A nurse is caring for a client who has end-stage kidney disease and refuses further hemodialysis treatments. The client has advance directives that indicate no life-sustaining treatments. Which of the following actions should the nurse take?
Contact the client's family to discuss the decision.
Encourage the client to complete a final hemodialysis treatment.
Discuss possible options for discharge with the client.
Discuss future treatment options with the client's health care surrogate.
The Correct Answer is C
Rationale:
A. Contact the client's family to discuss the decision: While family members may be involved, the nurse must prioritize respecting the client’s autonomy. The client has expressed their wishes, and involving family without consent may violate confidentiality and autonomy.
B. Encourage the client to complete a final hemodialysis treatment: Pressuring or encouraging a client to undergo treatment they have refused especially when they have advance directives in place disregards their legal and ethical right to make decisions about their own care.
C. Discuss possible options for discharge with the client: Respecting the client’s decision and exploring care planning, such as hospice or palliative care services, is appropriate. This supports autonomy while ensuring comfort and dignity in the end-of-life process.
D. Discuss future treatment options with the client's health care surrogate: A surrogate decision-maker is only consulted when the client is unable to make decisions. In this case, the client is alert and capable, so the discussion should remain between the nurse and client.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Assist the client to ambulate: Ambulation is encouraged after a laparoscopic cholecystectomy to stimulate peristalsis and help relieve abdominal distention caused by retained gas from insufflation during the procedure. It promotes bowel movement and absorption of gas, improving comfort.
B. Prepare the client for a paracentesis: Paracentesis is used to remove fluid from the peritoneal cavity, typically in clients with ascites or severe fluid retention. Abdominal distention after this procedure is usually due to gas, not fluid.
C. Insert a rectal suppository: Suppositories may stimulate bowel movements but are not the first-line intervention for post-laparoscopic gas-related distention. Encouraging natural movement through ambulation is more effective and less invasive initially.
D. Place the client in the prone position: The prone position is not typically used for relieving abdominal distention. It may cause discomfort and does not aid in gas movement through the intestines as effectively as upright or walking positions.
Correct Answer is D
Explanation
Rationale:
A. "Client in room 303 is requesting snacks between meals.": While client preferences are important, this information is non-urgent and can be communicated through care plans or written notes. It does not directly impact immediate nursing care during a shift change.
B. "Client in room 304 has a laptop that they use for relaxation.": This is personal, non-clinical information and is not essential for safe and effective handoff communication. Shift reports should focus on medical status, treatment plans, or immediate needs.
C. "Client in room 302 has multiple visitors.": Visitor status is not a priority item in a shift report unless it directly affects client care, safety, or monitoring. Including such information can distract from more clinically significant updates.
D. "Client in room 301 is in the cardiac catheterization lab.": This is critical information because it reflects a current procedure, potential risks, and possible post-procedure care needs. Reporting this ensures continuity of monitoring and prioritization.
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