A nurse is caring for a client who is seeking information about end-of-life decisions. According to the Patient Self-Determination Act, which of the following applies to medical decisions that can be made within organizations that receive Medicare and Medicaid reimbursements?
The person holding financial power of attorney will make health care decisions based on the client's advance directives.
The client has the right to refuse medical treatment, even if health care providers recommend it.
The client's eldest adult child has the right to change advance directives in an end-of-life situation.
If the client's advance directives are in writing and notarized, the client cannot change it in the future.
The Correct Answer is B
Rationale:
A. The person holding financial power of attorney will make health care decisions based on the client's advance directives: A financial power of attorney manages financial matters, not health care decisions. A separate designation such as a health care proxy or medical power of attorney is needed for making medical decisions.
B. The client has the right to refuse medical treatment, even if health care providers recommend it: Under the Patient Self-Determination Act (PSDA), clients have the legal right to make autonomous decisions about their care, including the right to refuse or discontinue treatment, regardless of medical advice.
C. The client's eldest adult child has the right to change advance directives in an end-of-life situation: Advance directives reflect the client’s own decisions. No family member, regardless of birth order, has the legal authority to change them unless specifically authorized as a health care proxy and even then, only if the client is incapacitated.
D. If the client's advance directives are in writing and notarized, the client cannot change it in the future: Clients can revise or revoke advance directives at any time, as long as they remain mentally competent. Notarization does not make the document legally fixed or unchangeable.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. 0.45% sodium chloride: This is a hypotonic solution that helps lower serum sodium levels by diluting extracellular sodium and promoting cellular rehydration. It is commonly used to treat hypernatremia when there is no significant fluid volume overload.
B. 0.9% sodium chloride: This isotonic solution contains the same concentration of sodium as the blood. It does not correct hypernatremia and may worsen it if sodium levels are already elevated, especially in dehydrated clients.
C. Lactated Ringer's: While this is an isotonic fluid, it contains sodium and electrolytes that do not help reduce high serum sodium levels. It is more appropriate for fluid resuscitation than for treating hypernatremia.
D. 3% sodium chloride: This hypertonic solution is used for severe hyponatremia, not hypernatremia. Administering it to someone with elevated sodium levels would further increase sodium concentration and worsen the condition.
Correct Answer is A
Explanation
Rationale:
A. Assist the client to ambulate: Ambulation is encouraged after a laparoscopic cholecystectomy to stimulate peristalsis and help relieve abdominal distention caused by retained gas from insufflation during the procedure. It promotes bowel movement and absorption of gas, improving comfort.
B. Prepare the client for a paracentesis: Paracentesis is used to remove fluid from the peritoneal cavity, typically in clients with ascites or severe fluid retention. Abdominal distention after this procedure is usually due to gas, not fluid.
C. Insert a rectal suppository: Suppositories may stimulate bowel movements but are not the first-line intervention for post-laparoscopic gas-related distention. Encouraging natural movement through ambulation is more effective and less invasive initially.
D. Place the client in the prone position: The prone position is not typically used for relieving abdominal distention. It may cause discomfort and does not aid in gas movement through the intestines as effectively as upright or walking positions.
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