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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.

If the client’s advance directives are in writing and notarized, the client cannot change it in the future.

The client’s eldest adult child has the right to change advance directives in an end-of-life situation.

Answer and Explanation

The Correct Answer is B

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.

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Correct Answer is C

Explanation

Choice A reason: Asking for more information about the surgery indicates the client seeks clarification but does not confirm understanding of informed consent. Informed consent requires comprehension of the procedure, risks, benefits, and alternatives, with agreement to proceed. This statement reflects curiosity, not confirmation of understanding, making it insufficient to demonstrate informed consent.
Choice B reason: Planning to ask the doctor about the surgery in the operating room suggests the client has not yet received or understood the necessary information. Informed consent must be obtained before entering the operating room, with full comprehension of risks and benefits. This statement indicates a lack of prior understanding, making it incorrect.
Choice C reason: Stating understanding of the risks, benefits, and agreement to the procedure demonstrates informed consent. This reflects that the client has been educated about the knee arthroplasty, including potential complications like infection or blood clots, and alternatives, and voluntarily agrees to proceed. This meets legal and ethical standards, indicating full comprehension and consent.
Choice D reason: Having family sign the consent form is inappropriate unless the client lacks decision-making capacity, which is not indicated. Informed consent requires the competent client’s understanding and agreement. This statement suggests reliance on others, not personal comprehension of the procedure’s risks and benefits, making it an incorrect indicator of understanding.

A. Encourage open communication among team members. B. Assign a mediator from outside the unit. C. Schedule mandatory team-building exercises. D. Reassign conflicting nurses to different shifts.

Correct Answer is A

Explanation

Choice A reason: Encouraging open communication fosters dialogue, allowing nurses to resolve conflicts directly. This reduces tension and improves teamwork by addressing interpersonal issues, aligning with psychological principles of conflict resolution. Effective communication mitigates misunderstandings, enhancing collaboration in high-stress healthcare environments.
Choice B reason: Assigning an external mediator may help but is premature without trying internal resolution. Encouraging team dialogue leverages existing relationships, fostering cohesion. External mediators may not address unit-specific dynamics, making internal communication a more effective first step in resolving nurse conflicts.
Choice C reason: Mandatory team-building exercises may improve morale but do not directly resolve specific conflicts. Forcing participation can increase resentment if issues persist. Communication-based strategies target root causes, making them more effective for conflict resolution in healthcare teams compared to generic team-building.
Choice D reason: Reassigning nurses to different shifts avoids conflict but disrupts workflow and patient care continuity. It fails to address underlying issues, allowing tensions to persist. Communication-focused approaches promote resolution, maintaining team integrity and collaboration in healthcare settings, unlike reassignment.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a client who is scheduled for a left knee arthroplasty. Which of the following statements regarding informed consent indicates client understanding of the teaching?

Correct Answer is C

Explanation

A nurse manager is planning to assist with resolving conflict within a group of nurses. Which of the following actions should the nurse manager take?

Correct Answer is A

Explanation

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