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Question 1 of 5

A client with metastatic esophageal cancer says, 'I don't want to be kept alive being fed by a tube.' What are the most appropriate ways for the nurse to ensure that this information is available to all who may need it for future decision-making? Select all that apply.

Correct Answer: A, B, C

Rationale: Documenting in the EHR (
A), discussing with the proxy (
B), and completing an advance directive (
C) ensure the client's wishes are communicated. Informed consent (
D) is irrelevant, and DNR (E) is not indicated.

Question 2 of 5

All of the following clients assigned to LPN/LVN ring their call bells. Which client needs the most immediate attention?

Correct Answer: C

Rationale: Chest pain during a blood transfusion suggests a possible transfusion reaction, a life-threatening emergency requiring immediate intervention. Bathroom needs, arthritis pain, or postoperative pain are less urgent.

Question 3 of 5

The nurse is giving home care to a 69-year-old client who has severe arthritis. Which comment made by the client would indicate to the nurse that the client is experiencing normal changes associated with the aging process?

Correct Answer: C

Rationale: Feeling cold and preferring a warmer environment is a normal age-related change due to decreased thermoregulation. Pain, loose stools, and visual changes may indicate pathology requiring further investigation.

Question 4 of 5

The nurse is talking to a client with rheumatoid arthritis who is reporting increased pain and stiffness of the joints in the morning. The nurse should encourage the client to

Correct Answer: C

Rationale: A warm shower and range-of-motion exercises (
C) reduce morning stiffness and improve mobility. Heating pads (
A) may help but are less comprehensive, high-calorie meals (
B) are irrelevant, and NSAIDs (
D) may not address stiffness immediately.

Question 5 of 5

A community health nurse is preparing to administer influenza vaccines. Which clients can safely receive the live-attenuated, intranasal influenza vaccine? Select all that apply.

Correct Answer: B, C

Rationale: The live-attenuated vaccine is safe for healthy individuals aged 2-49, like the 3-year-old (
B) and postpartum client (
C). It's contraindicated for infants under 2 (
A), pregnant women (
D), and immunocompromised clients (E).

Similar Questions

The nurse is reinforcing medication instructions for the parents of a child prescribed amoxicillin/clavulanate (liquid) twice a day for acute sinusitis. Which instructions are most important for the parents to remember? Select all that apply.
The home health aide reports to the practical nurse that the client has been trying to give away possessions. When the nurse asks the client about this behavior, the client says, 'With my spouse dead, there's no reason for me to go on.' What is the best response by the nurse?
A client with metastatic esophageal cancer says, 'I don't want to be kept alive being fed by a tube.' What are the most appropriate ways for the nurse to ensure that this information is available to all who may need it for future decision-making? Select all that apply.
Parents of a 6 month-old breast fed baby ask the nurse about increasing the baby's diet. Which of the following should be added first?
The nurse is caring for a 4-year-old child in the emergency department who has a 104 F (40 C) temperature, is obtunded, and has a positive Kernig's sign. The parents are refusing antibiotics and any treatment. The parents state that their religious belief is to trust in just prayer and believe the child will receive divine healing. What action does the nurse anticipate?

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