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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Correct Answer is D

Explanation

A. A complete blood cell count (CBC) is important for monitoring but is not an immediate priority during the admission process.

B. This is a conditional order (PRN/as needed). The nurse must first assess the client's bladder (e.g., check for distention, monitor output) and allow time for spontaneous voiding to occur. It's not the first action, but a necessary intervention if a certain condition (inability to void) is met later.

C. Advancing from clear liquids as tolerated can be important for nutrition but does not address immediate postoperative concerns regarding urinary function.

D. Cefazolin is a broad-spectrum antibiotic commonly prescribed for surgical prophylaxis to prevent postoperative infections. The first priority after surgery is infection prevention, since the client is most vulnerable during the immediate postoperative period. Administering the first dose of the antibiotic promptly helps reduce the risk of surgical site infections (SSIs), which can lead to serious complications. The other prescriptions are important but not time-critical compared to initiating antibiotic therapy.

A. Institute droplet precautions, place client in a private room, and keep the door closed. B. Explain to the client to inform others that they may have been potentially exposed in the last 14 days. C. Start an IV infusion for antiviral drug to be administered for positive COVID 19 test results. D. Counsel family members to monitor for illness symptoms for 2 weeks after last contact with patient.

Correct Answer is A

Explanation

A. Instituting droplet precautions is crucial to prevent the spread of COVID-19, especially since the client may be positive and symptomatic. Placing the client in a private room ensures the safety of others in the healthcare facility.

B. While informing others about potential exposure is important, it does not address immediate safety and infection control measures.

C. Starting an IV infusion for antiviral drugs may be appropriate after a positive test but does not take precedence over isolation measures.

D. Counseling family members to monitor for symptoms is helpful but is secondary to ensuring that the client is safely managed in the emergency department.

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Naxlex Comprehensive Predictor Exams

The nurse is admitting a client from the post-anesthesia unit to the postoperative surgical care unit. Which prescription should the nurse implement first?

Correct Answer is D

Explanation

Correct Answer is A

Explanation

The nurse observes that a client with ascites is dyspneic. Which action should the nurse implement first?

Which breakfast selection should the nurse recommend for a 16-year-old with diarrhea?

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.

The nurse is caring for a client who develops signs and symptoms of septic shock following a urinary tract infection one week ago. The healthcare provider prescribes a sepsis protocol to be initiated. Which intervention is most important for the nurse to include in the plan of care?

The nurse is performing tracheostomy care for a client when a code blue is called for another client on the unit who experiences a cardiopulmonary arrest. Which action should the nurse take?

The nurse is preparing a teaching plan for an older adult client diagnosed with osteoporosis. Which expected outcome has the highest priority for this client?

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?