An older adult male who is in his early 70's is admitted to the emergency department because of a COPD exacerbation. The client is struggling to breathe and the healthcare team is preparing for endotracheal intubation. The spouse's wile, who is 30 years younger than the client, asks the nurse to stop the procedure and provides the nurse a copy of the client's living will. Which action should the nurse take?

Alert the nursing staff of the client's do not resuscitate status.

Notify the healthcare provider of the client's wishes.

Place a certified copy of the living will in the client's record.

Facilitate a family meeting with the palliative care team.

Answer and Explanation

The Correct Answer is B

A. While the nursing staff should be aware of the DNR status, the immediate concern is the client's expressed wishes regarding treatment.

B. Notifying the healthcare provider is essential so that the medical team can respect the client’s wishes, especially in an acute situation where life-saving measures are being discussed.

C. Placing a certified copy of the living will in the record is important, but it should be done after informing the healthcare provider.

D. Facilitating a family meeting may be helpful, but the priority is to communicate the client's wishes to the medical team immediately.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","E"]

Explanation

A. This statement reflects a misunderstanding of the diagnosis. Acute stress disorder (ASD) does not mean the client is "crazy." ASD is a normal reaction to an abnormal situation, and it is important for the nurse to clarify that mental health diagnoses do not equate to losing control or being "crazy." Follow-up teaching should focus on reducing stigma and providing accurate information about the diagnosis.

B. This statement is generally accurate, as many individuals may experience similar symptoms after a traumatic event. Normalizing the client's feelings can help reduce isolation and encourage engagement in treatment, so no follow-up teaching is needed here.

C. This statement is correct; individuals with ASD are at increased risk for developing post-traumatic stress disorder (PTSD) if their symptoms persist. The nurse can confirm this information and discuss monitoring for ongoing symptoms.

D. This statement is appropriate, as holistic approaches such as meditation can complement traditional treatment for anxiety and stress. The nurse should encourage the use of these techniques and provide resources if necessary.

E. This statement requires follow-up teaching, as it may promote a negative outlook on treatment. While some individuals may need long-term medication, many people can successfully manage their symptoms through therapy and may not require lifelong medication. The nurse should discuss the importance of reevaluation and ongoing assessment of the need for medication.

F. This statement is accurate and encourages proactive engagement in treatment. Cognitive-behavioral therapy and other therapeutic techniques can help the client manage distressing thoughts, so no follow-up teaching is necessary.

A. horrible thoughts and memories about the house collapsing B. keeping her from falling asleep C. She states, "I used to be so happy before all of this happened. Now I can't seem to get out of this funk I am in." D. prefer to be in a quieter area of the unit E. she is currently by the nurses' station and hears talking and alarms constantly

Correct Answer is ["A","B","C","D"]

Explanation

Horrible Thoughts and Memories: The client expresses having "horrible thoughts and memories" about the house collapsing, which indicates the possibility of acute stress reactions or post-traumatic stress disorder (PTSD). This mental health concern needs immediate attention to ensure the client's psychological well-being.

Difficulty Falling Asleep: The client's difficulty falling asleep due to intrusive thoughts is concerning. Sleep is crucial for recovery, and ongoing sleep disturbances can exacerbate mental health issues and impede healing. Addressing her need for sleep medications or alternative interventions should be prioritized.

Emotional State: The client states, "I used to be so happy before all of this happened. Now I can't seem to get out of this funk I am in," indicating possible depression or an adjustment disorder. This emotional state warrants evaluation and support from a mental health professional.

Request for Quieter Area: The client requests a quieter area of the unit due to the noise from the nurses' station. While this may not be as urgent as the mental health concerns, accommodating her request can significantly improve her comfort and ability to rest

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits Which client statement(s) require(s) follow up teaching by the nurse? Select all that apply.

Correct Answer is ["A","E"]

Explanation

Correct Answer is ["A","B","C","D"]

Explanation

A client tells the nurse about beginning an exercise program a month ago to lose weight and improve sleep. The client states, "It still takes at least two hours to fall asleep at night." Which action should the nurse implement?

A client taking temazepam informs the nurse of plans to quit taking the medication due to feelings of "hungover" the next day. Which action should the nurse implement?

When developing a teaching plan for a client with newly diagnosed type 1 diabetes mellitus, the nurse should explain that an increased thirst is an early sign of diabetic ketoacidosis (DKA). Which action should the nurse instruct the client to implement if this sign of DKA occurs?

A newly hired unlicensed assistive personnel (UAP) is assigned to a home healthcare team along with two experienced UAPs. Which intervention should the home health nurse implement to ensure adequate care for all clients?

The nurse is performing a functional assessment on an older client who lost five pounds (2.27 Kg) of weight since the last visit 12 weeks ago, and who reports a decrease in energy and appetite. Which action should the nurse include during the assessment?

The healthcare provider prescribes the antibiotic cefdinir 300 mg PO every 12 hours for a client with a postoperative wound infection. Which foods should the nurse encourage this client to eat?

An adult client was diagnosed with stage IV lung cancer three weeks ago. The client's spouse approaches the nurse and asks how to know that the spouse's death is imminent because their two adult children want to be there when the client dies. Which is the best response by the nurse?

A 4-month-old infant is brought to the clinic by a parent with symptoms of a runny nose, a slight fever and cough for the last two days. Which finding should alert the nurse that the child is in acute respiratory distress?