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 D

Explanation

A. Apply heating blanket as needed: Fever can worsen intracranial pressure (ICP) by increasing metabolic demand. Instead, cooling measures such as antipyretics or a cooling blanket should be used to maintain normothermia and prevent further ICP elevation.

B. Position the head of bed greater than 45°: Elevating the head of the bed slightly (30–45°) promotes venous drainage and reduces ICP. However, excessive elevation (>45°) may decrease cerebral perfusion pressure (CPP), leading to inadequate brain oxygenation.

C. Administer laxatives rectally: Rectal administration can stimulate the vagus nerve and increase ICP. Oral or IV stool softeners should be preferred to prevent straining, which can further elevate ICP.

D. Decrease stimulation in environment: Reducing noise, dimming lights, and minimizing disturbances help prevent spikes in ICP by decreasing sensory overload and stress. A calm environment supports cerebral oxygenation and prevents further elevation of ICP.

A. Close the inline clamp. B. Flush the catheter with 10 mL of 0.9% sodium chloride. C. Apply a local anesthetic to the skin. D. Don sterile gloves.

Correct Answer is B

Explanation

A. Closing the inline clamp is necessary when the catheter is not in use to prevent air embolism, but it is not a required step before administering medication. The nurse should focus on flushing and checking for patency before medication administration.

B. Flushing the catheter with 10 mL of 0.9% sodium chloride before and after medication administration helps maintain patency, prevents occlusion, and ensures the catheter is functioning properly. This step is essential to avoid complications such as clot formation.

C. Applying a local anesthetic is not needed for routine medication administration through a nontunneled percutaneous central catheter. Anesthetic use is typically reserved for procedures like catheter insertion or painful dressing changes.

D. Donning sterile gloves is not required for medication administration through a central line. Clean gloves are sufficient, while sterile technique is reserved for dressing changes and catheter insertions.

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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 increased intracranial pressure. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is preparing to administer a medication for a client through a nontunneled percutaneous central catheter. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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