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Question 1 of 5.

A client receiving end-of-life care is no longer able to make decisions. The client's appointed medical power of attorney (MPOA) is considering placement of a percutaneous enterogastric feeding tube. The MPOA asks the nurse, 'What would you do if this was your family member?' How should the nurse respond?

A. I'm not sure what I would do, but I feel confident that you will make the right decision.

B. I will call the chaplain to help you sort through the options and discuss the issue.

C. What do you think are the advantages and disadvantages of a feeding tube?

D. You should meet with the family to discuss what the patient would have wanted.

Explanation: Exploring pros and cons (C) empowers the MPOA to make an informed decision. Personal opinions (A), chaplain referral (B), or family meetings (D) are less direct.

Question 2 of 5.

An alert adult is being admitted for elective surgery. Which comment made by the client indicates a need for more instruction regarding advance directives?

A. I brought a copy of the completed form with me.

B. I am glad I don't have to make decisions about my care anymore.

C. My husband is the one who gets to make decisions for me.

D. My children all have copies of the living will.

Explanation: Advance directives allow clients to specify care preferences, not relinquish decision-making entirely. This comment suggests a misunderstanding that requires further education.

Question 3 of 5.

A mother calls the pediatrician's office stating that her 15-month-old son received an MMR vaccination yesterday. Today, the site of the injection is red, warm, and puffy. What is the best action for the nurse to take?

A. Report the symptoms to the physician as an adverse reaction

B. Suggest the mother apply a warm compress every two hours

C. Advise the mother to give her son baby aspirin

D. Explain to the mother that this is an expected response

Explanation: Mild redness, warmth, and swelling at the MMR injection site are expected reactions, resolving without intervention.

Question 4 of 5.

A 56-year-old client who had a complete hysterectomy 8 months ago is admitted for opiate detoxification. The second day after admission, the client complains of abdominal cramping and sweating. What is the nurse's best response?

A. Contact the gynecologist for details of the operation

B. Suspect drug seeking and suggest the client take a walk around the unit

C. Tell the client she is probably constipated and ask for an order for Milk of Magnesia

D. Explain to the client that her symptoms are an expected physical response to detoxification and offer comfort medications as ordered

Explanation: Abdominal cramping and sweating are withdrawal symptoms during opiate detoxification, requiring comfort measures and reassurance.

Question 5 of 5.

Immediately following a cardiac catheterization, the client asks to go to the toilet. What is the best response by the nurse?

A. Assist the client to the toilet

B. Show the client where the toilet is and allow him/her to walk there if stable

C. Assist the client to a bedside commode

D. Assist the client onto a bedpan

Explanation: Post-catheterization, bed rest is required to prevent bleeding at the insertion site; a bedpan maintains immobility.

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