A nurse is caring for a client in the emergency department who is actively dying from a catastrophic injury. Which of the following is the priority in planning care for this client?

Discussing organ donation with the family

Communicating sensitively with the client and family

Creating a plan for pain relief, nutrition, and hydration

Contacting the family's spiritual advisor

Answer and Explanation

The Correct Answer is B

A. "Discussing organ donation with the family": While organ donation is important, it is not the priority in the setting of an actively dying client. The primary concern at this stage should be addressing the immediate needs of the client and their family, focusing on emotional support and comfort.
B. "Communicating sensitively with the client and family.": When caring for a client who is actively dying, providing emotional support and clear communication with the family is critical. Sensitively addressing the family’s concerns and the client’s comfort is essential in this stage of care.
C. "Creating a plan for pain relief, nutrition, and hydration.": While ensuring pain relief is important, in the context of an actively dying patient, the focus should primarily be on comfort rather than ongoing interventions like nutrition and hydration, which may no longer be beneficial.
D. "Contacting the family's spiritual advisor.": While spiritual support is valuable, it should not be the first priority. Ensuring the client’s comfort and providing emotional support to the family should be prioritized initially, and the spiritual advisor can be contacted afterward if desired.

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Correct Answer is A

Explanation

A. "The elevated blood sugar from my diabetes can cause underlying nerve damage.": Chronic hyperglycemia leads to damage of small blood vessels that nourish peripheral nerves, resulting in nerve dysfunction and symptoms such as tingling, numbness, and burning pain, especially in the feet.
B. "The older I get, there is less blood flowing to my feet.": While aging can reduce circulation, diabetic neuropathy is primarily caused by elevated glucose levels damaging nerves, not just reduced blood flow from age alone.
C. "The nerves just go to sleep when I lie down because no message gets from my brain to the spinal cord.": Peripheral neuropathy is not due to disrupted communication between the brain and spinal cord but from damage to peripheral nerves caused by long-term hyperglycemia.
D. "The nerve damage may occur for unknown reasons in any individual.": Diabetic neuropathy has a clearly defined cause—persistent high blood sugar levels—making it distinct from idiopathic neuropathies, which have no known origin.

A. Hypermagnesemia B. Hypocalcemia C. Hyponatremia D. Hyperkalemia

Correct Answer is B

Explanation

A. Hypermagnesemia: Hypermagnesemia is usually associated with lethargy, hypotension, and bradycardia, not neuromuscular excitability. It would not cause a positive Trousseau’s sign or bone pain, which are signs more consistent with low calcium levels.
B. Hypocalcemia: A positive Trousseau's sign indicates neuromuscular irritability due to hypocalcemia. Bone pain is also common in calcium deficiency because calcium is essential for bone integrity and strength, making this the most accurate choice.
C. Hyponatremia: Hyponatremia typically leads to neurological symptoms such as confusion, seizures, and altered mental status. It does not cause a positive Trousseau’s sign or bone discomfort, making it an unlikely electrolyte imbalance in this scenario.
D. Hyperkalemia: Hyperkalemia presents with muscle weakness, cardiac dysrhythmias, and paresthesia, but not with Trousseau’s sign. It primarily affects the electrical activity of muscles and the heart, not calcium-related neuromuscular signs.

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A nurse is caring for a client in the emergency department who is actively dying from a catastrophic injury. Which of the following is the priority in planning care for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is caring for a client who has a positive Trousseau's sign and bone pain. Which of the following electrolyte imbalances should the nurse suspect to find with this client?

Correct Answer is B

Explanation

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