A client dies in the emergency department. The client's mother states that she is overwhelmed and doesn't know how to proceed since she has never had a death in the family before. Which action should the nurse avoid?

Call the hospital social worker.

Recommend grief counseling groups

Recommend starting antidepressant medications

Call the mother's religious leader for support.

Answer and Explanation

The Correct Answer is C

Rationale:

A. Social workers are trained to provide emotional support, help the family navigate practical matters after a death, and connect them with grief resources. This is a supportive and professional intervention.

B. Support groups can provide comfort, normalize the grieving process, and allow the mother to share experiences with others who have faced similar losses. This is a non-invasive and helpful intervention.

C. Recommending antidepressants immediately is inappropriate because normal grief is not a psychiatric disorder and does not automatically require pharmacologic treatment. Prescribing or suggesting medication without a thorough assessment by a qualified provider can be harmful and may pathologize a natural grieving process.

D. Spiritual support can provide comfort, guidance, and coping strategies in accordance with the mother’s beliefs. It is an acceptable and culturally sensitive intervention.

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Correct Answer is B

Explanation

Rationale:

A. Normal ABG values indicate adequate gas exchange, but they do not confirm that the lung has fully re-expanded or that air and fluid are no longer accumulating in the pleural space. ABGs alone are insufficient to determine chest tube removal.

B. Fluctuation, or “tidaling,” in the water seal chamber reflects pleural pressure changes during respiration. When the lung has re-expanded and the pneumothorax has resolved, there is no longer a pressure change, and the water seal chamber ceases to fluctuate. This is the most reliable clinical indicator that the chest tube is no longer needed.

C. Absence of shortness of breath is reassuring, but it is subjective and does not confirm lung re-expansion or cessation of air/fluid leakage in the pleural space. Relying on symptoms alone is insufficient for chest tube removal.

D. Minimal drainage indicates decreased fluid output, but even with minimal drainage, air leaks may persist. The presence or absence of tidaling and air leak assessment is more important than fluid output in determining removal readiness.

A. PaO2 of 46 mm Hg (80-100 mm Hg) B. lack of adventitious lung sounds C. respirations of 20 breaths/min (12-20 breaths/min) D. oxygen saturation of 95% on room air (95-100%)

Correct Answer is A

Explanation

Rationale:

A. A PaO₂ of 46 mm Hg is critically low and indicates severe hypoxemia. Normal PaO₂ ranges from 80–100 mm Hg. A value of 46 mm Hg reflects significant impairment in oxygen exchange and can lead to tissue hypoxia, organ failure, and death if not treated immediately. Acute pancreatitis can lead to acute respiratory distress syndrome (ARDS) due to systemic inflammation and capillary leakage in the lungs. According to airway, breathing, and circulation (ABC) priority principles, impaired oxygenation is an immediate life-threatening condition and is the greatest concern.

B. Lack of adventitious lung sounds is not necessarily abnormal. Clear lung sounds can be present even in early respiratory compromise. The absence of crackles, wheezes, or rhonchi does not rule out hypoxemia. Therefore, this finding is not as concerning as a critically low PaO₂.

C. A respiratory rate of 20 breaths per minute is at the upper limit of normal (12–20 breaths/min). While it may suggest mild compensation or anxiety, it is not immediately life-threatening and does not indicate severe respiratory compromise by itself.

D. An oxygen saturation of 95% on room air is within normal limits. Although it should be monitored closely in a client with respiratory distress, this value alone does not indicate acute deterioration.

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A client dies in the emergency department. The client's mother states that she is overwhelmed and doesn't know how to proceed since she has never had a death in the family before. Which action should the nurse avoid?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses a client with a chest tube inserted to treat pneumothorax. Which assessment finding best indicates that a chest tube is no longer needed?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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