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 B

Explanation

Choice A reason: Broccoli is a good source of vitamin K, which is essential for blood clotting. However, it also contains vitamin C, which can interfere with the action of warfarin, a medication used to treat Westerly syndrome. Therefore, broccoli should be consumed in moderation and with caution.

Choice B reason: Bananas are high in potassium, which can affect the heart rhythm and cause arrhythmias in people with Westerly syndrome. Therefore, bananas should be avoided or limited in the diet.

Choice C reason: Mushrooms are low in vitamin K and do not interact with warfarin. They are also a good source of protein, fiber, and antioxidants. Therefore, mushrooms can be safely consumed by people with Westerly syndrome.

Choice D reason: Popcorn is high in sodium, which can increase blood pressure and worsen the symptoms of Westerly syndrome. Therefore, popcorn intake should be limited or avoided.

A. Measure the intake and output of a client who has received furosemide. B. Reinforce teaching with a client about crutch-gait walking. C. Assess the pain level of a client who has received acetaminophen. D. Check a client's peripheral IV site for redness or swelling.

Correct Answer is A

Explanation

Choice A reason: This is correct because measuring the intake and output of a client is a routine task that can be delegated to an AP.

Choice B reason: This is incorrect because reinforcing teaching with a client requires the nurse's knowledge and judgment and cannot be delegated to an AP.

Choice C reason: This is incorrect because assessing the pain level of a client is a nursing responsibility that involves critical thinking and evaluation and cannot be delegated to an AP.

Choice D reason: This is incorrect because checking a client's peripheral IV site for redness or swelling is a nursing skill that requires the nurse's assessment and intervention and cannot be delegated to an AP.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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