A nurse is caring a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue the client’s feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make?
“You should contact the provider about your wishes to your family member.”
“You should speak with the facility’s ethics committee about your concerns.”
“We’ll need to have the nursing supervisor review the client’s advance directives.”
“As the health care surrogate, the client’s partner can make this decision.”
The Correct Answer is D
a. "You should contact the provider about your wishes for your family member."
While the provider may ultimately be involved in decision-making, it's important for the nurse to address the conflicting wishes and provide guidance on the appropriate steps to take in such situations.
b. "You should speak with the facility’s ethics committee about your concerns."
In cases of conflicting wishes or ethical dilemmas, involving the ethics committee can be beneficial. However, this response might not address the immediate need for clarification and guidance.
c. "We’ll need to have the nursing supervisor review the client’s advance directives."
Reviewing advance directives with the nursing supervisor is a reasonable step to ensure that the client's wishes are documented and followed. However, it might not directly address the conflicting wishes or provide immediate resolution.
d. "As the health care surrogate, the client’s partner can make this decision."
This is the correct response. The health care surrogate, appointed by the client or legally recognized as such, has the authority to make medical decisions on behalf of the unconscious client. It's important to follow the client's advance directives and legal designations regarding
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a. Decreased level of consciousness:
This finding is concerning and may indicate worsening neurological status, increased intracranial pressure, or impending herniation. A decreased level of consciousness requires immediate evaluation by the provider to assess for neurological deterioration and potential interventions to stabilize the client's condition.
b. Increased temperature:
While an increased temperature (fever) is commonly associated with meningitis due to the inflammatory response, it may not necessarily require immediate reporting unless it is extremely high or accompanied by other concerning symptoms. Fever management is important, but it may not warrant immediate provider notification unless it is severe or refractory to treatment.
c. Generalized rash over trunk:
A generalized rash can be associated with certain types of meningitis, such as meningococcal meningitis, and may indicate sepsis or disseminated infection. However, it may not always require immediate provider notification unless it is accompanied by other concerning symptoms or signs of systemic illness.
d. Report of photophobia:
Photophobia (sensitivity to light) is a common symptom of meningitis and is often reported by clients. While photophobia is significant in the context of meningitis, it may not require immediate provider notification unless it is severe or accompanied by other worrisome neurological symptoms.
Correct Answer is A
Explanation
a. Contact the case manager to discuss discharge options: This is an appropriate action. The case manager can assist in assessing the client's needs and coordinating appropriate discharge arrangements, such as arranging for home health services or exploring alternative care options.
b. Request another family member assist the client’s partner with care: This may be a helpful action if there is another family member who can provide support. However, it's important to consider the availability and willingness of other family members to take on caregiving responsibilities.
c. Recommend the partner place the client in a long-term care facility: This option may be considered if the partner is unable to continue providing care and there are no other feasible options available. However, it should be discussed with the client and their partner and explored as one of several potential solutions.
d. Ask the provider to delay the client’s discharge home for a few more days: This may be appropriate if there are concerns about the client's safety or if additional time is needed to arrange for alternative care options. However, it's important to address the underlying issues contributing to the partner's inability to provide care and to explore long-term solutions.
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