The newly licensed RN overhears two nurses talking in the elevator about a client who will lose her leg because of negligence of the staff. Which action by the newly licensed RN would be implemented first?

Monitor the nurses closely for further occurrences.

Advise them to cease their communication.

Inform the nurse manager of the conversation.

Submit an occurrence or variance report.

Answer and Explanation

The Correct Answer is B

Choice A reason: Monitoring for further occurrences is passive and doesn’t address the immediate breach of confidentiality. Advising to stop the conversation protects the client, making this incorrect, as it delays the nurse’s priority of halting the unethical discussion promptly.

Choice B reason: Advising the nurses to cease their communication is the first action to stop the breach of client confidentiality in a public setting. This aligns with ethical and privacy standards, making it the correct initial step for the newly licensed RN to take.

Choice C reason: Informing the manager is important but secondary to stopping the conversation to prevent further disclosure. Advising to cease is immediate, making this incorrect, as it’s not the first action the RN should take to address the confidentiality breach.

Choice D reason: Submitting a report follows stopping the conversation and notifying the manager. Advising to cease is the first step, making this incorrect, as it delays the RN’s priority of immediately halting the nurses’ inappropriate discussion about the client.

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Correct Answer is C

Explanation

Choice A reason: Aggressive treatment continues curative care, not palliative care, which focuses on comfort. A DNR prioritizes comfort, making this incorrect, as it contradicts the nurse’s understanding of palliative care’s role in the patient’s treatment plan post-DNR.

Choice B reason: Stopping all treatment isn’t palliative care, which includes comfort measures like pain relief. Comfort without prolonging life is correct, making this incorrect, as it misrepresents the nurse’s expectation of continued supportive care under a DNR order.

Choice C reason: Palliative care with a DNR focuses on comfort, such as pain management, without prolonging life. This aligns with end-of-life care principles, making it the correct description of how the DNR and palliative care affect the patient’s treatment plan.

Choice D reason: Hospice transfer may occur later, but palliative care can begin in the hospital. Comfort care is immediate, making this incorrect, as it’s not the primary effect of the DNR compared to the nurse’s focus on current palliative treatment.

A. pH: 7.40, PaO2: 90 mm Hg, CO2: 39 mEq/L, HCO3: 23 mEq/L. B. pH: 7.32, PaO2: 85 mm Hg, CO2: 57 mEq/L, HCO3: 26 mEq/L. C. pH: 7.47, PaO2: 82 mm Hg, CO2: 30 mEq/L, HCO3: 31 mEq/L. D. pH: 7.30, PaO2: 95 mm Hg, CO2: 22 mEq/L, HCO3: 19 mEq/L.

Correct Answer is B

Explanation

Choice A reason: Normal ABG values (pH 7.40, CO2 39) don’t reflect COPD’s chronic hypercapnia and compensated acidosis. pH 7.32 with elevated CO2 is typical, making this incorrect, as it doesn’t match the nurse’s expected findings in a client with chronic obstructive pulmonary disease.

Choice B reason: In COPD, chronic CO2 retention (57 mEq/L) causes respiratory acidosis (pH 7.32) with compensatory HCO3 increase (26 mEq/L). Low PaO2 (85 mm Hg) reflects hypoxemia. This aligns with COPD pathophysiology, making it the correct ABG finding the nurse anticipates in this client.

Choice C reason: Alkalotic pH (7.47) and low CO2 (30 mEq/L) suggest hyperventilation, not COPD’s CO2 retention. Acidosis with high CO2 is expected, making this incorrect, as it contradicts the typical ABG profile in the nurse’s assessment of a COPD client.

Choice D reason: Low CO2 (22 mEq/L) and acidosis (pH 7.30) suggest metabolic acidosis, not COPD’s respiratory acidosis with hypercapnia. Elevated CO2 is typical, making this incorrect, as it doesn’t reflect the nurse’s expected ABG findings in chronic obstructive pulmonary disease.

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The newly licensed RN overhears two nurses talking in the elevator about a client who will lose her leg because of negligence of the staff. Which action by the newly licensed RN would be implemented first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse caring for a client with chronic obstructive pulmonary disease (COPD) anticipates which arterial blood gas (ABG) findings?

Correct Answer is B

Explanation

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