A nurse is caring for a client who is seeking information about end-of-life decisions. According to the Patient Self-Determination Act, which of the following applies to medical decisions that can be made within organizations that receive Medicare and Medicaid reimbursements?
The person holding financial power of attorney will make health care decisions based on the client's advance directives.
The client has the right to refuse medical treatment, even if health care providers recommend it.
The client's eldest adult child has the right to change advance directives in an end-of-life situation.
If the client's advance directives are in writing and notarized, the client cannot change it in the future.
The Correct Answer is B
Rationale:
A. The person holding financial power of attorney will make health care decisions based on the client's advance directives: A financial power of attorney manages financial matters, not health care decisions. A separate designation such as a health care proxy or medical power of attorney is needed for making medical decisions.
B. The client has the right to refuse medical treatment, even if health care providers recommend it: Under the Patient Self-Determination Act (PSDA), clients have the legal right to make autonomous decisions about their care, including the right to refuse or discontinue treatment, regardless of medical advice.
C. The client's eldest adult child has the right to change advance directives in an end-of-life situation: Advance directives reflect the client’s own decisions. No family member, regardless of birth order, has the legal authority to change them unless specifically authorized as a health care proxy and even then, only if the client is incapacitated.
D. If the client's advance directives are in writing and notarized, the client cannot change it in the future: Clients can revise or revoke advance directives at any time, as long as they remain mentally competent. Notarization does not make the document legally fixed or unchangeable.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}
Explanation
Rationale for Correct Choices:
- Self-harm: The client expresses suicidal ideation influenced by delusions, indicating a strong risk of acting on these impulses. In schizophrenia, command hallucinations are particularly dangerous when they involve instructions to harm oneself.
- Command hallucinations: The client reports hearing voices directing them to act, which is a hallmark of command hallucinations. These are associated with a heightened risk of harm to self or others, especially when the client appears fearful or paranoid, as in this case.
Rationale for Incorrect Choices:
- Palming medications: Although the client is suspicious and refuses medication (“I’m not letting you poison me”), there is no evidence yet of palming or hiding pills. The agitation could indicate refusal, but not covert medication avoidance.
- Poor hygiene: While the client shows confusion regarding bathing and clothing, these are not the most immediate safety threats compared to suicide risk. Poor hygiene is a concern in schizophrenia but not the most critical issue at this time.
- Impaired memory: Impaired memory is evident (e.g., forgetting routines), but this is not directly linked to a life-threatening risk. Memory issues can affect functioning but don’t explain the urgency of the client’s safety threat.
- Distractibility: The client appears distracted at times (e.g., during dressing), but distractibility alone does not account for the risk of self-harm. It contributes to disorganization but is not the main safety concern.
Correct Answer is B
Explanation
Rationale:
A. Prepare an IV bolus of dextrose 5% in water: Dextrose in water does not reverse magnesium toxicity. It may be used as a fluid carrier but does not serve as an antidote or address the neuromuscular and cardiac effects of excessive magnesium.
B. Administer calcium gluconate IV: Calcium gluconate is the antidote for magnesium sulfate toxicity. It helps reverse respiratory depression, muscle weakness, and cardiac conduction delays caused by high magnesium levels, making it the immediate intervention.
C. Position the client supine: The supine position can worsen hypotension by decreasing venous return, especially in pregnant clients. Left lateral positioning is generally preferred to improve circulation to vital organs and the fetus.
D. Administer methylergonovine IM: Methylergonovine is used to treat postpartum hemorrhage, but it is contraindicated in clients with hypertension or preeclampsia due to its vasoconstrictive effects. It does not treat magnesium toxicity and could increase blood pressure dangerously.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.