A nurse is assisting with the care of a client.

Exhibits

Select the 4 responsibilities the nurse has in relation to the client's advance directives.

Communicate advance directives status via the medical record and shift report.

Provide the client with written information about advance directives.

Inform the client that an advance directive discontinues further care.

Instruct the client that an advance directive is a legal document and must be honored by care providers.

Document that the provider discussed do-not-resuscitate status with the client.

Initiate a power of attorney for health care document.

Answer and Explanation

Correct Answer : A,B,D,E

A. Communicate advance directives status via the medical record and shift report. The nurse is responsible for ensuring that all members of the healthcare team are aware of the client’s advance directives. Documenting this information in the medical record and shift report helps guide care in accordance with the client’s wishes.
B. Provide the client with written information about advance directives. Clients have the right to receive information about advance directives, including living wills and do-not-resuscitate (DNR) orders. The nurse should provide educational materials to help the client make informed decisions.
C. Inform the client that an advance directive discontinues further care. An advance directive does not automatically discontinue all medical care. It provides instructions regarding specific interventions the client wishes to accept or decline, such as resuscitation, mechanical ventilation, or artificial nutrition. The nurse should clarify this to avoid misconceptions.
D. Instruct the client that an advance directive is a legal document and must be honored by care providers. Advance directives are legally binding documents that must be followed by healthcare providers. The nurse should reinforce that the client’s wishes, as stated in the directive, will be respected.
E. Document that the provider discussed do-not-resuscitate status with the client. Proper documentation is essential to ensure the client's preferences regarding resuscitation and end-of-life care are acknowledged and followed. The nurse should record discussions regarding advance directives in the medical record.
F. Initiate a power of attorney for health care document. The nurse does not have the authority to initiate a power of attorney for health care. The client must complete this legal document independently or with legal assistance, and it typically requires notarization or witness signatures. The nurse can provide information about it but cannot create or execute it on the client’s behalf.

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Correct Answer is D

Explanation

A. "You should avoid exercising for the next 6 weeks." Exercise is encouraged after a total hip arthroplasty to promote circulation, prevent complications such as deep vein thrombosis, and strengthen the muscles supporting the hip joint. However, high-impact activities should be avoided until cleared by the healthcare provider.
B. "You should avoid putting a pillow between your legs when in bed." Placing a pillow between the legs, especially while sleeping, helps maintain proper hip alignment and prevents excessive internal rotation or adduction, reducing the risk of dislocation.
C. "You should avoid lying on your right side." Lying on the operative side is not necessarily contraindicated, but it should be done with caution and with proper support. Clients are usually advised to lie on their non-operative side with a pillow between their legs for alignment.
D. "You should avoid crossing your legs for 3 months." Crossing the legs can cause hip adduction and internal rotation, increasing the risk of dislocation of the prosthetic joint. Clients are typically instructed to avoid crossing their legs for at least 3 months or until cleared by their provider.

A. "You will suffer serious health issues if you don't take your medication." B. "I'd like to hear your thoughts about giving yourself this medication." C. "Have you considered how your decision to refuse medication will affect your family?" D. "Why don't you want to learn how to give yourself your medication?"

Correct Answer is B

Explanation

A. "You will suffer serious health issues if you don't take your medication." While it is important to convey the seriousness of diabetes management, this statement may come across as threatening or coercive. It does not encourage open communication or exploration of the client's feelings about their diagnosis or treatment.
B. "I'd like to hear your thoughts about giving yourself this medication." This response invites the client to express their feelings and concerns about self-administering insulin. It promotes open dialogue and allows the nurse to understand the client’s perspective, fears, or misconceptions, which can help tailor the education and support provided.
C. "Have you considered how your decision to refuse medication will affect your family?" While family considerations can be important, this response may place undue pressure on the client and shift focus away from their personal feelings about their treatment. It does not foster a supportive environment for the client to share their concerns.
D. "Why don't you want to learn how to give yourself your medication?" This question may come across as confrontational or judgmental. Instead of encouraging a collaborative discussion, it might make the client defensive. It’s essential to create a safe space for clients to share their thoughts and feelings.

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A nurse is assisting with the care of a client. Exhibits Select the 4 responsibilities the nurse has in relation to the client's advance directives.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing discharge teaching with a client who had a right total hip arthroplasty. Which of the following instructions should the nurse include?

Correct Answer is D

Explanation

A nurse is caring for a client who has a new diagnosis of diabetes mellitus and is refusing to learn how to self-administer insulin. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

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A nurse is assisting with the care of a client.

Exhibits

Select the 4 responsibilities the nurse has in relation to the client's advance directives.