A patient with terminal lymphoma says to the nurse, "I'm tired of being so fatigued all the time. Can't you just give me a big shot of morphine and help me end this suffering? Which of the following responses by the nurse is most appropriate?

"You have orders for morphine 10 to 15 mg I don't think that's enough to end your suffering"

"That is really not appropriate to ask. Would you like a shot to take away the pain?"

"Are you sure that is what you want me to do? Maybe you should think about it first."

"You sound frustrated. It must be difficult to feel so tired all the time."

Answer and Explanation

The Correct Answer is D

A.   This response focuses solely on the adequacy of the medication dosage and does not address the patient's emotional distress.

B.   This response dismisses the patient's request and does not address the underlying feelings of suffering.
C.   This response does not provide support or explore the patient's feelings further and may come across as judgmental.
D.   This response acknowledges the patient's feelings and opens the door for further discussion and exploration of their emotional distress.

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Correct Answer is D

Explanation

A. Facial flushing is not typically associated with end-stage kidney disease and waiting for transport to dialysis. It may be indicative of other conditions such as fever, allergic reactions, or hormonal changes.
B. Hypotension is not a common finding in patients with end-stage kidney disease.

These patients often experience hypertension due to fluid overload and electrolyte imbalances.
C. Diaphoresis, or excessive sweating, is not typically associated with end-stage kidney disease and waiting for transport to dialysis. It may occur in response to other factors such as fever, pain, or anxiety.

D. Peripheral edema, or swelling in the extremities, is a common finding in patients with end-stage kidney disease due to fluid retention and impaired fluid balance regulation.

A. 80-year-old male patient with a history of atrial fibrillation with rapid ventricular response whose cardiac monitor shows a heart rate of 92 B. 66-year-old female patient with a newly inserted permanent pacemaker whose cardiac monitor shows a heart rate of 50 C. 72-year-old male patient with an implantable cardiac defibrillator that delivered a shock 4 hours ago whose cardiac monitor shows normal sinus rhythm and a heart rate of 68 D. 78-year-old male patient with chronic atrial fibrillation who is prescribed metoprolol (Toprol) whose cardiac monitor shows a heart rate of 58.

Correct Answer is B

Explanation

A. While atrial fibrillation with a rapid ventricular response requires attention, it is not an immediate concern unless associated with symptoms such as chest pain, shortness of breath, or hemodynamic instability.
B. A heart rate of 50 in a patient with a newly inserted permanent pacemaker may indicate bradycardia, which could be a sign of pacemaker malfunction or lead dislodgement. This patient requires immediate assessment to rule out complications.
C. While recent implantable cardioverter-defibrillator (ICD) discharge warrants evaluation, the patient is currently in normal sinus rhythm with a heart rate of 68, suggesting stability. This patient's assessment can be prioritized after the patient with the pacemaker issue is seen.
D. A heart rate of 58 in a patient with chronic atrial fibrillation on beta-blocker therapy may not be immediately concerning if the patient is asymptomatic and hemodynamically stable. This patient can be assessed after addressing the more urgent pacemaker issue.

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A patient with terminal lymphoma says to the nurse, "I'm tired of being so fatigued all the time. Can't you just give me a big shot of morphine and help me end this suffering? Which of the following responses by the nurse is most appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has end-stage kidney disease and is waiting for transport to dialysis. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

You are caring for this team of patients. Which patient is the priority to see first to collect data?

Correct Answer is B

Explanation

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