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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Rationale:

A. Make an audio recording of the adolescent's responses: Audio recordings require consent and may not be legally or ethically appropriate in suspected abuse cases. Documentation should be written, factual, and follow institutional policies and mandatory reporting laws.

B. Promise not to disclose information shared during the interview: Nurses must never promise confidentiality in suspected abuse cases, as they are mandated reporters. All disclosures of abuse must be reported to child protective services or appropriate authorities.

C. Obtain a history from both the adolescent and their caregiver: Gathering information from both parties helps identify inconsistencies and assess the situation fully. However, this should be done separately to allow the adolescent to speak freely and without coercion.

D. Use leading questions during the interview: Leading questions can influence the adolescent’s responses and compromise the integrity of the assessment. Open-ended, nonjudgmental questions are essential to support accurate and unbiased information gathering.

A. Penicillin B. Zolpidem C. Clopidogrel D. Ipratropium

Correct Answer is C

Explanation

Rationale:

A. Penicillin: Saw palmetto does not interfere with antibiotic action or metabolism. No significant pharmacodynamic or pharmacokinetic interaction exists between penicillin and saw palmetto.

B. Zolpidem: While both may cause some central nervous system effects, there is no established adverse interaction between zolpidem and saw palmetto. Co-administration is generally not contraindicated.

C. Clopidogrel: Saw palmetto has antiplatelet properties and can potentiate the effects of clopidogrel, increasing the risk of bleeding. Clients taking both may face elevated risk of gastrointestinal or intracranial hemorrhage.

D. Ipratropium: Ipratropium is an anticholinergic agent used primarily for respiratory conditions. It does not have a known interaction with saw palmetto, and their pharmacologic mechanisms do not overlap.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is obtaining a health history from an adolescent who they suspect is experiencing physical maltreatment. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is reviewing the medication administration record of a client who has benign prostatic hyperplasia (BPH). The client asks the nurse about taking saw palmetto. The nurse should instruct the client that which of the following medications interacts adversely with saw palmetto?

Correct Answer is C

Explanation

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