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.)

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.

A. Facilitates remote physical assessment and monitoring of chronic conditions

Explanation: Telehealth technology allows healthcare providers to remotely assess and monitor chronic conditions, enabling timely interventions and personalized care plans.

D. Promotes self-management of illness in rural and underserved areas

Explanation: Telehealth technology can help individuals in rural and underserved areas access healthcare services and information, promoting self-management of illnesses and improving overall health outcomes.

E. Decreases costs by reducing hospital readmissions

Explanation: Telehealth technology can contribute to reducing hospital readmissions by enabling remote monitoring, early detection of issues, and timely interventions, ultimately lowering healthcare costs associated with avoidable hospitalizations.

The following options are not accurate in relation to the benefits of telehealth technology:

B. Decreases costs by replacing the role of the nurse with technology

Explanation: Telehealth technology is not meant to replace the role of healthcare professionals, including nurses. Instead, it enhances their ability to provide care by extending access to patients, facilitating communication, and improving monitoring. The goal is to complement healthcare services rather than replace them.

C. Reimbursed by all health care insurances

Explanation: While reimbursement for telehealth services has expanded, it is not universally covered by all healthcare insurances. Coverage varies depending on the payer, state regulations, and the type of telehealth service provided. Reimbursement policies continue to evolve, and not all services may be covered by every insurance plan.