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 D
Explanation
Rationale:
A. Circular Red Area: This is a Stage 1 Pressure Injury (non-blanchable erythema or shallow ulcer).
B. Bruise on Leg: This shows contusion/bruising (ecchymosis) and possible swelling, which is a closed injury, not an open wound that requires healing by intention.
C. Sutured Incision (Primary intention): The wound edges are cleanly approximated (brought together) with sutures, staples, or adhesive. Minimal tissue loss occurred. Healing occurs rapidly, with minimal granulation tissue and minimal scarring. The image showing the clean, surgical incision closed with staples or sutures.
D. Open Ulcer/Pressure Injury (Secondary Intention): The wound has significant tissue loss, irregular borders, and the edges cannot be approximated (closed). The wound is left open to heal by granulation (formation of new connective tissue) from the bottom up. This process is slower and results in a larger, more noticeable scar.
Correct Answer is ["A","E","G"]
Explanation
Rationale for Correct Choices
- Pain rating of 8/10 with no relief from pain medications: Increased or uncontrolled pain can indicate infection, inflammation, or ineffective wound healing. The lack of pain relief suggests the current wound vac therapy is not adequately addressing the underlying issue.
- Wound size increased from 2 cm × 2 cm to 3 cm × 2 cm: Wound enlargement indicates delayed or ineffective healing. Effective wound vac therapy should reduce wound size and promote closure; an increase in size signals treatment failure.
- Mild purulent drainage noted: Presence of purulent drainage suggests infection or poor wound healing. Effective negative-pressure therapy should promote a clean, granulating wound bed without signs of infection.
Rationale for Incorrect Choices
- Wound bed vascular with some approximation of the edges: This finding suggests that some healing is occurring. A vascular wound bed indicates good blood supply, which is necessary for tissue repair, and partial approximation of edges shows that some granulation tissue is forming and the wound is attempting to close.
- Respirations even and nonlabored, abdomen soft and nondistended, heart rate regular: These systemic findings suggest the client is stable overall. They indicate that there is no acute systemic compromise from the wound,
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