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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Red meat is high in saturated fats and sodium, which can elevate blood pressure, worsening hypertension. It is not recommended for a heart-healthy diet, as it increases cardiovascular strain. The nurse should suggest leaner proteins instead, making this an incorrect dietary choice.
Choice B reason: Cheese is often high in sodium and saturated fat, contributing to increased blood pressure and cardiovascular risk in hypertension. Low-sodium alternatives are preferred, but cheese is generally discouraged, making this an inappropriate food to recommend for this client’s diet.
Choice C reason: Canned black beans are high in sodium, which exacerbates hypertension by promoting fluid retention and vascular strain. Rinsing reduces sodium, but fresh or low-sodium options are better. This choice is less ideal than fresh produce, making it incorrect for hypertension management.
Choice D reason: Fresh spinach is rich in potassium, magnesium, and fiber, which help lower blood pressure by counteracting sodium and relaxing blood vessels. It aligns with the DASH diet, an evidence-based approach for hypertension, making it the best food to recommend for this client’s condition.
Correct Answer is C
Explanation
Choice A reason: Preventing leakage is not the primary purpose of flushing an intermittent infusion device. Flushing maintains patency by clearing blood or medication residue, preventing clots or blockages. Leakage is addressed by proper capping or clamping, not flushing, making this statement incorrect as it misrepresents the procedure’s purpose.
Choice B reason: Flushing an infusion device does not contribute to hydration, as the flush solution (typically saline) is minimal and not intended for fluid replacement. The purpose is to maintain catheter patency by clearing debris or clots. This statement is incorrect, as it inaccurately suggests a hydration benefit unrelated to the procedure.
Choice C reason: Flushing an intermittent infusion device with saline clears blood or medication residue from the catheter, preventing occlusion and maintaining patency. Blood left in the line can clot, increasing infection risk or blocking the device. This statement accurately reflects the procedure’s purpose, ensuring continued functionality for future medication administration.
Choice D reason: Flushing does not ensure sterility, as the device is already in place and exposed to the bloodstream. Sterility is maintained during insertion or access, not flushing. The primary goal is patency, not sterilization, making this statement incorrect as it misaligns with the procedure’s clinical purpose.
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