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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.

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Rationale:

A. Use a cane for support while walking: A cane can enhance balance and reduce the risk of falls in clients with multiple sclerosis, who may experience muscle weakness, spasticity, or ataxia. It promotes mobility while maintaining safety in the home environment.

B. Avoid the use of orthotics: Orthotic devices, such as ankle-foot orthoses, can actually be helpful in improving gait and preventing foot drop. Advising against their use may deprive the client of important supportive tools.

C. Implement a rigorous range-of-motion exercise plan: While exercise is important, a rigorous plan may lead to fatigue and overheating, which can worsen MS symptoms. A gentle, balanced routine tailored to the client’s tolerance is safer.

D. Walk with feet close together for stability: Keeping the feet close together narrows the base of support and increases fall risk. A wider stance improves balance and stability, which is safer for ambulating clients with MS.

A. "Apply the ointment to the skin every 4 hr." B. "Spread the ointment in a thin, even layer.” C. "Apply the ointment to the forearm." D. "Massage the ointment into the skin."

Correct Answer is B

Explanation

Rationale:

A. "Apply the ointment to the skin every 4 hr.": Nitroglycerin topical ointment is applied every 6 to 8 hours, depending on the provider's instructions. Applying it every 4 hours may increase the risk of side effects such as hypotension or tolerance due to excessive dosing frequency.

B. "Spread the ointment in a thin, even layer.": The medication should be applied in a thin, consistent layer to allow for proper absorption through the skin. The dose is usually measured and spread using applicator paper, avoiding rubbing or massaging it in.

C. "Apply the ointment to the forearm.": The preferred application sites are hairless areas of the chest, back, or upper arms. The forearm is not typically used due to variability in absorption and the presence of thinner skin and more movement.

D. "Massage the ointment into the skin.": Nitroglycerin ointment should never be massaged into the skin. Massaging can lead to unpredictable absorption rates and an increased risk of hypotension or headache due to rapid systemic absorption.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing home care with a client who has multiple sclerosis. Which of the following precautions should the nurse recommend to promote client safety?

Correct Answer is A

Explanation

A nurse is providing teaching to a client who has a new prescription for nitroglycerin topical ointment. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

The nurse is continuing to care for the client. Exhibits The nurse is initiating the client's plan of care. Which of the following interventions should the nurse plan to implement? Select all that apply.

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