A nurse is reviewing the purpose of advance directives with a client. Which of the following statements should the nurse make?

"It expresses your wishes regarding health care when you can no longer communicate."

"It specifies your choices regarding funeral arrangements."

"It defines the criteria for the distribution of your assets."

"It appoints a health care provider to speak for you with power of attorney for health care."

Answer and Explanation

The Correct Answer is A

Rationale:

A. "It expresses your wishes regarding health care when you can no longer communicate.": Advance directives are legal documents that state a client's preferences for medical care if they become unable to communicate those decisions themselves. This includes choices about life-sustaining treatments, resuscitation, and organ donation.

B. "It specifies your choices regarding funeral arrangements.": Funeral arrangements are typically addressed in a will or separate personal document, not in advance directives. Advance directives focus on medical decisions, not postmortem planning.

C. "It defines the criteria for the distribution of your assets.": The distribution of assets is handled through a last will and testament or estate planning documents, not through an advance directive. The directive is solely for healthcare-related decisions.

D. "It appoints a health care provider to speak for you with power of attorney for health care.": An advance directive may include the appointment of a health care proxy or agent, but it does not appoint a health care provider. It designates a trusted individual—not a clinician to make decisions if the client is incapacitated.

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Correct Answer is A

Explanation

Rationale:

A. Severe immunodeficiency: The MMR vaccine is a live attenuated vaccine and is contraindicated in clients with severe immunodeficiency, such as those undergoing chemotherapy or with advanced HIV/AIDS. These individuals cannot mount an appropriate immune response, placing them at risk for vaccine-related complications.

B. Asymptomatic HIV: Clients with asymptomatic HIV and adequate CD4 counts may safely receive the MMR vaccine. It is not contraindicated unless the client is significantly immunocompromised.

C. Mild febrile illness: Mild illnesses, such as low-grade fever or upper respiratory infections, do not contraindicate vaccine administration. The MMR vaccine can still be safely given, as minor illness does not significantly alter vaccine response or increase risks.

D. Egg allergy: Although the MMR vaccine is cultured in chick embryo fibroblasts, it does not contain significant egg protein, and studies have shown it can be safely administered to individuals with egg allergies. An egg allergy is not a valid reason to withhold the vaccine.

A. Urinary frequency B. Difficulty swallowing C. Decreased sleep D. Increased senses

Correct Answer is B

Explanation

Rationale:

A. Urinary frequency: As death approaches, urinary output typically decreases due to reduced kidney perfusion. Urinary frequency is not a common sign of impending death and may suggest other unrelated conditions.

B. Difficulty swallowing: Difficulty swallowing is a common manifestation of impending death. As muscle tone declines, the child may struggle to manage secretions or food, increasing the risk of aspiration and signaling the body is shutting down.

C. Decreased sleep: Clients nearing death often exhibit increased sleep or lethargy, not decreased sleep. Diminished responsiveness and longer periods of unresponsiveness are expected in the final stages of life.

D. Increased senses: Sensory function generally declines as death nears. Vision, hearing, taste, and touch may all diminish, and the child may become less responsive to external stimuli. Increased senses are not expected at this stage

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A nurse is reviewing the purpose of advance directives with a client. Which of the following statements should the nurse make?

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