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 ["A","B","D"]

Explanation

A. The Global Deterioration Scale

Explanation: The Global Deterioration Scale (GDS) is a tool used to assess the cognitive function and stage of cognitive decline in individuals, especially those with dementia.

B. Mini Mental State Exam (MMSE)

Explanation: The Mini Mental State Exam (MMSE) is a widely used tool to assess cognitive function and screen for cognitive impairment. It evaluates various cognitive domains, including orientation, memory, attention, and language.

C. Older American's Resources and Services (OARS)

Explanation: The Older American's Resources and Services (OARS) is not a cognitive assessment tool. It is a comprehensive assessment tool that covers various domains, including physical health, mental health, and social resources.

D. Mini-Cog

Explanation: The Mini-Cog is a brief cognitive screening tool that includes a three-item recall test for memory and a clock-drawing task. It is used to quickly assess cognitive function and detect potential cognitive impairment.

E. The Barthel Index

Explanation: The Barthel Index is not a cognitive assessment tool. It is a tool used to assess an individual's ability to perform activities of daily living (ADLs), providing information about their functional independence rather than cognitive status.

A. Right to visitation from others except legal advisors, who must obtain permission from the nursing facility before visiting the older adult B. Right to be free from restraints C. Right to have a say in their care and treatment D. Right to voice grievances E. Right to information about their health but not about their medications F. Right to be free from abuse

Correct Answer is ["A","B","C","D","F"]

Explanation

A. Right to visitation from others except legal advisors, who must obtain permission from the nursing facility before visiting the older adult

Explanation: The right to receive visitors is generally protected, with some reasonable restrictions, to ensure the safety and well-being of residents.

B. Right to be free from restraints

Explanation: Residents have the right to be free from unnecessary physical or chemical restraints, as outlined in their Bill of Rights. Restraints should only be used when necessary for the safety of the resident or others, and their use should be minimized.

C. Right to have a say in their care and treatment

Explanation: Residents have the right to actively participate in decisions about their care and treatment. This includes being informed about their options and having the opportunity to express their preferences.

D. Right to voice grievances

Explanation: Residents have the right to voice complaints or grievances without fear of retaliation. The nursing home must have a system in place to address and resolve residents' concerns.

E. "Right to information about their health but not about their medications" is not accurate. Residents have the right to be informed about all aspects of their health, including information about medications prescribed to them. Information about medications is an important component of informed consent and shared decision-making.

F. Right to be free from abuse

Explanation: Residents have the right to be free from any form of abuse, whether it is physical, verbal, psychological, or any other form. Nursing homes must take measures to prevent and address any instances of abuse.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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.)

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

Explanation

The Bill of Rights for long-term residents was created to protect the rights of the residents in nursing homes. Which of the following examples protect these rights? (Select all that apply.)

Correct Answer is ["A","B","C","D","F"]

Explanation

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

Which of the following is a true statement about elimination in older adults?

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.)

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

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 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?

As a nurse caring for a cognitively impaired older adult client, you need to observe for which of the following? (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?