A nurse is admitting a client to the medical-surgical unit. The Patient Self-Determination Act requires the nurse to perform which of the following actions during the admission process?

Document in the client's medical record if the client has advance directives.

Ensure the client has an attorney to contact for assistance with end-of-life documents.

Provide end-of-life education if the client has a terminal illness.

Provide the client with a list of eligible individuals who can serve as a health care proxy.

Answer and Explanation

The Correct Answer is A

A. The Patient Self-Determination Act (PSDA) requires health care facilities to ask clients about advance directives upon admission and document their status in the medical record. This ensures that the client’s treatment preferences are known and respected.
B. Ensuring the client has an attorney is not a requirement of the PSDA. Clients may choose legal assistance, but it is not mandated by the act.
C. Providing end-of-life education is beneficial but not specifically required by the PSDA. The act focuses on informing clients of their rights regarding advance directives.
D. The PSDA does not require facilities to provide a list of eligible health care proxies. Instead, it ensures clients are informed of their right to appoint one.

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Correct Answer is D

Explanation

A. Strain the client's urine. This is incorrect because straining urine is necessary for clients with radioactive seeds placed in the bladder, but not for prostate cancer brachytherapy, where the seeds typically remain in place.
B. Limit each of the client's visitors to 2 hr per day. This is incorrect because visitors should be limited to short durations, but the exact time is typically restricted to 30 minutes per visit rather than a total of 2 hours per day.
C. Attach a dosimeter to the client's gown. This is incorrect because a dosimeter should be worn by healthcare staff, not attached to the client. It helps monitor radiation exposure for staff members.
D. Instruct visitors to stay 1 m (3.3 feet) away from the client. This is correct because maintaining a safe distance from the client helps minimize radiation exposure for visitors. Visitors should also limit their time near the client and avoid close contact.

A. Hypertension B. Muscle twitching C. Bounding pulse. D. Increased urine output

Correct Answer is B

Explanation

A. Hypertension is not a typical finding of hypocalcemia. Instead, hypocalcemia can cause hypotension due to decreased myocardial contractility.
B. Muscle twitching is a common manifestation of hypocalcemia. Low calcium levels increase neuromuscular excitability, leading to twitching, tetany, and spasms.
C. A bounding pulse is not associated with hypocalcemia. Instead, hypocalcemia can cause weak, thready pulses due to decreased cardiac output.
D. Increased urine output is not a direct symptom of hypocalcemia. However, hypercalcemia can lead to polyuria due to its effect on the kidneys.

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A nurse is admitting a client to the medical-surgical unit. The Patient Self-Determination Act requires the nurse to perform which of the following actions during the admission process?

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