A hospice nurse is planning care for a client who does not have advance directives. Which of the following interventions should the nurse include in the plan of care?

Provide the client with information about advance directives.

Encourage the client to contact an attorney to create advance directives.

Inform the client that they will need a relative to witness their advance directives.

Tell the client that The Joint Commission requires clients to have advance directives.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Providing the client with information about advance directives is an appropriate intervention. Advance directives are legal documents that allow individuals to communicate their preferences for medical treatment in the event they become unable to make decisions for themselves. Educating the client about the importance and benefits of advance directives empowers them to make informed decisions about their care.

Choice B rationale:

Encouraging the client to contact an attorney to create advance directives is not the primary responsibility of the hospice nurse. While legal assistance might be helpful, the nurse should first ensure that the client understands the concept of advance directives and their significance before suggesting legal involvement.

Choice C rationale:

Informing the client that they will need a relative to witness their advance directives is not accurate. While witnesses are often required when signing legal documents, the specific requirements for advance directives can vary by jurisdiction. It's important for the nurse to provide accurate information and not make assumptions about legal processes.

Choice D rationale:

Telling the client that The Joint Commission requires clients to have advance directives is not accurate. While The Joint Commission emphasizes the importance of patient rights and informed decision-making, it does not mandate that all clients must have advance directives. The decision to create advance directives is a personal choice and should be based on the individual's values and preferences.

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Correct Answer is B

Explanation

Choice A rationale:

Involving the client's parents in treatment decisions might not be appropriate if the client does not want them involved. Furthermore, the client's autonomy and wishes should be respected, and decisions about treatment should be primarily based on the client's preferences.

Choice B rationale:

This is the correct response. The nurse should respect the client's decision to discontinue chemotherapy and provide information about palliative care as an alternative option. Palliative care focuses on symptom management and improving the client's quality of life, aligning with the client's wishes to stop chemotherapy.

Choice C rationale:

Contacting the spiritual advisor is not directly related to the client's expressed desire to discontinue chemotherapy. While spiritual and emotional support are important, the primary concern here is addressing the client's medical decisions.

Choice D rationale:

Contacting the client's parents to discuss durable power of attorney is not appropriate if the client does not want them involved in the decision-making process. The client's autonomy and preferences should be respected, and they should be empowered to make their own medical decisions.

A. "Change-of-shift report can be given at the client's bedside.” B. "I can provide client information over the phone if the caller identifies themselves as family.” C. "A client cannot see their medical record because it is considered to be property of the facility.” D. "Access to client information is limited to direct care providers.”

Correct Answer is D

Explanation

Choice A rationale:

Giving change-of-shift report at the client's bedside is not appropriate due to privacy concerns. The client's room is not a private area for discussing their medical information, and other clients or visitors might overhear sensitive details. A more appropriate location, such as a designated nursing station, should be used for shift handoffs.

Choice B rationale:

Providing client information over the phone to callers identifying themselves as family is incorrect. Even if the caller identifies as family, the nurse cannot verify their identity over the phone. Sharing confidential client information without proper verification violates confidentiality policies and can compromise the client's privacy.

Choice C rationale:

Stating that the client cannot see their medical record because it is considered property of the facility is incorrect. Clients have the legal right to access their medical records under the Health Insurance Portability and Accountability Act (HIPAA). While the physical record might be owned by the facility, clients have the right to review their medical information.

Choice D rationale:

Access to client information is limited to direct care providers is the correct statement. Confidentiality requirements dictate that only authorized individuals involved in the client's care, treatment, or payment processes have access to their medical information. This helps protect the client's privacy and ensures that sensitive information is not disclosed to unauthorized parties.

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A hospice nurse is planning care for a client who does not have advance directives. Which of the following interventions should the nurse include in the plan of care?

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