A health care provider asks the nurse about an older adult client's durable power of attorney (POA) because consent is needed for a medically necessary invasive procedure. The client has end-stage disease, is intubated, and is on mechanical ventilation. Which steps should the nurse implement?

Assist with obtaining informed consent from the client.

Refer to the client's advance directive for a name.

Determine the client's inability to make reasonable decisions.

Use the oral trail-making test to measure cognitive function.

Answer and Explanation

The Correct Answer is C

A. Assist with obtaining informed consent from the client.
Explanation: Informed consent is a critical aspect of healthcare procedures, but it requires the patient to have the capacity to understand and make decisions. In this scenario, the client is intubated and on mechanical ventilation, which might compromise their ability to communicate effectively. If the client lacks capacity, obtaining consent from the durable power of attorney (POA) is more appropriate.

B. Refer to the client's advance directive for a name.
Explanation: Advance directives, including the durable POA, provide guidance on a person's wishes for healthcare decisions when they are unable to communicate. However, the advance directive may not always specify a particular person's name for decisions related to specific medical interventions. The key consideration in this situation is to determine the current decision-making capacity and involve the appropriate decision-maker if needed.

C. Determine the client's inability to make reasonable decisions.
Explanation: This is the correct answer. In this scenario, the nurse should assess the client's capacity to make decisions. If the client lacks capacity, the durable POA can be activated to make healthcare decisions on behalf of the client. Capacity involves the ability to understand relevant information, appreciate the consequences of decisions, and communicate a choice.

D. Use the oral trail-making test to measure cognitive function.
Explanation: The oral trail-making test is a cognitive screening tool, but it may not be suitable in this critical care scenario with an intubated and mechanically ventilated patient. Moreover, the primary concern in this situation is determining the capacity to make healthcare decisions, which requires a more comprehensive evaluation than a specific cognitive function test. The focus should be on decision-making capacity rather than a cognitive assessment.

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Correct Answer is A

Explanation

A. Sub-acute care is more intensive than traditional nursing home care.

Explanation: Sub-acute care is generally more intensive and focused on providing specialized, short-term medical care and rehabilitation services. It is designed for individuals who require a higher level of care than what is typically provided in traditional nursing home settings.

B. Sub-acute care and nursing home care are identical.

Explanation: This statement is incorrect. Sub-acute care and nursing home care serve different purposes. Sub-acute care is typically provided for individuals recovering from acute medical conditions or surgeries, while nursing homes often cater to individuals with chronic illnesses or long-term care needs.

C. Sub-acute care is reimbursed by either Medicaid or private pay.

Explanation: This statement is not entirely accurate. Sub-acute care may be reimbursed by a variety of sources, including Medicare, private insurance, and, in some cases, Medicaid. The reimbursement sources can vary based on the specific circumstances and the services provided.

D. Professional nursing staff levels are the same as those in traditional nursing home settings.

Explanation: This statement is generally incorrect. Sub-acute care settings often have a higher ratio of skilled healthcare professionals, including nurses and therapists, compared to traditional nursing homes. This higher level of staffing is necessary to meet the more intensive medical and rehabilitation needs of sub-acute care patients.

A. To improve the quality of care B. To evaluate the level of client disability C. To improve the communication about the individual D. To serve as a guide for reimbursement

Correct Answer is ["A","B","C","D"]

Explanation

A. To improve the quality of care

Explanation: The OASIS assessment is designed to gather information about a patient's health status, functional abilities, and service needs. This information is crucial for developing individualized care plans and providing high-quality care.

B. To evaluate the level of client disability

Explanation: OASIS includes items that assess various aspects of a patient's health, including their functional abilities and disabilities. This evaluation helps healthcare providers understand the client's level of disability and tailor care accordingly.

C. To improve communication about the individual

Explanation: OASIS serves as a standardized tool for collecting and communicating essential information about a patient's health and care needs. This promotes effective communication among healthcare providers, ensuring that everyone involved in the patient's care has access to relevant and consistent information.

D. To serve as a guide for reimbursement

Explanation: OASIS is used in the home health care setting to guide reimbursement. The data collected through OASIS is used to determine the patient's case-mix classification, which, in turn, influences the reimbursement rates for home health services.

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A health care provider asks the nurse about an older adult client's durable power of attorney (POA) because consent is needed for a medically necessary invasive procedure. The client has end-stage disease, is intubated, and is on mechanical ventilation. Which steps should the nurse implement?

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Naxlex Comprehensive Predictor Exams

An older client is being discharged from the hospital to a sub-acute unit. The client says to a nurse, "I am not sure I understand the difference between a sub-acute unit and a nursing home. Can you help me understand?" The nurse considers which of the following in formulating a response:

Correct Answer is A

Explanation

The OASIS was implemented to provide the format for a comprehensive assessment in the home health care setting. How is this assessment tool used? (Select all that apply.)

Correct Answer is ["A","B","C","D"]

Explanation

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As a nurse caring for a cognitively impaired older adult client, you need to observe for which of the following? (Select all that apply.)

What components are included in a person-centered community? (Select all that apply.)

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