A nurse is teaching a client who is pregnant about nonstress testing. Which of the following statements by the client indicates an understanding of the teaching?

"This test will tell me if my baby has a genetic problem."

"I will get oxytocin during this test."

"During this test. I must not eat or drink anything."

"During this test. I will push a button if my baby moves."

Answer and Explanation

The Correct Answer is D

D. "During this test, I will push a button if my baby moves."

Rationale:
A. "This test will tell me if my baby has a genetic problem." - Nonstress testing (NST) is used to evaluate fetal well-being by assessing fetal heart rate accelerations in response to fetal movement. It does not diagnose genetic problems.
B. "I will get oxytocin during this test." - Oxytocin is not typically administered during nonstress testing. NST is a non-invasive procedure that involves placing a fetal heart rate monitor on the mother's abdomen to monitor the baby's heart rate.
C. "During this test, I must not eat or drink anything." - While it's generally recommended to have a snack or meal before the test to encourage fetal movement, fasting is not required for NST unless otherwise instructed by the healthcare provider.
D. "During this test, I will push a button if my baby moves." - This statement demonstrates an understanding of how NST works. The client is instructed to push a button whenever they feel fetal movement, allowing the healthcare provider to correlate fetal movement with changes in the fetal heart rate pattern.

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Correct Answer is A

Explanation

A. "You might feel a bit confused for a few hours after the procedure": Confusion is a common side effect of electroconvulsive therapy (ECT) immediately following the procedure. It typically resolves within a few hours as the effects of anesthesia wear off. Providing this information prepares the client for potential post-procedure effects.
B. "You might notice some changes in your voice after the procedure": Changes in voice are not typically associated with ECT. Therefore, this statement is not relevant to the client's education about what to expect during or after the procedure.
C. "You'll wake up about 30 minutes after the procedure": The duration of unconsciousness following ECT can vary from person to person. While clients typically awaken within minutes after the procedure, specifying a time frame of 30 minutes may not accurately reflect individual experiences.
D. "You can expect to feel some pulsations in your neck during the procedure": Feeling pulsations in the neck is not a common sensation experienced during ECT. This statement does not accurately describe the procedure or its associated sensations.

A. Provide the client with a list of eligible individuals who can serve as a health care proxy. B. Document in the client's medical record if the client has advance directives. C. Provide end-of-life education if the client has a terminal illness. D. Ensure the client has an attorney to contact for assistance with end-of-life documents.

Correct Answer is B

Explanation

A. Provide the client with a list of eligible individuals who can serve as a health care proxy. - While it is important for clients to have information about selecting a healthcare proxy, the Patient Self-Determination Act does not specifically require nurses to provide a list of eligible individuals. However, nurses should educate clients about their rights to designate a healthcare proxy if desired.
B. Document in the client's medical record if the client has advance directives. - This is the correct action required by the Patient Self-Determination Act. The act mandates that healthcare facilities receiving Medicare or Medicaid funds must inform clients about their rights to make decisions about their medical care, including the right to have advance directives. Nurses are responsible for documenting in the client's medical record whether the client has advance directives, such as a living will or durable power of attorney for healthcare.
C. Provide end-of-life education if the client has a terminal illness. - While providing end-of-life education is important for clients with terminal illnesses, it is not specifically mandated by the Patient Self-Determination Act. However, the act does require healthcare facilities to inform clients about their rights to make decisions about end-of-life care, including the right to have advance directives.
D. Ensure the client has an attorney to contact for assistance with end-of-life documents. - The Patient Self-Determination Act does not mandate that nurses ensure clients have an attorney for assistance with end-of-life documents. While legal assistance may be helpful for some clients in completing advance directives, it is not a requirement of the act.

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