ATI RN
Client Comfort and End of Life Care Questions
Question 1 of 5
The nurse is caring for a client who reports pain relief after a nerve block. What does the nurse understand about this procedure?
Correct Answer: B
Rationale: The nurse understands that a nerve block blocks nerve impulses, as it injects anesthetic (e.g., lidocaine) near nerves, halting pain signal transmission to the braineffective for localized pain (e.g., post-op, chronic). This is its core mechanism. Choice A, numbs the skin, is partialtopical numbing differs; blocks target deeper nerves. Choice C, reduces inflammation, isn't primarysteroids might, but nerve blocks focus on signal interruption, not swelling. Choice D, increases blood flow, is falseblocks don't alter circulation; relief is neural. Choice B is correct, informing nursing carenurses monitor block duration (hours) and sensation return, ensuring pain control and safety (e.g., no injury to numb areas), distinct from systemic analgesics.
Question 2 of 5
A female patient is receiving furosemide (Lasix), 40 mg P.O. b.i.d. In the plan of care, the nurse should emphasize teaching the patient about the importance of consuming:
Correct Answer: B
Rationale: Furosemide (Lasix) is a loop diuretic that increases urine output, commonly used to treat edema or hypertension, but it also causes significant potassium loss, a condition called hypokalemia. The nurse must educate the patient to consume potassium-rich foods to counteract this side effect. Bananas and oranges (Choice B) are excellent sources of potassiumbananas contain about 400 mg per medium fruit, and oranges around 240 mgmaking them ideal choices to maintain electrolyte balance. Fresh green vegetables (Choice A) like spinach offer some potassium but are less concentrated than bananas and oranges, and their primary benefit lies in vitamins like A and C. Lean red meat (Choice C) is rich in protein and iron but low in potassium, while creamed corn (Choice D) is high in carbohydrates and sodium, not potassium. Hypokalemia can lead to muscle cramps, arrhythmias, or fatigue, so prioritizing potassium intake is critical. Teaching the patient to include bananas and oranges ensures they address the diuretic's most significant electrolyte impact, making Choice B the best answer.
Question 3 of 5
Which intervention should the nurse in charge try first for a client that exhibits signs of sleep disturbance?
Correct Answer: D
Rationale: For a client with sleep disturbance, the nurse should start with the least invasive, most natural intervention: providing normal sleep aids like pillows, back rubs, and snacks (Choice D). These promote comfort and relaxation without medication or complex techniques, addressing common causes like discomfort or anxiety. Administering sleeping medication (Choice A) is a last resort due to risks like dependency and side effects, reserved for when simpler methods fail. Asking about sleep quantity (Choice B) is assessment, not intervention, and doesn't immediately improve sleep. Teaching relaxation techniques (Choice C) is effective but requires skill and time, making it less immediate than basic aids. For example, adjusting pillows or offering a warm snack can quickly ease a client into sleep by mimicking natural routines, aligning with holistic care principles. If ineffective, the nurse can escalate to other options, but starting with Choice D ensures safety, simplicity, and patient-centered care, making it the correct first step.
Question 4 of 5
Which document addresses the client's right to information, informed consent, and treatment refusal?
Correct Answer: B
Rationale: The Patient's Bill of Rights (Choice B) is a legal and ethical document ensuring clients' rights to information about their care, informed consent before procedures, and refusal of treatment without coercion. Adopted by healthcare facilities, it empowers patientse.g., a client can refuse surgery after understanding risks. Standards of Nursing Practice (Choice A) outline professional expectations for nurses, not patient rights. The Nurse Practice Act (Choice C) defines nursing scope and licensure by state, focusing on practitioners, not patients. The Code for Nurses (Choice D), from the ANA, guides ethical nursing behavior but isn't a patient-facing rights document. For instance, if a client asks about chemotherapy risks, the Bill of Rights mandates full disclosure and consent, not the Code. Choice B directly addresses these autonomy rights, making it the correct answer.
Question 5 of 5
The nurse in charge is caring for an Italian client. He's complaining of pain, but he falls asleep right after his complaint and before the nurse can assess his pain. The nurse concludes that:
Correct Answer: A
Rationale: An Italian client complaining of pain then falling asleep suggests cultural expressiveness and fatigue, leading to the conclusion he may have a low pain threshold (Choice A). Italian heritage often correlates with vocalizing discomfort readily (per cultural studies, e.g., Zborowski), meaning small pain feels significant, yet sleep indicates exhaustion, not absence of pain. Faking pain (Choice B) assumes deceit without evidence; sleep doesn't disprove his report. Someone else medicating him (Choice C) is speculativeno record or timing supports this. Pain going away (Choice D) is unlikely, as sudden resolution wouldn't cause instant sleep. For example, postoperative pain might overwhelm him, prompting a loud complaint, then fatigue takes over. He may still need analgesia upon waking. Choice A reflects cultural sensitivity and clinical reasoning, making it correct.