A nurse is providing care to a client who is preparing to undergo surgery. The client inquires about advance directives. Which of the following statements should the nurse make?

Choice A reason: Explaining pros and cons informs but may pressure the client. Supporting autonomy respects their choice, aligning with lung cancer end-of-life preferences better.

Choice B reason: Supporting the client’s DNR decision upholds autonomy and aids communication. In lung cancer, respecting end-of-life wishes is critical, making this the best response.

Choice C reason: Involving a social worker delegates support, not directly honoring the client’s wish. Nurses should first affirm autonomy in such terminal cancer scenarios.

Choice D reason: Suggesting family discussion undermines autonomy, adding burden. The client’s decision in advanced cancer should be respected without implying external validation needs.

Choice A reason: Dry mucous membranes signal dehydration, not hyperkalemia directly. High potassium affects cardiac and nerve function, not mucosal hydration status in renal failure.

Choice B reason: Hyperactive reflexes occur in hypocalcemia, not hyperkalemia. Excess potassium depresses nerve and muscle activity, often reducing reflexes instead of enhancing them.

Choice C reason: Trousseau’s sign indicates hypocalcemia, with carpal spasm from cuff pressure. Hyperkalemia in renal failure doesn’t trigger this; it’s a calcium issue.

Choice D reason: Irregular heart rate, like bradycardia or arrhythmias, stems from hyperkalemia’s effect on cardiac conduction. In renal failure, potassium excess disrupts rhythms critically.