A nurse is caring for a client who is comatose and has advance directives that indicate the client does not want life-sustaining measures. The client's family wants the client to have life-sustaining measures. Which of the following actions should the nurse take?

Arrange for an ethics committee meeting to address the family's concerns.

Complete an incident report.

Support the family's decision and initiate life-sustaining measures.

Encourage the family to contact an attorney.

Answer and Explanation

The Correct Answer is A

A. Arrange for an ethics committee meeting to address the family's concerns. An ethics committee can provide guidance in situations where there is conflict between advance directives and family wishes. This supports ethical decision-making while honoring the client’s autonomy and legal rights.
B. Complete an incident report. An incident report is used for errors or unusual events, not ethical dilemmas or conflicts over advance directives. It is not appropriate in this scenario.
C. Support the family's decision and initiate life-sustaining measures. The nurse is legally and ethically bound to follow the client’s advance directives, not the family’s wishes, especially when the client’s decisions are documented and clear.
D. Encourage the family to contact an attorney. While families have legal rights, referring them directly to an attorney does not address the immediate ethical issue or facilitate collaborative resolution in the care setting.

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Correct Answer is C

Explanation

A. “Take your diuretic medication with your evening meal." Taking diuretics in the evening can increase nighttime urination, worsening sleep disruption and incontinence. They should generally be taken in the morning to minimize nocturia.
B. "Decrease your intake of cranberry juice." Cranberry juice is often recommended to promote urinary tract health, though it doesn’t directly worsen urge incontinence. It is not necessary to avoid it unless advised by a provider for another reason.
C. "Plan to urinate every 3 hours while you are awake." Scheduled voiding at regular intervals is a key strategy in bladder retraining. It helps reduce urgency episodes and gradually increases bladder capacity and control over time.
D. “Limit your fluid intake to 500 milliliters per day." Severely limiting fluids can lead to dehydration, concentrated urine, and bladder irritation, potentially worsening incontinence. Adequate fluid intake should be maintained unless otherwise directed.

A. Candidiasis B. Chlamydia C. Herpes simplex virus D. Human papillomavirus

Correct Answer is B

Explanation

A. Candidiasis. This is a common fungal infection, often caused by Candida albicans. It is not a reportable disease to public health authorities because it is not typically considered a public health threat.
B. Chlamydia. Chlamydia is a nationally notifiable infectious disease due to its high prevalence and potential for serious complications such as infertility. Providers are required to report it to the state health department to aid in public health surveillance and control efforts.
C. Herpes simplex virus. While herpes is a common sexually transmitted infection, it is not currently on the national notifiable disease list and is not required to be routinely reported to public health agencies.
D. Human papillomavirus (HPV). HPV is widespread and associated with cervical cancer, but routine HPV infection is not reportable. However, certain types of cancer caused by HPV may be included in cancer registries.

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A nurse is caring for a client who is comatose and has advance directives that indicate the client does not want life-sustaining measures. The client's family wants the client to have life-sustaining measures. Which of the following actions should the nurse take?

Nursing Test Bank

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