Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is completing postmortem documentation for a client. Which of the following information should the nurse include in the documentation?
A. Location of the identification tag on the client's body
a. Location of the identification tag on the client's body: This is essential information that should be included in the documentation. It ensures that the deceased person is properly identified and helps prevent any mix-ups during subsequent processes, such as transferring the body to the morgue or a funeral home.
B. Cause of the client's death
While this information is important, it's typically documented by the physician on the death certificate and is not generally part of the nurse's postmortem documentation.
C. Last set of the client's vital signs
The last set of vital signs is not usually required for postmortem documentation. Postmortem documentation focuses on the condition of the body and identification rather than the final vital signs, which are often irrelevant after death.
D. Copy of the client's advance directives
None
This question is an excerpt from Nurse Dive's nursing test bank - PN Comprehensive Predictor PN 2020 Proctored Exam. Take the full exam now
Full Explanation
a. Location of the identification tag on the client's body: This is essential information that should be included in the documentation. It ensures that the deceased person is properly identified and helps prevent any mix-ups during subsequent processes, such as transferring the body to the morgue or a funeral home.
b-While this information is important, it's typically documented by the physician on the death certificate and is not generally part of the nurse's postmortem documentation.
c-The last set of vital signs is not usually required for postmortem documentation. Postmortem documentation focuses on the condition of the body and identification rather than the final vital signs, which are often irrelevant after death.
d-Advance directives should be reviewed before death and guide the care provided, but they are not part of postmortem documentation. A copy of the client's advance directives may also be included in their medical record but is not typically included in postmortem documentation.
Similar Questions
A nurse is reinforcing teaching with a client who has a prescription for ferrous sulfate elixir.
Which of the following statements by the client indicates an understanding of the teaching?
A. "I can prevent nausea if I take the medication on an empty stomach."
Ferrous sulfate works best when you take it on an empty stomach. However, taking ferrous sulfate on an empty stomach can actually increase the risk of gastrointestinal side effects, such as nausea. It is often recommended to take it with food to reduce nausea, even though absorption is best on an empty stomach. Thus, this statement does not indicate proper understanding.
B. "I will report black stools to my doctor."
Black stools are a common side effect of taking iron supplements and are usually not a cause for concern unless they are tarry or associated with other symptoms, which could indicate gastrointestinal bleeding. Reporting black stools to the doctor is typically not necessary unless the stool is tarry and has other concerning symptoms like abdominal pain or bleeding. This statement reflects a misunderstanding of common side effects.
C. "I will mix the medication with a full glass of water."
Mixing ferrous sulfate elixir with a full glass of water is advisable because it helps dilute the medication, making it easier to swallow and reducing the risk of gastrointestinal irritation. This practice also ensures that the medication is taken completely. This statement indicates a correct understanding of how to take the medication properly.
D. "I can prevent constipation if I drink more milk while taking this medication."
While staying hydrated can help manage constipation, milk is not recommended with iron supplements because calcium in milk can interfere with the absorption of iron. Instead, increasing water intake, eating a high-fiber diet, and considering other dietary measures would be better advice for preventing constipation.
Full Explanation
a. Ferrous sulfate works best when you take it on an empty stomach. However, taking ferrous sulfate on an empty stomach can actually increase the risk of gastrointestinal side effects, such as nausea. It is often recommended to take it with food to reduce nausea, even though absorption is best on an empty stomach. Thus, this statement does not indicate proper understanding.
b. Black stools are a common side effect of taking iron supplements and are usually not a cause for concern unless they are tarry or associated with other symptoms, which could indicate gastrointestinal bleeding. Reporting black stools to the doctor is typically not necessary unless the stool is tarry and has other concerning symptoms like abdominal pain or bleeding. This statement reflects a misunderstanding of common side effects.
c. Mixing ferrous sulfate elixir with a full glass of water is advisable because it helps dilute the medication, making it easier to swallow and reducing the risk of gastrointestinal irritation. This practice also ensures that the medication is taken completely. This statement indicates a correct understanding of how to take the medication properly.
d. While staying hydrated can help manage constipation, milk is not recommended with iron supplements because calcium in milk can interfere with the absorption of iron. Instead, increasing water intake, eating a high-fiber diet, and considering other dietary measures would be better advice for preventing constipation.
A nurse is collecting data from the caregiver of a client who has Alzheimer's disease. The caregiver reports the client has difficulty sleeping at night and wanders throughout the house.
Which of the following interventions should the nurse recommend?
A. Give the client a barbiturate medication at bedtime.
Barbiturate medications can cause excessive sedation.
B. Encourage the client to take frequent walks during the day.
As a nurse, the intervention that should be recommended is encouraging the client to take frequent walks during the day. This will help the client expend some energy and reduce the restlessness that could be causing the sleep disturbance at night.
C. Allow the client to nap for at least 1 hr during the day.
Allowing the client to nap for at least 1 hour during the day can interfere with their ability to sleep at night.
D. Put a simple lock on the client's bedroom door.
Putting a lock on the client's door can be a safety risk in case of an emergency.
Full Explanation
As a nurse, the intervention that should be recommended is encouraging the client to take frequent walks during the day. This will help the client expend some energy and reduce the restlessness that could be causing the sleep disturbance at night.
The other options are not recommended because barbiturate medications can cause excessive sedation, allowing the client to nap for at least 1 hour during the day can interfere with their ability to sleep at night, and putting a lock on the client's door can be a safety risk in case of an emergency.
A nurse is reinforcing teaching with a client who has a new prescription for transdermal nitroglycerin patches. Which of the following statements indicates an understanding of the teaching?
A. "I will place the patch on a hairless area of skin."
The client should choose a clean, dry, hairless area of skin to apply the patch. It is important to rotate the application site to avoid skin irritation and ensure consistent drug absorption.
B. "I will remove the patch if I develop a headache."
If the client experiences a headache, it is not necessary to remove the patch, as headaches can be a common side effect of nitroglycerin use.
C. "I will replace the patch every 12 hours."
The patch should be replaced every 24 hours, not every 12 hours
D. "I will apply the patch in the same place every day."
Applying the patch in the same place every day can lead to skin irritation and decreased absorption.
Full Explanation
The client should choose a clean, dry, hairless area of skin to apply the patch. It is important to rotate the application site to avoid skin irritation and ensure consistent drug absorption. The patch should be replaced every 24 hours, not every 12 hours. If the client experiences a headache, it is not necessary to remove the patch, as headaches can be a common side effect of nitroglycerin use. Applying the patch in the same place every day can lead to skin irritation and decreased absorption.
