A nurse is caring for a client who has an abdominal aortic aneurysm and reports a feeling of heaviness in the chest while ambulating in the hall. Which of the following actions should the nurse take first?

Choice A reason: Financial power of attorney manages monetary decisions, not health care, unless specified as a health care surrogate. Advance directives guide health decisions, but this role is distinct, making this statement incorrect under the Patient Self-Determination Act’s provisions.
Choice B reason: The Patient Self-Determination Act ensures clients’ rights to refuse treatment, even against provider recommendations, promoting autonomy through advance directives. This legal protection applies in Medicare/Medicaid facilities, making it the correct principle for end-of-life decision-making in this context.
Choice C reason: Advance directives can be changed by a competent client, even if notarized, as the Act supports ongoing autonomy. Stating they cannot be altered is incorrect, as flexibility is a core feature, making this an inaccurate representation of the law.
Choice D reason: The eldest adult child cannot change advance directives unless designated as a surrogate. The Act prioritizes the client’s documented wishes or appointed decision-maker, not family hierarchy, making this statement incorrect and misaligned with legal requirements.

Choice A reason: Providing transportation information is helpful but does not directly coordinate care, as it addresses access rather than securing services. Coordination involves arranging specific care delivery, so this action is supportive but less comprehensive, making it incorrect for demonstrating care coordination.
Choice B reason: Encouraging self-advocacy empowers the client but does not actively coordinate care, which requires arranging services or resources. This action is educational, not logistical, and does not ensure access to health services, making it incorrect for this context.
Choice C reason: Informing about providers who accept insurance is informative but not sufficient for coordination, which involves facilitating actual care delivery. Without arranging services, this action remains preparatory, making it less effective than directly securing an appointment, thus incorrect.
Choice D reason: Arranging an appointment with a mobile health clinic directly facilitates access to care, addressing rural barriers. This active coordination ensures the client receives services, aligning with case management principles for underserved populations, making it the correct demonstration of care coordination.