The family members of an older adult client are expressing disagreement over whether the client should have surgery that is recommended by the provider. The oldest adult child has durable power of attorney. The client is oriented to person, place, and time. Which of the following people has the legal authority to make the care decision?

Choice A reason: Documenting the concern in the nurse's notes is not an appropriate action. The nurse's notes are for recording the client's condition and the care provided, not for expressing the nurse's personal issues. This action does not address the problem or ensure the safety of the clients.

Choice B reason: Requesting help from the personnel on the unit is a good action, but not the best one. The nurse should seek assistance and guidance from experienced staff members, but they should also communicate their concern to the nurse manager, who is responsible for making appropriate assignments and providing support and resources.

Choice C reason: Contacting the nurse manager to discuss the situation is the best action. The nurse manager can evaluate the nurse's competency and experience level, and adjust the assignment accordingly. The nurse manager can also provide feedback, education, and supervision to the nurse to enhance their skills and confidence.

Choice D reason: Refusing to accept the assignment is not an appropriate action. The nurse has a professional and ethical obligation to provide care to the clients, unless there is a clear conflict of interest or violation of standards. The nurse should not abandon the clients or the unit without a valid reason.

Choice A reason: Nurses who have advanced training may provide direct care for clients, but this is not specific to case management. Case management is a collaborative process that involves assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and human service needs.

Choice B reason: Nurses use critical pathways when caring for clients as part of case management. Critical pathways are standardized plans of care that outline the expected outcomes, interventions, and time frames for a specific diagnosis or procedure. They help to ensure quality, continuity, and cost-effectiveness of care.

Choice C reason: Nurses delegate and supervise assigned tasks, but this is a general nursing responsibility and not specific to case management. Case management requires more than just task delegation and supervision. It also involves communication, coordination, and evaluation of care.

Choice D reason: The nurse completes one specific task for a group of clients is not an accurate description of case management. Case management is not task-oriented, but client-centered and outcome-focused. The nurse is responsible for the overall care of the client, not just one aspect of it.