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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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is ["A","B","E"]

Explanation

Choice A reason: Bilateral pedal pulses at 88 beats/min indicate restored circulation post-fasciotomy, preventing compartment syndrome. This aligns with vascular assessment post-burn and fracture, making it a correct finding showing the nurse’s actions were effective in maintaining perfusion in the leg.

Choice B reason: No swelling in lower extremities post-fasciotomy indicates reduced pressure and effective decompression, preventing tissue damage. This aligns with post-surgical burn care, making it a correct finding demonstrating the nurse’s actions were successful in managing the client’s leg injury.

Choice C reason: Spontaneous respirations are expected with intubation but unrelated to fasciotomy effectiveness for leg burn and fracture. Pulse presence is more relevant, making this incorrect, as it does not reflect the outcome of the nurse’s actions on the leg injury.

Choice D reason: Pulse oximetry of 93% reflects respiratory status, not fasciotomy effectiveness for leg perfusion. No swelling is a direct outcome, making this incorrect, as it’s unrelated to the nurse’s actions addressing the burn and fracture in the client’s leg.

Choice E reason: Pain reduced to 5/10 from 10 post-fasciotomy indicates effective decompression and pain management. This aligns with post-surgical burn care outcomes, making it a correct finding showing the nurse’s actions improved the client’s comfort and leg injury status.

Choice F reason: Normal temperature of 98.6°F is expected but doesn’t directly indicate fasciotomy effectiveness for leg perfusion. Pedal pulses are more specific, making this incorrect, as it’s not a primary outcome of the nurse’s actions for the client’s leg injury.

A. Elevated creatinine level. B. Decreased hemoglobin level. C. Decreased red blood cell count. D. Increased number of white blood cells in the urine.

Correct Answer is A

Explanation

Choice A reason: Elevated creatinine is a hallmark of chronic kidney disease, reflecting reduced glomerular filtration rate. This aligns with renal function assessment, making it the correct finding the nurse would expect in a client with chronic kidney disease based on laboratory results.

Choice B reason: Decreased hemoglobin may occur in chronic kidney disease due to anemia, but it’s less specific than elevated creatinine, a direct renal marker. This is incorrect, as it’s secondary to the nurse’s primary expectation of creatinine elevation in kidney disease.

Choice C reason: Decreased red blood cell count accompanies anemia in kidney disease but is less direct than creatinine, which measures kidney function. This is incorrect, as it’s not the primary finding the nurse would expect compared to elevated creatinine levels.

Choice D reason: Increased white blood cells in urine suggest infection, not a universal finding in chronic kidney disease. Elevated creatinine is more consistent, making this incorrect, as it’s not the nurse’s primary expected lab result in kidney disease assessment.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","E"]

Explanation

The nurse is reviewing a client’s record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding?

Correct Answer is A

Explanation

The laboratory notifies the night nurse that the patient has a critical magnesium level of 1.1 mEq/L. The patient has a do-not-resuscitate order. The nurse does not inform the practitioner because of the patient’s code status. In doing so, the nurse is negligent for which action?

Which assessments are most important for the nurse to perform to prevent harm on a client with a sodium level of 118 mEq/L (mmol/L)? (Select all that apply)

You are taking care of 4 clients who are receiving opioid analgesics for pain management. Which patient is MOST likely to be experiencing a life-threatening opioid side effect?

The nurse cares for a client with 0.9% sodium chloride infusing at 125 mL/h. 2 hours after the infusion was started, the client’s central venous pressure (CVP) reading is 16 cm H2O. It is MOST important for the nurse to take which action?

A nurse is assessing a client. Which of the following manifestations would indicate that the client is in cardiogenic shock? (Select all that apply)

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 is actively bleeding from esophageal varices. Which medication would the nurse most expect to be administered to this client?

You are working on a busy unit and need to delegate tasks to the LPN and M