A client is newly admitted to a long-term care facility. The client is not satisfied with the conditions of the facility, takes a highly active role in one's health care and, because of the ability to access information, has as much knowledge as the health care providers on some health issues. Which intervention(s) will the nurse use to support this client? (Select All that Apply.)

Offer the client options in the health care provided to him or her.

Defer to the client in all matters of health care.

Ask open-ended questions to determine health knowledge.

Encourage the client to join the resident council.

Inform the client that the health care provider has the final say in care.

Answer and Explanation

Correct Answer : A,C,D

A. Offer the client options in the health care provided to him or her: This intervention recognizes the client's autonomy and empowers them to make choices about their healthcare. By offering options, the nurse respects the client's preferences and allows them to participate in decision-making, which can enhance their sense of control and satisfaction with their care.

B. Defer to the client in all matters of health care: While it's important to respect the client's autonomy and involve them in decision-making, deferring to the client in all matters of healthcare may not always be appropriate. Healthcare decisions should be made collaboratively, considering the client's preferences along with the healthcare provider's expertise and evidence-based practice.

C. Ask open-ended questions to determine health knowledge: Open-ended questions encourage the client to express their thoughts, concerns, and preferences freely. By asking open-ended questions, the nurse can gain insight into the client's level of health literacy, understanding of their condition, and preferences for care. This information can inform the development of a tailored care plan that meets the client's individual needs.

D. Encourage the client to join the resident council: Joining the resident council allows the client to actively participate in decision-making processes within the long-term care facility. It provides them with a platform to voice their opinions, advocate for their needs, and contribute to the improvement of facility policies and practices. This involvement can enhance the client's sense of empowerment, social connectedness, and overall satisfaction with their living environment.

E. Inform the client that the healthcare provider has the final say in care: While healthcare providers play a crucial role in guiding and implementing healthcare decisions, it's essential to emphasize shared decision-making and collaborative care. Informing the client that the healthcare provider has the final say may undermine their autonomy and discourage active participation in decision-making. Instead, the focus should be on fostering a partnership between the client and healthcare team, where decisions are made collaboratively based on mutual respect, trust, and shared goals.

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Correct Answer is A

Explanation

A. Whomever the client appointed will make medical decisions.

This choice reflects the principle of autonomy and respects the client's wishes as expressed in their living will. If the client has appointed a healthcare proxy or surrogate decision-maker in their living will, that individual would be authorized to make medical decisions, including providing consent for surgery, on behalf of the client. This option emphasizes the importance of honoring the client's preferences and autonomy in healthcare decision-making.

B. The client will always give consent to any procedure.

This choice is not accurate, particularly in situations where the client lacks decision-making capacity due to conditions such as Alzheimer's disease. If the client is unable to provide informed consent, the responsibility for decision-making may shift to a designated healthcare proxy or surrogate decision-maker as outlined in the client's living will. While the client's preferences and values should be considered, their ability to provide consent may be compromised by their medical condition.

C. The family will provide consent.

While family members may be involved in discussions about the client's care and may provide input, the ultimate responsibility for providing consent for medical procedures typically rests with the individual designated as the healthcare proxy or surrogate decision-maker in the client's living will. If the living will specifies a healthcare proxy, their role supersedes that of the family in decision-making regarding medical treatment.

D. A court-appointed conservator will be consulted.

In some cases where there is no living will or designated healthcare proxy, and the family is unable to reach a consensus on medical decisions, a court-appointed conservator may become involved to make decisions on behalf of the client. However, the involvement of a conservator is typically a last resort and may not be necessary if there is a living will specifying a healthcare proxy or surrogate decision-maker. The involvement of a conservator would be determined through legal proceedings and may not be the primary course of action in situations where the client's wishes are clearly outlined in a living will.

A. fried chicken with collard greens B. grilled salmon with summer squash C. tomato sandwich on white bread D. 2% milk with high-fiber cereal

Correct Answer is A

Explanation

A. Fried chicken with collard greens: Fried foods are high in fat, which can exacerbate symptoms of pancreatitis. Collard greens, although a vegetable, are often prepared with added fats. This choice would warrant a teaching plan on avoiding high-fat foods to prevent aggravating pancreatitis.

B. Grilled salmon with summer squash: Grilled salmon is a lean protein source and summer squash is a low-fat vegetable. This choice aligns well with dietary recommendations for pancreatitis management, so no additional teaching plan may be necessary.

C. Tomato sandwich on white bread: Tomatoes are acidic and may cause discomfort for some individuals with pancreatitis. White bread is refined and lacks fiber, which may not be ideal for digestive health. This choice could prompt a teaching plan on selecting foods that are gentle on the digestive system and higher in fiber.

D. 2% milk with high-fiber cereal: While 2% milk is not excessively high in fat, it still contains some fat which may be problematic for pancreatitis. High-fiber cereal is generally a good choice, but it depends on the specific ingredients and whether they are well-tolerated by the individual. This choice could lead to a teaching plan on selecting low-fat dairy alternatives and choosing high-fiber foods that are easier on the digestive system.

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Naxlex Comprehensive Predictor Exams

An 81-year-old client with a diagnosis of Alzheimer disease needs surgery. There is a living will on file. Which direction will the nurse follow to determine who should provide consent?

Correct Answer is A

Explanation

A nurse is assisting an older adult client who is being treated for pancreatitis to create a menu. Which food selection by the client would lead the nurse to develop a teaching plan for the client?

Correct Answer is A

Explanation

A nurse is providing care to an older adult who is experiencing stress incontinence. The nurse explains effective methods of controlling this condition to the client. Which role is the nurse assuming?

A nurse is assessing a client who is recently widowed. History reveals that the client worked at home as a full-time wife and mother throughout her adult life. Based on this information, the nurse would most likely expect the client to experience which situation?

A nurse manager at a long-term care facility is engaged in efforts to change many staff members' inaccurate and negative views of older adults. When talking with the staff, which statement indicates the need for the nurse manager to intervene?

A gerontological nurse is conducting a program for a group of nurses who work with older adults. During the program, one of the nurses asks, "Everybody gets old. Why do we need to understand the aging process?" Which response by the nurse would be appropriate?

A gerontological nurse is assuming the role of an advocate. Which action would exemplify this role?

A nurse is providing care for an older adult client who has been admitted to the hospital with cirrhosis. The client has expressed that the details of the current condition and treatment remain confidential. Which response by the nurse would be appropriate?