major competencies for the nurse giving end oflife care include

NCLEX-PN

Best NCLEX Next Gen Prep

1. What are major competencies for the nurse giving end-of-life care?

A. demonstrating respect and compassion, and applying knowledge and skills in the care of the family and the client.
B. assessing and intervening to support total management of the family and client.
C. setting goals, expectations, and dynamic changes to care for the client.
D. keeping all sad news away from the family and client.

Correct answer: A

Rationale: Major competencies for nurses providing end-of-life care involve a combination of skills and qualities. Demonstrating respect and compassion towards the family and the client is essential in end-of-life care. Additionally, applying knowledge and skills in caring for both the family and the client is crucial to ensure comprehensive and compassionate care. Option A is the correct choice as it accurately reflects these key competencies. Option B, which focuses on assessing and intervening for total management, is important but does not fully address the holistic approach necessary for end-of-life care. Option C, about setting goals and expectations, is relevant but not as critical as the core competencies mentioned in option A. Option D is incorrect as withholding sad news goes against the principles of honesty and transparency in end-of-life care.

2. When determining a fetal heart rate (FHR) and noting accelerations from the baseline rate when the fetus is moving, a nurse interprets this finding as:

A. A reassuring sign
B. An indication of the need to contact the physician
C. An indication of fetal distress
D. A nonreassuring sign

Correct answer: A

Rationale: When a nurse notes accelerations from the baseline rate of the fetal heart rate, particularly when they occur with fetal movement, it is considered a reassuring sign. This indicates a healthy response to fetal activity. Reassuring signs in FHR monitoring include an average rate between 120 and 160 beats/min at term, a regular rhythm with slight fluctuations, accelerations from the baseline rate (often associated with fetal movement), and the absence of decreases from the baseline rate. Choices B, C, and D are incorrect because accelerations in FHR with fetal movement are not indicative of the need to contact the physician, fetal distress, or a nonreassuring sign. These signs would typically be associated with other abnormal FHR patterns that would warrant further assessment and intervention.

3. The nurse is caring for a 4-year-old client. What is the most appropriate pain scale for the nurse to use during the assessment?

A. McGill Pain Scale
B. FLACC Pain Scale
C. CRIES Pain Scale
D. Wong-Baker Pain Scale

Correct answer: D

Rationale: The correct answer is the Wong-Baker Pain Scale. This scale is specifically designed for pediatric clients, including children as young as 3 years old, making it the most appropriate choice for a 4-year-old. It utilizes a simple visual scale with facial expressions that children can easily understand and use to express their pain levels. The FLACC and CRIES Pain Scales are also used for pediatric clients but are more focused on non-verbal cues and specific populations like infants or critically ill children. The McGill Pain Scale, on the other hand, is more complex and uses descriptive words, making it more suitable for adult clients who can better articulate their pain experiences.

4. Why is Kleinman's Explanatory Model of Health and Illness significant?

A. it explains the health beliefs a family is likely to have.
B. it emphasizes the role of culture in shaping health explanations.
C. it discusses the significant role of popular and folk domains of influence.
D. it is structured based on education.

Correct answer: B

Rationale: Kleinman's Explanatory Model of Health and Illness is significant because it emphasizes the crucial role that popular and folk domains of influence play in shaping individuals' understanding of health and illness. Kleinman distinguishes between disease, which is the biomedical understanding of health problems, and illness, which is the individual's personal interpretation of their health condition. By focusing on the cultural factors that influence these domains of influence, Kleinman's model underscores the impact of cultural beliefs and practices on health perceptions. Choice A is incorrect because the model goes beyond just family health beliefs. Choice B is more precise as it emphasizes the broader influence of culture. Choice C highlights the correct significance of popular and folk domains of influence, making it the correct choice. Choice D is incorrect as the model's significance lies in cultural domains, not educational structure.

5. A 37-year-old female client asks the nurse about contraception options and expresses interest in oral contraception pills. Which of the following statements would indicate that oral contraception is appropriate for this client?

A. "I quit smoking last year, but I started again recently. Maybe I'll try to quit later this year."?
B. "I am very diligent in taking my thyroid medications at the same time every day."?
C. "I was hospitalized for deep vein thrombosis five years ago."?
D. "I was recently diagnosed with breast cancer."?

Correct answer: C

Rationale: The correct answer is the statement mentioning a history of deep vein thrombosis five years ago. Oral contraceptives are generally not recommended for individuals with a history of deep vein thrombosis due to the increased risk of blood clots. Choice B, about being diligent in taking thyroid medications, does not directly relate to the safety of using oral contraceptives. Choice D, about a recent breast cancer diagnosis, would contraindicate the use of hormonal contraceptives. Choice A, mentioning a recent return to smoking, raises concerns about using hormonal contraceptives due to the increased risk of cardiovascular complications.