A nurse is caring for a client who has gone into cardiac arrest. The client's chart indicates refusal of life-sustaining measures in a living will signed 10 years ago, but a do-not-resuscitate (DNR) prescription has not been written by the provider. Which of the following actions by the nurse is appropriate?

Contact the provider for instructions regarding a DNR.

Consult with the client's family regarding resuscitation efforts.

Comply with the living will and let the client expire naturally.

Call a code because a DNR prescription has not been written.

Answer and Explanation

The Correct Answer is D

A. Contacting the provider for instructions could delay immediate resuscitative efforts, which are required in the absence of a DNR order.
B. Consulting with the client’s family may not be effective in an emergency, as the living will is a legal document, and family members cannot override it without a DNR order.
C. Complying with the living will and letting the client expire naturally would be inappropriate without a formal DNR order in place.
D. Calling a code is the correct action because, legally, resuscitative efforts must be initiated in the absence of a written DNR order from the provider, despite the existence of a living will.

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Correct Answer is A

Explanation

A. Difficulty swallowing (dysphagia) is the priority because it increases the risk of aspiration, which can lead to aspiration pneumonia, a serious and potentially life-threatening complication for clients with Parkinson's disease.
B. Insomnia, while impacting quality of life, is not as immediately life-threatening as aspiration risk.
C. Needing additional help to stand reflects disease progression but does not carry the immediate risk of a life-threatening complication.
D. Difficulty dressing also indicates disease progression but does not pose an immediate danger to the client’s health.

A. Inserting an indwelling urinary catheter B. Administering heparin subcutaneously C. Suctioning a client's new tracheostomy D. Classifying a pressure ulcer

Correct Answer is C

Explanation

A. Inserting an indwelling urinary catheter can be performed by licensed practical nurses (LPNs) under the supervision of an RN, so this task does not need to be reassigned.
B. Administering heparin subcutaneously is a task that can be performed by LPNs, so it does not require reassignment to an RN.
C. Suctioning a client's new tracheostomy is a more complex procedure that requires advanced skills and assessment, making it appropriate for an RN rather than an LPN.
D. Classifying a pressure ulcer is a task that can be done by both RNs and LPNs, so it does not need to be reassigned.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a long-term care facility is collecting data for an interprofessional care conference for a client who has Parkinson's disease. Which of the following findings is the priority for the nurse to report at the conference?

Correct Answer is A

Explanation

A nurse is reviewing his client care assignments after receiving change-of-shift report. The nurse should notify the charge nurse that which of the following tasks should be reassigned to an RN?

Correct Answer is C

Explanation

A nurse is supervising a newly licensed nurse who is suctioning a client who has a tracheostomy. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure?

A nurse in a long-term care facility is witnessing a conflict between two staff nurses about a client assignment. Which of the following actions should the nurse take first?

A nurse is contributing to a quality improvement plan to improve the shift reporting process on the unit. Which of the following actions is the first step the nurse should suggest to promote a change in the reporting process?

A nurse reviewing prescriptions for a client who has a gastrointestinal bleed is determining the need for special informed consent. Which of the following prescriptions should the nurse identify as covered under the client's general consent for treatment?

A nurse is assisting with the plan of care for a client. Which of the following activities should the nurse include in the implementation phase of the nursing process?

A nurse is caring for a 16-year-old client who was in a motor-vehicle crash and needs surgical intervention immediately. The staff cannot reach either of the client's parents. The nurse should identify that which of the following is true about obtaining consent?

A nurse in a long-term care facility is monitoring clients in the day room. A client who has dementia becomes angry and starts screaming at the nurse. Which of the following interventions should the nurse take first?

A nurse is receiving a telephone prescription from a provider for propranolol 40 mg PO BID. When reading back the information to the provider, which of the following actions should the nurse take?