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. This response provides the family member with accurate information about the limited effectiveness of drugs in improving appetite and weight gain, along with the potential for serious side effects. It promotes informed decision-making.

B. Stating that there are no drugs that impact appetite or weight gain is not entirely accurate. Some drugs may have an impact, but the effectiveness varies, and they often come with potential side effects.

C. Blanket's statements that these drugs are not permitted in long-term care facilities are not accurate. The use of medications should be based on individual assessment and treatment plans.

D. Saying "Yes, there are some very effective drugs out there. Your mother should be on one of them" is not an appropriate response. It oversimplifies the situation and may not reflect the individualized approach needed in assessing and addressing nutritional concerns.

A. Women have significantly higher mortality rates from hip fractures than do men B. Hip fractures are associated with very high morbidity and mortality. C. Hip fractures are a leading cause of hospitalization for older people D. Nearly all older patients who sustain a hip fracture will regain prefracture mobility status within 1 year. E. The major cause of hip fractures is falls

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

Explanation

A. Women have significantly higher mortality rates from hip fractures than do men.
Explanation: This statement is generally true. Women, particularly older women, tend to have higher mortality rates associated with hip fractures compared to men. This is partly because women are more prone to osteoporosis, a condition that increases the risk of fractures.

B. Hip fractures are associated with very high morbidity and mortality.
Explanation: This statement is generally true. Hip fractures can have significant consequences, including increased morbidity and mortality. Complications, such as infections, immobility-related issues, and other medical conditions, can contribute to the overall impact on health.

C. Hip fractures are a leading cause of hospitalization for older people.
Explanation: This statement is generally true. Hip fractures are a common reason for hospitalization among older adults. The severity of the injury often requires medical intervention, surgery, and rehabilitation.

D. Nearly all older patients who sustain a hip fracture will regain prefracture mobility status within 1 year.
Explanation: This statement is not accurate. While many older patients can regain some mobility with appropriate rehabilitation, not all will regain their prefracture mobility status. The extent of recovery varies among individuals and depends on factors such as overall health, comorbidities, and the severity of the fracture.

E. The major cause of hip fractures is falls.
Explanation: This statement is accurate. Falls are a major cause of hip fractures in older adults. Understanding and addressing factors contributing to falls are essential in preventing hip fractures.

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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

A resident's family member is concerned that the resident is not eating adequately and is at risk for malnutrition. The family member says to a nurse, "I heard that there are drugs that can make my mother eat better. Do you think she should be on one?" What is the best response by the nurse?

Correct Answer is A

Explanation

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

Explanation

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

The health care provider has not ordered the use of a restraint for an alert patient at high risk for falling. The nurse should implement which side rail use?

A nurse is assessing an older adult's nutritional status. The nurse understands that which of the following is the most important indicator for a potential nutritional deficit?

A nurse is assessing an older adult's nutritional status. The nurse understands that which of the following is the most important indicator for a potential nutritional deficit?

Which of the following assessments should be included in a post fall prevention assessment of an older adult? (Select all that apply.)

In reviewing an older adult's insurance history, you find that he is on Medicaid. What do you know that Medicaid is used for?