A health care provider asks the nurse about an older adult client's durable power of attorney (POA) because consent is needed for a medically necessary invasive procedure. The client has end-stage disease, is intubated, and is on mechanical ventilation. Which steps should the nurse implement?
Assist with obtaining informed consent from the client.
Refer to the client's advance directive for a name.
Determine the client's inability to make reasonable decisions.
Use the oral trail-making test to measure cognitive function.
The Correct Answer is C
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.
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Related Questions
Correct Answer is ["A","D","E"]
Explanation
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.
Correct Answer is D
Explanation
A. HIPAA (Health Insurance Portability and Accountability Act)
Explanation: HIPAA, enacted in 1996, focuses on protecting the privacy and security of individuals' health information. While it is essential in healthcare, it is not directly connected to the nursing home reform mandated by the 1987 law.
B. OASIS (Outcome and Assessment Information Set)
Explanation: OASIS is a set of standardized assessments used in home health care, primarily for Medicare-certified home health agencies. It is not directly connected to the nursing home reform mandated by the 1987 law.
C. Fulmer SPICES
Explanation: Fulmer SPICES is a tool used for assessing common geriatric syndromes, but it is not specifically associated with the nursing home reform mandated by the 1987 law.
D. Resident Assessment Instrument (RAI).
Explanation: The Resident Assessment Instrument (RAI) is associated with nursing home reform mandated by the Omnibus Budget Reconciliation Act (OBRA) of 1987. OBRA '87 established regulations and standards for nursing homes, including requirements for comprehensive assessments, care planning, and quality of care. The RAI, specifically the Minimum Data Set (MDS), is a standardized assessment tool used to evaluate the health status and needs of nursing home residents, ensuring a consistent and comprehensive approach to resident assessment and care planning.
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