A nurse is admitting a client to the medical-surgical unit. The Patient Self-Determination Act requires the nurse to perform which of the following actions during the admission process?

Provide the client with a list of eligible individuals who can serve as a health care proxy.

Document in the client's medical record if the client has advance directives.

Provide end-of-life education if the client has a terminal illness.

Ensure the client has an attorney to contact for assistance with end-of-life documents.

Answer and Explanation

The Correct Answer is B

A. Provide the client with a list of eligible individuals who can serve as a health care proxy. - While it is important for clients to have information about selecting a healthcare proxy, the Patient Self-Determination Act does not specifically require nurses to provide a list of eligible individuals. However, nurses should educate clients about their rights to designate a healthcare proxy if desired.
B. Document in the client's medical record if the client has advance directives. - This is the correct action required by the Patient Self-Determination Act. The act mandates that healthcare facilities receiving Medicare or Medicaid funds must inform clients about their rights to make decisions about their medical care, including the right to have advance directives. Nurses are responsible for documenting in the client's medical record whether the client has advance directives, such as a living will or durable power of attorney for healthcare.
C. Provide end-of-life education if the client has a terminal illness. - While providing end-of-life education is important for clients with terminal illnesses, it is not specifically mandated by the Patient Self-Determination Act. However, the act does require healthcare facilities to inform clients about their rights to make decisions about end-of-life care, including the right to have advance directives.
D. Ensure the client has an attorney to contact for assistance with end-of-life documents. - The Patient Self-Determination Act does not mandate that nurses ensure clients have an attorney for assistance with end-of-life documents. While legal assistance may be helpful for some clients in completing advance directives, it is not a requirement of the act.

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Correct Answer is D

Explanation

A. Holding a vibrating tuning fork 1 to 2 cm from the child's ears is not a part of the Weber's test procedure. The Weber's test involves assessing lateralization of sound in cases of unilateral hearing loss. Placing the tuning fork close to the ears may interfere with the accuracy of the test.
B. Measuring the amount of time the child can hear the sound is not relevant to the Weber's test. This action does not assess lateralization of sound but rather evaluates the duration of hearing.
C. Obtaining a tympanogram reading is not necessary before initiating the Weber's test. Tympanometry is a separate test used to assess the function of the middle ear, particularly the movement of the eardrum and the conduction bones.
D. Placing a vibrating tuning fork on the top of the child's head is the correct action for performing the Weber's test. During this test, the nurse activates a tuning fork and places it on the midline of the child's head or forehead. The child is asked if they hear the sound equally in both ears or if it is louder in one ear than the other. This helps determine if there is asymmetrical hearing loss.

A. "I will take the medication in the morning." B. "I will avoid crushing this medication." C. "I will take the medication on an empty stomach." D. "I will expect to gain weight."

Correct Answer is B

Explanation

A. "I will take the medication in the morning." - Metformin extended-release tablets are typically taken with the evening meal to minimize gastrointestinal side effects. Taking it in the morning may increase the risk of side effects during the day.
B. "I will avoid crushing this medication." - Metformin extended-release tablets should not be crushed, chewed, or broken, as doing so can disrupt the extended-release mechanism, leading to an increased risk of adverse effects or decreased efficacy.
C. "I will take the medication on an empty stomach." - While metformin can be taken with or without food, it is generally recommended to take it with meals to reduce gastrointestinal side effects. Taking it on an empty stomach may increase the risk of nausea or upset stomach.
D. "I will expect to gain weight." - Weight loss is a common side effect of metformin, particularly in individuals with type 2 diabetes. Therefore, expecting weight gain would indicate a misunderstanding of the medication's effects.

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