A nurse provides care to an older hospitalized client who is newly admitted for advanced liver failure. The client states, "I've told my doctor to let me die if my heart stops beating or if I quit breathing. I do not want to be revived." To best ensure the client's request is honored, which of the following should the nurse do?

Assure the client that their end-of-life wishes are followed right away.

Check the medical record for a DNR order.

Ask the client if they have a healthcare proxy who can speak for them if needed.

Verify a signed copy of the advance directives in the medical record.

Answer and Explanation

The Correct Answer is B

Choice A reason : While it is important to assure the client, the nurse must first verify that there is a formal DNR order in place to legally honor the client's wishes¹².

Choice B reason : Checking for a DNR order in the medical record is the correct action to ensure that the client's wishes regarding resuscitation are documented and will be followed by all healthcare providers¹².

Choice C reason : Asking about a healthcare proxy is important, but it is secondary to confirming that the client's wishes are documented in the medical record through a DNR order or advance directives¹².

Choice D reason : Verifying a signed copy of the advance directives is crucial, but the immediate step is to check for a DNR order, which is specifically related to the client's request not to be resuscitated¹².

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Correct Answer is A

Explanation

Choice A reason : Regular exercise, as tolerated and recommended by a healthcare provider, is beneficial for heart failure patients as it can improve cardiovascular health and overall well-being⁵.

Choice B reason : Taking naproxen sodium for generalized discomfort is not recommended for heart failure patients as nonsteroidal anti-inflammatory drugs (NSAIDs) can worsen heart failure by causing fluid retention and increasing blood pressure⁵.

Choice C reason : Taking diuretics early in the morning is advised to avoid nocturia; however, taking them before bedtime is not recommended for the same reason, as it can disrupt sleep due to the need for frequent urination⁵.

Choice D reason : Patients should be instructed to notify their healthcare provider of a weight gain of 0.5 kg (1 lb) in a week as it may indicate fluid retention, which is a common issue in heart failure⁵.

A. The catheter can become infected even with sterile precautions. B. The volume of the output solution should be greater than the input solution. C. The fluid from my abdomen will be clear or slightly yellow. D. The microwave in my kitchen can warm the solution before I use it.

Correct Answer is D

Explanation

Choice A reason : The statement is correct; even with sterile precautions, there is a risk of infection. It's important for clients to understand this risk and recognize signs of infection early¹.

Choice B reason : This statement is incorrect and indicates a misunderstanding. The volume of the output solution should be equal to or slightly less than the input solution due to fluid removal from the body¹.

Choice C reason : The fluid from the abdomen should indeed be clear or slightly yellow. Cloudy or discolored fluid can indicate an infection or other complication¹.

Choice D reason : Using a microwave to warm the solution is not recommended as it can lead to uneven heating and potentially damage the solution. The solution should be warmed to body temperature using a warming device designed for this purpose¹³.

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure. Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is teaching a client about self-administered peritoneal dialysis. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is D

Explanation

A nurse is providing teaching to a client who has a new prescription for tamoxifen to treat breast cancer. The nurse should include that which of the following is an adverse effect of this medication?

A nurse is caring for a client who frequently attempts to remove his IV catheter. A family member requests that the nurse apply restraints. Which of the following responses should the nurse make?

A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values?

A nurse is providing teaching for a client who has a new diagnosis of fibromyalgia. Which of the following client statements indicates the need for further teaching?

A nurse is providing discharge instructions for a client who has congestive heart failure. Which of the following client statements indicates to the nurse that the teaching was effective?

A nurse is reviewing the health history of a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider?

A nurse in a clinic is caring for a client who has recently begun taking warfarin. The nurse is reviewing potential drug and food interaction risks and should instruct the client to avoid which of the following?

Anxiolytics, known as Benzodiazepines, are especially useful in which behavioral health patient treatment?