A nurse is caring for a client who has named a person to serve as his health care proxy. The client talks about this type of advance directives. Which of the following statements by the client indicates a need for clarification?
"I can change who I designate as my health care proxy at any time."
"I have to choose a family member as my health proxy."
"I become incapacitated, end-of-life choices will be made by my proxy"
"The health care proxy does not go into effect until 1 am incapable of making decisions,"
The Correct Answer is B
A. "I can change who I designate as my health care proxy at any time": This statement is correct. Clients have the right to change their designated health care proxy at any time as long as they are competent to do so. It's important for clients to know that they have flexibility in selecting their proxy based on their preferences and trust in the individual's ability to represent their wishes.
B. "I have to choose a family member as my health proxy": This statement requires clarification. While many clients may choose a family member as their health care proxy, it is not a requirement. Clients have the autonomy to choose any individual they trust to make medical decisions on their behalf, whether it's a family member, friend, or even a legal representative. It's crucial to ensure that the chosen proxy understands the client's wishes and is willing and able to advocate for them.
C. "If I become incapacitated, end-of-life choices will be made by my proxy": This statement is accurate. A health care proxy is designated to make medical decisions on behalf of the client if they become incapacitated and are unable to make decisions for themselves. The proxy is responsible for advocating for the client's wishes, including end-of-life preferences, if outlined in the advance directive or communicated to the proxy beforehand.
D. "The health care proxy does not go into effect until I am incapable of making decisions": This statement is generally correct. Health care proxies typically become active only when the client is deemed incapacitated and unable to make decisions for themselves, as determined by a healthcare provider. However, the specifics may vary depending on state laws and the language of the advance directive document. It's essential for clients to understand when the proxy's authority begins and how it transitions based on their capacity to make decisions.
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Related Questions
Correct Answer is B
Explanation
A. Administer the medication into the deltoid muscle: Olanzapine is typically administered deep into the muscle to ensure proper absorption. However, the deltoid muscle may not be the preferred site for intramuscular injections of medications like olanzapine due to the risk of hitting the underlying radial nerve. The ventrogluteal or vastus lateralis muscles are often preferred sites for IM injections to reduce the risk of nerve damage.
B. Monitor the client for at least 3 hr after the injection: After administering olanzapine IM, the nurse should monitor the client closely for at least 3 hours to assess for any adverse reactions or side effects, such as sedation, hypotension, or extrapyramidal symptoms. This allows for early detection and prompt intervention if needed.
C. Withhold the medication if the client reports hallucinations: Olanzapine is an antipsychotic medication commonly used to treat schizophrenia and other psychotic disorders. Hallucinations are a symptom of schizophrenia, and olanzapine is often prescribed to help manage such symptoms. Withholding the medication solely based on the client reporting hallucinations would not be appropriate without further assessment and consideration of the overall treatment plan.
D. Instruct the client to expect difficulty sleeping: While olanzapine can cause sedation and may affect sleep patterns in some individuals, it is not a universal side effect for everyone. Providing anticipatory guidance about potential side effects is essential, but instructing the client to expect difficulty sleeping without individual assessment may lead to unnecessary anxiety or concerns.
Correct Answer is C
Explanation
A. A room with another nonsurgical client: Placing a client with active tuberculosis in a room with another nonsurgical client is not appropriate because it increases the risk of transmission to other patients. Tuberculosis is highly contagious, and isolation precautions are necessary to prevent the spread of the disease.
B. A room in the ICU: While isolation precautions are necessary for a client with active tuberculosis, placing the client in the intensive care unit (ICU) may not be necessary unless the client requires critical care. However, the priority is to provide a room that meets the requirements for airborne infection isolation, which may not necessarily be in the ICU.
C. A room with air exhaust directly to the outdoor environment: This is the correct choice. A room with air exhaust directly to the outdoor environment is essential for a client with active tuberculosis. Airborne infection isolation rooms (AIIRs) have negative air pressure and special ventilation systems that prevent the circulation of air from the room to other areas of the healthcare facility, reducing the risk of transmission to healthcare workers and other patients.
D. A room that is within view of the nursing station: While it may be convenient for the nursing staff to have the client's room within view of the nursing station for monitoring purposes, the priority for a client with active tuberculosis is to ensure that they are placed in a room with appropriate airborne infection isolation precautions, including proper ventilation, to minimize the risk of transmission to others.
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