A community health nurse is discussing advance directives with a client. The nurse should identify that which of the following statements made by the client indicates an understanding of the purpose of advance directives?

They ease the difficult decisions faced by those involved in my care.

They decrease the potential for receiving palliative care.

They help to uphold the ethical principle of veracity.

They detail my doctor's decisions about my end-of-life care.

Answer and Explanation

The Correct Answer is A

Choice A reason: This statement is true and relevant. Advance directives are legal documents that allow the client to express their wishes and preferences regarding their health care in case they become unable to communicate or make decisions. They ease the difficult decisions faced by those involved in the client's care, such as family members, health care providers, and legal representatives.

Choice B reason: This statement is false and misleading. Advance directives do not decrease the potential for receiving palliative care, but rather enable the client to choose whether they want to receive it or not. Palliative care is a type of care that focuses on relieving pain and suffering and improving quality of life for clients with serious or terminal illnesses.

Choice C reason: This statement is partially true, but not the best answer. Advance directives help to uphold the ethical principle of veracity, which means telling the truth and respecting the client's autonomy and dignity. However, advance directives also help to uphold other ethical principles, such as beneficence, nonmaleficence, and justice.

Choice D reason: This statement is false and misleading. Advance directives do not detail the doctor's decisions about the client's end-of-life care, but rather detail the client's own decisions and preferences. The doctor's role is to respect and follow the client's wishes as much as possible, unless they conflict with the law or profession

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Correct Answer is C

Explanation

A. "I don't want to lose control of my ability to make decisions." This statement reflects a fear of losing autonomy, which is common among individuals with chronic illnesses. While it indicates anxiety and concern about the future, it does not directly suggest suicidal ideation.

B. "I am afraid of experiencing pain near the end." This response shows a fear of suffering and pain, which is also common in terminal illnesses. Although it indicates distress, it does not necessarily imply a risk for suicide.

C. "I know that everything will be better soon." This statement can be a red flag for suicidal ideation, as it may imply that the person believes death is imminent or that they have a plan to end their suffering. It suggests a sense of hopelessness and a potential desire to escape their current situation.

D. "I am relying more and more on my partner for support." This response indicates a need for increased support and dependency on a partner. While it shows a reliance on others, it does not directly suggest suicidal thoughts or intentions.

A. The client's insurance provides coverage for palliative care B. The client has declined additional life prolonging treatments C. The client requires inpatient care due to lack of a caregiver D. The client has documentation stating he has less than 12 months to live

Correct Answer is B

Explanation

Choice A: The client’s insurance provides coverage for palliative care

This option is incorrect. While insurance coverage for palliative care is important, it is not a qualifying criterion for hospice care. Hospice care eligibility is primarily based on the patient’s medical condition and prognosis, not on insurance coverage.

Choice B: The client has declined additional life prolonging treatments

This option is correct. One of the key criteria for hospice care is that the patient must choose palliative care (comfort care) over curative treatments. This means the patient has decided to stop treatments aimed at prolonging life and instead focus on quality of life and symptom management.

Choice C: The client requires inpatient care due to lack of a caregiver

This option is incorrect. While the need for inpatient care can be a factor in the type of hospice services provided, it is not a criterion for qualifying for hospice care. Hospice care can be provided in various settings, including the patient’s home, regardless of caregiver availability.

Choice D: The client has documentation stating he has less than 12 months to live

This option is incorrect. The standard criterion for hospice care is a prognosis of six months or less to live if the disease follows its usual course. Documentation stating a life expectancy of less than 12 months does not meet the hospice eligibility requirement.

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A community health nurse is discussing advance directives with a client. The nurse should identify that which of the following statements made by the client indicates an understanding of the purpose of advance directives?

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