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. Hospice care.

Explanation: Both Medicare Part A and Part B cover hospice care, and hospice care is not a fundamental difference between the two parts.

B. Home care services.

Explanation: Both Medicare Part A and Part B cover certain home care services. While the specific services covered may vary, home care services are not a fundamental difference between the two parts.

C. Health care setting.

Explanation: Medicare Part A and Part B cover different aspects of healthcare and are designed for different health care settings.

Medicare Part A (Hospital Insurance): Primarily covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care services. It is generally associated with institutional settings.

Medicare Part B (Medical Insurance): Covers outpatient care, preventive services, doctor visits, and some home health care services. It is more focused on services provided in non-institutional settings.

D. Invasive procedures.

Explanation: Both Medicare Part A and Part B cover various medical services, including invasive procedures. The nature of procedures covered may differ, but it is not a fundamental difference distinguishing between Part A and Part B.

A. Participants in Pace programs must be able to perform their own ADLs Independently. B. Participants in Pace programs must have been residents in a nursing home prior to enrollment in the Pace program. C. Participants in Pace programs must be eligible for either Medicare or Medicaid. D. Pace programs only provide service to individuals who are age 55 and over. E. Pace programs provide services to individuals who meet the criteria for nursing home admission

Correct Answer is ["C","D","E"]

Explanation

A. Participants in PACE programs must be able to perform their own ADLs independently.

Explanation: This statement is generally not true. PACE programs are designed to provide comprehensive and coordinated care for individuals who are frail and meet the criteria for nursing home admission. The emphasis is on maintaining participants in their homes and communities. Participants in PACE programs often have limitations in Activities of Daily Living (ADLs), and the program is designed to support them in these activities.

B. Participants in PACE programs must have been residents in a nursing home prior to enrollment in the PACE program.

Explanation: This statement is generally not true. PACE programs aim to keep individuals out of nursing homes by providing comprehensive healthcare services in a community setting. Participants in PACE programs are often those at risk of nursing home placement due to their health and functional status.

C. Participants in PACE programs must be eligible for either Medicare or Medicaid.

Explanation: This statement is generally true. PACE programs are funded through Medicare and Medicaid. Participants must be eligible for both Medicare and Medicaid to enroll in a PACE program. Medicaid eligibility may vary by state.

D. PACE programs only provide service to individuals who are age 55 and over.

Explanation: This statement is generally true. PACE programs typically serve individuals who are 55 years of age or older. However, the specific age eligibility may vary by state.

E. PACE programs provide services to individuals who meet the criteria for nursing home admission.

Explanation: This statement is generally true. PACE programs are designed for individuals who are at risk of nursing home placement due to their health and functional status. Participants must meet the criteria for nursing home admission to be eligible for PACE services.

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is C

Explanation

Correct Answer is ["C","D","E"]

Explanation

A client care assistant has been assigned to feed your female client with dysphagia. Which of the following instructions would you give the assistant? (Select all that apply.)

What components are included in a person-centered community? (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.)

The health care provider has not ordered the use of a restraint for an alert patient at high risk for falling. The nurse should implement which side rail use?

To prevent malnutrition in older clients with dementia, which of the following would benefit your client? (Select all that apply.)

A 79-year-old client resides independently in the community. The visiting home health nurse finds that despite it being 90°F outside, the windows are closed and the client is wearing a sweater. The nurse initially recognizes that this behavior may be related to what?

A home health nurse is making a home visit to an older adult client. A nurse conducts a home safety assessment and screens the environment for potential hazards for falls. The nurse recommends that the client eliminate which of the following? (Select all that apply.)

A resident's family member is concerned that the resident is not eating adequately and is at risk for malnutrition. The family member says to a nurse, "I heard that there are drugs that can make my mother eat better. Do you think she should be on one?" What is the best response by the nurse?