A nurse is caring for a client who has named a person to serve as his health care proxy. The client talks about this type of advance directives. Which of the following statements by the client indicates a need for clarification?

"I can change who I designate as my health care proxy at any time."

"I have to choose a family member as my health proxy."

"I become incapacitated, end-of-life choices will be made by my proxy"

"The health care proxy does not go into effect until 1 am incapable of making decisions,"

Answer and Explanation

The Correct Answer is B

A. "I can change who I designate as my health care proxy at any time": This statement is correct. Clients have the right to change their designated health care proxy at any time as long as they are competent to do so. It's important for clients to know that they have flexibility in selecting their proxy based on their preferences and trust in the individual's ability to represent their wishes.
B. "I have to choose a family member as my health proxy": This statement requires clarification. While many clients may choose a family member as their health care proxy, it is not a requirement. Clients have the autonomy to choose any individual they trust to make medical decisions on their behalf, whether it's a family member, friend, or even a legal representative. It's crucial to ensure that the chosen proxy understands the client's wishes and is willing and able to advocate for them.
C. "If I become incapacitated, end-of-life choices will be made by my proxy": This statement is accurate. A health care proxy is designated to make medical decisions on behalf of the client if they become incapacitated and are unable to make decisions for themselves. The proxy is responsible for advocating for the client's wishes, including end-of-life preferences, if outlined in the advance directive or communicated to the proxy beforehand.
D. "The health care proxy does not go into effect until I am incapable of making decisions": This statement is generally correct. Health care proxies typically become active only when the client is deemed incapacitated and unable to make decisions for themselves, as determined by a healthcare provider. However, the specifics may vary depending on state laws and the language of the advance directive document. It's essential for clients to understand when the proxy's authority begins and how it transitions based on their capacity to make decisions.

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Correct Answer is B

Explanation

A. "I will tell your family of your concern so that they can be here." This option involves the family in the client's care, which is important during end-of-life situations. However, it assumes that the client's primary concern is about the family's presence rather than exploring the underlying emotions or fears the client may be experiencing. While involving the family is beneficial, it may not directly address the client's emotional needs.
B. "I wonder if you are fearful of dying alone." This response demonstrates therapeutic communication by acknowledging the client's statement and exploring the underlying feelings or concerns behind it. It shows empathy and provides an opportunity for the client to express their emotions. Fear of dying alone is a common concern for many individuals facing the end of life, and addressing this fear can help alleviate distress.
C. "We will call your family in time for them to get here." While involving the family is important, this response primarily focuses on the logistics of family arrival rather than addressing the client's emotional needs. It may not fully explore or validate the client's feelings about dying alone.
D. "I will make sure a staff member is in your room at all times." While providing support and ensuring the client's comfort is essential, this response does not directly address the client's emotional needs or explore their concerns about dying alone. It also may not be feasible to have a staff member constantly present in the room. This option may not fully address the client's underlying fears or emotions related to dying alone.

A. "I will wear gloves when removing food from the freezer" B. "I will take my medications at the first sign of an attack" C. "I will try to anticipate and avoid stressful situations when possible" D. "I will complete the smoking cessation program I started"

Correct Answer is B

Explanation

A. "I will wear gloves when removing food from the freezer": This statement demonstrates understanding of the need to protect the hands from cold exposure, which can trigger Raynaud's disease symptoms. Wearing gloves when handling cold objects, such as food from the freezer, helps minimize the risk of a vasospastic episode.
B. "I will take my medications at the first sign of an attack": This statement indicates a misunderstanding of the appropriate use of medications for Raynaud's disease. While medications such as calcium channel blockers may be prescribed to prevent or reduce the frequency and severity of attacks, they are typically taken regularly as part of ongoing management rather than at the first sign of symptoms. This client may need additional education on the proper use of medications for Raynaud's disease.
C. "I will try to anticipate and avoid stressful situations when possible": Stress can exacerbate symptoms of Raynaud's disease by triggering vasospasm, so anticipating and avoiding stressful situations is a proactive strategy to help prevent attacks. This statement reflects an understanding of the importance of stress management in managing the condition.
D. "I will complete the smoking cessation program I started": Smoking is a significant risk factor for Raynaud's disease and can worsen symptoms by constricting blood vessels. Committing to a smoking cessation program demonstrates the client's recognition of the importance of lifestyle modifications in managing the condition.

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A nurse is caring for a client who has named a person to serve as his health care proxy. The client talks about this type of advance directives. Which of the following statements by the client indicates a need for clarification?

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