NUR 402 FINAL EXAM NCLEX QUESTIONS AND ANSWERS WITH RATIONALES LATEST UPDATE GRADED A 2023/2024

NUR 402 FINAL EXAM NCLEX QUESTIONS AND ANSWERS WITH RATIONALES LATEST UPDATE GRADED A 2023/2024 For the past 5 years Tom has repeatedly asked his mother to donate his deceased father's belongings to charity, but his mother has refused. She sits in the bedroom closet, crying and talking to her long -dead husb and. What type of grief is Tom's mother experiencing? A) Adaptive grief B) Disruptive grief C) Anticipatory grief D) Prolonged grief disorder D) Prolonged grief disorder Prolonged grief disorder is prolonged, intense mourning and includes symptoms such as recurrent distressing emotions and intrusive thoughts related to the loss of a loved one, severe pangs of emotion, self -neglect, and denial of the loss for longer than 6 months. The home health nurse visits a 40 -year-old patient with metastatic breast can cer who is receiving palliative care. The patient is experiencing pain at a level of 7 (on a 10 -point scale). In prioritizing activities for the visit, the nurse would do which first? A) Auscultate for breath sounds. B) Administer PRN pain medication. C) C heck pressure points for skin breakdown. D) Ask family about patient's food and fluid intake. B) Administer PRN pain medication. Meeting the patient's physiologic and safety needs is the priority. Physical care focuses on the needs for oxygen, nutrition, pain relief, mobility, elimination, and skin care. The patient is not experiencing oxygenation problems; the priority is to treat the severe pain with pain medication. While caring for his dying wife, the husband states that his wife is a devout Roman Catholic but he is a Baptist. Who is considered the most reliable source for spiritual preferences concerning EOL care for the dying w ife? A) A priest B) Dying wife C) Hospice staff D) Husband of dying wife B) Dying wife Assessment of spiritual needs for palliative care is a key consideration, and individual choices should be respected. The preferences of the patient and family with reg ard to spiritual guidance or pastoral care services should be assessed and appropriate referrals made. The patient is the most reliable source for the spiritual assessment. The family attorney informed a patient's adult children and wife that the patient d id not have an advance directive after he suffered a serious stroke. Who is responsible for making the decision about EOL measures when the patient cannot communicate his or her specific wishes? A) Notary and attorney B) Physician and family C) Wife and ad ult children D) Physician and nursing staff C) Wife and adult children In the event that the patient is not capable of communicating his or her wishes, the surrogate decision maker, who is usually the next of kin (spouse or other family member), determine s what measures will or will not be taken. The surrogate decision maker is responsible for making the final decision. The physician and nurse should discuss with surrogate decision makers what the options are. The children caregivers of an elderly patient whose death is imminent have not left the bedside for the past 36 hours. In the nurse's assessment of the family, what findings indicate the potential for an abnormal grief reaction to occur (select all that apply)? A) Family cannot express their feelings to one another. B) Dying patient is becoming more restless and agitated. C) A family member is going through a difficult divorce. D) Family talks with and reassures the patient at frequent intervals. E) Siblings who were estranged from each other have now reunited. A) Family cannot express their feelings to one another. C) A family member is going through a difficult divorce. The nurse must be able to recognize signs and behaviors among family members who may be at risk for abnormal grief reactions. They m ay include dependency and negative feelings about the dying person, inability to express feelings, sleep disturbances, a history of depression, difficult reactions to previous losses, perceived lack of social or family support, low self -esteem, multiple previous bereavements, alcoholism, and substance abuse. Caregivers with concurrent life crises are especially at risk. A nurse has been working full time with terminally ill patients for 3 years. He has been experiencing irritability and mixed emotions when expressing sadness since four of his patients died on the same day. To optimize the quality of his nursing care, he should examine his own A) full -time work schedule. B) past feelings toward death. C) patterns for dealing with grief. D) demands for involvement in patient care. C) patterns for dealing with grief. Caring for a dying patient is intense and emotionally charged, and nurses must be aware of how grief affects them. The nurse may have feelings of loss, helplessness, and power lessness when dealing with death. Feelings of sorrow, guilt, and frustration need to be expressed. Recognizing personal feelings allows openness in exchanging feelings with the patient and family. The nurse is admitting a 68 -year-old preoperative patient with a suspected abdominal aortic aneurysm (AAA). The medication history reveals that the patient has been taking warfarin (Coumadin) on a daily basis. Based on this history and the patient's admission diagnosis, the nurse should prepare to administer which medication? A) Vitamin K B) Cobalamin C) Heparin sodium D) Protamine sulfate A) Vitamin K Coumadin is a Vitamin K antagonist anticoagulant that could cause excessive bleeding during surgery if clotting times are not corrected before surgery. For this reason, vitamin K is given as the antidote for warfarin (Coumadin). A 62 -year-old H ispanic male patient with diabetes mellitus has been diagnosed with peripheral artery disease (PAD). The patient is a smoker and has a history of gout. What should the nurse focus her teaching on to prevent complications for this patient? A) Gender B) Smok ing C) Ethnicity D) Co -morbidities B) Smoking Smoking is the most significant factor for this patient. PAD is a marker of advanced systemic atherosclerosis. Therefore tobacco cessation is essential to reduce PAD progression, CVD events, and mortality. Dia betes mellitus and hyperuricemia are also risk factors. Being male or Hispanic are not risk factors for PAD. What medications should the nurse expect to include in the teaching plan to decrease the risk of cardiovascular events and death for PAD patients ( select all that apply)? A) Ramipril (Altace) B) Cilostazol (Pletal)