A client in the final stages of terminal cancer tells the nurse: "I wish I could be just be allowed to die. I'm tired of fighting this illness. I have lived life a good life. I only continue my chemotherapy and radiation treatment because my family wants me to." What is the best nurse's best response?

Correct Answer: A

Rationale: The best response for the nurse to provide in this situation is to offer the client the option to talk to a psychologist about their thoughts and feelings. This demonstrates the nurse's understanding and compassion towards the client's emotional struggles and the complexity of their situation. By suggesting a professional to talk to, the nurse can provide the client with the appropriate support and guidance to help them navigate their feelings of wanting to be allowed to die. It also allows the client to voice their concerns and emotions with a trained professional who can offer them coping strategies and support tailored to their individual needs.

Correct Answer: B

Rationale: When ambulating a patient for the first time postoperatively, it is crucial to ensure patient safety by using two people to assist the patient. This helps in providing adequate support and stability, especially if the patient is weak, dizzy, or at risk of falling. Having two people allows for better control over the patient's movement and reduces the risk of accidents or falls during ambulation. Additionally, having an extra person provides assistance in case the patient becomes unsteady or requires immediate support.

Correct Answer: D

Rationale: The nurse's best response is D, "Your heart is not an efficient pump." Heart failure is a condition where the heart is unable to pump blood efficiently, leading to a decrease in the heart's ability to supply the body with oxygen and nutrients. This can result in symptoms such as shortness of breath, fatigue, and fluid retention. It is important for the patient to understand that heart failure does not mean the heart stops or has an area of dead muscle, but rather it is a condition where the heart is not able to function properly as a pump.

Correct Answer: B

Rationale: The internal mammary and internal thoracic arteries in the chest are often used for grafting in procedures such as coronary artery bypass surgery. These arteries have been found to have good long-term patency rates when used as grafts to bypass blocked coronary arteries. The internal mammary artery, in particular, is commonly used for this purpose due to its accessibility and long-term durability. The use of these arteries for grafting helps to improve blood flow to the heart muscle, relieving symptoms of coronary artery disease and reducing the risk of heart-related complications.

Correct Answer: B

Rationale: When administering IV fluids to clients with hypertension, the nurse must closely monitor the site and progress of the infusion every hour to ensure proper hydration and detect any signs of complications such as infiltration or infection. Checking the blood pressure every hour, as in choice A, may not be necessary unless specifically indicated by the healthcare provider. Checking the progress of the infusion once a day, as in choice C, does not provide adequate monitoring for a client with hypertension who may be at higher risk for fluid volume overload. Checking the client's pulse rate every hour, as in choice D, is important but does not directly address the immediate monitoring needs related to the administration of IV fluids.