Case 1
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
Mr. Desai tells the nurse that he feels more short of breath each day and it is now diflcult to C. "There are medications that can ease your breathing."
speak more than a few words at a time. What is the nurse's best response?
A. "That means the cancer is spreading rapidly."
B. "You should go to the hospital right away."
C. "There are medications that can ease your breathing."
D. "Try to walk a little each day to keep your lungs working."
Case 1
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
Mr. Desai's daughter asks how they will know when death is near. What should the nurse B. "You might see changes in breathing and skin color."
include in the response?
A. "He will likely become more alert before passing."
B. "You might see changes in breathing and skin color."
C. "He will experience chest pain shortly before death."
D. "He will stop talking about his past experiences."
Case 1
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
During a visit, the nurse finds Mr. Desai unresponsive, with agonal breathing and a weak
B. "He is actively dying; this is part of the natural process."
pulse. The family asks what is happening. What is the most appropriate response by the
nurse?
A. "He has likely passed away already."
B. "He is actively dying; this is part of the natural process."
C. "He needs emergency care; I will call an ambulance."
D. "This is a sign that treatment is no longer working."
Case 1
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
B. Secure the medication and return it to the community pharmacy.
After Mr. Desai passes away, the nurse notes several unused vials of hydromorphone. What
is the nurse's best action?
A. Ask the family to flush the medication down the toilet.
B. Secure the medication and return it to the community pharmacy.
, C. Leave the medication with the family to manage later.
D. Report the medication to public health services for disposal.
Case 1
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
A few weeks after Mr. Desai's death, the nurse reflects on a sense of emotional heaviness and A. Seek peer support or debrief with colleagues.
fatigue. What is the most appropriate initial step for the nurse to take?
A. Seek peer support or debrief with colleagues.
B. Submit a request to transfer out of palliative care.
C. Suppress the feelings and continue working.
D. Avoid forming bonds with future patients.
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
Which of the following interventions is a priority for Mr. Nguyen upon arrival in the emergency B. Administer nitroglycerin as ordered0
department?
A. Administer a beta-blocker
B. Administer nitroglycerin as ordered
C. Start an intravenous infusion of normal saline
D. Obtain consent for cardiac catheterization
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
The health care team wants to assess the extent of Mr. Nguyen's coronary artery disease. D. Coronary angiography
Which diagnostic test will provide the most detailed information?
A. Electrocardiography (ECG)
B. Cardiac enzyme panel
C. Chest X-ray
D. Coronary angiography
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
C. To place a stent to open the blocked coronary artery
Mr. Nguyen is scheduled for an emergency percutaneous coronary intervention (PCI). What
is the primary goal of this procedure?
A. To bypass the blockage with a graft
, B. To dissolve the clot in the coronary artery
C. To place a stent to open the blocked coronary artery
D. To assess heart valve function
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
Following PCI, the nurse is monitoring Mr. Nguyen's puncture site in the right groin. Which B. A hard, painful lump forming at the site
of the following findings requires immediate follow-up?
A. A small amount of dried blood on the dressing
B. A hard, painful lump forming at the site
C. Bruising about 1 cm in diameter
D. Slight warmth near the site
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
Twelve hours after PCI, Mr. Nguyen reports feeling weak and light-headed upon standing. C. Assess orthostatic blood pressure
What should the nurse do first?
A. Encourage deep breathing exercises
B. Check his latest hemoglobin level
C. Assess orthostatic blood pressure
D. Increase his oral fluid intake
Case 3
A nurse educator is conducting an orientation session on documentation for a group of
newly hired nurses working in a long-term care facility. The session covers legal, ethical, and
professional standards related to client documentation.
The nurse educator explains the purpose of accurate documentation. What is the primary
B. To communicate client care and condition with the health care team
reason for documenting client care?
A. To ensure accountability to the nursing manager
B. To communicate client care and condition with the health care team
C. To protect the nurse in the event of a complaint
D. To provide evidence for workload measurement and staflng
Case 3
A nurse educator is conducting an orientation session on documentation for a group of
newly hired nurses working in a long-term care facility. The session covers legal, ethical, and
professional standards related to client documentation.
B. "The agency owns the record, but the client has the right to access it."
One of the new nurses asks who owns the client's health record. What should the nurse
educator respond?
A. "The client owns the entire record and controls access to it."
B. "The agency owns the record, but the client has the right to access it."
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
Mr. Desai tells the nurse that he feels more short of breath each day and it is now diflcult to C. "There are medications that can ease your breathing."
speak more than a few words at a time. What is the nurse's best response?
A. "That means the cancer is spreading rapidly."
B. "You should go to the hospital right away."
C. "There are medications that can ease your breathing."
D. "Try to walk a little each day to keep your lungs working."
Case 1
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
Mr. Desai's daughter asks how they will know when death is near. What should the nurse B. "You might see changes in breathing and skin color."
include in the response?
A. "He will likely become more alert before passing."
B. "You might see changes in breathing and skin color."
C. "He will experience chest pain shortly before death."
D. "He will stop talking about his past experiences."
Case 1
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
During a visit, the nurse finds Mr. Desai unresponsive, with agonal breathing and a weak
B. "He is actively dying; this is part of the natural process."
pulse. The family asks what is happening. What is the most appropriate response by the
nurse?
A. "He has likely passed away already."
B. "He is actively dying; this is part of the natural process."
C. "He needs emergency care; I will call an ambulance."
D. "This is a sign that treatment is no longer working."
Case 1
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
B. Secure the medication and return it to the community pharmacy.
After Mr. Desai passes away, the nurse notes several unused vials of hydromorphone. What
is the nurse's best action?
A. Ask the family to flush the medication down the toilet.
B. Secure the medication and return it to the community pharmacy.
, C. Leave the medication with the family to manage later.
D. Report the medication to public health services for disposal.
Case 1
A nurse is working in a community-based oncology program and is providing care to Mr.
Desai, a 72-year-old man diagnosed with metastatic non-small cell lung cancer. Mr. Desai has
declined aggressive treatment and opted for palliative care at home, supported by his wife
and adult daughter.
A few weeks after Mr. Desai's death, the nurse reflects on a sense of emotional heaviness and A. Seek peer support or debrief with colleagues.
fatigue. What is the most appropriate initial step for the nurse to take?
A. Seek peer support or debrief with colleagues.
B. Submit a request to transfer out of palliative care.
C. Suppress the feelings and continue working.
D. Avoid forming bonds with future patients.
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
Which of the following interventions is a priority for Mr. Nguyen upon arrival in the emergency B. Administer nitroglycerin as ordered0
department?
A. Administer a beta-blocker
B. Administer nitroglycerin as ordered
C. Start an intravenous infusion of normal saline
D. Obtain consent for cardiac catheterization
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
The health care team wants to assess the extent of Mr. Nguyen's coronary artery disease. D. Coronary angiography
Which diagnostic test will provide the most detailed information?
A. Electrocardiography (ECG)
B. Cardiac enzyme panel
C. Chest X-ray
D. Coronary angiography
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
C. To place a stent to open the blocked coronary artery
Mr. Nguyen is scheduled for an emergency percutaneous coronary intervention (PCI). What
is the primary goal of this procedure?
A. To bypass the blockage with a graft
, B. To dissolve the clot in the coronary artery
C. To place a stent to open the blocked coronary artery
D. To assess heart valve function
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
Following PCI, the nurse is monitoring Mr. Nguyen's puncture site in the right groin. Which B. A hard, painful lump forming at the site
of the following findings requires immediate follow-up?
A. A small amount of dried blood on the dressing
B. A hard, painful lump forming at the site
C. Bruising about 1 cm in diameter
D. Slight warmth near the site
Case 2
Michael Nguyen, age 60, is brought to the emergency department by his partner after
experiencing severe, unrelenting chest pain radiating to his left arm and jaw. He is diaphoretic
and anxious. An electrocardiogram (ECG) shows ST-segment elevation, and his troponin levels
are elevated. He is diagnosed with an acute ST-elevation myocardial infarction (STEMI).
Twelve hours after PCI, Mr. Nguyen reports feeling weak and light-headed upon standing. C. Assess orthostatic blood pressure
What should the nurse do first?
A. Encourage deep breathing exercises
B. Check his latest hemoglobin level
C. Assess orthostatic blood pressure
D. Increase his oral fluid intake
Case 3
A nurse educator is conducting an orientation session on documentation for a group of
newly hired nurses working in a long-term care facility. The session covers legal, ethical, and
professional standards related to client documentation.
The nurse educator explains the purpose of accurate documentation. What is the primary
B. To communicate client care and condition with the health care team
reason for documenting client care?
A. To ensure accountability to the nursing manager
B. To communicate client care and condition with the health care team
C. To protect the nurse in the event of a complaint
D. To provide evidence for workload measurement and staflng
Case 3
A nurse educator is conducting an orientation session on documentation for a group of
newly hired nurses working in a long-term care facility. The session covers legal, ethical, and
professional standards related to client documentation.
B. "The agency owns the record, but the client has the right to access it."
One of the new nurses asks who owns the client's health record. What should the nurse
educator respond?
A. "The client owns the entire record and controls access to it."
B. "The agency owns the record, but the client has the right to access it."
