A nurse is assisting with the postmortem care of a client whose partner is at the bedside. Which of the following actions should the nurse take?

Direct the partner to leave and return once postmortem care is complete.

Instruct the partner not to touch the client’s body.

Place the client’s personal belongings in a safe location in the facility.

Ask the partner about any rituals they would like to be performed.

Answer and Explanation

The Correct Answer is D

Choice A reason: Directing the partner to leave and return once postmortem care is complete is not respectful of the partner's feelings and wishes. The nurse should allow the partner to stay and participate in the postmortem care if they desire.

Choice B reason: Instructing the partner not to touch the client’s body is not compassionate or supportive of the partner's grief. The nurse should encourage the partner to touch, hold, or kiss the client’s body as a way of saying goodbye.

Choice C reason: Placing the client’s personal belongings in a safe location in the facility is a necessary action, but not the priority. The nurse should first ask the partner if they want to keep any of the belongings or give them to the nurse for safekeeping.

Choice D reason: Asking the partner about any rituals they would like to be performed is the most appropriate action. The nurse should respect and facilitate the partner's cultural, religious, or personal preferences for postmortem care.

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Correct Answer is D

Explanation

Choice A reason: Increased convex curve of the cervical spine is not an indication of scoliosis, but of kyphosis. Kyphosis is a condition that causes a forward rounding of the upper back, resulting in a hunched posture.

Choice B reason: Increased concave curve of the thoracic spine is not an indication of scoliosis, but of lordosis. Lordosis is a condition that causes an excessive inward curvature of the lower back, resulting in a swayback posture.

Choice C reason: Expansion of the upper intercostal spaces is not an indication of scoliosis, but of emphysema. Emphysema is a lung disease that causes the air sacs to become damaged and enlarged, resulting in difficulty breathing and a barrel chest.

Choice D reason: Unequal height of the shoulders is an indication of scoliosis. Scoliosis is a condition that causes a sideways curvature of the spine, resulting in an asymmetrical appearance of the shoulders, hips, and waist.

A. Remove blankets from the client. B. Place cold packs on the client’s axillae. C. Place a fan to blow air across the client. D. Give the client an alcohol sponge bath.

Correct Answer is A

Explanation

Choice A reason: Removing blankets from the client is a good action to take. Blankets can trap heat and increase the body temperature. Removing them can help the client lose heat through radiation and convection.

Choice B reason: Placing cold packs on the client’s axillae is not a good action to take. Cold packs can cause vasoconstriction and shivering, which can increase the metabolic rate and the heat production. They can also cause discomfort and skin damage.

Choice C reason: Placing a fan to blow air across the client is not a good action to take. A fan can cause evaporation of sweat and moisture, which can lower the body temperature. However, it can also cause dehydration and electrolyte imbalance, which can worsen the client’s condition.

Choice D reason: Giving the client an alcohol sponge bath is not a good action to take. Alcohol can cause vasodilation and evaporation, which can lower the body temperature. However, it can also cause skin irritation, dryness, and absorption, which can lead to toxicity and complications.

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A nurse is assisting with the postmortem care of a client whose partner is at the bedside. Which of the following actions should the nurse take?

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