PN End of Life HESI Case Study Questions and Answers Graded A+

PN End of Life HESI Case Study Questions and Answers Graded A+ The client asks the practical nurse (PN) why his medication was changed. What is the most likely reason for this change? B. Dry cough is a common side effect of an ACE inhibitor. The HCP ordered 80 mg of Valsartan (Diovan) to be administered twice daily. The available dose is Valsartan (Diovan) 40 mg tablets. How many tablets will the PN administer to Mr. Pinner with each dose? 2 Which medication or combination of medications that Mr. Pinner listed as his home medications, may contribute to his upset stomach? A. Hydrocodone and Acetaminophen (Norco) When reinforcing the teaching to a client about the use of nitroglycerin, which of the following points should the PN include? (Select all that apply.) A. Nitroglycerin should be kept in a tightly closed container. D. Nitroglycerin should be dissolved under the tongue, not chewed or swallowed. Which of the following ECG findings indicate that Mr. Pinner may be having another MI? C. ST segment elevation How much oxygen should Mr. Pinner receive at this time? B. Give oxygen at 2 L per minute by nasal cannula titrated for saturation greater than 94%. What action should the PN take first? A. Stop the HCP and remind the HCP of client confidentiality. What is the best response by the PN? A. "Mr. Pinner, you may be correct. We do not know for certain if you have cancer and the HCP said further testing will be obtained." Mr. Pinner complains of pain to the PN. What is the best method for measuring his pain? C. Ask the client to rate his pain on a scale of 0 to 10. What action(s) should the PN implement? A. Explain to Mr. Pinner that he will not become addicted to morphine with one dose. C. Evaluate Mr. Pinner for allergies. While evaluating Mr. Pinner at the beginning of the shift, the PN notes that Mr. Pinner has a saline lock in place that will be used for tests with contrast media administration. What is the best location for Mr. Pinner's saline lock placement? D. His left antecubital (AC). What documentation is needed before a thoracentesis is performed? B. An informed consent. Who can legally give consent for the client who is unable to sign for himself? (Select all that apply.) A. The legal next of kin. B. The designee of a medical power of attorney. What potential complication could occur during a thoracentesis due to the client's daily aspirin regimen? B. Bleeding. What laboratory tests or analyses would the PN anticipate being ordered on Mr. Pinner's pleural fluid specimen to confirm the diagnosis of metastatic disease? (Select all that apply.) C. Cytology. E. Color. Which signs and symptoms will the PN tell Mr. Pinner to report immediately? (Select all that apply.) A. Pain on the affected side. B. The feeling of a rapid heart rate. C. New onset of a "nagging" cough. E. Feeling like he cannot catch his breath. What action should the PN take next? C. Notify the HCP as soon as possible, allowing the HCP to talk with the client. What is the PN's role in informing clients about terminal illness? D. Remain at the bedside, listening to the client's concerns while the HCP talks to the client. On hearing Mr. Pinner's request to refuse further treatment, what should the PN do? C. Explain again to Mr. Pinner the options for treatment, including chemotherapy, radiation, and no action, and respect his wishes to refuse treatment. What are the reasons for a client to receive medications while on hospice care? A. Relieve symptoms of the illness and allow a dignified death. What document is needed for Mr. Pinner to receive only comfort care while in the hospital? B. A do not resuscitate order (DNR). What documentation will Mr. Pinner need to ensure emergency personnel do not perform heroic measures at his home? C. An out of hospital DNR document if approved in the state. Mr. Pinner becomes short of breath during any activity. What is the priority intervention for this client? B. Provide the client with oxygen by nasal cannula. What response(s) should the PN provide to Mr. Pinner's daughters? (Select all that apply.) A. "We need to follow your father's wishes explicitly. Your father really did not want a feeding tube." C. "When a client is nearing the end of life, many times the body processes slow and start to shut down. If we provide food when the client is not physically hungry, we may cause more discomfort than support." E. "Clients taking more pain medications can become constipated, which decreases their appetite. We may provide a stool softener and a stimulant." Mr. Pinner is trying to right wrongs from his life. Which stage of grief is he experiencing? B. Acceptance.