The nurse is providing end-of-life care and determines the patient is experiencing critical distress related to concerns about the afterlife. Which portion of the nursing process should the nurse use to guide the plan of care?

Planning.

Assessment.

Analysis.

Implementation.

Answer and Explanation

The Correct Answer is A

Choice A reason: Planning guides end-of-life care by developing interventions to alleviate anxiety about the future, identified during assessment. Anxiety activates the amygdala, increasing stress hormones. Planning may include spiritual support or counseling, addressing psychological needs to reduce distress, ensuring a tailored care plan promotes comfort and dignity at end-of-life.

Choice B reason: Assessment identifies anxiety but does not guide the care plan directly. It collects data (e.g., verbalized fears) about future concerns, while planning translates this into interventions, like spiritual care. Anxiety’s physiological effects (e.g., elevated cortisol) require targeted strategies, making planning the step to address these needs effectively.

Choice C reason: Analysis interprets data to diagnose anxiety, but the question states it’s already identified. Planning follows, creating interventions to reduce end-of-life distress, such as meditation or family involvement. Anxiety disrupts emotional regulation via the limbic system, requiring a structured plan to implement relief, making analysis secondary here.

Choice D reason: Implementation enacts the care plan, but anxiety about the future requires planning to design interventions first. Actions like providing spiritual resources follow action development to address psychological distress. Anxiety increases sympathetic activity, and planning ensures interventions target this, making implementation premature without a defined strategy.

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Correct Answer is B

Explanation

Choice A reason: Documenting the HCP’s refusal is necessary but passive, not addressing the ethical conflict. Notifying the ethics committee actively advocates for the client’s wishes, ensuring the living will is reviewed. Documentation alone delays resolution, per ethical decision-making and patient autonomy standards in nursing.

Choice B reason: Notifying the hospital ethics committee is the priority, as it ensures an impartial review of the HCP’s refusal to honor the living will. This advocates for the client’s autonomy, resolving ethical conflicts and upholding advance directives, per bioethics and patient rights standards in healthcare.

Choice C reason: Facilitating a meeting may help communication but does not resolve the HCP’s refusal to honor the living will. The ethics committee provides formal mediation, ensuring the client’s wishes are upheld. A meeting alone risks ongoing conflict, per ethical conflict resolution and nursing advocacy principles.

Choice D reason: Having resuscitation equipment available contradicts the client’s natural death wish in the living will. Notifying the ethics committee supports the client’s autonomy, preventing unwanted interventions. This action disregards advance directives, per end-of-life care and ethical nursing practice standards.

A. A private room with both contact and airborne precautions. B. A semiprivate room with a roommate who has the same diagnosis and contact precautions. C. A semiprivate room with a roommate who has the same diagnosis and airborne precautions. D. A private room with both standard and droplet precautions.

Correct Answer is A

Explanation

Choice A reason: Varicella zoster virus (chickenpox) is highly contagious, spreading via airborne droplets and contact with lesions. A private room with contact and airborne precautions (N95 mask, negative pressure) prevents transmission to others. This isolates the virus, protecting immunocompromised patients, as varicella can cause severe complications, making this the correct assignment.

Choice B reason: A semiprivate room with contact precautions is insufficient, as varicella requires airborne precautions due to droplet nuclei transmission. Sharing a room, even with the same diagnosis, risks cross-infection if precautions fail. A private room ensures isolation, minimizing viral spread, making this option inadequate for infection control.

Choice C reason: A semiprivate room with airborne precautions is better but still risky, as sharing space increases transmission potential if precautions lapse. Varicella’s airborne spread requires a private room with negative pressure to contain droplet nuclei. A private room with both precautions ensures optimal isolation, making this option less safe.

Choice D reason: Standard and droplet precautions are inadequate for varicella, which requires airborne and contact precautions. Droplet precautions (surgical mask) do not protect against smaller airborne particles. A private room with full precautions prevents viral spread, as varicella can cause pneumonia in vulnerable patients, making this option incorrect.

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The nurse is providing end-of-life care and determines the patient is experiencing critical distress related to concerns about the afterlife. Which portion of the nursing process should the nurse use to guide the plan of care?

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Correct Answer is B

Explanation

A client is being admitted to the unit with a varicella zoster virus infection. Which room should the charge nurse assign to the client?

Correct Answer is A

Explanation

When initiating oxygen per mask to a client who is short of breath, the nurse hears a loud hissing sound after inserting the flowmeter into the wall outlet. Which should the nurse do next?

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