored, which of the following should the nurse do?
Assure the client that their end-of-life wishes are followed right away.
Check the medical record for a DNR order.
Ask the client if they have a healthcare proxy who can speak for them if needed.
Verify a signed copy of the advance directives in the medical record.
The Correct Answer is B
Choice A reason : While it is important to assure the client, the nurse must first verify that there is a formal DNR order in place to legally honor the client's wishes¹².
Choice B reason : Checking for a DNR order in the medical record is the correct action to ensure that the client's wishes regarding resuscitation are documented and will be followed by all healthcare providers¹².
Choice C reason : Asking about a healthcare proxy is important, but it is secondary to confirming that the client's wishes are documented in the medical record through a DNR order or advance directives¹².
Choice D reason : Verifying a signed copy of the advance directives is crucial, but the immediate step is to check for a DNR order, which is specifically related to the client's request not to be resuscitated¹².
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason : While it is important to assure the client, the nurse must first verify that there is a formal DNR order in place to legally honor the client's wishes¹².
Choice B reason : Checking for a DNR order in the medical record is the correct action to ensure that the client's wishes regarding resuscitation are documented and will be followed by all healthcare providers¹².
Choice C reason : Asking about a healthcare proxy is important, but it is secondary to confirming that the client's wishes are documented in the medical record through a DNR order or advance directives¹².
Choice D reason : Verifying a signed copy of the advance directives is crucial, but the immediate step is to check for a DNR order, which is specifically related to the client's request not to be resuscitated¹².
Correct Answer is A
Explanation
Choice A reason : Anginal pain is commonly triggered by physical exertion or emotional stress, which increases the heart's demand for oxygen. When the narrowed coronary arteries cannot supply enough oxygen-rich blood to the heart muscle, angina occurs³⁷.
Choice B reason : While sitting up may help relieve discomfort for some conditions, anginal pain is typically relieved by resting or taking prescribed medication such as nitroglycerin, which helps to widen the blood vessels and improve blood flow to the heart muscle³⁶.
Choice C reason : This statement is incorrect. Anginal pain does not persist with rest and organic nitrates; these are actually the measures taken to alleviate the pain. Resting decreases the heart's demand for oxygen, and nitrates are effective in relieving anginal pain³.
Choice D reason : Typically, anginal pain does not last longer than a few minutes. If chest pain persists for more than 20 minutes, it may indicate a more serious condition, such as a heart attack, and immediate medical attention is required³.
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