A nurse is caring for a client who has end-stage cancer and is receiving chemotherapy. The client tells the nurse, "I want to discontinue treatment, but my children insist I continue." Which of the following responses should the nurse make?

"Your provider would not prescribe this treatment if it weren't necessary."

"Chemotherapy is your best chance for survival."

"It is your decision whether to continue chemotherapy."

"Why don't you want to continue treatment?"

Answer and Explanation

The Correct Answer is C

A. "Your provider would not prescribe this treatment if it weren't necessary.": While the provider recommends treatment based on medical necessity, the decision to continue or discontinue chemotherapy ultimately lies with the client. This response does not acknowledge the client’s autonomy.

B. "Chemotherapy is your best chance for survival.": This response focuses on treatment efficacy rather than addressing the client's emotional and personal concerns. It may also create pressure rather than supporting the client’s decision-making process.

C. "It is your decision whether to continue chemotherapy.": This response is appropriate as it acknowledges the client’s autonomy and right to make healthcare decisions. It validates the client’s concerns while offering support without imposing an opinion.

D. "Why don't you want to continue treatment?": Asking "why" may make the client feel defensive or pressured to justify their decision. A more open-ended approach, such as "Can you tell me more about your concerns?" would be a better way to explore the client’s feelings.

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Correct Answer is C

Explanation

A. PO oxycodone: Oral medications are contraindicated in clients with paralytic ileus because of impaired gastrointestinal motility, which prevents proper absorption and increases the risk of gastric retention. IV administration is preferred for effective pain control in this scenario.

B. Ibuprofen via NG tube: NSAIDs can cause gastric irritation and increase the risk of gastrointestinal bleeding, especially in clients with pancreatitis. Additionally, an NG tube is not an appropriate route for medication administration in the presence of an ileus due to impaired intestinal function.

C. IV hydromorphone: IV opioids provide effective and rapid pain relief for clients with severe pain, especially when oral or enteral administration is not feasible. Hydromorphone is commonly used in acute pancreatitis because it controls pain effectively without exacerbating the underlying condition.

D. Topical lidocaine patch: While lidocaine patches provide localized pain relief, they are not sufficient for managing severe visceral pain associated with pancreatitis and ileus. Systemic analgesia via IV opioids is more appropriate for controlling this level of pain.

A. Apply a vest restraint daily at bedtime to prevent nighttime wandering. B. Apply soft heel protectors bilaterally while client is in bed. C. Apply an abduction pillow between the client's knees while they are in bed to prevent hip dislocation. D. Apply mitten restraints to prevent the client from disconnecting their tube feeding.

Correct Answer is A

Explanation

A. Applying a vest restraint daily at bedtime is inappropriate because restraints should only be used as a last resort when other interventions have failed. Restraints must be ordered based on ongoing assessment rather than routine use, as they pose risks such as impaired circulation, skin breakdown, and decreased mobility.

B. Soft heel protectors help prevent pressure injuries and provide cushioning for clients at risk of skin breakdown. They are a non-restrictive intervention and do not require verification with the provider.

C. An abduction pillow helps maintain proper hip alignment and prevents dislocation in clients following hip surgery. This is a standard postoperative intervention that does not require additional verification.

D. Mitten restraints are a less restrictive alternative to wrist restraints and may be used to prevent a client from interfering with medical devices. However, their use still requires a provider's order and close monitoring to ensure patient safety.

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A nurse is caring for a client who has end-stage cancer and is receiving chemotherapy. The client tells the nurse, "I want to discontinue treatment, but my children insist I continue." Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has developed a paralytic ileus related to acute pancreatitis and reports pain as 8 on a scale of 0 to 10. The client has prescriptions for multiple PRN pain medications. Which of the following medications should the nurse administer?

Correct Answer is C

Explanation

A nurse is reviewing providers' prescriptions for four clients. Which of the following prescriptions should the nurse verify with the provider?

Correct Answer is A

Explanation

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