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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Inject 15 units of air into the regular insulin vial. When mixing NPH and regular insulin, air is first injected into both vials without touching the solution. After injecting air into the NPH vial, the next step is to inject air into the regular insulin vial to maintain proper vial pressure before withdrawing the dose.
B. Place the cap over the needle. Recapping needles increases the risk of needlestick injuries and is not necessary during the insulin preparation process. The needle should remain uncapped until both insulins are drawn and the injection is ready.
C. Withdraw 10 units of NPH insulin. Regular insulin should be drawn first to prevent contamination with NPH insulin. Since NPH is a cloudy suspension and regular insulin is clear, drawing regular insulin first ensures that the short-acting insulin remains unaltered.
D. Verify the dosage with another nurse. While verifying high-risk medications like insulin is important, the appropriate step after injecting air into the NPH vial is to proceed with injecting air into the regular insulin vial before withdrawing any insulin.
Correct Answer is A
Explanation
A. Initiate droplet precautions. Respiratory syncytial virus (RSV) is primarily transmitted through respiratory secretions, requiring contact and droplet precautions to prevent the spread. Isolation measures, including wearing masks and gowns, help protect healthcare workers and other patients.
B. Administer fluconazole to the preschooler. Fluconazole is an antifungal medication, which is not effective against RSV, a viral infection. Treatment for RSV is mainly supportive, focusing on airway management, hydration, and oxygen therapy as needed.
C. Monitor the preschooler's urine for protein. Proteinuria is associated with kidney conditions such as nephrotic syndrome, not RSV. RSV primarily affects the respiratory system, causing bronchiolitis and increased mucus production rather than kidney involvement.
D. Request an x-ray of the preschooler's neck. A neck x-ray is typically used to evaluate airway obstruction from conditions like epiglottitis. RSV affects the lower respiratory tract, leading to bronchiolitis, and does not usually require imaging unless complications arise.
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