A nurse is assessing a client’s pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

Choice A reason: Financial power of attorney manages monetary decisions, not health care, unless specified as a health care surrogate. Advance directives guide health decisions, but this role is distinct, making this statement incorrect under the Patient Self-Determination Act’s provisions.
Choice B reason: The Patient Self-Determination Act ensures clients’ rights to refuse treatment, even against provider recommendations, promoting autonomy through advance directives. This legal protection applies in Medicare/Medicaid facilities, making it the correct principle for end-of-life decision-making in this context.
Choice C reason: Advance directives can be changed by a competent client, even if notarized, as the Act supports ongoing autonomy. Stating they cannot be altered is incorrect, as flexibility is a core feature, making this an inaccurate representation of the law.
Choice D reason: The eldest adult child cannot change advance directives unless designated as a surrogate. The Act prioritizes the client’s documented wishes or appointed decision-maker, not family hierarchy, making this statement incorrect and misaligned with legal requirements.

Choice A reason: Administering atomoxetine, used for ADHD, is inappropriate for panic attacks, which require short-acting anxiolytics like benzodiazepines if medicated. This medication does not address acute anxiety and may worsen symptoms, making it incorrect and potentially harmful.
Choice B reason: Encouraging television watching may distract but does not address the acute distress of a panic attack. It lacks the calming, supportive presence needed to reduce anxiety, making it less effective and inappropriate compared to direct emotional support.
Choice C reason: Sitting with the client provides a calming presence, reducing fear and enhancing security during a panic attack. This therapeutic intervention supports emotional regulation and aligns with evidence-based anxiety management, making it the correct and most effective action.
Choice D reason: Instructing strenuous exercise during a panic attack can exacerbate symptoms like tachycardia and breathlessness, worsening anxiety. Calming techniques like deep breathing are preferred, so this action is counterproductive and potentially harmful, making it incorrect.