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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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.

A. 4+ pitting edema of both lower extremities. B. Hypoactive bowel sounds with infrequent bowel movements. C. Braden risk assessment scale rating score of ten. D. Warm, dry skin with a fever of 100.0° F (37.8° C).

Correct Answer is C

Explanation

A. Pitting edema, especially at a 4+ level, indicates significant fluid retention in the lower extremities. While this can be a concern for skin integrity and may contribute to skin breakdown due to increased pressure and reduced mobility, it is not the most direct indicator for turning schedules.
B. Hypoactive bowel sounds and infrequent bowel movements suggest gastrointestinal issues, such as constipation or reduced bowel motility. While these issues are important to address for overall client health, they do not directly impact the scheduling of turning to prevent pressure ulcers.
C. The Braden Risk Assessment Scale is a tool used to evaluate a client's risk for developing pressure ulcers. A score of 10 indicates a high risk for pressure ulcer development. This assessment directly informs the need for a more aggressive turning schedule and other preventive measures to protect skin integrity.
D. Warm, dry skin and a low-grade fever might indicate an infection or other underlying condition, but these factors are not the primary considerations for determining the turning schedule. While fever and skin temperature can be important for overall assessment and care, they do not directly impact the need for turning to prevent pressure ulcers.

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is B

Explanation

In planning the turning schedule for a bedfast client, it is most important for the nurse to consider which assessment finding?

Correct Answer is C

Explanation

An older client is hospitalized following an embolic stroke resulting in right-sided paresis. Three days after admission, the nurse notes edema and erythema to the right lower leg. These findings should alert the nurse to which possible condition?

A client's spouse has just learned of the client's terminal illness. The spouse is sitting in the corner of the client's room crying, and says to the nurse, "I feel as if I'm already so alone." Which action should the nurse take first?

The nurse is demonstrating three-point gait crutch walking to an older adult man who broke his foot while playing soccer with his grandchildren. Which behavior indicates that the client understands proper crutch walking?

A client who has a continuous tube feeding develops a fever and reports experiencing dyspnea. Which action should the nurse implement?

The nurse is teaching another nurse about the administration of medication using the Z track technique. Which is the primary reason for using a Z track technique to administer a medication?

The nurse assesses an adult client with a partial rebreather mask and notes that the oxygen reservoir bag does not deflate completely during inspiration and the client's respiratory rate is 14 breaths/minute. Which action should the nurse implement?

A client has a total serum calcium level of 7.0 mg/dL (1.75 mmol/L). Based on this information, which action is most important for the nurse to include while measuring the client's vital signs? Reference Range: Total Calcium (9 to 10.5 mg/dL (2.25 to 2.62 mmol/L)]