An adult client has been hospitalized for the past three weeks due to complications experienced following elective surgery. When the client's condition first began to deteriorate, the client's spouse reminded the healthcare provider that the client has a living will explaining the desire for a natural death. The healthcare provider does not agree with the client's living will and refuses to honor it. Which action should the nurse take?

Notify the hospital ethical committee to assist with client's wishes.

Have resuscitation equipment readily available.

Document healthcare provider's refusal to honor client's wishes.

Facilitate a meeting between the healthcare provider and the spouse.

Answer and Explanation

The Correct Answer is A

A.   The ethics committee can provide guidance on how to navigate the conflict between the healthcare provider’s beliefs and the client's documented wishes. The committee can mediate discussions and help ensure that the client's rights and preferences are respected according to legal and ethical standards.
B.   While having resuscitation equipment available might be relevant if there is a sudden need for emergency intervention, it does not directly address the issue of honoring the client’s living will. This action does not resolve the ethical conflict or ensure that the client’s wishes are respected.
C.   Documenting the healthcare provider’s refusal is important for legal and medical records but does not resolve the situation or ensure that the client’s wishes are respected. Documentation alone does not address the ethical conflict or take action to honor the client’s living will.
D.   Facilitating a meeting between the healthcare provider and the spouse could be beneficial for discussing the client’s wishes and potentially reaching a mutual understanding. However, if the healthcare provider remains unwilling to honor the living will despite such discussions, this action alone may not resolve the conflict.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A. Decreasing the time intervals between toileting can help prevent accidents by ensuring that the resident has more frequent opportunities to use the bathroom. Encouraging Kegel exercises (pelvic floor exercises) can help strengthen the muscles responsible for controlling urination and may improve incontinence.
B. Using disposable undergarments and changing them frequently can help manage incontinence and protect the skin from irritation and breakdown. However, this intervention primarily addresses the symptoms of incontinence rather than the underlying causes.
C. Limiting fluid intake in the evening can reduce the likelihood of nocturia (nighttime urination) and may help in managing urinary incontinence. However, reducing fluid intake can also lead to dehydration and other health issues.
D. Offering emotional support and reassurance is important for the resident’s mental well-being and can help reduce anxiety related to incontinence. Understanding that urinary incontinence is common among older adults can be comforting, but this approach alone does not address the practical management of the condition or contribute to improving urinary control.

A. Egg whites, toast, and coffee. B. Bran muffin, mixed fruit, and orange juice. C. Granola bar and grapefruit juice. D. Bagel with jelly and skim milk.

Correct Answer is B

Explanation

A. While this breakfast is healthy and nutritious, it does not contain significant amounts of calcium or vitamin D, which are essential for bone health.
B. Bran muffins, mixed fruit, and orange juice are all good sources of calcium and vitamin D, two essential nutrients for bone health. A diet rich in calcium and vitamin D is recommended for individuals with osteoporosis to help strengthen bones and reduce the risk of fractures.
C. While granola bars and grapefruit juice can be healthy, they may not provide enough calcium and vitamin D to meet the nutritional needs of a client with osteoporosis.
D. While skim milk is a good source of calcium, the bagel and jelly do not provide significant amounts of calcium or vitamin D.

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Naxlex Comprehensive Predictor Exams

An older female resident of a long-term care facility is experiencing frequent episodes of urinary incontinence. Which intervention is best for the nurse to implement with this client?

Correct Answer is A

Explanation

Which breakfast selection indicates that the client understands the nurse's instructions about the dietary management of osteoporosis?

Correct Answer is B

Explanation

When assessing a client's pain, the nurse determines the location and intensity of the pain. To gather data about the quality of the pain, which action should the nurse take?

The nurse prepares to instill an adolescent client's ear drops as seen in the picture. Which should the nurse do next?

While inserting an indwelling urinary catheter into a female client, the nurse observes urine flow in the tubing. Which action should be taken next?

The nurse is assessing an older female client who was admitted to a long-term facility two days ago. The resident refuses to go to the dining room for meals and calls for help with all activities of daily living. Which nursing problem is best to include in this client's plan of care?

The unlicensed assistive personnel (UAP) tells the nurse that an older client has requested powder applied after a tub bath to relieve itchy dry skin. Which instruction should the nurse provide to the UAP?

A client is having trouble breathing while lying in a dorsal recumbent position. Which action should the nurse implement first?

A client with a gastrostomy tube is receiving a continuous feeding, and the nurse suspects that the client has aspirated some of the feeding. Which action should the nurse take?