A nurse is caring for a client who has end-stage kidney disease and refuses further hemodialysis treatments. The client has advance directives that indicate no life-sustaining treatments. Which of the following actions should the nurse take?
Contact the client's family to discuss the decision.
Encourage the client to complete a final hemodialysis treatment.
Discuss possible options for discharge with the client.
Discuss future treatment options with the client's health care surrogate.
The Correct Answer is C
Rationale:
A. Contact the client's family to discuss the decision: While family members may be involved, the nurse must prioritize respecting the client’s autonomy. The client has expressed their wishes, and involving family without consent may violate confidentiality and autonomy.
B. Encourage the client to complete a final hemodialysis treatment: Pressuring or encouraging a client to undergo treatment they have refused especially when they have advance directives in place disregards their legal and ethical right to make decisions about their own care.
C. Discuss possible options for discharge with the client: Respecting the client’s decision and exploring care planning, such as hospice or palliative care services, is appropriate. This supports autonomy while ensuring comfort and dignity in the end-of-life process.
D. Discuss future treatment options with the client's health care surrogate: A surrogate decision-maker is only consulted when the client is unable to make decisions. In this case, the client is alert and capable, so the discussion should remain between the nurse and client.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Troponin level: Troponin is a cardiac biomarker used to detect myocardial injury or infarction. It is not an indicator of nutritional status and does not reflect protein levels or nutrient balance.
B. Serum albumin: Albumin is a plasma protein synthesized in the liver and commonly used as a marker of long-term nutritional status. Low levels may suggest protein-energy malnutrition or chronic illness affecting nutrient absorption or intake.
C. Erythrocyte sedimentation rate: ESR is a nonspecific marker of inflammation or infection. While chronic disease can indirectly affect nutrition, ESR does not directly assess nutrient levels or dietary sufficiency.
D. Serum sodium: Sodium levels reflect fluid balance and electrolyte status but are not indicators of nutritional status. They may be influenced by hydration, renal function, or hormonal imbalances, not by dietary protein intake.
Correct Answer is B
Explanation
Rationale:
A. Obtaining the initial assessment of assigned clients: Initial assessments require nursing judgment and are part of the nursing process, which cannot be delegated to assistive personnel. Only licensed nurses may perform comprehensive initial assessments.
B. Changing a nonsterile dressing: This is a routine and predictable task that does not require clinical judgment and can be safely delegated to assistive personnel, depending on facility policy and the client’s condition.
C. Interpreting a client's diagnostic laboratory results: Interpretation of lab values requires analysis and clinical decision-making, which are nursing responsibilities. Assistive personnel are not licensed to interpret or evaluate clinical data.
D. Educating a client and family members on home care: Client education involves assessing understanding, using clinical knowledge, and adapting teaching methods, functions reserved for licensed nurses, not assistive personnel.
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