After an unsuccessful resuscitation attempt, the nurse calls the family of the deceased.
The family wish to see the body before it is taken to the funeral home.
Which intervention(s) should the nurse take to prepare the body before the family enters the room? (Select all that apply.).
Take out dentures and place in a labeled cup.
Gently close the eyes.
Place a small pillow under the head.
Apply a body shroud.
Remove resuscitation equipment from the room.
Correct Answer : B,C,D,E
The correct answers are Choices B, C, D, and E.
Choice A rationale: Dentures should remain in place to preserve facial structure and dignity. Removing them may cause facial collapse, distressing the family during viewing and violating postmortem presentation standards.
Choice B rationale: Gently closing the eyes prevents ocular drying and maintains a peaceful appearance. If eyelids resist closure, moistened cotton balls may be used temporarily to assist with natural positioning.
Choice C rationale: Placing a small pillow under the head elevates it, preventing blood pooling and facial discoloration due to livor mortis. It supports a natural, respectful presentation for family viewing.
Choice D rationale: Applying a body shroud ensures hygienic containment and visual dignity. It’s standard practice before transport and aligns with institutional protocols for respectful postmortem care.
Choice E rationale: Removing resuscitation equipment reduces trauma triggers for the family, restores environmental calm, and supports emotional closure. It also complies with facility standards for postmortem room preparation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Increasing the supplemental oxygen to 15 L/min via nasal cannula may seem like a logical step given the client’s low oxygen saturation. However, it’s important to note that oxygen therapy should be titrated carefully. Too much oxygen can lead to oxygen toxicity, which can cause cellular damage and worsen the client’s condition. Therefore, this is not the priority action.
Choice B rationale:
Notifying the health care provider of the client’s condition is the priority action. The client’s oxygen saturation is 88% on room air, which is below the normal range of 95% to 100%. This indicates that the client is not getting enough oxygen, which can lead to hypoxia and other serious complications. The health care provider needs to be informed immediately so that appropriate interventions can be initiated.
Choice C rationale:
Administering ibuprofen as ordered for fever is important, but it’s not the priority in this situation. While fever can indicate an infection, which could be contributing to the client’s low oxygen saturation, addressing the immediate issue of hypoxia is more critical.
Choice D rationale:
Obtaining a sputum culture from the client could provide valuable information about the type of bacteria causing the pneumonia and guide antibiotic therapy. However, this is not an immediate priority compared to addressing the client’s low oxygen saturation. In summary, while all these actions are important in caring for a client with pneumonia, the nurse must prioritize interventions based on their urgency and potential impact on the client’s health status. In this case, notifying the health care provider of the client’s condition is the most critical action.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
Explanation
Choice A rationale:
A pH level of 7.35 to 7.45 and HCO3- level of 22 to 26 mEq/L indicate a resolution of ketoacidosis. The normal pH range for the body is 7.35 to 7.45, and a return to this range indicates that the body’s acid-base balance has been restored. The bicarbonate (HCO3-) level is a measure of the metabolic component of the body’s acid-base balance, and the normal range is 22 to 26 mEq/L. A return to this range indicates that the metabolic acidosis caused by the ketoacidosis has been resolved.
Choice B rationale:
A pH level of 7.25 to 7.35 and HCO3- level of 18 to 22 mEq/L would indicate that the client is still in a state of mild acidosis, as the pH is below the normal range and the bicarbonate level is also slightly low, indicating a metabolic acidosis.
Choice C rationale:
A pH level of 7.15 to 7.25 and HCO3- level of 14 to 18 mEq/L would indicate a moderate acidosis. Both the pH and bicarbonate levels are significantly below their normal ranges, indicating a significant disruption in the body’s acid-base balance.
Choice D rationale:
A pH level of 7.05 to 7.15 and HCO3- level of 10 to 14 mEq/L would indicate severe acidosis, which would be life-threatening if not corrected. Both the pH and bicarbonate levels are far below their normal ranges, indicating a severe disruption in the body’s acid-base balance. In conclusion, choice A is correct because it represents values within the normal ranges for both pH and bicarbonate, indicating a resolution of ketoacidosis.
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