While assessing a client who is dying for signs of impending death, what should the nurse observe for?

Correct Answer: B

Rationale: When assessing a client for signs of impending death, the nurse should observe for Cheyne-Stokes respiration. This pattern involves rhythmic waxing and waning of respirations from very deep breathing to very shallow breathing with periods of temporary apnea. It is often associated with cardiac failure and can be a significant indicator of impending death. Elevated blood pressure and pulse rate are not typical signs of impending death; in fact, they may indicate other conditions. A decreased temperature is also not a common sign of impending death, as temperature changes can vary among individuals and may not always correlate with the dying process.

Correct Answer: D

Rationale: According to the Code of Ethics for Nurses, the nurse should try to make the client as comfortable as possible but refuse to assist in death. It is not within the scope of nursing practice to assist in death, even if requested by the client. Choice A is incorrect as advance directives do not directly relate to the client's request for assistance in dying. Choice B is inappropriate as passing the responsibility to another nurse does not address the ethical dilemma at hand. Choice C is incorrect because instructing the client that only a physician can legally assist in suicide does not address the ethical considerations involved in the request. Therefore, the most appropriate action for the nurse is to provide comfort measures while upholding ethical standards and not participating in ending the client's life.

Correct Answer: B

Rationale: Ashley is somatizing by experiencing emotional conflict as physical symptoms associated with severe anxiety. Somatizing involves converting emotions into physical symptoms. Acting out involves behaviors like anger, crying, and verbal abuse, not physical symptoms. Withdrawal is when one withdraws psychic energy in response to anxiety, not converting emotions into physical symptoms. Problem-solving occurs when anxiety is identified and the underlying need is addressed, not converting emotions into physical symptoms.

Correct Answer: A

Rationale: Drug tolerance is characterized by the ability to ingest a larger dose without adverse effects and decreased sensitivity to the substance. In this scenario, the client needing an increased dose of hydrocodone to achieve the same pain relief indicates tolerance developing, not addiction. Choice B is incorrect as it describes drug dependence, where the individual is preoccupied with the drug and has a loss of control. Choice C is incorrect because addiction involves psychological behaviors related to substance use, not just physical dependence with withdrawal symptoms and tolerance. Choice D is incorrect as it refers to a dual diagnosis, which is the coexistence of substance abuse and psychiatric disorders, not the development of tolerance to a drug.