A nurse is preparing a client who speaks limited d. Seek the assistance of a
English for surgery. Which of the following is the most nurse on the floor who is
appropriate nursing action in obtaining informed fluent in the client's
consent from this client? language.
Select one:
a. Do nothing as this is the provider's The nurse is responsible for
primary concern. ensuring that the client
understands the information
b. The nurse should explain the procedures
provided regarding the
using pictures and hand gestures.
procedure.
c. Have the nurse respond to the client's concerns
so the provider can prepare for surgery.
d. Seek the assistance of a nurse on the floor who is
fluent in the client's language.
A nurse is performing initial teaching with a client who a. "My Dilantin dose will be
will be receiving electroconvulsive therapy (ECT). increased several days before
the procedure."
Which statement by the client indicates a need for
further teaching?
elect one: Because the therapeutic
a. "My Dilantin dose will be increased several days action of ECT is to induce
seizures, any medications that
before the procedure."
affect the client's seizure
b. "Before the procedure, I will have an EKG to assess threshold must be decreased
for heart irregularities." or discontinued several days
c. "I will need to continue taking my regular blood before the procedure.
pressure medication."
d. "I will stop taking my lithium for 2 weeks prior to
my procedure."
Any cardiac conditions, such
as dysrhythmias, should be
monitored and treated before
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, the procedure
A daughter of a client with a terminal illness pulls a a. "The living will documents
nurse to the side and says, "Although my mother's your mother's wishes and
living will states she is not to be resuscitated, the must be followed."
family wants everything done to save her if she has a
cardiac arrest." How should the nurse respond?
Select one: A living will is a document
that expresses the client's
a. "The living will documents your mother's
wishes regarding medical
wishes and must be followed."
treatment in the event the
b. "I will contact the provider to make him aware of client becomes incapacitated
your request." and is facing end-of-life
c. "If your mother has a cardiac arrest, we will begin issues. The client's wishes
resuscitation if you wish." should be followed by the
health care provider.
d. "Since the living will is a legal document a lawyer
will have to make the changes."
A provider informs the wife of a comatose client with d. Consult the hospital's ethics
terminal cancer that she will need to sign the consent committee.
for insertion of a gastrostomy feeding tube. The nurse
knows this is against the client's wishes. What is the
appropriate action by the nurse? If the nurse believes the
provider's actions are directly
against the client's wishes,
the nurse should contact the
Select one:
hospital's ethics committee.
a. Inform the wife she cannot sign the consent These committees are
typically multidisciplinary and
b. Prepare the consent for the wife to sign.
are organized to consciously
c. Ask the provider for an order for a NG tube instead. and reflectively consider
d. Consult the hospital's ethics committee. significant and often difficult
issues related to client care.
Any nurse can consult the
P a g e 2 | 135
, hospital's ethics committee
when deemed necessary.
Unless the client has designed
another person as his health
care power of attorney, the
wife, as immediate next of
kin, can legally sign the
consent for the procedure if
she wishes.
A client is seeking treatment for stress related to a. "I have excellent job skills;
unexpected loss of employment and is engaging in I just need to find a new
the stress management technique of cognitive employer."
reframing. Which of the following statements would
indicate to the nurse that the client understands this
stress management technique? Cognitive reframing is a
simple and effective
technique for reducing stress
Select one:
by looking at things in a more
a. "I have excellent job skills; I just need to find a positive light in order to
new employer." experience them as less
b. "When I do my daily yoga exercises, I feel so much stressful. Cognitive reframing
better." for this client would involve
building confidence in job
c. "Once I decided what was most important to me, skills and searching for a new
things got easier." job.
d. "I can visualize the perfect interview and being
offered a new job."
A nurse is preparing a client with terminal illness for a. Contact the client's case
discharge to a nursing home when he states: "I don't manager.
want to go to a nursing home to die. I would rather
die at home." What would be the most appropriate
action by the nurse? Contact the client's case
manager would be the most
appropriate action by the
Select one:
nurse. The case manger
a. Contact the client's case manager. would be able to determine
b. Continue to make the discharge arrangements. if the client's wishes could be
carried out.
c. Assess the client's reasons for feeling this way.
d. Inform the provider of the client's decision.
A client is hospitalized for multiple rib fractures a. Assist the client to deep
P a g e 3 | 135
, following a motor vehicle accident (MVA). The results breathe, splinting with a
of an arterial blood gas (ABG's) are; pH 7.30, pCO2 pillow.
48, HCO3 26 and pO2 91 on 2 L/min of oxygen per
nasal cannula. Which of the following interventions
has the highest priority?
The client is experiencing
P a g e 4 | 135
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