A physician orders a nasogastric (NG) tube for a young adult diagnosed with end-stage ovarian cancer and suspected of having a bowel obstruction. The newly hired nurse explains the procedure and rationale for NG tube placement. The client refuses to consent to NG tube placement, stating, "I would rather keep vomiting than have the tube in my nose." Following the American Nurses Association Code of Ethics for Nurses, what should the nurse do next?
Delegate the NG tube placement to a more experienced nurse.
Make a referral to Social Services related to body image disturbance.
Seek the client's spouse for consent to the procedure.
Document the client's wishes and notify the physician.
The Correct Answer is D
Choice A reason : Delegating the NG tube placement to a more experienced nurse does not address the client's refusal of the procedure. The nurse must respect the client's autonomy and decision-making rights.
Choice B reason : While a referral to Social Services may be appropriate in some cases, it does not directly address the immediate concern of the client's refusal of the NG tube placement.
Choice C reason : Seeking consent from the client's spouse is not appropriate as the client is competent and has the right to refuse treatment. The client's autonomy must be respected.
Choice D reason : Documenting the client's wishes and notifying the physician is the correct action. The nurse must respect the client's right to refuse treatment and communicate this decision to the physician so that alternative management can be considered.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason : Bradykinesia refers to the slowness of movement and is commonly associated with Parkinson's disease, not meningitis. It is characterized by a gradual loss of spontaneous movement and can affect the ability to initiate and continue movements¹.
Choice B reason : Brudzinski's sign is a clinical sign that suggests meningitis when neck flexion causes reflex flexion of the hips and knees. It occurs due to meningeal irritation caused by spinal cord movement or nerves against the meninges¹. This sign is considered positive when passive flexion of the neck results in reflex flexion of the hips and knees, indicating meningeal irritation².
Choice C reason : Kernig's sign is another clinical sign used to evaluate for meningitis. It involves extending and straightening one knee while the individual lies on their back with their hips and knees bent at a 90-degree angle. A positive Kernig’s sign indicates pain or resistance when the leg is extended, which suggests meningitis³. However, it is not the condition described in the scenario.
Choice D reason : Nuchal rigidity is an inability to flex the neck forward due to rigidity of the neck muscles. While it is a sign of meningitis, it does not involve the involuntary flexion of the legs as described in the scenario. Nuchal rigidity is typically assessed by attempting to flex the patient's neck forward while they are in a supine position⁴.
Correct Answer is A
Explanation
Choice A reason : In primary hypothyroidism, the thyroid gland is underactive and does not produce sufficient thyroid hormones. As a result, the pituitary gland releases more TSH to stimulate the thyroid, leading to elevated levels of TSH in the blood⁶⁷⁸.
Choice B reason : Free T3 levels might not be elevated in primary hypothyroidism. Free T3 is the active form of triiodothyronine and could be normal or low depending on the severity and type of hypothyroidism⁶.
Choice C reason : Serum T3 levels are typically not the first indicator to change in primary hypothyroidism and may remain within normal ranges even when TSH is elevated⁶.
Choice D reason : Serum T4 levels are expected to be low in primary hypothyroidism because the thyroid gland is not producing enough of this hormone. However, the initial and most sensitive indicator of primary hypothyroidism is an elevated TSH level⁶.
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