A nurse is caring for an older adult client who has a terminal illness and is ventilator dependent. The client is alert and oriented and he wants to discontinue use of the ventilator. The nurse should be aware that continued treatment against the client’s wishes is a violation of which of the following ethical principles?

Justice

Veracity

Fidelity

Autonomy

Answer and Explanation

The Correct Answer is D

Choice A reason: Justice. This answer is incorrect because justice is the ethical principle that ensures fair and equal treatment for all clients, regardless of their personal or social characteristics. Justice does not apply to this situation, as the client is not being discriminated against or denied any resources.

Choice B reason: Veracity. This answer is incorrect because veracity is the ethical principle that requires honesty and truthfulness from the provider and the nurse in providing information and education to the client. Veracity does not apply to this situation, as the client is not being deceived or misled about their condition or treatment options.

Choice C reason: Fidelity. This answer is incorrect because fidelity is the ethical principle that obligates the provider and the nurse to be faithful and loyal to the client and to honor their commitments and promises. Fidelity does not apply to this situation, as the client is not being abandoned or betrayed by the provider or the nurse.

Choice D reason: Autonomy. This answer is correct because autonomy is the ethical principle that respects the client's right to make their own decisions about their health care, even if they are different from the provider's or the nurse's recommendations. Autonomy applies to this situation, as the client is expressing their preference to discontinue the ventilator, which is a life sustaining treatment.

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Correct Answer is D

Explanation

Choice A reason: This is incorrect. It is not best to take medication with meals. Rifampin is better absorbed when taken on an empty stomach, at least 1 hour before or 2 hours after a meal. Taking rifampin with food can reduce its effectiveness and increase the risk of drug resistance. The nurse should advise the client to take the medication as directed by the doctor, and to avoid foods that can interact with rifampin, such as cheese, yogurt, or alcohol.
Choice B reason: This is incorrect. Treatment with this medication will not last for 1 month. Rifampin is usually given as part of a combination therapy for pulmonary tuberculosis, along with other drugs such as isoniazid, pyrazinamide, and ethambutol. The standard treatment regimen for drug susceptible tuberculosis consists of an intensive phase of 2 months, followed by a continuation phase of 4 or 7 months, depending on the drug regimen and the patient's response. The nurse should inform the client about the duration and the importance of completing the full course of treatment, even if the symptoms improve or the tests become negative.
Choice C reason: This is incorrect. This medication does not cause insomnia. Rifampin does not affect the sleep cycle or the quality of sleep. However, rifampin can cause other side effects, such as nausea, vomiting, diarrhea, headache, or rash. The nurse should instruct the client to report any severe or persistent side effects to the doctor, and to avoid taking over-the-counter drugs or herbal supplements without consulting the doctor, as rifampin can interact with many other medications and reduce their effectiveness.
Choice D reason: This is correct. Urine and other secretions might turn orange. Rifampin can cause a harmless discoloration of body fluids, such as urine, saliva, sweat, tears, or breast milk. The color can range from orange to red or brown, depending on the concentration of the drug and the pH of the fluid. The nurse should reassure the client that this is a normal and expected effect of rifampin, and that it does not indicate any damage to the kidneys or other organs. The nurse should also warn the client that rifampin can stain contact lenses, dentures, or clothing, and advise the client to use disposable lenses, remove dentures before taking the drug, and wear dark colored clothes.

A. History of hypertension B. Genetics C. Obesity D. History of smoking

Correct Answer is B

Explanation

Choice A reason: History of hypertension is not a nonmodifiable risk factor for developing a stroke, but a modifiable risk factor. Hypertension is a high blood pressure, defined as 140/90 mm Hg or higher. Hypertension can damage the blood vessels and increase the risk of stroke by causing atherosclerosis, aneurysm, or hemorrhage. The nurse should teach the clients to monitor their blood pressure and take medications as prescribed to lower their blood pressure and reduce their stroke risk.

Choice B reason: Genetics is a nonmodifiable risk factor for developing a stroke. Genetics refers to the inherited traits that are passed down from parents to children. Genetics can influence the risk of stroke by affecting the susceptibility to certain conditions, such as sickle cell disease, clotting disorders, or familial hypercholesterolemia, that can increase the risk of stroke. The nurse should teach the clients to know their family history and discuss their genetic risk factors with their provider.

Choice C reason: Obesity is not a nonmodifiable risk factor for developing a stroke, but a modifiable risk factor. Obesity is a condition of having excess body fat, defined as a body mass index (BMI) of 30 or higher. Obesity can increase the risk of stroke by contributing to other risk factors, such as hypertension, diabetes, or high cholesterol. The nurse should teach the clients to maintain a healthy weight and follow a balanced diet and exercise regimen to lower their stroke risk.

Choice D reason: History of smoking is not a nonmodifiable risk factor for developing a stroke, but a modifiable risk factor. Smoking is the inhalation of tobacco or other substances that contain nicotine or other harmful chemicals. Smoking can increase the risk of stroke by damaging the blood vessels, increasing the blood pressure, reducing the oxygen in the blood, and promoting blood clotting. The nurse should teach the clients to quit smoking and avoid exposure to secondhand smoke to lower their stroke risk.

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who has pulmonary tuberculosis and a new prescription for rifampin. Which of the following information should the nurse provide?

Correct Answer is D

Explanation

A nurse is teaching about risk factors for developing a stroke with a group of older adult clients. Which of the following nonmodifiable risk factors should the nurse include?

Correct Answer is B

Explanation

A home health nurse is caring for a client who is quadriplegic following a spinal cord injury and who is adjusting to the home environment. Which of the following client statements indicates the client is adapting?

A nurse is evaluating teaching on a client who has a new prescription for montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take?

A nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client’s parent on administering the medication?

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