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.
If the client’s advance directives are in writing and notarized, the client cannot change it in the future.
The client’s eldest adult child has the right to change advance directives in an end-of-life situation.
The Correct Answer is B
Choice A reason: Financial power of attorney manages monetary decisions, not health care, unless specified as a health care surrogate. Advance directives guide health decisions, but this role is distinct, making this statement incorrect under the Patient Self-Determination Act’s provisions.
Choice B reason: The Patient Self-Determination Act ensures clients’ rights to refuse treatment, even against provider recommendations, promoting autonomy through advance directives. This legal protection applies in Medicare/Medicaid facilities, making it the correct principle for end-of-life decision-making in this context.
Choice C reason: Advance directives can be changed by a competent client, even if notarized, as the Act supports ongoing autonomy. Stating they cannot be altered is incorrect, as flexibility is a core feature, making this an inaccurate representation of the law.
Choice D reason: The eldest adult child cannot change advance directives unless designated as a surrogate. The Act prioritizes the client’s documented wishes or appointed decision-maker, not family hierarchy, making this statement incorrect and misaligned with legal requirements.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
Choice A reason: Inability to concentrate is a common symptom of hypoglycemia in type 1 diabetes, as low blood glucose impairs brain function, leading to confusion and difficulty focusing. This neuroglycopenic symptom results from insufficient glucose for cerebral energy, making it a critical indicator requiring prompt intervention like glucose administration.
Choice B reason: Polydipsia is associated with hyperglycemia, not hypoglycemia, in type 1 diabetes. It results from osmotic diuresis due to high blood glucose, causing dehydration and thirst. This symptom does not indicate low blood sugar, making it incorrect for identifying hypoglycemia in this scenario.
Choice C reason: Tremors are a hallmark of hypoglycemia, caused by the sympathetic nervous system’s response to low blood glucose, triggering catecholamine release. This leads to shakiness, a common adrenergic symptom, signaling the need for immediate glucose to restore normal levels, making it a correct indicator.
Choice D reason: Acetone breath odor is linked to diabetic ketoacidosis (DKA), a complication of hyperglycemia, not hypoglycemia. It results from ketone production during fat metabolism in uncontrolled diabetes. This finding is irrelevant to low blood sugar, making it incorrect for this scenario.
Choice E reason: Diaphoresis, or excessive sweating, is a classic hypoglycemia symptom due to autonomic activation from low blood glucose. The body releases adrenaline, causing sweating as a stress response. This reliable indicator prompts urgent treatment to prevent severe complications, making it a correct choice.
Correct Answer is B
Explanation
Choice A reason: Hypernatremia is unlikely with 0.45% sodium chloride, a hypotonic solution that dilutes serum sodium. Over-infusion risks hyponatremia, not high sodium levels. Monitoring for hypernatremia is inappropriate, as the solution’s low sodium content does not contribute to elevated sodium in fluid therapy.
Choice B reason: Assessing for fluid overload is essential, as 0.45% sodium chloride, being hypotonic, can cause water to shift into cells, risking pulmonary or cerebral edema. This is critical in clients with renal or cardiac issues, where monitoring for dyspnea or swelling ensures safe fluid administration.
Choice C reason: Hypoglycemia is not directly linked to 0.45% sodium chloride, which affects fluid and electrolytes, not glucose. Fluid shifts may indirectly stress metabolism, but hypoglycemia relates to fasting or insulin issues, making this an inappropriate focus for monitoring in this fluid therapy context.
Choice D reason: Dehydration is unlikely, as 0.45% sodium chloride provides free water, promoting hydration. It corrects hypernatremia or replaces fluid losses. Evaluating for dehydration is unnecessary unless infusion is inadequate or losses persist, which is not indicated in the context of this hypotonic solution.
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