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 ["B","D"]

Explanation

B. Provide nutritious food according to the residents' expressed food preferences.

Explanation: Offering nutritious food based on residents' preferences can enhance their satisfaction with meals, making them more likely to eat and maintain adequate nutritional intake. Taking individual preferences into account helps create a more person-centered approach to nutrition.

D. Distribute "med-pass" nutritional supplements.

Explanation: Nutritional supplements may be beneficial for residents who have difficulty meeting their nutritional needs through regular meals. "Med-pass" supplements can be distributed with medications or as a separate supplement to enhance calorie and nutrient intake, especially for those with specific dietary requirements.

The other options are not recommended:

A. Develop a seating chart for the main dining room based on the unit to facilitate a more organized and efficient meal delivery.

Explanation: While organization and efficiency are important, creating a seating chart based on the unit might not directly address the nutritional status of residents. Instead, focus should be on providing appetizing, nutritious meals and accommodating residents' preferences.

C. Replace the fluorescent lighting with candles at every table to create a cozy, restaurant-like atmosphere.

Explanation: While creating a pleasant dining environment is important, replacing fluorescent lighting with candles may not be practical or safe in a healthcare setting. Moreover, the emphasis should be on the nutritional content of the meals rather than the ambiance.

A. Some of the residents are wearing blankets around their shoulders to keep warm. B. It feels much warmer in the administration wing than out in the client care areas C. An ambient temperature of 62°F is unsuitable for older people because they have impaired thermoregulation D. It is not fair for older adults to have to deal with an uncomfortable environment

Correct Answer is C

Explanation

A. Some of the residents are wearing blankets around their shoulders to keep warm.

Explanation: While this indicates that some residents are taking measures to keep warm, it is more of an observation than a documentation of the overall impact of temperature on the health and well-being of all residents.

B. It feels much warmer in the administration wing than out in the client care areas.

Explanation: This statement relates to variations in temperature within the facility but does not directly address the suitability of the overall ambient temperature for the well-being of older adults.

C. An ambient temperature of 62°F is unsuitable for older people because they have impaired thermoregulation.

Explanation: Older adults often have impaired thermoregulation, making them more vulnerable to temperature extremes. A temperature of 62°F may be too cold for older adults, increasing the risk of hypothermia or discomfort. Addressing the potential impact of impaired thermoregulation on older individuals' health and well-being is crucial in maintaining a safe and comfortable environment.

D. It is not fair for older adults to have to deal with an uncomfortable environment.

Explanation: While fairness and comfort are valid considerations, the primary concern should be the potential impact of the ambient temperature on the health and well-being of older adults, especially considering their impaired thermoregulation.

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is ["B","D"]

Explanation

The overall temperature in the gerontological unit is 62°F during the evening shift. In documenting this concern to the administration, which factor is the most important for the health and well-being of older adults?

Correct Answer is C

Explanation

The nurse should encourage which of the following exercise(s) to assist with balance for a client who is at high risk for falls? (Select all that apply.

In reviewing an older adult's insurance history, you find that he is on Medicaid. What do you know that Medicaid is used for?

Which patient assessment data does the nurse recognize could contribute to an older adult's risk of hyperthermia?

Which option is part of a program that addresses bowel incontinence in an older adult client?

The nurse wants to suggest exercise program options for an older client who is recovering losing her balance and falling. Which nursing intervention is suitable for this older adult?

Hypothermia is a medical emergency defined as a core temperature less than 95°F. Which of the following tips to prevent hypothermia should you tell your elderly client? (Select all that apply.)

A nurse is assessing an older adult's nutritional status. The nurse understands that which of the following is the most important indicator for a potential nutritional deficit?