So very mad!!!

melmarie23, MSN, RN · Nov 23, 2009

I would say B for all

Mell Bell · Nov 23, 2009

I think I would choose B for all as well. Definitely for 1 and 3. The second question is the hardest, I would also call the Dr. and provide comfort measures, but I think that B. respecting the clients wishes is the "most right" answer. What answers did you put?

CrunchyMama, ASN, RN · Nov 23, 2009

1. a pt. has a signed dnr and starts having dyspnea and says "i'm having a hard time breathing, help me!" you should....(i'm leaving out the 2 answers that weren't in question)

a. check the chart to see if there's a mistake and really a dnr

b. help the client i put this answer because she verbally asked for help. if i was this lady, gasping for air and i asked for help, i would not want the nurse to leave to go check the chart to double check if i have a dnr. as the nurse you should already know if the pt. does or not, right?

2. an ill jewish pt. is fasting during (insert jewish fasting holiday). what should you do?

a. remind the pt. that some religions excuse ill pts. from fasting i put this answer because this is what it says in our book. but apprently it's respect the clients wishes. but shouldn't you try to inform them that some religions excuse those that are ill? if they still want to fast, then you should respect their wishes.

b. respect clients wishes

c. call dr.

d. provide comfort measures

what would you choose for both questions??? there's so many others.....ohhhh just thought of another....

a pt. has died, what do you do....

a. tape the wedding ring on the finger again, i answered this because it's in our book. but the "correct" answer is b.....but taking inventory is normally done upon admission, so wouldn't a list of their belongings already be in their chart?

b. document all the jewelry to keep a record

c. put all jewelry in a bag to give to funeral home

melmarie23, MSN, RN · Nov 24, 2009

1. a pt. has a signed dnr and starts having dyspnea and says "i'm having a hard time breathing, help me!" you should....(i'm leaving out the 2 answers that weren't in question)
a. check the chart to see if there's a mistake and really a dnr
b. help the client i put this answer because she verbally asked for help. if i was this lady, gasping for air and i asked for help, i would not want the nurse to leave to go check the chart to double check if i have a dnr. as the nurse you should already know if the pt. does or not, right?

dnrs can be verbally reversed though, i had thought. even so, she is not unconscious or coding, so you must help her.

think about it this way: say this same patient chokes on a piece of corn she had as part of her meal that night. do you let her choke to death because she is dnr? no, you perform the heimlich and help her.

2. an ill jewish pt. is fasting during (insert jewish fasting holiday). what should you do?
a. remind the pt. that some religions excuse ill pts. from fasting i put this answer because this is what it says in our book. but apprently it's respect the clients wishes. but shouldn't you try to inform them that some religions excuse those that are ill? if they still want to fast, then you should respect their wishes.
b. respect clients wishes
c. call dr.
d. provide comfort measures

that may be so, but how do you know that this is true of their specific religion? just because some religions make this exception, it is not safe to say that all do. and even so, they still have the right to refuse.

what would you choose for both questions??? there's so many others.....ohhhh just thought of another....
a pt. has died, what do you do....
a. tape the wedding ring on the finger again, i answered this because it's in our book. but the "correct" answer is b.....but taking inventory is normally done upon admission, so wouldn't a list of their belongings already be in their chart?
b. document all the jewelry to keep a record
c. put all jewelry in a bag to give to funeral home

you double check the inventory before discharge, no? this, to me, is sort of the same concept, except in this case, the patient has passed.

generally speaking though, i think you are reading too much into the questions. its tough, because sometimes you can rationalize all answers. its taken me awhile to learn how to answer these, and i am not even 100% there yet, so i totally feel your frustration.

melmarie23, MSN, RN · Nov 24, 2009

and I don't even know why you would take the wedding ring for to the finger? What does your book say on this? I am now curious...

Siamo · Nov 24, 2009

I'm in my 1st semester of nursing and been doing pretty good so far. 1st test=88, 2nd test=90, 3rd=86. So last week was our 4th test and I walked out confident. Today I find out I got a 68!!!!! We go over the tests and it was horrible....we were all arguing with the prof. Every test is made up by a different prof. and my particular one made this test. Some of the questions, the answers were right in the book and she didn't want to hear it. Me and a few others are thinking of going to the dept. head. Let me give some examples....
1. A pt. has a signed DNR and starts having dyspnea and says "I'm having a hard time breathing, help me!" You should....(I'm leaving out the 2 answers that weren't in question)
A. check the chart to see if there's a mistake and really a DNR
B. help the client
2. An ill Jewish pt. is fasting during (insert Jewish fasting holiday). What should you do?
A. Remind the pt. that some religions excuse ill pts. from fasting
B. Respect clients wishes
C. call Dr.
D. provide comfort measures
What would you choose for both questions??? There's so many others.....ohhhh just thought of another....
A pt. has died, what do you do....
A. tape the wedding ring on the finger
B. document all the jewelry to keep a record
C. put all jewelry in a bag to give to funeral home

On 1 I would help the client if they asked because otherwise you're DNRing them against their stated will. Also they're not requesting resuscitation, just assistance.

On 2 I would put "respect the client's wishes". In my Fund.s they were pretty heavy on cultural and religious sensitivity and the pt should do pretty much as they please (within reason) and the nurse's role is only to assist them in doing it.

On 3 I would put "document the jewelry". Taping the ring seems silly and I seem to recall family member's claiming personal items after a family member's death at the hospital.

I feel your frustration about the instructor though. One of my instructors doesn't even give her own test review anymore so we can't challenge any questions. If you ask her outside of the test review she tells you she can't answer without having the rationales. Bah. :no:

CrunchyMama, ASN, RN · Nov 24, 2009

dnrs can be verbally reversed though, i had thought. even so, she is not unconscious or coding, so you must help her.
think about it this way: say this same patient chokes on a piece of corn she had as part of her meal that night. do you let her choke to death because she is dnr? no, you perform the heimlich and help her.
that may be so, but how do you know that this is true of their specific religion? just because some religions make this exception, it is not safe to say that all do. and even so, they still have the right to refuse.
you double check the inventory before discharge, no? this, to me, is sort of the same concept, except in this case, the patient has passed.
generally speaking though, i think you are reading too much into the questions. its tough, because sometimes you can rationalize all answers. its taken me awhile to learn how to answer these, and i am not even 100% there yet, so i totally feel your frustration.

i also thought a dnr can be verbally reversed. that's why i chose that answer.....the others didn't make sense to me and i can honestly say that if this were to happen in real life...i would help the pt.

the religion question....by reminding them that most religions excuse fasting for illness, you'll find out by their answer if their religion does or if they wish to go against their religion. i understand your point though.

CrunchyMama, ASN, RN · Nov 24, 2009

and I don't even know why you would take the wedding ring for to the finger? What does your book say on this? I am now curious...

My book doesn't give an explanation but my prof. says it's so the ring doesn't get stolen.

CBsMommy · Nov 24, 2009

I would say B for all as well. I've never heard of taping the wedding ring to the finger. That's new to me! I would document the ring as well as everything else in the client's possession, along with another witness in the room. If the ring seemed to be falling off the deceased patient's finger I would probably take it off and put it in an envelope to hand to the family.

melmarie23, MSN, RN · Nov 24, 2009

but do most religions make that exception? I honestly dont know and to me, that is an assumption.

basically, regardless their religious affiliation, you cant force a patient to do something against their will. So if they refuse to eat, they refuse to eat.

CrunchyMama, ASN, RN · Nov 24, 2009

I would say B for all as well. I've never heard of taping the wedding ring to the finger. That's new to me! I would document the ring as well as everything else in the client's possession, along with another witness in the room. If the ring seemed to be falling off the deceased patient's finger I would probably take it off and put it in an envelope to hand to the family.

I'm assuming you'd document it along with everything else upon admission. But to tape it to the finger, is right in my book. Does sound kind of silly, IMO...considering the tape can easily be ripped off if someone really wanted to steal it.