Practice

The nurse helps a client with end-stage renal disease and a serum potassium level of 5.2mEq/L to plan menu choices. Which items would be best to include in the meal plan? 1. Black beans and rice, sliced tomatoes, half a cantaloupe 2. Grilled chicken sandwich on white bread, applesauce 3. Hamburger patty on whole wheat bun, carrot sticks, chocolate pudding 4. Poached salmon, green peas, baked potato, strawberries

2 Clients with ESRD are unable to excrete potassium, therefore, the nurse should teach them to choose foods low in potassium. Grilled chicken sandwich on white bread and applesauce are low in potassium

A client is in cardiac arrest, and resuscitation efforts are in progress when the client's spouse arrives. The client's spouse insists on coming into the room. How should the nurse respond? 1. Allow the spouse into the room and provide a chair 2. Call the chaplain to sit with the spouse outside the room 3. Have the unit secretary escort the spouse to the waiting room 4. Tell the spouse that the resuscitation is too graphic to be witnessed

1 Allowing family to be present during resuscitative efforts and invasive procedures can help the family process and cope with the client's condition, alleviate fears and anxiety, and facilitate the grieving process if the expected outcome is poor. The nurse should permit the client's spouse to enter the room and provide a location to observe and another nurse should explain the treatment measures that are occurring

The nurse is caring for an adult client who is in soft wrist restraints. Which nursing action should be included in the plan of care? Select all that apply 1. Offer fluids, nutrition, and toileting every 2 hours and as needed 2. Perform neurovascular assessment every hour 3. Reassess client's continued need for restraints every 12 hours 4. Release restraints to perform range of motion exercises every 2 hours 5. Remove restraints for a trial discontinuation every 4 hours

1, 2, 4 Option 3: Restraints should a last resort and discontinued as soon as possible. The nurse should regularly reassess (every hour) the client's continued need for restraints Option 5: Once restraints are discontinued, a new prescription is required to reapply them. Trial discontinuations are not permitted

A nurse reviews the plan of care for a client who has increased intracranial pressure. Which nursing actions should be included? Select all that apply 1. Administer a stool softener 2. Dim lights when not providing care 3. Elevate head on several pillows 4. Maintain body in midline position 5. Only perform oral suctioning when necessary

1, 2, 4, 5 Nursing interventions to decrease ICP include: -Position head of bed to 30 degrees to promote venous return from the head, which will decrease cerebral edema. Elevating the head >30 degrees decreases blood pressure, which can decrease cerebral perfusion pressure; therefore position the client to balance ICP and CPP -Keep head and body midline and avoid extreme hip or neck flexion as this impedes venous drainage -Administer stool softeners to prevent straining -Suction only when needed to maintain airway and for no longer than 10 seconds per suctioning pass -Reduce metabolic demands (pain, seizures, hypoxia fever). Treat fever aggressively (acetaminophen) but avoid shivering Option 3: For clients with increased ICP, elevating head of bed is preferred over utilizing pillows to elevate the head as pillows may flex the neck, decrease venous drainage, and increase ICP

Which client situation would be classified as an adverse event, requiring the nurse to complete an incident report? Select all that apply 1. CSF fluid sample is sent to the lab labeled as a urine sample 2. Client who has a hemoglobin of 6 g/dL refuses recommended blood products 3. Nurse does not report potassium result of 6.5 mEq/L to HCP 4. Postpartum client who is post epidural anesthesia falls while ambulating to the bathroom 5. Provider prescribes 5,000 units of heparin, nurse gives 1 mL (10,000 units/mL) of heparin

1, 3, 4, 5 An incident/adverse event is an unforeseen or unintended outcome that RESULTS IN HARM or has the POTENTIAL TO CAUSE HARM, and may or may not be preventable. Adverse events may involve clients, staff, or visitors, and require completion of incident reports. An incident report should be COMPLETED SEPARATELY FROM THE MEDICAL RECORD. Completion of this report is not mentioned in the medical record, which should contain only an objective description of observed events Examples of client incidents include falls, mislabeled laboratory specimens, and medication administration errors. Communication errors may also be classified as the omission or miscommunication of critical information may result in harm. incomplete treatment, or inadequate follow up. Other incident types involving health care staff include needlestick injuries or confidentiality breaches of protected health information

A nurse is reading a client's tuberculin skin test 48 hours after placement and notes an 11 mm area of induration. The client is a recent immigrant from Nigeria and reports no symptoms. Which actions would be appropriate by the nurse? Select all that apply 1. Ask the client about a history of bacille Calmette-Guerin vaccine 2. Document the negative response in the client's medical record 3. Have the client return in a week to receive a second injection 4. Obtain a prescription for a chest x-ray from the HCP 5. Place the client in droplet precautions and wear a surgical mask during care

1, 4 The skin is assessed at the bleb administration site 48-72 hours after placement. Positive results include an induration of >15 mm in healthy individuals, >5 mm in high-risk populations and >10 mm in clients with potential risk or mild immunosuppression This immigrant client has a positive test (>10 mm induration). The bacille Calmette-Guerin vaccine improves TB resistance in high risk countries but produces false-positive tuberculin skin test results Positive results warrant further testing. Chest x-ray helps identify clients who do not have symptoms but still have active disease. Sputum cultures can be used for diagnosis if the client is symptomatic

A nurse in the cardiac intensive care receives report on 4 clients. Which client should the nurse assess first? 1. Client 2 months post heart transplant with sustained sinus tachycardia of 110/min at rest 2. Client 3 hours post coronary artery stent placement via femoral approach and reporting severe back pain 3. Client receiving IV antibiotics for infective endocarditis with a temp of 101.5 4. Client who had coronary bypass graft surgery 3 days ago and has swelling in the leg used for the donor graft

2 A client who undergoes percutaneous coronary intervention (PCI) and intracoronary stent placement using the femoral approach is at increased risk for RETROPERITONEAL HEMORRHAGE Administration of antithrombotic drugs before, during, and after PCI can exacerbate potentially life-threatening bleeding from the femoral artery Hypotension, back pain, flank ecchymosis (Grey-Turner sign), hematoma formation, and diminished distal pulses can be early signs of bleeding into the retroperitoneal space Option 1: During a heart transplant, the donor heart is cut off from the autonomic nervous system, which alters the heart rate during rest and exercise after the transplant. The transplanted heart is expected to be tachycardic (90-110/min) Option 4: Some clients notice swelling in the leg used for donor venous graft (interruption of blood flow). Elevating the leg and wearing compression stockings can help

A nurse hears various alarms sounding from different client rooms. Which alarm will the nurse address first? 1. Distal occlusion alarm on an infusion pump infusing heparin 2. Low-pressure limit alarm on a ventilator 3. Monitor alarm for a low respiratory rate of 11bpm 4. Occlusion alarm on continuous enteral feeding pump

2 A low-pressure limit alarm on the ventilator is triggered when the amount of positive pressure necessary to deliver a breath to the client is decreased. A decrease in resistance to airflow occurs due to complications that arise in the client (loss of airway), artificial airway (cuff leak), and/or ventilatory system (tubing disconnect). All of these conditions impair airway and ventilation; therefore, addressing this alarm is the highest priority

The charge nurse is making client assignments for the oncoming shift. Which client assignment is most appropriate for a nurse who is 10 weeks pregnant? 1. Client receiving brachytherapy for endometrial cancer 2. Client with an infected surgical wound positive for methicillin-resistant staphylococcus aureus 3. Client with a herpes zoster rash on the face and scalp 4. Client with pneumonia who recently traveled to a region with the Zika virus

2 A pregnant nurse does not have a high risk for contracting MRSA if appropriate infection precautions are used. The nurse should carefully follow contact precautions, including wearing gloves and gown and performing strict hand hygiene. Even if the pregnant nurse were to contact MRSA, there are a few known harmful effects to the fetus TORCH infections (Toxoplasmosis, Other [parvovirus B19/varicella-zoster virus], Rubella, Cytomegalovirus, Herpes simplex virus) can cause fetal abnormalities and clients with these infections should not be assigned to pregnant health care workers

While the nurse and UAP are turning an intubated and heavily sedated client during a bath, the client coughs and expels the endotracheal tube. What is the priority nursing action? 1. Assess respiratory rate and breath sounds to ensure ventilation is occurring 2. Deliver rescue breathing with a bag valve mask attached to 100% oxygen 3. Immediately alert the HCP and prepare for reintubation 4. Initiate a code blue to prepare for potential cardiac arrest due to hypoxemia

2 Accidental extubation is a medical emergency. A sedated client is unable to protect the airway and requires immediate reintubation. If a client is accidentally extubated, the nurse should remain with the client, protect the airway using the head-tilt chin-lift or the jaw-thrust maneuver if spinal injury is suspected, and deliver breaths using a bag valve mask with 100% oxygen until reintubation is achieved Option 1: Assessing the respiratory system is important but is not the priority action. Rescue breathing should not be delayed, as sedation significantly depresses respiration Option 3: Another nurse can notify the HCP. Oxygenation is the priority action

The registered nurse supervises an LPN and UAP caring for clients receiving brachytherapy. Which action would require the nurse to intervene? 1. LPN who reinforces the purpose of prescribed bed rest for a client with a radium implant for cervical cancer 2. LPN who, when caring for a client with a radium implant, turns away from the client while wearing a lead apron 3. UAP who changes the bed linens of a client with a radium implant and leaves the removed linens in the room 4. UAP who empties the urinal of a client with implanted radioactive seeds for prostate cancer into the toilet

2 Brachytherapy is an internal radiation treatment that is ingested, injected into a cavity or bloodstream, or implanted (seeds, capsules, wires). Brachytherapy emits radiation in or near a tumor to treat certain cancers. When caring for clients undergoing brachytherapy, nurses should maintain specific precautions to ensure safety, including: -Limit the time of exposure (30 min/day). Cluster care and wear a designated dosimeter badge -Maximize distance from the source; 6 feet is recommended -Use shielding (lead apron, portable lead shields) appropriately. Lead aprons typically shield the front of the body; turning the back to the client is a risk for exposure Pregnant women and children should not be exposed to clients undergoing brachytherapy Option 3: Dressings, bed linens, and trash must remain in the client's room until the implant is removed Option 4: The body fluids of clients with implanted radioactive seeds in the prostate are generally not radioactive. Some seeds may be passed through the urine; however, they emit very little radiation

During the discharge process, the nurse observes a new parent placing a newborn into a car seat in the vehicle. Which action by the parent requires the nurse to intervene? 1. Anchors the car seat in the center of the vehicle's back seat 2. Dresses the newborn in a sleep sack before securing the harness 3. Keeps the car seat at a 45 degree angle 4. Uses a car seat that faces the rear of the vehicle

2 Newborns and children age <2 years must be placed in a rear-facing car seat in the vehicle's back seat. The harness fits securely when the newborn is dressed in lightweight clothing. Tucking blankets between the newborn and the harness or dress the newborn in bulky coats ora a sleep sack reduces the car seats's effectiveness Option 1: The car sear should be placed in the back seat and in the center (away from doors). This protects the child from airbag deployment as well as collisions to the vehicle's side

The nurse is caring for a pediatric client with osteomyelitis. Prior to the nurse administering IV antibiotics, the client's parent states, "We don't believe in antibiotics. Healing comes from within, and medications are toxic to that process." What is the nurse's priority response? 1. "Please tell me how medications are toxic to the healing process." 2. "Please tell your understanding of your child's condition?" 3. "What type of healing practices would you prefer for your child?" 4. "Without this medication, your child can get worse and could die."

2 Parental refusal of necessary medication for a minor creates an ethical dilemma. The nurse's first response should be assessment of a parental knowledge deficit regarding the client's condition. The nurse should ask open-ended questions, allowing the parent to demonstrate knowledge. Option 3: Preferred healing practices are an important aspect of spiritual assessment; however, the priorities are to obtain parental consent for and initiate necessary treatment. Spiritual and cultural elements may be appropriate to include after physical needs (antibiotics) are met

A nurse is caring for a client who had a transurethral resection of the prostate and is receiving continuous bladder irrigation by gravity. Which tasks can the nurse delegate to UAP? Select all that apply 1. Calculating the difference between irrigant intake and total drainage output 2. Cleaning around the catheter insertion site daily 3. Immediately notifying the nurse if the client reports pain 4. Increasing the irrigation rate when the urine becomes more red than pink 5. Measuring the total volume of output in the drainage collection bag

2, 3, 5 Continuous bladder irrigation is prescribed following surgical transurethral resection of the prostate and prevents obstruction of urine outflow by removing clotted blood from the bladder. The RN should consider the 5 rights of delegation when delegating to UAP: -Catheter care is a routine, noncomplex task that may be safely delegated to UAP Option 1: Clots or kinks may obstruct drainage and cause a smaller volume of outflow than inflow. The nurse should calculate this difference to determine the need to reestablish patency using manual irrigation

The nurse is teaching about constipation prevention to a client. Which of the following client statements indicate appropriate understanding of the teaching? Select all that apply 1. "Drinking more caffeinated drinks such as tea and soda helps to stimulate the bowel." 2. "Having a routine for bowel movements is important, but I should not wait if I feel the urge." 3. "I can use an OTC laxative every other day if needed." 4. "I should try to eat more fruits and veggies every day." 5. "Increasing my daily exercise level may keep my bowel movements regular."

2, 4, 5 Option 1: Clients should avoid caffeinated beverages, which promote diuresis and dehydration and may lead to constipation Option 3: Clients should avoid using laxatives and enemas unless prescribed by a HCP because overuse can cause physical and psychological dependence

The staff nurse caring for a client with a history of drug abuse approaches the charge nurse and says "my client is constantly requesting pain medicine. I had to administer NS instead of morphine because it is too early for another dose of morphine." Which action by the charge nurse is the priority at this time? 1. Document the incident in the nurse's employee file and review it with the unit manager 2. Follow institutional protocol for filing an incident or variance report 3. Instruct the nurse to notify the HCP about the lack of pain relief 4. Report the incident to the hospital's ethics committee for evaluation

3 Administration of a placebo outside of a consented research trial is unethical and deceitful. Clients with a history of drug abuse and increased opioid tolerance often require a higher-dose analgesic or stronger opioid to achieve pain relief. The most appropriate action by the charge nurse at this time is to instruct the staff nurse to contact the HCP to discuss the client's frequent requests for morphine to alleviate uncontrolled pain Options 1 and 2: Any documentation or reporting should be completed after addressing the issue with the nurse, to ensure the client receives the appropriate medications for pain relief Option 4: A hospital ethics committee examines the overall plan of care for clients with complex, often life or limb-threatening conditions. A scenario such as this client's should be resolved by unit management and not be escalated to the ethics committee

A pregnant client at 38 weeks gestation is admitted to the labor and delivery unit reporting contractions, severe abdominal pain, and dark vaginal bleeding. What is the nurse's priority action? 1. Initiate large bore (18 gauge) peripheral IV line 2. Notify operating room staff of emergency c-section 3. Palpate abdomen and apply fetal heart rate monitor 4. Perform vaginal exam to assess cervical dilation

3 Placental abruption occurs when the placenta prematurely detaches from the uterine wall. This life-threatening complication can interrupt fetal oxygen supply and cause maternal hemorrhage. Associated symptoms may include frequent contractions, abdominal pain, dark red vaginal bleeding, uterine tenderness, and elevated uterine resting tone. Priorities include assessment of maternal vital signs, palpation of the abdomen/uterus, and continuous fetal heart rate monitoring. If monitoring indicates fetal distress and/or maternal hemodynamic compromise, the health care team with prepare for emergency c-section Option 4: Vaginal exam is not performed in the presence of active bleeding until the possibility of placenta previa is ruled out; placenta previa typically presents with PAINLESS VAGINAL BLEEDING

The nurse cares for a client with an established ascending colostomy. Which statement made by the client indicates that further teaching is required? 1. "I always try to drink 3 liters of water each day." 2. "I avoid eating beans, onions, broccoli, and cauliflower." 3. "I change the appliance and bag every other day." 4. "I empty the bag when it is about one-third full."

3 Stool is contained in an ostomy appliance bag secured to the skin. The appliance opening is cut to fit closely around the stoma. If the appliance does not fit well, liquid stool may leak onto the peristomal skin, and skin irritation occurs due to the digestive enzymes in stool. Peristomal skin irritation may also occur if the ostomy appliance is removed and changed too frequently. The appliance should be changed every 5-10 days

The nurse is planning care for a client with bipolar disorder and acute mania who is being admitted involuntarily after attempting to run across a five-lane highway. Which intervention is the priority to include in the care plan? 1. Assist the client with dressing by giving instructions one at a time 2. Collaborate with unit staff to set consistent limits on manipulative behavior 3. Offer high-calorie snacks the client can eat while on the move and during tasks 4. Secure the client's credit cards to prevent compulsive spending and bankruptcy

3 When caring for a client with mania, the nurse should prioritize physiological needs over psychological or self-fulfillment needs. The nurse can address imbalanced nutrition in a manic client by providing high-calorie snacks and finger foods that the client can carry and eat without having to sit down

The charge nurse is responsible for making room assignments for multiple clients. Which pair of client assignments to a shared room is appropriate? 1. Client with blood loss anemia and client with intractable diarrhea 2. Client with gastroenteritis and client with chemotherapy-induced nausea and vomiting 3. Client who had a bowel resection 1 day ago and client with asthma exacerbation 4. Client who had a total hip arthroplasty 2 days ago and client with influenza

3 When making room assignments, it is important to remember that a client with an active or suspected infection should not be paired with a client who has a fresh surgical wound or is immunocompromised. A client having an asthma exacerbation does not have an infection and is not at risk for spreading infection to a client who had recent bowel resection surgery Option 1: A client with uncontained or excessive excretions, drainage, or secretions (profuse diarrhea, draining wounds) is more likely to spread infection

A nurse is preparing to administer a unit of packed red blood cells to a client with a hemoglobin of 7 g/dL. The unit secretary retrieved the blood 25 minutes ago. When entering the client's room, the nurse notes that the client's IV is not patent and is unsuccessful at inserting the new IV. What should the nurse do next? 1. Have another nurse attempt to restart the IV 2. Notify the HCP of the delay 3. Place the blood in the unit refrigerator 4. Return the blood to the blood bank

4 Blood products should NOT BE LEFT AT ROOM TEMPERATURE FOR > 30 MINUTES BEFORE A TRANSFUSION is started. Leaving blood out at room temperature for a prolonged period increases the likelihood of bacterial growth. If the start of the transfusion is delayed, the blood should be returned to the blood bank, where it can be refrigerated at a precise temperature

The nurse on the antepartum unit is performing shift assessments of several pregnant clients. Which client assessment is the priority to report to the HCP? 1. Client with gestational diabetes reporting dysuria 2. Client with hyperemesis gravidarum with a blood pressure of 90/48 3. Client with oligohydramnios and a reactive fetal nonstress test 4. Client with preeclampsia with 3+ reflexes and 2 beats of clonus

4 Clients with preeclampsia are at risk for developing preeclampsia-associated seizure activity (eclampsia) as a result of increased central nervous system irritability. The presence of neurologic manifestations (hyperreflexia, clonus) may indicate worsening preeclampsia and can precede seizure activity Option 2: Hyperemesis gravidarum usually affects clients in the first trimester and is characterized by severe nausea and vomiting that can lead to dehydration, hypotension, electrolyte imbalances, and nutritional deficits. The client should be assessed for further symptoms of hypotension (dizziness, blurred vision) before notifying the HCP Option 3: Oligohydramnios indicates low amniotic fluid, which may lead to umbilical cord compression and fetal compromise. However, a reactive nonstress test is a reassuring finding

The nurse accidentally administers orally dissolving mirtazapine through a client's PEG tube instead of the prescribed sublingual route. After assessing the client for adverse reactions, what is the nurse's priority action? 1. Disclose the medication error to the client 2. Document the error on an incident report 3. Inform the nurse manager about the error 4. Notify the prescribing HCP

4 Orally dissolving mirtazapine is an antidepressant specifically formulated for mucous membrane absorption, allowing quick entry into the bloodstream. Crushing and administering this medication through a percutaneous endoscopic gastrostomy tube is a wrong-route medication error If medication error occurs, the priority is client safety. The nurse should first assess for adverse effects and stabilize the client's condition, if needed. The nurse should then immediately notify the HCP of the error and assessment findings. The HCP may prescribe new interventions to prevent or reduce harm to the client The nurse should inform the client and nurse manager about the error and complete an incident report after stabilizing the client's condition, notifying the HCP, and implementing new prescriptions

A client arrives in the ED with right-sided paralysis and slurred speech. The nurse understands that the client cannot receive thrombolytic therapy due to which reason? 1. Client had gallbladder surgery 2 months ago 2. Client has experienced loss of gag reflex 3. Client has platelet count of 130,000 4. Client has symptoms that started 12 hours earlier

4 Thrombolytic therapy (tissue plasminogen activator tPA) is used to dissolve blood clots and restore perfusion in clients with ischemic stroke. tPa must be administered within a 3- 4.5 hour window from onset of symptoms for full effectiveness Option 1: Recent major surgery within the past 14 days is a contraindication as tPA dissolves all clots in the body and may disrupt the surgical site. Gallbladder surgery 2 months ago is outside the window of contraindication Option 2: Loss of gag reflex would make the client a candidate due to proof of deficits from stroke Option 3: Clients with thrombocytopenia (platelets <100,000) and/or coagulation disorders should not receive tPa as these conditions further increase the risk for bleeding. Other contraindications include hemorrhagic stroke, uncontrolled HTN, and stroke or head trauma within the past 3 months

The nurse is caring for an African American client with DIC. Which locations are best to assess for the presence of petechiae? 1. Buccal mucosae and conjunctivae of the eyes 2. Nail beds of the fingers and toes 3. Palms of the hands and soles of the feet 4. Skin over the sacrum and behind the heels

1 In dark-skinned clients, petechiae can best be assessed in the conjunctivae of the eyes and the buccal mucosae Option 2: The nail bed of fingers are the best location to assess dark-skinned clients for cyanosis. Petechiae does not occur in the nail beds Option 3: The palms of the hands and soles of the feet are ideal locations for assessing for jaundice in dark-skin people

The HCP has explained the risks and benefits of a planned surgical procedure and asks the nurse to witness the client's signature on the consent form. Which situation would affect the legitimacy of the signature? 1. Client asks whether a blood transfusion will be required during the surgery 2. Client expresses a fear of post op pain 3. Client received a dose of hydrocodone for pain 12 hours ago 4. Client wishes to wait to sign the consent until the spouse is present

1 A client questioning regarding the need for a blood transfusion during surgery indicates an incomplete understanding of risk and would invalidate the signature Option 3: Narcotics can cause sedation and impairment. The client can provide informed consent only after the effects of sedating medications have worn off. The duration of action for hydrocodone is 4-6 hours, a client who received a dose 12 hours ago would no longer be impaired from the medication

A client with sickle cell crisis reports severe generalized pain. Which intervention is a priority for correcting vasoocclusion? 1. Administering high-flow IV fluids 2. Applying oxygen via nasal cannula 3. Maintaining strict bed rest 4. Transfusing packed red blood cells

1 Sickle cell crisis occurs when inadequate oxygenation or hydration exacerbates sickling and causes red blood cells to clump together in the capillaries (vasooclussion). Vasooclusion causes severe ischemic pain, hypoxia, and possible organ dysfunction if left untreated Adequate oxygenation and hydration may reverse the acute sickling response. In the sickled state, RBCs cannot carry enough oxygen from the lungs to the tissues, even with supplemental oxygen, The priority intervention is the administration of IV fluids to reduce blood viscosity and restore perfusion to the areas previously affected

A client with emphysema arrives at the clinic for a routine follow-up visit. Which manifestations are characteristics of emphysema? Select all that apply 1. Activity intolerance 2. Barrel chest 3. Hyperresonance on percussion 4. Stridor 5. Tracheal deviation

1, 2, 3 Emphysema is characterized by alveolar wall destruction. Lung tissues lose elasticity (recoil) due to permanently enlarged "floppy" alveoli. This causes hyperinflation of the lungs (air trapping), manifested by hyperresonance on percussion and prolonged expiration Hyperinflation of the lungs causes the client to develop a barrel-shaped chest. Hyperinflated lungs also prevent the client from meeting oxygen demands during increased activity, leading to activity intolerance and anxiety. Pursed lip breathing, accessory muscle use, and the tripod position (leaning forward with hands on the knees) are seen during exertion as the disease progresses Option 4: Stridor (harsh, high pitched breathing) is due to obstruction or constriction of the upper airway (aspiration of foreign object, anaphylaxis, epiglottitis). Stridor indicates life-threatening airway compromise and requires prompt intervention Option 5: Tracheal deviation occurs with a tension pneumothorax. When an injury causes air to become trapped in the pleural space, intrapleural pressure increases and pushes on the heart and great vessels.

The nurse cares for a client with a terminal disease who has an advance directive supporting a do not resuscitate code status. The client stops breathing a loses a pulse. The client's adult child states "I changed my mind. Do whatever you can to save him!" Which intervention is most appropriate at this time? 1. Call for help to initiate CPR 2. Call the HCP to confirm the DNR status 3. Explain the client's wishes to the client's child 4. Offer to call the hospital to provide support

3 Advance directives outline the client's choices for medical care ahead of time. This allows the family and care team to follow the client's wishes at the end of life. Clients can sign a do not resuscitate directive instructing that CPR and other life-saving measures be withheld. With an advance directive in place, the client's wishes are followed, even if they conflict with the wishes of loved ones