A nurse is explaining advance care directives, or “living wills,” to a client and the client’s spouse. Which detail would the nurse include in the description of an advance care directive?

The document tells what treatment is to be omitted or provided if the client is unable to make the decision.

A client is required to sign the “living will” document with an attorney present.

An attorney draws up the papers to be given to the client and his or her family.

The client’s physician must act as a witness when the client signs the document.

Answer and Explanation

The Correct Answer is A

The correct answer is A.
Choice A reason:
An advance care directive, or “living will,” is a legal document that specifies what medical treatments the client wishes to receive or omit if they become unable to make decisions for themselves. This document guides healthcare providers and family members in making decisions that align with the client’s preferences.
Choice B reason:
A client is not required to sign the “living will” document with an attorney present. While it is advisable to consult with an attorney when creating legal documents, it is not a requirement for the validity of an advance care directive.
Choice C reason:
An attorney may assist in drafting the advance care directive, but it is not necessary for the attorney to draw up the papers. The client can create the document with the help of healthcare providers or legal advisors.
Choice D reason:
The client’s physician does not need to act as a witness when the client signs the document. Typically, witnesses are required to ensure the document is signed voluntarily and without coercion, but they do not have to be the client’s physician.

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Correct Answer is B

Explanation

Choice A reason:
Neuroleptic malignant syndrome (NMS) is a rare but serious side effect of antipsychotic medications. It is characterized by symptoms such as high fever, muscle rigidity, altered mental status, and autonomic dysfunction. The client’s description of needing to move around does not align with the symptoms of NMS.
Choice B reason:
Akathisia is a common side effect of first-generation antipsychotic medications. It is characterized by a feeling of inner restlessness and an urgent need to move. The client’s behavior of pacing and the statement “I just need to move around” are indicative of akathisia.
Choice C reason:
Tardive dyskinesia is a long-term side effect of antipsychotic medications, characterized by involuntary, repetitive movements, particularly of the face and tongue. The client’s symptoms of needing to move around do not match the typical presentation of tardive dyskinesia.
Choice D reason:
Impaired ability to regulate body temperature can occur with antipsychotic medications, but it is not characterized by the need to move around. The client’s symptoms are more consistent with akathisia rather than issues with thermoregulation.

A. “What are the voices telling you to do?” B. “You need to understand that there are no voices.” C. “Why do you think you are hearing the voices?” D. “You need to tell the voices to leave you alone.”

Correct Answer is A

Explanation

Choice A reason:
Asking “What are the voices telling you to do?” is an appropriate response because it allows the nurse to assess the content of the hallucinations and determine if the client is at risk of harming themselves or others. This approach shows empathy and concern while gathering important information for the client’s safety.
Choice B reason:
Telling the client “You need to understand that there are no voices” dismisses the client’s experience and can increase their distress. It is important to acknowledge the client’s feelings and perceptions, even if they are not based in reality.
Choice C reason:
Asking “Why do you think you are hearing the voices?” may not be helpful in the moment of distress. The client may not be able to provide a rational explanation for their hallucinations, and this question could increase their confusion and anxiety.
Choice D reason:
Telling the client “You need to tell the voices to leave you alone” may not be effective, as the client may not have the ability to control their hallucinations. It is more important to assess the content of the hallucinations and provide support.

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A nurse is explaining advance care directives, or “living wills,” to a client and the client’s spouse. Which detail would the nurse include in the description of an advance care directive?

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Correct Answer is B

Explanation

A nurse is talking with a client who has schizophrenia. Suddenly the client states, “I’m frightened. Do you hear that? The voices are telling me to do terrible things.” Which of the following responses by the nurse is appropriate?

Correct Answer is A

Explanation

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