A physician orders a nasogastric (NG) tube for a young adult diagnosed with end-stage ovarian cancer and suspected of having a bowel obstruction. The newly hired nurse explains the procedure and rationale for NG tube placement. The client refuses to consent to NG tube placement, stating, "I would rather keep vomiting than have the tube in my nose." Following the American Nurses Association Code of Ethics for Nurses, what should the nurse do next?

Delegate the NG tube placement to a more experienced nurse.

Make a referral to Social Services related to body image disturbance.

Seek the client's spouse for consent to the procedure.

Document the client's wishes and notify the physician.

Answer and Explanation

The Correct Answer is D

Choice A reason : Delegating the NG tube placement to a more experienced nurse does not address the client's refusal of the procedure. The nurse must respect the client's autonomy and decision-making rights.

Choice B reason : While a referral to Social Services may be appropriate in some cases, it does not directly address the immediate concern of the client's refusal of the NG tube placement.

Choice C reason : Seeking consent from the client's spouse is not appropriate as the client is competent and has the right to refuse treatment. The client's autonomy must be respected.

Choice D reason : Documenting the client's wishes and notifying the physician is the correct action. The nurse must respect the client's right to refuse treatment and communicate this decision to the physician so that alternative management can be considered.

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Correct Answer is D

Explanation

Choice A reason : Tarry stools, also known as melena, can be a sign of gastrointestinal bleeding, which may occur in cirrhosis due to the development of esophageal varices. However, it is not a direct symptom of cirrhosis itself but rather a complication that can arise from the condition¹.

Choice B reason : Blood in the urine is not a typical finding associated with cirrhosis. While cirrhosis can lead to problems with kidney function, hematuria is not a direct symptom of liver disease and may indicate other urological conditions¹.

Choice C reason : Moist skin is not commonly associated with cirrhosis. Patients with cirrhosis often experience skin changes, but these typically include jaundice, bruising, and spider angiomas, not increased moisture of the skin¹.

Choice D reason : Spider angiomas are a common finding in cirrhosis. They are small, spider-like capillaries visible under the skin and are caused by the increased estrogen levels that occur due to the liver's inability to metabolize hormones properly. They are most often found on the face, neck, upper chest, and arms¹².

A. White beans B. Cantaloupe C. Cabbage D. Green beans

Correct Answer is C

Explanation

Choice A reason : White beans do not have a significant interaction with warfarin. They are a good source of protein and fiber and can be included in the diet unless otherwise contraindicated.

Choice B reason : Cantaloupe does not interact significantly with warfarin and can be consumed as part of a balanced diet. It is rich in vitamins and hydration.

Choice C reason : Cabbage contains vitamin K, which can interfere with the effectiveness of warfarin. Vitamin K is essential for blood clotting, and warfarin works by inhibiting the effects of this vitamin. Therefore, patients on warfarin are advised to maintain a consistent intake of vitamin K and avoid sudden increases in foods high in this nutrient.

Choice D reason : Green beans have a moderate amount of vitamin K but are not typically restricted for patients on warfarin. It is important for patients to maintain a consistent intake of vitamin K; thus, they should not make significant changes to their diet without consulting their healthcare provider.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client?

Correct Answer is D

Explanation

A nurse in a clinic is caring for a client who has recently begun taking warfarin. The nurse is reviewing potential drug and food interaction risks and should instruct the client to avoid which of the following?

Correct Answer is C

Explanation

A nurse is teaching a client about the seven warning signs of cancer. Which of the following signs should the nurse include as manifestations of cancer? (Select all that apply.)

A nurse is caring for an older adult client who has a WBC count of 2,000/mm^3^ after three rounds of chemotherapy. Which of the following actions should the nurse take?

A nurse is providing teaching for a client who has a new diagnosis of angina pectoris. Which of the following information should the nurse include about anginal pain?

A nurse is planning care for a client who had a traumatic brain injury and is emerging restlessly from a coma. Which of the following interventions should the nurse include in the plan?

A nurse is caring for a client who is unable to make any decisions for themselves and needs constant reassurance. The nurse should identify that these are manifestations of which of the following personality disorders?

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 assessing a client who has an obstruction of the common bile duct resulting from chronic cholecystitis. Which of the following findings should the nurse expect?