A nurse is evaluating a newly licensed nurse's understanding of advance directives. The newly licensed nurse should identify that which of the following individuals is responsible for deciding whether a client is capable of making their own decisions regarding medical treatment?
Primary provider
Health care surrogate
Social worker
Charge nurse
The Correct Answer is A
Rationale
A. Primary provider: The primary provider is responsible for assessing and determining a client’s decision-making capacity regarding medical treatment. This evaluation includes the client’s ability to understand information, appreciate the consequences of decisions, reason logically, and communicate choices clearly. The determination guides informed consent and advance directive discussions.
B. Health care surrogate: A health care surrogate makes decisions only when a client is deemed incapable of making their own medical decisions. The surrogate’s authority is activated after the provider determines the client lacks decision-making capacity.
C. Social worker: Social workers provide support, education, and advocacy regarding advance directives and care planning but do not have the legal authority to determine decision-making capacity. They assist in facilitating communication between the client, family, and healthcare team.
D. Charge nurse: The charge nurse oversees unit operations and coordinates care but is not responsible for determining a client’s capacity to make medical decisions. This responsibility lies with the provider evaluating the client’s clinical and cognitive status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale
A. Acceptance: Acceptance is the stage of grief in which the client comes to terms with their prognosis and makes peace with the situation. Choosing comfort care over further treatment reflects understanding of their terminal condition and a focus on quality of life rather than curative measures. Documentation should reflect the client’s informed decision and readiness to embrace this stage.
B. Denial: Denial involves refusal to acknowledge the reality of the illness or prognosis. The client in this scenario is aware of their condition and is making conscious choices, indicating they are not in denial. Recognizing denial helps identify when clients may need additional support or education.
C. Bargaining: Bargaining involves attempting to negotiate for more time or a different outcome, often through “if only” statements or promises. The client is not seeking alternative treatments or making deals to extend life, so bargaining is not applicable in this case.
D. Depression: Depression is characterized by deep sadness, hopelessness, or withdrawal in response to loss. While the client may experience emotional responses, the statement indicates acceptance rather than pervasive despair. Distinguishing between acceptance and depression ensures accurate documentation of the client’s emotional stage.
Correct Answer is B
Explanation
Rationale
A. Rinse the linens prior to removing them from the client's room: Rinsing soiled linens is not recommended because it can spread infectious material through splashing or aerosolization. Contaminated linens should be handled carefully to prevent environmental contamination.
B. Tie the linens' bag securely at the top: Securing the bag prevents the spread of pathogens during transport to the laundry area. Properly tying the bag reduces the risk of exposure to healthcare personnel and maintains infection control standards for clients on contact precautions.
C. Wear sterile gloves when handling the linens: Sterile gloves are not required for routine handling of soiled linens. Clean gloves are sufficient to protect the nurse from direct contact with contaminated materials while conserving sterile supplies for invasive procedures.
D. Double-bag the linens: Double-bagging is not routinely necessary unless the linens are excessively wet or contaminated with highly infectious material. Following standard precautions and using a single securely tied bag is usually adequate for contact precautions.
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