A nurse is planning care for a client who has lung cancer and who requests a do-not-resuscitate (DNR) prescription. Which of the following actions should the nurse take?
Discuss the client's wishes with the interprofessional team.
Request a provider's prescription to discontinue chemotherapy.
Counsel the client to postpone the DNR prescription
Verify that the family agrees with the client's DNR request.
The Correct Answer is A
Rationale:
A. Discuss the client's wishes with the interprofessional team is the correct action. The nurse’s role is to advocate for the client by ensuring the healthcare team is aware of the client’s preferences for end-of-life care. Collaboration ensures that the DNR order is implemented appropriately and respected across all care settings.
B. Requesting a provider's prescription to discontinue chemotherapy is not directly related to a DNR order. A DNR only addresses resuscitation efforts in the event of cardiac or respiratory arrest, not ongoing treatment decisions like chemotherapy.
C. Counseling the client to postpone the DNR prescription would violate the client’s autonomy. Clients have the right to make informed decisions about their own care, including the choice to implement a DNR.
D. Verifying that the family agrees with the client’s DNR request is not required. A DNR decision is the client’s legal right, and the nurse should respect the client’s wishes even if the family disagrees, provided the client is competent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Documentation audits for use of clinical guidelines measure process compliance, not direct client outcomes. They help ensure protocols are followed but do not directly reflect improvement in health outcomes.
B. Percentage of completed client plans of care is also a process measure, assessing whether documentation tasks are completed, rather than whether clients’ health outcomes have improved.
C. Surgical site infection rates are a direct client outcome measure. A decrease in infection rates indicates that care interventions and quality improvement initiatives are effectively improving patient health outcomes. This measurement reflects the actual impact of nursing and medical care on patient safety and recovery.
D. Staffing ratio audits assess resource allocation and workload but do not directly measure patient health outcomes. While staffing affects outcomes indirectly, it is a structural measure rather than an outcome measure.
Correct Answer is C
Explanation
Rationale:
A. Documentation in the incident report should be objective and factual, but the phrase “Entered room and discovered client lying prone on the floor” is somewhat narrative and includes unnecessary detail about the nurse’s actions rather than the client’s condition.
B. Including statements about the incident report in the nurse’s notes is inappropriate. Incident reports are separate legal documents and should not be referenced in the medical record to avoid legal implications.
C. Documenting in the incident report that the client was found lying on the floor after falling out of bed is objective, factual, and concise, which is appropriate for incident reporting. It clearly communicates the event without including speculation, blame, or unnecessary detail.
D. Writing “Incident report completed and filed” in the nurse’s notes is not appropriate. The nurse’s notes should focus on the client’s condition, assessment findings, and care provided, not the completion of the incident report.
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