An adult male was diagnosed with stage IV lung cancer three weeks ago.

His wife approaches the nurse and asks how she will know that her husband's death is imminent because their two adult children want to be there when he dies.

Which is the best response by the nurse?

Gather information regarding how long it will take for the children to arrive.

Explain that the client will start to lose consciousness and the body systems will slow down.

Offer to discuss the client's health status with each of the adult children.

Reassure the spouse that the healthcare provider will notify when to call the children.

Answer and Explanation

The Correct Answer is B

Choice B rationale:

Explaining that the client will start to lose consciousness and the body systems will slow down is the best response. This is a common pattern in the dying process, and it provides the wife with a clear and compassionate explanation of what to expect as her husband's death approaches.

Choice A rationale:

Gathering information regarding how long it will take for the children to arrive is important but does not address the immediate need for information on the dying process.

Choice C rationale:

Offering to discuss the client's health status with each of the adult children is a good approach for involving them in their father's care but does not provide the immediate information the wife is seeking.

Choice D rationale:

Reassuring the spouse that the healthcare provider will notify when to call the children does not offer information about the dying process itself, which is what the wife is interested in understanding.

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Correct Answer is A

Explanation

Choice A rationale:

Instructing the UAP to apply a warm blanket and massage the client's back is the appropriate intervention in response to the client's complaints of feeling dizzy and cold during a fecal impaction removal procedure. These symptoms suggest a vasovagal response, which can be managed by keeping the client warm and providing comfort. This intervention helps increase blood flow and alleviate symptoms.

Choice B rationale:

Inserting a gloved finger into the rectum and massaging the rectal sphincter is not the first-line intervention when a client complains of feeling dizzy and cold during a fecal impaction removal. This invasive procedure should be reserved for cases where other interventions have failed, and it is necessary to complete the impaction removal.

Choice C rationale:

Stopping the procedure and observing for a reduction in symptoms before continuing is a reasonable approach, but it does not address the immediate discomfort and distress the client is experiencing. Providing comfort measures, such as applying a warm blanket and massaging the client's back, should be the initial response.

Choice D rationale:

Encouraging the client to take slow, deep breaths while continuing the procedure may not be effective in addressing the client's symptoms of dizziness and coldness. The client may require immediate comfort measures to stabilize their condition.

A. Check the client’s temperature B. Assess the client’s level of consciousness. C. Ask the client about any history of allergies. D. Obtain a blood sample for culture and sensitivity.

Correct Answer is D

Explanation

Choice A rationale:

Checking the client's temperature is important for assessing the client's condition, but it is not a priority before administering penicillin G IV for meningitis.

Choice B rationale:

Assessing the client's level of consciousness is essential for monitoring neurological status, but it is not the highest priority action before administering penicillin G IV for meningitis.

Choice C rationale:

Asking the client about any history of allergies is important for assessing potential allergic reactions to medications. However, the most critical action before administering penicillin G IV for meningitis is to obtain a blood sample for culture and sensitivity. This action helps identify the causative organism and guides appropriate antibiotic therapy, as meningitis can be life-threatening and requires prompt treatment.

Choice D rationale:

Obtaining a blood sample for culture and sensitivity is the highest priority action before administering penicillin G IV for meningitis. Identifying the specific pathogen responsible for the infection is crucial for selecting the most effective antibiotic therapy and preventing complications.

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An adult male was diagnosed with stage IV lung cancer three weeks ago. His wife approaches the nurse and asks how she will know that her husband's death is imminent because their two adult children want to be there when he dies. Which is the best response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a fecal impaction removal, an older client complains of feeling dizzy and cold. Which intervention should the nurse implement?

Correct Answer is A

Explanation

A nurse is caring for a client who has meningitis caused by Streptococcus pneumoniae. The provider orders penicillin G IV for this client. Before administering the medication, which of the following actions should the nurse take?

Correct Answer is D

Explanation

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A client is admitted to the intensive care unit with diabetes insipidus due to a pituitary gland tumor. Which potential complication should the nurse monitor closely?

An adult male was diagnosed with stage IV lung cancer three weeks ago.

His wife approaches the nurse and asks how she will know that her husband's death is imminent because their two adult children want to be there when he dies.

Which is the best response by the nurse?