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
A nonstress test (NST) does not require the client to fast. The client can eat and drink normally, and sometimes a sugary beverage is even encouraged to stimulate fetal movement, as the test aims to record fetal heart rate accelerations in response to these movements.
Choice B rationale
The nonstress test is a screening tool used to assess fetal well-being by measuring the fetal heart rate's response to fetal movement. It does not provide information about genetic problems, which are typically identified through genetic testing or prenatal diagnostic procedures such as amniocentesis.
Choice C rationale
A key component of the nonstress test involves the mother noting fetal movements. The client is given a marker, often a button, to press each time she feels the baby move. This action correlates the mother's perception of movement with the fetal heart rate accelerations recorded on the monitor.
Choice D rationale
Oxytocin is not administered during a nonstress test. The purpose of this test is to assess the baby's baseline heart rate and accelerations without external stimulation. Oxytocin is used in a contraction stress test, which is a different procedure to evaluate how the baby handles uterine contractions. *.
Correct Answer is D
Explanation
Choice A rationale
A tracheostomy tray is used to perform an emergency tracheostomy. This procedure is not a standard requirement for a client with a thoracotomy and chest tube placement, as the primary respiratory intervention is typically managed via the chest tube and other supportive measures.
Choice B rationale
Montgomery straps are used to secure dressings that require frequent changes, preventing skin irritation from repeated tape removal. They are useful for abdominal wounds or other high-drainage sites but are not a specific or essential piece of equipment for a chest tube.
Choice C rationale
Wire cutters are used to cut stainless steel wires that may be used to secure the sternum after cardiac surgery. A thoracotomy is an incision into the chest wall to access the thoracic cavity; it does not involve sternal wiring.
Choice D rationale
A padded clamp is an essential piece of equipment at the bedside for a client with a chest tube. In the event of a chest tube dislodgement or if the drainage system needs to be changed, the clamp is used to temporarily occlude the tube to prevent a pneumothorax. .
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