A client nearing the end of life requests that he be given no food or fluids.
The physician orders the insertion of a nasogastric tube to feed the client.
What situation does this create for the nurse providing care?

The nurse must follow the physician's orders.

The physician's order creates a barrier to establishing an effective nurse-client relationship.

The nurse faces an ethical dilemma about inconsistent courses of action.

The nurse is unable to provide care for the client.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While nurses are generally expected to follow physician's orders, they also have a professional and ethical responsibility to advocate for their patients. In situations where an order conflicts with the patient's wishes and ethical principles, blindly following the order can lead to moral distress.

Choice B rationale

The physician's order, which contradicts the patient's explicit request, can indeed create a barrier to establishing an effective nurse-client relationship built on trust and respect for the patient's autonomy. The nurse may feel conflicted in carrying out an unwanted intervention.

Choice C rationale

The situation creates an ethical dilemma for the nurse because there are conflicting courses of action with moral implications. The nurse faces a conflict between the duty to follow the physician's order and the ethical principle of respecting the patient's autonomy and right to refuse treatment, even life-sustaining measures at the end of life.

Choice D rationale

The nurse is not unable to provide care but faces a complex ethical challenge in determining the most appropriate and ethical course of action that respects the patient's wishes while navigating the physician's order.

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Correct Answer is A

Explanation

Choice A rationale

Playing music chosen by the client can promote relaxation by providing a familiar and comforting auditory stimulus. Music can help to reduce anxiety and create a calming environment, thus minimizing sensory overload in a client recovering from a stroke in the intensive care unit. This personalized approach respects the client's preferences and can positively influence their emotional state, fostering a more restful atmosphere conducive to healing.

Choice B rationale

Encouraging frequent visitors throughout the day can contribute to sensory overload for a client recovering from a stroke. While social support is important, excessive stimulation from multiple visitors can be overwhelming and disrupt the client's rest and recovery process in the intensive care unit, potentially increasing agitation and hindering relaxation.

Choice C rationale

Sitting in a chair next to the client and talking can be stimulating and may not promote relaxation, especially for a client who has recently experienced a stroke. Depending on the content and tone of the conversation, this interaction could increase sensory input and potentially cause agitation or fatigue rather than fostering a calm and restful environment needed for recovery in the intensive care unit.

Choice D rationale

Turning on the television to the Super Bowl would likely exacerbate sensory overload due to the bright lights, loud noises, and fast-paced visual stimulation. This type of environment is counterproductive to promoting relaxation and can be particularly overwhelming for a client recovering from a stroke in the intensive care unit, potentially increasing anxiety and hindering rest.

A. How loud is his snoring? B. How often are you awakened at night due to his loud snoring? C. Is there silence after snoring which then is followed with a snort? D. How long does he snore each night? . . .

Correct Answer is C

Explanation

Choice A rationale

Asking "How loud is his snoring?" is subjective and difficult for the spouse to quantify accurately. While loudness can be a factor, it doesn't directly address potential underlying medical conditions like obstructive sleep apnea.

Choice B rationale

Determining the frequency of awakenings due to snoring provides some information about the impact on the spouse's sleep but doesn't offer specific details about the nature of the snoring itself or potential pauses in breathing.

Choice C rationale

Asking "Is there silence after snoring which then is followed with a snort?" directly inquires about a pattern indicative of obstructive sleep apnea. Apneic episodes involve cessation of breathing (silence), followed by a gasp or snort as the airway reopens.

Choice D rationale

Knowing the duration of snoring each night provides a general overview but doesn't offer specific details about the characteristics of the snoring, such as pauses in breathing or gasping, which are crucial for identifying potential sleep disorders. .

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A client nearing the end of life requests that he be given no food or fluids.The physician orders the insertion of a nasogastric tube to feed the client.What situation does this create for the nurse providing care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client is in the intensive care unit following a stroke.The nurse is intervening in the plan of care to promote relaxation for the client and to prevent sensory overload.What independent nursing intervention would the nurse choose to do?

Correct Answer is A

Explanation

The client is a male who states his wife complains that his snoring awakens her at night.The spouse is present.To obtain further data, the nurse asks the spouse:

Correct Answer is C

Explanation

The nurse has just graduated with a Bachelor of Science in Nursing and is eager to find a mentor at this early stage in her career.Which of the following individuals is most likely to be an appropriate mentor for the nurse?

The nurse is caring for a patient who presents in the emergency room with respiratory acidosis.After assessing the patient, which of the patient's findings is the probable cause of respiratory acidosis?

Which guideline does the nurse apply to discussion of sleep patterns with older adult clients?

Which individual with diarrhea for three days is most likely to suffer from fluid and electrolyte imbalance?

Which client likely faces a risk for the nursing diagnosis of Disturbed Sleep Pattern: Difficulty Remaining Asleep?

A client nearing the end of life requests that he be given no food or fluids.
The physician orders the insertion of a nasogastric tube to feed the client.
What situation does this create for the nurse providing care?