A nurse is admitting a client who requests not to be intubated or have any other life saving measures initiated. Which of the following actions should the nurse take?
Ask the client if they have a copy of their advance directive
Inform the client that their family can override their decision
Ask the client family if they're in agreement with the client's request
Inform the client that the provider must agree with this decision
The Correct Answer is A
A. An advance directive is a legal document that outlines a person's preferences for medical treatment, including end-of-life care. Asking the client if they have a copy of their advance directive is appropriate because it can provide valuable information about their wishes regarding medical interventions. It allows the nurse to review the document to ensure that the client's current wishes align with what is documented in their advance directive.
B. In most cases, a competent adult's healthcare decisions, including decisions to refuse treatment, are legally binding and cannot be overridden by family members. It is important for the nurse to educate the client about their rights and ensure that their wishes are respected. Family members may be involved in discussions and support the client's decisions, but they cannot override a competent adult's wishes regarding their medical care.
C. While it's important to involve family members in discussions about the client's wishes, especially if they are the client's designated healthcare proxy or legally authorized decision-maker, family agreement is not required for the client's decision to refuse life-saving measures. The nurse should primarily focus on the client's expressed wishes and ensure that these wishes are understood and respected.
D. The provider's agreement with the client's decision may be necessary to document and implement the plan of care accordingly, but ultimately, the decision to refuse treatment rests with the competent client. The nurse should facilitate communication between the client and the provider to ensure that the client's wishes are understood and documented appropriately.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hoarseness or changes in voice quality is one of the hallmark symptoms of laryngeal cancer. It occurs due to the tumor affecting the vocal cords or surrounding structures. Hoarseness is often persistent and does not resolve with voice rest or usual treatments for laryngitis.
B. Dysphagia, or difficulty swallowing, can occur in laryngeal cancer, especially if the tumor affects the structures involved in swallowing. However, dysphagia typically occurs later in the course of the disease as the tumor grows and obstructs the passage of food or liquids.
C. Weight loss can be a symptom of advanced laryngeal cancer but is less commonly reported as an early manifestation. Significant weight loss may occur as a result of difficulty eating due to dysphagia or as a generalized effect of cancer on the body.
D. Dyspnea, or difficulty breathing, is not typically an early manifestation of laryngeal cancer unless the tumor is large and obstructs the airway. It is more commonly associated with advanced disease or tumors that have spread to nearby structures.
Correct Answer is A
Explanation
A. Tachycardia refers to a rapid heart rate, typically defined as a heart rate greater than 100 beats per minute. Theophylline can stimulate the heart and central nervous system, leading to an increase in heart rate. Tachycardia is a known adverse effect of theophylline and can occur especially if the medication is taken in higher doses or if there are interactions with other medications or caffeine.
B. Constipation is not a common adverse effect of theophylline. Theophylline primarily affects the respiratory and cardiovascular systems rather than the gastrointestinal system. Therefore, constipation is unlikely to be caused by theophylline therapy.
C. Drowsiness is generally not a common adverse effect of theophylline. Instead, theophylline is more likely to cause CNS stimulation, which can lead to insomnia, restlessness, or anxiety rather than drowsiness.
D. Oliguria refers to decreased urine output, which is not typically associated with theophylline use. Theophylline primarily affects respiratory function and cardiovascular parameters. Decreased urine output can occur in certain conditions or with medications that affect kidney function, but it is not a recognized adverse effect of theophylline.
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