A nurse is assisting with the care of a client. Laboratory Results

1100:

Abdominal ultrasound: mass present in small intestine proximal to ileocecal valve. Size of mass is 6 cm x 7 cm (2.4 in x 2.8 in).

Select the 4 responsibilities the nurse has in relation to the client's advance directives.

Provide the client with written information about advance directives

Instruct the client that an advance directive is a legal document and must be honored by care providers

Initiate a power of attorney for health care document

Communicate advance directives status via the medical record and shift report

Document that the provider discussed-do-not-resuscitate status with the client

Inform the client that an advance directive discontinues further care

Answer and Explanation

Correct Answer : A,B,C,D

Provide the client with written information about advance directives: It is important for the nurse to educate the client about advance directives, their purpose, and how they can make informed decisions about their healthcare.

Instruct the client that an advance directive is a legal document and must be honored by care providers: The nurse should explain to the client that an advance directive is a legally binding document that guides healthcare decisions, and it must be respected and followed by healthcare providers.

Communicate advance directives status via the medical record and shift report: The nurse should ensure that the client's advance directives status is accurately documented in the medical record and communicated to other members of the healthcare team during shift handoffs. This helps ensure that the client's wishes are known and respected by all involved in their care.

Initiate a power of attorney for health care document: The nurse can assist the client in initiating a power of attorney for healthcare document if the client wishes to appoint someone as their healthcare proxy or agent. This document designates someone to make medical decisions on behalf of the client if they become unable to do so.

The other options listed are not appropriate or accurate in relation to the responsibilities of the nurse regarding advance directives:

Document that the provider discussed-do-not-resuscitate status with the client: While discussing do-not-resuscitate (DNR) status may be part of the advance care planning process, it is not directly related to advance directives as a whole.

Inform the client that an advance directive discontinues further care: This statement is incorrect and misleading. An advance directive does not automatically discontinue care but rather guides the provision of care according to the client's wishes.

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Correct Answer is C

Explanation

Assessing the client's suicidal intent and the presence of a specific plan for self-harm is crucial in determining the level of immediate risk and the need for intervention. This question directly addresses the client's current state and potential danger.

While all the questions are important in assessing the client's situation, determining the presence of a plan for self-harm takes precedence as it helps evaluate the level of imminent danger and the need for immediate intervention.

The other questions are also important but can be addressed after ensuring the client's safety and appropriate intervention based on the information gathered regarding the plan for self-harm. These questions can provide additional information to further assess the client's support system, history, and current stressors, which can contribute to understanding the context and potential risk factors for the client.

Remember, if the client expresses an immediate plan and intent for self-harm, it is essential to take appropriate steps to ensure their safety, such as involving the appropriate mental health professionals, implementing a safety plan, and providing constant supervision as needed.

A. I should take a zinc supplement while taking this medication. B. This medication will darken the color of my eyes. C. 1 should check my heart rate while taking this medication. D. This medication will dilate my eyes.

Correct Answer is C

Explanation

Explanation

C.I should check my heart rate while taking the medication

Timolol is a medication commonly prescribed for the treatment of primary open-angle glaucoma, which is a chronic eye condition characterized by increased intraocular pressure

hacking the heart rate while taking timolol eye drops is important. Timolol belongs to a class of medications called beta-blockers, which can have systemic effects. These medications can enter the bloodstream and potentially affect heart rate and blood pressure. Monitoring the heart rate can help assess for any potential adverse effects of the medication.

Taking a zinc supplement in (option A) is not correct because it is not typically necessary while taking timolol eye drops. Zinc supplementation is not a direct requirement or related to the use of timolol for glaucoma treatment. The client should follow their healthcare provider's instructions regarding medication use and potential dietary modifications, but zinc supplementation is not specifically associated with timolol.

Timolol eye drops in (option B) is not correct because it does not darken the colour of the eyes. The purpose of timolol eye drops is to reduce intraocular pressure by decreasing the production of fluid in the eye. Eye colour changes are not known effects of timolol eye drops.

Timolol eye drops in (option D) is incorrect because it does not dilate the eyes. In fact, they work by reducing intraocular pressure, not by dilating the eyes. Eye dilation is typically achieved with the use of specific eye drops called mydriatics or with the use of specialized ophthalmic instruments during an eye examination.

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A nurse is assisting with the care of a client. Laboratory Results 1100: Abdominal ultrasound: mass present in small intestine proximal to ileocecal valve. Size of mass is 6 cm x 7 cm (2.4 in x 2.8 in). Select the 4 responsibilities the nurse has in relation to the client's advance directives.

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Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is expressing suicidal ideations. Which of the following questions is the nurse's priority?

Correct Answer is C

Explanation

A nurse is reinforcing teaching with a client who has primary open-angle glaucoma and a new prescription for timolol eye drops. Which of the following statements indicates an understanding of the teaching?

Correct Answer is C

Explanation

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A nurse is assisting with the care of a client. Laboratory Results

1100:

Abdominal ultrasound: mass present in small intestine proximal to ileocecal valve. Size of mass is 6 cm x 7 cm (2.4 in x 2.8 in).

Select the 4 responsibilities the nurse has in relation to the client's advance directives.