A nurse is assisting with the care of a client.
Select the 4 responsibilities the nurse has in relation to the client's advance directives.
Communicate advance directives status via the medical record and shift report.
Provide the client with written information about advance directives.
Inform the client that an advance directive discontinues further care.
Instruct the client that an advance directive is a legal document and must be honored by care providers.
Document that the provider discussed do-not-resuscitate status with the client.
Initiate a power of attorney for health care document.
Correct Answer : A,B,D,E
A. Communicate advance directives status via the medical record and shift report. The nurse is responsible for ensuring that all members of the healthcare team are aware of the client’s advance directives. Documenting this information in the medical record and shift report helps guide care in accordance with the client’s wishes.
B. Provide the client with written information about advance directives. Clients have the right to receive information about advance directives, including living wills and do-not-resuscitate (DNR) orders. The nurse should provide educational materials to help the client make informed decisions.
C. Inform the client that an advance directive discontinues further care. An advance directive does not automatically discontinue all medical care. It provides instructions regarding specific interventions the client wishes to accept or decline, such as resuscitation, mechanical ventilation, or artificial nutrition. The nurse should clarify this to avoid misconceptions.
D. Instruct the client that an advance directive is a legal document and must be honored by care providers. Advance directives are legally binding documents that must be followed by healthcare providers. The nurse should reinforce that the client’s wishes, as stated in the directive, will be respected.
E. Document that the provider discussed do-not-resuscitate status with the client. Proper documentation is essential to ensure the client's preferences regarding resuscitation and end-of-life care are acknowledged and followed. The nurse should record discussions regarding advance directives in the medical record.
F. Initiate a power of attorney for health care document. The nurse does not have the authority to initiate a power of attorney for health care. The client must complete this legal document independently or with legal assistance, and it typically requires notarization or witness signatures. The nurse can provide information about it but cannot create or execute it on the client’s behalf.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Oxytocin. This medication is typically administered intravenously or intramuscularly to promote uterine contractions and control postpartum hemorrhage. It is not given via the sublingual or rectal route.
B. Misoprostol. This prostaglandin analog is effective in managing postpartum hemorrhage by stimulating uterine contractions. It can be administered via several routes, including oral, sublingual, and rectal, making it a versatile option in hemorrhage control. The rectal route is often preferred in emergencies due to rapid absorption and minimal gastrointestinal side effects.
C. Carboprost. This medication is a prostaglandin used to treat postpartum hemorrhage but is administered intramuscularly rather than sublingually or rectally. It is typically reserved for cases that do not respond to first-line treatments due to its potential for significant gastrointestinal and cardiovascular side effects.
D. Methylergonovine. This ergot alkaloid is effective in reducing postpartum hemorrhage by inducing strong uterine contractions. However, it is administered intramuscularly or orally and is contraindicated in clients with hypertension due to its vasoconstrictive properties.
Correct Answer is ["B","F","G"]
Explanation
A. "I can continue my current alcohol intake." The client should avoid alcohol while taking tuberculosis (TB) medications such as isoniazid and rifampin, as alcohol increases the risk of hepatotoxicity.
B. "I can expect my contact lenses to turn red or orange." Rifampin, a common medication used to treat TB, can cause bodily fluids such as urine, sweat, tears, and saliva to turn red or orange. This can stain soft contact lenses permanently, so clients should be informed of this side effect.
C. "I will need to take my medications for a total of 6 weeks." The standard treatment for TB typically lasts at least 6 months, not just 6 weeks. Clients must complete the full course of therapy to prevent drug resistance and recurrence.
D. "I will need to have a repeat Mantoux test in 4 weeks." A Mantoux test (tuberculin skin test) is not needed after a confirmed TB diagnosis with a positive sputum culture. Instead, follow-up evaluations include repeat sputum cultures and chest x-rays.
E. "I am no longer contagious." Clients with active pulmonary TB are considered contagious until they have completed at least two weeks of effective treatment, have improving symptoms, and have three consecutive negative sputum cultures.
F. "I should notify my provider if I start taking new over-the-counter or prescription medications." TB medications, especially rifampin, can interact with many drugs, including oral contraceptives, anticoagulants, and antiretrovirals. Clients must inform their provider of any new medications.
G. "I will need to have someone observe me when I take medication." Directly observed therapy (DOT) is recommended for clients with TB to ensure medication adherence and reduce the risk of treatment failure or drug resistance.
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