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,"
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
A. Polyuria: Polyuria, or excessive urination, is not typically associated with cervical spinal cord injury. In fact, urinary retention or neurogenic bladder is more commonly observed due to disruption of bladder control. Clients with cervical spinal cord injury often experience bladder dysfunction, which can lead to urinary retention rather than polyuria.
B. Hypotension: Hypotension is a common complication of cervical spinal cord injury, particularly in cases involving injury above the level of T6. Damage to the sympathetic nervous system can result in neurogenic shock, characterized by vasodilation and bradycardia, leading to hypotension. Monitoring for signs of hypotension, such as decreased blood pressure and altered mental status, is essential for early intervention and prevention of complications.
C. Weakened gag reflex: Cervical spinal cord injury can impair the gag reflex due to disruption of the glossopharyngeal nerve (CN IX) and vagus nerve (CN X) function. This impairment can lead to difficulty swallowing, aspiration risk, and increased susceptibility to respiratory complications such as aspiration pneumonia. Therefore, monitoring the gag reflex and assessing for signs of dysphagia are crucial in clients with cervical spinal cord injury to prevent respiratory compromise and aspiration-related complications.
D. Hyperthermia: Hyperthermia is less commonly associated with cervical spinal cord injury. However, in some cases, autonomic dysreflexia—a potentially life-threatening condition—can occur, leading to increased body temperature among other symptoms. This is more common in injuries above the T6 level.
E. Absence of bowel sounds: Neurogenic bowel dysfunction, including the absence of bowel sounds, is a common complication of cervical spinal cord injury. Disruption of autonomic nervous system function can lead to decreased peristalsis and absent bowel sounds.
Correct Answer is ["0.5"]
Explanation
Let's convert the digoxin dosage from mcg (micrograms) to mg (milligrams) and then divide it by the amount of digoxin per tablet to find out how many tablets are needed.
Steps to solve:
- Convert digoxin dose from mcg to mg:
- We know 1 mg is equal to 1000 mcg.
- Digoxin dose (mg) = Digoxin dose (mcg) / 1000 mcg/mg
- Digoxin dose (mg) = 125 mcg / 1000 mcg/mg
- Digoxin dose (mg) = 0.125 mg
- Calculate the number of tablets required:
- Number of tablets = Digoxin dose (mg) / Digoxin per tablet (mg)
- Number of tablets = 0.125 mg / 0.25 mg/tablet
Since the result is 0.5, we need to round to the nearest tenth.
Answer: The nurse should administer 0.5 tablets per dose.
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