A nurse is discussing psychiatric advance directives (PAD) with a client. Which of the following statements should the nurse make?
"PAD does not allow a client to choose someone to make healthcare decisions on their behalf if they are unable to do so."
"PAD is not a legally binding document, like a living will."
"PAD is used by the majority of clients who have a mental illness."
"PAD can include preferences for treatment, such as medications and preferred providers."
The Correct Answer is D
A. "PAD does not allow a client to choose someone to make healthcare decisions on their behalf if they are unable to do so." PADs can include the designation of a health care proxy or durable power of attorney for health care decisions.
B. "PAD is not a legally binding document, like a living will." PADs are legally recognized in many jurisdictions and serve a similar purpose to living wills for psychiatric care.
C. "PAD is used by the majority of clients who have a mental illness." While beneficial, PADs are not widely used by most individuals with mental illness.
D. "PAD can include preferences for treatment, such as medications and preferred providers." PADs allow clients to outline their treatment preferences, including medications and preferred health care providers, in case they lose decision-making capacity.
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Related Questions
Correct Answer is A
Explanation
A. Autonomy refers to a client’s right to make their own decisions regarding care. Allowing them to choose between morning and afternoon therapy respects their independence and decision-making ability.
B. Justice refers to fairness and equal treatment in healthcare. While offering a choice is ethical, it is not related to ensuring fair resource distribution.
C. Beneficence means acting in the best interest of the client to promote well-being. While giving choices can be beneficial, this scenario specifically highlights autonomy.
D. Nonmaleficence means "do no harm." While respecting choices can prevent distress, this principle is more related to avoiding harm rather than promoting independence.
Correct Answer is B
Explanation
A. Cultural humility involves recognizing and respecting differences in beliefs and values while maintaining self-awareness. It does not explain erratic emotional responses.
B. Countertransference occurs when a nurse projects personal emotions onto a client, leading to overinvolvement (excessive kindness) or negative reactions (hostility). This can affect professional boundaries and care.
C. Transference occurs when a client unconsciously transfers feelings about past relationships onto the nurse (e.g., treating the nurse as a parental figure). This is the reverse of countertransference.
D. Professional competency refers to maintaining clinical skills and ethical behavior. Displaying inconsistent emotional responses toward a client is not an example of competency.
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