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 C
Explanation
Rationale:
A. Drinks 3 cups of 1% milk per day: This intake is appropriate for an 8-year-old child. It supports bone development by providing sufficient calcium and vitamin D, aligning with dietary guidelines for school-age children.
B. Weight has increased by 5 kg (11 lb): A weight gain of about 2–3 kg (4.4–6.6 lb) per year is typical for children between ages 6 and 12. A 5 kg increase over one year is within normal limits and does not require provider notification unless accompanied by other concerns.
C. Height has increased by 3.8 cm (1.5 in): This is below the expected annual growth rate for an 8-year-old, which is typically 5 to 6.5 cm (2 to 2.5 in) per year. Slowed linear growth can indicate underlying medical or nutritional issues and should be reported for evaluation.
D. Consumes three meals and two snacks per day: This is a healthy and age-appropriate eating pattern for a school-age child, promoting stable energy levels and supporting growth and development.
Correct Answer is ["A","C","E"]
Explanation
Rationale:
A. Keep objects in the client's room in the same place: Maintaining a consistent environment helps clients with vision loss navigate safely and confidently. Sudden changes in object placement can increase the risk of disorientation and injury.
B. Ensure there is high-wattage lighting in the client's room: While good lighting benefits clients with partial vision, high-wattage lighting can cause glare or discomfort. The focus should be on well-distributed, non-glare lighting suited to individual needs rather than universally high intensity.
C. Touch the client gently to announce presence: Gently touching a visually impaired client before speaking helps avoid startling them and fosters trust. It is a respectful way to make presence known when visual cues are unavailable.
D. Approach the client from the side: Approaching from the front is preferable so the client can better perceive the nurse's presence through remaining visual fields or auditory cues. Side approaches may lead to disorientation or surprise.
E. Allow extra time for the client to perform tasks: Clients with vision loss may require additional time to complete self-care or communication tasks. Rushing them can increase stress and compromise safety, so patience supports their independence.
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