In-home hospice care is arranged for a client with stage 4 lung cancer. While the palliative care nurse is arranging for discharge, the client verbalizes concerns about pain. Which action should the nurse implement?

Recommend asking the healthcare professional for a patient-controlled analgesia (PCA) pump.

Explain the respiratory problems that can occur with morphine use.

Teach family how to evaluate the effectiveness of analgesics.

Provide client with a schedule of around-the-clock prescribed analgesic use.

Answer and Explanation

The Correct Answer is D

A. A PCA pump could be considered, but the immediate action should be ensuring the client understands and follows the prescribed pain management regimen.
B. While explaining potential side effects like respiratory depression is important, this action may increase anxiety about pain management rather than address the client's current concern.
C. Teaching the family how to evaluate the effectiveness of analgesics is important but secondary to ensuring the client is consistently receiving pain relief.
D. Providing the client with a schedule of around-the-clock prescribed analgesic use is crucial in managing pain effectively in hospice care. Consistent pain management, rather than waiting for pain to become severe, is a key principle in palliative care to ensure comfort.

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Correct Answer is B

Explanation

A. While applying a barrier ointment is important for preventing further skin breakdown, it does not address the immediate need to assess the severity of existing damage.
B. Determining the size and depth of skin breakdown is crucial for assessing the severity of the pressure injury and planning appropriate treatment. Accurate assessment helps in selecting the right interventions and monitoring the progression of the wound.
C. Completing a functional assessment of the client's self-care abilities is important for overall care planning but should follow the initial assessment of the skin breakdown to ensure immediate needs are addressed.
D. Establishing a toileting schedule is a preventive measure for future incontinence but does not address the current skin breakdown that needs immediate assessment and treatment.

A. Leave the dressing off until consulting with the healthcare provider. B. Apply a hydrocolloidal gel dressing. C. Replace the gauze with a transparent dressing. D. Increase the frequency of the dressing changes.

Correct Answer is B

Explanation

A. Leaving the dressing off could increase the risk of infection and delay wound healing. It is important to follow established wound care protocols and consult the healthcare provider if necessary.
B. Applying a hydrocolloidal gel dressing is appropriate for a stage 3 pressure ulcer with significant granulation tissue as it helps maintain a moist wound environment conducive to healing and protects the wound from external contaminants.
C. Replacing gauze with a transparent dressing might not provide adequate moisture control for a granulating wound and could potentially cause damage when removed.
D. Increasing the frequency of dressing changes may not be necessary and could potentially disrupt the healing process. It is important to balance between protecting the wound and allowing it to heal properly.

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In-home hospice care is arranged for a client with stage 4 lung cancer. While the palliative care nurse is arranging for discharge, the client verbalizes concerns about pain. Which action should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An older adult client is admitted to the medical unit following a fall at home. While undressing the client, the nurse observes that the client is wearing an adult diaper and skin breakdown is obvious over the sacral area. Which action should the nurse implement first?

Correct Answer is B

Explanation

The nurse is performing a routine dressing change for a client with a stage 3 pressure ulcer that is red with significant granulation. The wound has a gauze dressing covering the area. Which action should the nurse implement?

Correct Answer is B

Explanation

The mother of a child born with Tetralogy of Fallot asks the nurse, "Why did this happen to my baby? What did I do wrong?" Which response by the nurse is most helpful?

During the admission process, a client requests more information about advance directives. Which professional should the nurse recommend the client contact?

The nurse plans to encourage a group of young adult clients to engage in problem-solving strategies. Which action is most useful for the nurse to include during the teaching session?

A client is requesting medicine for pain 30 minutes after receiving morphine sulfate 5 mg intravenously. Which intervention should the nurse implement next?

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The nurse notes that a client has cyanosis of the toes and fingertips. Which vital sign should the nurse obtain first?

A small, round raised area appears under the client's skin as the nurse administers an intradermal medication. Which action should the nurse take?

During the prodromal stage of an infection, which is the priority nursing intervention?