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. Decreased serum potassium: Dehydration can lead to electrolyte imbalances, including hypokalemia. Muscle cramps and constipation are common signs of low potassium levels, as potassium is essential for normal muscle and nerve function. Monitoring electrolytes helps guide appropriate replacement therapy.
B. Decreased BUN: Dehydration typically causes an elevation in BUN due to hemoconcentration and reduced renal perfusion. A decreased BUN would not be expected in fluid volume deficit.
C. Decreased hematocrit (Hct): Hematocrit usually increases during dehydration because of reduced plasma volume, leading to hemoconcentration. A decreased Hct would suggest anemia or fluid overload, not dehydration.
D. Decreased specific gravity: Specific gravity of urine increases with dehydration as the kidneys concentrate urine to conserve water. A decreased specific gravity indicates diluted urine, which is not consistent with fluid deficit.
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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