A patient was admitted several weeks ago with an acute myocardial infarction and subsequently underwent coronary artery bypass grafting surgery. Since a cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram shows no meaningful brain activity. The patient does not have an advance directive. Which statement would be the best way to approach the family regarding ongoing care?

“I will refer this case to the hospital ethics committee, and they will contact you when they have a decision.”

“What do you want to do about the patient’s care at this point?”

“Dr. Smith believes that there is no hope at this point and recommends do-not-resuscitate status.”

“What would the patient want if he knew he were in this situation?”

Answer and Explanation

The Correct Answer is D

Choice A reason: Referring to the ethics committee is premature without discussing the patient’s wishes with the family. Asking about the patient’s preferences respects autonomy, making this incorrect, as it bypasses the family’s role in decision-making for the unresponsive patient.

Choice B reason: Asking what the family wants is vague and may pressure them without context. Inquiring about the patient’s wishes guides ethical decisions, making this incorrect, as it’s less focused than the nurse’s approach to honor the patient’s likely preferences.

Choice C reason: Stating the doctor’s recommendation may bias the family and doesn’t explore the patient’s wishes. Asking what the patient would want is more patient-centered, making this incorrect, as it’s less collaborative in discussing ongoing care options.

Choice D reason: Asking what the patient would want respects autonomy and guides family decision-making in the absence of an advance directive. This aligns with ethical principles, making it the correct approach for the nurse to discuss ongoing care with the family.

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Correct Answer is B

Explanation

Choice A reason: White bread and carbonated beverages may trigger IBS symptoms like bloating. Chicken, rice, and broccoli are low-irritant, making this incorrect, as it includes potential IBS triggers compared to the nurse’s teaching on a suitable diet for symptom management.

Choice B reason: Broiled chicken, brown rice, and steamed broccoli are low-irritant, high-fiber foods, with apple juice being IBS-friendly. This aligns with dietary recommendations for IBS, making it the correct menu selection showing the client’s understanding of the nurse’s teaching.

Choice C reason: Grilled cheese’s dairy and hot tea’s caffeine may exacerbate IBS symptoms. Chicken and rice are safer, making this incorrect, as it includes potential irritants compared to the nurse’s teaching on a diet that minimizes IBS symptom triggers for the client.

Choice D reason: Coffee, even with low-fat milk, is a known IBS trigger due to caffeine. Chicken, rice, and broccoli are better choices, making this incorrect, as it includes a stimulant that contradicts the nurse’s dietary teaching for managing irritable bowel syndrome effectively.

A. A 45-year-old with a nasogastric (NG) tube who has dry oral mucosa and reports feeling very thirsty. B. A 57-year-old receiving IV diuretics whose blood pressure is 88/52 mm Hg. C. A 67-year-old with nausea and vomiting who reports abdominal cramps. D. A 77-year-old with normal saline infusing at 150 mL/hr with an average hourly urine output.

Correct Answer is B

Explanation

Choice A reason: Dry mucosa and thirst suggest dehydration, but hypotension (88/52) is more life-threatening. Low blood pressure requires immediate assessment, making this incorrect, as it’s less urgent than the nurse’s priority to address the client with critical hemodynamic instability.

Choice B reason: A blood pressure of 88/52 mm Hg in a client on IV diuretics indicates severe hypotension, a life-threatening condition requiring immediate assessment. This aligns with prioritization in acute care, making it the correct client for the nurse to assess first post-shift report.

Choice C reason: Nausea, vomiting, and cramps are concerning but less urgent than hypotension (88/52), which risks organ perfusion. Low blood pressure is critical, making this incorrect, as it’s secondary to the nurse’s priority of assessing the client with unstable vitals.

Choice D reason: Normal saline at 150 mL/hr with adequate urine output is stable. Hypotension (88/52) is more critical, making this incorrect, as it’s a lower priority compared to the nurse’s need to assess the client with life-threatening low blood pressure first.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client’s understanding. Which menu selection indicates that the client correctly understands the dietary teaching?

Correct Answer is B

Explanation

After receiving the change-of-shift report, which client does the nurse assess first?

Correct Answer is B

Explanation

A client is being treated for diabetes insipidus (DI) with synthetic vasopressin (desmopressin). What is the priority health teaching that the nurse provides regarding drug therapy?

The nurse cares for a client in the emergency department diagnosed with deep partial thickness burns of the arms and chest. The nurse notes that the client is very restless and anxious. Which action should the nurse take FIRST?

A client with peripheral artery disease is suffering from ineffective tissue perfusion. Which of the following would be appropriate outcomes for this nursing diagnosis? (Select all that apply)

The nurse caring for a client with chronic obstructive pulmonary disease (COPD) anticipates which arterial blood gas (ABG) findings?

Which actions are considered best practices for the nurse to use during the administration of parenteral potassium to a client with a serum potassium level of 1.9 mEq/L (mmol/L)? (Select all that apply)

In collaboration with the registered dietitian nutritionist (RDN), which foods will the nurse teach a client who is taking a potassium-sparing diuretic to avoid or use cautiously? (Select all that apply)

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations supports this diagnosis? (Select all that apply)

The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption?