A nurse is teaching a newly licensed nurse about advance directives.
Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
The provider will choose a client's health care surrogate.
The client can resume control of health care after a temporary loss of competency.
A health care surrogate must be a family member.
The provider can go against the client's wishes regarding advance directives.
The Correct Answer is B
Choice A rationale
A healthcare surrogate, or proxy, is a person designated by the patient themselves through a legal document called a durable power of attorney for healthcare. The provider's role is to provide medical care, not to make legal decisions for the patient. The patient retains the autonomy to choose who will make decisions for them when they are unable to do so. This is a fundamental principle of patient self-determination and legal rights.
Choice B rationale
A patient's competency can fluctuate. In situations of temporary incapacity, such as during a surgical procedure with anesthesia or a period of severe illness, a health care surrogate may make decisions. However, once the patient regains competency and is able to make informed decisions for themselves, they automatically resume control of their health care. This is a core tenet of patient autonomy and the purpose of advance directives.
Choice C rationale
A healthcare surrogate does not have to be a family member. The person designated by the patient can be a friend, a partner, or any trusted individual. The only requirement is that the surrogate is an adult who is willing and able to make healthcare decisions on the patient's behalf. It is a legal designation, not a familial one, that is based on the patient's trust and personal wishes.
Choice D rationale
A provider is legally and ethically obligated to follow a patient's wishes as outlined in their advance directives, as long as those wishes are within the bounds of standard medical practice and are not medically futile. To go against a patient's documented wishes would be a violation of patient autonomy and a breach of the legal protections afforded by advance directives.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Looping the tubing so it is lower than the collection bag creates a dependent loop, which can cause urine to pool and create a backflow into the bladder. This stasis of urine provides a fertile environment for bacteria to multiply and ascend the urinary tract, significantly increasing the client's risk for a urinary tract infection. The bag should always be below the bladder.
Choice B rationale
Keeping the urinary bag at bladder level or higher when ambulating is a significant risk factor for urinary tract infections. This positioning allows for the backflow of urine from the collection bag into the bladder. The retrograde flow of urine can transport bacteria into the sterile bladder, leading to bacterial colonization and a subsequent infection.
Choice C rationale
Securing the catheter to the client's thigh is a crucial intervention for minimizing the risk of a UTI. It prevents movement and traction on the catheter at the urethral meatus. This minimizes urethral tissue irritation and micro-trauma, which can serve as entry points for bacteria. It also reduces tension on the catheter, preventing accidental dislodgement.
Choice D rationale
Disconnecting the tubing connections to obtain a urinary sample is a high-risk action for introducing microorganisms. Each disconnection breaks the closed, sterile system, allowing airborne bacteria or contaminants from the external environment to enter the catheter and tubing. This breach of sterility can lead to bacterial ascension into the bladder, causing a urinary tract infection. *.
Correct Answer is A
Explanation
Choice A rationale
The ST segment represents the time from the end of ventricular depolarization to the beginning of ventricular repolarization. It is identified as the flat baseline following the QRS complex and preceding the T wave. This segment is isoelectric, meaning it's at the same level as the PR segment, and any deviation can indicate myocardial ischemia or injury.
Choice B rationale
The peak of the R wave represents the peak of ventricular depolarization. It signifies the moment of maximum electrical activity in the ventricles, as the impulse spreads through the ventricular walls. It is a critical point in the QRS complex, but it is not the location of the ST segment.
Choice C rationale
The beginning of the P wave marks the onset of atrial depolarization. This electrical event represents the contraction of the atria as they pump blood into the ventricles. The P wave is the first deflection in the cardiac cycle and occurs well before the QRS complex and the ST segment.
Choice D rationale
The interval between the S wave and the T wave is not a standard electrocardiographic term. The correct terminology is the ST segment, which is a segment, not an interval, and it specifically follows the S wave and precedes the T wave. An interval would typically include a wave, like the QT interval. *.
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