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 wife, 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.

Facilitate a family meeting with the palliative care team.

Notify the healthcare provider of the client's wishes.

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

Answer and Explanation

The Correct Answer is C

Rationale

A. A living will often includes directives regarding life-sustaining treatments, including intubation. If the living will explicitly states a preference against intubation, the nurse should ensure this information is known to the healthcare team. However, a living will does not automatically imply a DNR status unless specifically stated.

B. When a living will is presented, and decisions need to be made regarding life-sustaining treatments like intubation, it is appropriate to facilitate a family meeting. In this meeting, the healthcare team, including palliative care specialists if available, can discuss the client's wishes as outlined in the living will. The goal is to ensure everyone understands the client's preferences and to make informed decisions about the course of treatment.

C. The nurse should notify the attending healthcare provider about the existence of the client's living will and its directives regarding medical interventions such as intubation. The healthcare provider needs to be aware of the client's wishes to guide the decision-making process and ensure appropriate care is provided according to the client's preferences.

D. It is crucial to ensure that the living will, once verified and certified as authentic, is placed in the client's medical record. This document serves as a legal and ethical guide for healthcare decisions, especially during critical situations like an exacerbation requiring intubation.

Nursing Test Bank

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Correct Answer is C

Explanation

A. While bleeding can occur postoperatively from the catheter insertion site, it is more indicative of venous or capillary bleeding rather than arterial obstruction. Arterial obstruction typically presents with signs related to decreased arterial blood flow rather than external bleeding.

B. This finding suggests a difference in peripheral pulses between the two lower extremities. While it could indicate arterial compromise, the question specifically asks about arterial obstruction at the site of the catheterization (right femoral artery).

C. This finding is concerning for arterial obstruction. Coolness, pallor, and blanching of the right foot indicate decreased arterial blood flow to the extremity. Arterial obstruction can lead to reduced perfusion distal to the occlusion site, resulting in these clinical signs.

D. These vital sign changes could indicate systemic complications, such as shock, rather than isolated arterial obstruction at the femoral artery site. While systemic changes can occur secondary to arterial obstruction, they are not specific indicators of obstruction at the femoral artery.

A. Phototherapy B. Administration of lithium C. Consciousness raising D. Cognitive behavioral therapy E. Electroconvulsive therapy F. Animal therapy

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

Explanation

A. Phototherapy involves exposure to specific wavelengths of light to help regulate mood and alleviate symptoms of depression, anxiety, or sleep disorders. It can be particularly beneficial in a hospital setting where natural light exposure may be limited, potentially aiding in mood stabilization and improving sleep patterns.
B. Lithium is a mood stabilizer commonly used to treat bipolar disorder. While the client's symptoms and presentation do not immediately suggest bipolar disorder, lithium could be considered if there are indications of mood instability or severe emotional dysregulation that are not adequately controlled by other medications.
C. Consciousness raising refers to increasing awareness and understanding of one's thoughts, emotions, and behaviors. In the context of therapy, it can help the client process traumatic experiences, gain insight into their reactions, and develop coping strategies. This approach can be integrated into various forms of psychotherapy.
D. CBT is a structured form of psychotherapy that focuses on identifying and modifying dysfunctional thought patterns and behaviors. It has been shown to be effective in treating anxiety, depression, PTSD, and other trauma-related disorders by helping individuals challenge negative thoughts and develop healthier coping mechanisms.
E. ECT involves passing electrical currents through the brain to intentionally trigger a brief seizure. It is primarily used for severe depression or other mental illnesses that have not responded to other treatments. Given the client's presentation and the availability of less invasive treatments, ECT would generally not be considered unless her condition worsens significantly and other therapies are ineffective or contraindicated.
F. Animal therapy involves interacting with animals, such as therapy dogs or horses, to improve mood, reduce stress, and provide emotional support. This type of therapy can be beneficial for individuals experiencing trauma or emotional distress, offering comfort and companionship.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a 3-year-old client who is two hours postoperative from a cardiac catheterization via the right femoral artery. Which assessment finding is an indication of arterial obstruction?

Correct Answer is C

Explanation

Exhibits Which other treatment(s) might be helpful for this client? Select all that apply.

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

Explanation

While preparing to administer a scheduled IV medication, the client tells the nurse that the IV site hurts and refuses to allow the nurse to administer a flush to assess the site. Which intervention should the nurse implement?

Exhibits The nurse notifies the healthcare provider of the client's status. The healthcare provider comes to the bedside to evaluate the client. Which should the nurse do? Select all that apply.

Exhibits Click to specify which client statement or behaviors is most likely associated with each of the listed defense mechanisms. Some statements or behaviors may be consistent with more than one mechanism. Each column must have at least one response selected.

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 assesses the client after the dose of albuterol and documents the findings in the chart. Exhibits Which action(s) should the nurse plan for the rest of the shift? Select all that apply.

A client with a history of inflammatory bowel disease develops severe ulcerative colitis and is admitted to the intensive care unit after surgery for a fistula repair. Which intervention is most important for the nurse to include in the plan of care?

When conducting diet teaching for a client who was diagnosed with hypertension, which food(s) should the nurse encourage the client to eat? Select all that apply.