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1. Which of the following man- When recognizing cues, the nurse should identify that an absent
ifestations should the nurse corneal reflex, an absent gag reflex, and the absence of pupil
identify for the client to be a response to light indicate the client is a potential organ donor.
potential organ donor?
Select all that apply.
2. A nurse is caring for a client Of the client's distressing manifestations, the nurse should first
who has terminal ovarian address
cancer and has a do not PAIN, followed by DYSPNEA.
resuscitate (DNR) prescrip-
tion. Complete the follow-
ing sentence by using the
list of options.
3. A nurse is caring for a client When analyzing cues, the nurse should recognize that skin with
who has end-stage heart mottling noted in lower extremities, lung sounds with rales bilater-
failure. Click to highlight the ally throughout, respirations noisy with Cheyne-stokes respiratory
findings that require imme- pattern, oxygen saturation 86%, and 4+ pitting edema noted to
diate follow up. To deselect bilateral feet and ankles are associated with a worsening condition
a finding, click on the find- and require immediate follow-up. These findings could be associ-
ing again. ated with the end of life.
4. A nurse is caring for a client When analyzing cues, the nurse should recognize that an anticipat-
who has terminal colon can- ed provider prescription includes hospice care due to the client's
cer. For each of the follow- diagnosis of stage four colon cancer with possible metastasis to
ing, click to specify whether the liver, a prognosis of six months or less left to live, do not
the prescription is antici- resuscitate prescription, and the provider has also discontinued
pated, nonessential or con- treatments. Another anticipated provider prescription is morphine
traindicated for the client. (Duramorph) 5 mg orally every 4 hours as needed for pain. The
client demonstrated they have been having moderate to severe
abdominal pain increasing from a 5 on the pain scale at 1345 to a
7 at 1820. A Do Not Intubate (DNI) order is used in conjunction
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, RN End of Life Assessment - ATI
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with a Do Not Resuscitate (DNR) order. The nurse should also
recognize that the client is not having manifestations of respiratory
difficulty. The lungs are clear and the oxygen saturation is within an
acceptable range. Therefore, the provider prescription for oxygen
at 7L/min per face mask is contraindicated. With comfort being the
goal at end of life, a face mask would not be the first choice for
oxygen delivery.
5. A nurse is caring for a client When taking actions, the nurse should initiate oxygen at 43L/min
who has terminal lung can- per nasal cannula, administer morphine (Duramorph) 4mg sub-
cer and has a do not resus- lingual, and perform the Respiratory Distress Observational Scale.
citate (DNR) prescription. This client has an oxygen saturation of 79%, therefore oxygen
Which of the following ac- must be initiated to correct the hypoxia. This client is unable to
tions should the nurse per- communicate information regarding their dyspnea, therefore the
form for this client? Respiratory Distress Observational Scale should be performed.
Select all that apply. Morphine improves dyspnea by improving gas exchange and is an
appropriate intervention.
6. A nurse is caring for a Plan an interdisciplinary meeting with the parents and child to
13-year-old client with ter- review the treatment plan.
minal brain cancer. The
client tells the nurse, "I
am always so sick; I don't
want to do this anymore."
The parent has informed
the nurse that the family
strongly wishes to try any
available treatment to cure
their child. Which of the fol-
lowing interventions by the
nurse is most appropriate?
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