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. Ataxia: Ataxia is a neurologic manifestation that may occur in diabetes insipidus due to severe dehydration and resulting hypernatremia. Elevated sodium levels can disrupt normal brain function, leading to symptoms like unsteadiness, confusion, muscle twitching, and poor coordination, which may progress if not corrected.
B. Poor skin turgor: Poor skin turgor is a clinical sign of dehydration but reflects fluid loss in the integumentary system rather than a neurologic complication. It helps assess fluid volume status but does not involve cognitive or motor function changes.
C. Hypotension: Hypotension is commonly seen in diabetes insipidus due to volume depletion from excessive urination. However, it is a circulatory effect and does not directly reflect neurologic involvement or function.
D. Dilute urine: Producing large amounts of dilute urine is a defining feature of DI, caused by a deficiency of antidiuretic hormone or kidney resistance to it. This finding pertains to renal output rather than a neurologic complication.

A. Coughing B. Motor vehicle accidents C. Falls D. Assault

Correct Answer is B

Explanation

A. Coughing: While coughing can be a symptom of respiratory distress or lung injury, it is not typically a direct cause of flail chest. Flail chest is characterized by multiple rib fractures leading to a segment of the chest wall moving independently, which can result from blunt trauma like a motor vehicle accident.
B. Motor vehicle accidents: Flail chest commonly results from significant trauma, such as that from a motor vehicle accident. The blunt force of the impact during an accident can cause multiple rib fractures, which can result in the characteristic paradoxical chest movement seen in flail chest.
C. Falls: Although falls can result in rib fractures, they are less likely to cause the severe trauma and multiple rib fractures required to result in flail chest. While serious falls could contribute to a flail chest in certain scenarios, motor vehicle accidents are more common for this type of injury.
D. Assault: While an assault can cause chest injuries, including rib fractures, it is less commonly associated with flail chest compared to the more significant force from motor vehicle accidents. The mechanism of injury in assaults may not involve the level of blunt trauma that leads to multiple rib fractures and flail chest.

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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

A nurse is providing care for an older adult client who has diabetes insipidus (DI). The nurse should monitor the client for which of the following neurologic effects?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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