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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
The shoulder harness straps should be positioned at or below the infant's shoulders when using a rear-facing car seat. This placement ensures that the crash forces are distributed across the strongest parts of the body and prevents the baby from sliding up out of the straps during an impact.
Choice B rationale
The retainer clip, or chest clip, should be placed at the level of the armpits, across the sternum. This position ensures that the shoulder straps remain securely on the shoulders and prevents the baby from being ejected from the harness in the event of a collision. Placing it on the abdomen can cause serious injury.
Choice C rationale
A 45-degree angle in a rear-facing car seat is a crucial safety measure. This reclined position ensures that the infant's airway remains open and unobstructed. It prevents the head from slumping forward, which could lead to positional asphyxiation, especially in newborns who lack strong neck control.
Choice D rationale
Current safety recommendations advise keeping a child rear-facing for as long as possible, until they reach the maximum height or weight limits of their car seat, which is typically well beyond one year of age. Turning the seat forward-facing at 1 year is no longer considered the safest practice. *.
Correct Answer is B
Explanation
Choice A rationale
Antacids containing mint, such as peppermint, can actually worsen the symptoms of GERD. Mint is known to relax the lower esophageal sphincter, which allows stomach acid to reflux into the esophagus more easily. This can increase heartburn and discomfort, so it should be avoided.
Choice B rationale
Chocolate contains methylxanthines, which can decrease the pressure of the lower esophageal sphincter, allowing stomach contents to reflux into the esophagus. This can trigger or worsen GERD symptoms like heartburn and regurgitation. Therefore, clients with GERD should limit or avoid consuming foods containing chocolate to minimize symptom severity.
Choice C rationale
Lying down after eating can exacerbate GERD symptoms because it allows gravity to work against the lower esophageal sphincter, making it easier for stomach acid to flow back into the esophagus. Clients should remain upright for at least 3 hours after a meal to aid digestion and prevent reflux.
Choice D rationale
Citrus fruits are highly acidic and can irritate the already inflamed esophageal lining in a client with GERD, leading to increased pain and discomfort. Consuming acidic foods can worsen heartburn symptoms and should be limited or avoided to manage the condition effectively. *.
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