An older adult client who is cognitively intact and has decision-making capacity makes a decision to stop chemotherapy for breast cancer after being told of further spread of the cancer. The client's daughter is upset at her parent's decision an approaches the nurse and states: "I don't agree with the decision to stop treatments, I am my parent's health care proxy, I want to override that decision." What is the best response by the nurse?

"As the health care proxy, you are the one who makes the decisions. Let's call your mones doctor.

"I understand why you are so upset. I don't think she is doing the right thing either. Let us think together how we can change her mind

You will need to go to court and be declared a guardian"

"Health care proxies only come into play when the individual can no longer make their own decisions. Your mother is able to make her own decisions. I suggest you talk with her."

Answer and Explanation

The Correct Answer is D

A. "As the health care proxy, you are the one who makes the decisions. Let's call your mom's doctor."
Explanation: This response inaccurately suggests that the health care proxy has the authority to make decisions even when the client has decision-making capacity. The focus should be on the client's autonomy.

B. "I understand why you are so upset. I don't think she is doing the right thing either. Let us think together how we can change her mind."
Explanation: This response is inappropriate as it involves the nurse expressing a personal opinion and attempting to influence the client's decision. The nurse's role is to support the client's autonomy and facilitate communication between the client and their family.

C. "You will need to go to court and be declared a guardian."
Explanation: Involving the court and seeking guardianship is not warranted when the client has decision-making capacity. This option is not aligned with the principles of respecting the client's autonomy and decision-making capacity.

D. "Health care proxies only come into play when the individual can no longer make their own decisions. Your mother is able to make her own decisions. I suggest you talk with her."
Explanation: In this scenario, the client is cognitively intact and has decision-making capacity. As long as the older adult is able to make their own decisions, the health care proxy's role is not activated. The nurse appropriately advises the daughter to communicate directly with her mother about her concerns and decisions. This respects the autonomy of the client, who has the right to make decisions about their own healthcare as long as they have the capacity to do so.

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Correct Answer is C

Explanation

A. Driving in heavy traffic is fine as long as it is not raining.
Explanation: Driving in heavy traffic can pose challenges for individuals, especially those who may experience age-related changes in vision, reaction time, and cognitive function. The recommendation is to avoid heavy traffic, especially if it might increase stress and the likelihood of accidents.

B. If you have a passenger, you may drive at any time of the day.
Explanation: The presence of a passenger does not necessarily eliminate the potential challenges associated with age-related changes in driving abilities. It is important for older individuals to consider factors such as time of day, visibility, and overall driving conditions.

C. Limit driving to familiar places close to home.
Explanation: Limiting driving to familiar places close to home is a safer practice for older individuals who may face challenges with vision, reaction time, and other factors that can impact driving. Familiar routes are more likely to be navigated confidently, reducing the risk of getting lost or encountering unexpected challenges.

D. Playing music will help keep you alert.
Explanation: While playing music can be enjoyable, it may not be an effective strategy for maintaining alertness, especially during challenging driving conditions. The focus should be on adopting safe driving habits and minimizing distractions to ensure overall safety on the road.

A. Assist with obtaining informed consent from the client. B. Refer to the client's advance directive for a name. C. Determine the client's inability to make reasonable decisions. D. Use the oral trail-making test to measure cognitive function.

Correct Answer is C

Explanation

A. Assist with obtaining informed consent from the client.
Explanation: Informed consent is a critical aspect of healthcare procedures, but it requires the patient to have the capacity to understand and make decisions. In this scenario, the client is intubated and on mechanical ventilation, which might compromise their ability to communicate effectively. If the client lacks capacity, obtaining consent from the durable power of attorney (POA) is more appropriate.

B. Refer to the client's advance directive for a name.
Explanation: Advance directives, including the durable POA, provide guidance on a person's wishes for healthcare decisions when they are unable to communicate. However, the advance directive may not always specify a particular person's name for decisions related to specific medical interventions. The key consideration in this situation is to determine the current decision-making capacity and involve the appropriate decision-maker if needed.

C. Determine the client's inability to make reasonable decisions.
Explanation: This is the correct answer. In this scenario, the nurse should assess the client's capacity to make decisions. If the client lacks capacity, the durable POA can be activated to make healthcare decisions on behalf of the client. Capacity involves the ability to understand relevant information, appreciate the consequences of decisions, and communicate a choice.

D. Use the oral trail-making test to measure cognitive function.
Explanation: The oral trail-making test is a cognitive screening tool, but it may not be suitable in this critical care scenario with an intubated and mechanically ventilated patient. Moreover, the primary concern in this situation is determining the capacity to make healthcare decisions, which requires a more comprehensive evaluation than a specific cognitive function test. The focus should be on decision-making capacity rather than a cognitive assessment.

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Naxlex Comprehensive Predictor Exams

A nurse counseling an 85-year-old person regarding modifying driving habits would include

Correct Answer is C

Explanation

A health care provider asks the nurse about an older adult client's durable power of attorney (POA) because consent is needed for a medically necessary invasive procedure. The client has end-stage disease, is intubated, and is on mechanical ventilation. Which steps should the nurse implement?

Correct Answer is C

Explanation

Which is the fundamental difference between Medicare Part A and Medicare Part B?

The nurse plans care to prevent a dangerous thermal environment for an older adult client who lives in a northern climate of the United States. Which client assessment data does the nurse recognize that can contribute to the risk of hypothermia? (Select all that apply.)

The nurse assesses an older adult's cognitive status using a standard assessment instrument. Which of the following are cognitive assessment tools? (Select all that apply.)

Which attempt by the family to prevent an older frail adult from falling causes the home health nurse concern?

The nurse assesses the quality of which of the following patient characteristics when applying the Get-Up-and-Go test from the Hendrich II Fall Risk Model?

The nurse is trying to improve the nutritional status of residents in the nursing home. Which recommendations should the nurse implement?

Which recommendations for daily food intake is correct for older adults according to the MyPlate for Older Adults? (Select all that apply.)