A nurse is teaching a client about advance directives. Which of the following statements by the client indicates an understanding of the teaching?

"A living will is a document that includes my wishes about health care decisions."

"My partner needs to be present as a witness when I sign a living will."

"My provider will make my health care decisions if I complete advance directives."

"Advance directives outline who inherits my material possessions in the event of my death."

Answer and Explanation

The Correct Answer is A

A. "A living will is a document that includes my wishes about health care decisions.": A living will is an advance directive that specifies a client’s preferences for medical treatment in situations where they are unable to communicate.

B. "My partner needs to be present as a witness when I sign a living will.": Witness requirements vary by state, and typically a neutral adult, not necessarily a partner, must witness the signing.

C. "My provider will make my health care decisions if I complete advance directives.": Advance directives are intended to communicate the client’s own wishes, not delegate decision-making solely to the provider. The provider’s role is to follow the client’s documented preferences.

D. "Advance directives outline who inherits my material possessions in the event of my death.": Inheritance is addressed in a will, not advance directives. Advance directives focus exclusively on medical and end-of-life care decisions.

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Correct Answer is C

Explanation

Rationale:

A. Generativity vs self-absorption: This stage occurs in middle adulthood, typically between ages 40 and 65, when individuals focus on contributing to society, guiding the next generation, and creating a lasting legacy.

B. Trust vs mistrust: This is the first stage of Erikson’s theory, occurring in infancy (birth to 1 year). It centers on developing a sense of trust when basic needs are met consistently by caregivers.

C. Identity vs role confusion: This stage occurs during adolescence (approximately ages 12 to 18) and involves exploring personal values, beliefs, and goals to develop a stable sense of self. Success leads to identity formation, while failure results in role confusion.

D. Intimacy vs isolation: This stage takes place in young adulthood (approximately ages 20 to 40) and focuses on forming deep, committed relationships while balancing independence and emotional closeness.

A. Increased creatinine B. Increased calcium C. Increased bicarbonate D. Increased hemoglobin

Correct Answer is A

Explanation

Rationale:

A. Increased creatinine: Chronic kidney disease reduces the kidneys’ ability to filter waste products effectively, causing creatinine to accumulate in the blood. Elevated creatinine is a key indicator of declining renal function and is expected in this condition.

B. Increased calcium: Clients with chronic kidney disease often have decreased calcium levels due to impaired vitamin D activation and phosphate retention. Increased calcium would be unusual unless the client is receiving supplementation.

C. Increased bicarbonate: Metabolic acidosis is common in chronic kidney disease because the kidneys cannot adequately excrete hydrogen ions or reabsorb bicarbonate. This typically results in decreased, not increased, bicarbonate levels in the blood.

D. Increased hemoglobin: Anemia frequently occurs in chronic kidney disease due to reduced erythropoietin production by the kidneys. This leads to lower hemoglobin levels, so an increase would not be expected unless treated with erythropoiesis-stimulating agents.

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A nurse is teaching a client about advance directives. Which of the following statements by the client indicates an understanding of the teaching?

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