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.

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason : Chronic back pain is not a specific symptom of SLE. While individuals with SLE may experience musculoskeletal pain, it is not as characteristic as other symptoms associated with the condition.

Choice B reason : A facial rash, particularly the classic "butterfly rash" that appears across the cheeks and bridge of the nose, is one of the hallmark signs of SLE. This rash is photosensitive and can be triggered or worsened by exposure to sunlight.

Choice C reason : Thickened skin is more commonly associated with systemic sclerosis (scleroderma) than with SLE. In SLE, skin involvement can include rashes and lesions, but not typically generalized skin thickening.

Choice D reason : Nausea is not a direct symptom of SLE, although it can be a side effect of medications used to treat SLE or may occur if the gastrointestinal system is affected by the disease.

A. Assure the client that their end-of-life wishes are followed right away. B. Check the medical record for a DNR order. C. Ask the client if they have a healthcare proxy who can speak for them if needed. D. Verify a signed copy of the advance directives in the medical record.

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.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

Correct Answer is B

Explanation

A nurse is planning care for a client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse plan to take?

A nurse is caring for a client who is experiencing manifestations of alcohol withdrawal. Which of the following medications should the nurse anticipate the provider to prescribe?

A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect?

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A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement?

A nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan of care?

A client diagnosed with major depressive disorder with psychotic features hears voices commanding self-harm. The client refuses to commit to developing a plan for safety. What should be the nurse's priority intervention at this time?