A nurse is evaluating a newly licensed nurse's understanding of advance directives. The newly licensed nurse should identify that which of the following individuals is responsible for deciding whether a client is capable of making their own decisions regarding medical treatment?
Primary provider
Health care surrogate
Social worker
Charge nurse
The Correct Answer is A
Rationale
A. Primary provider: The primary provider is responsible for assessing and determining a client’s decision-making capacity regarding medical treatment. This evaluation includes the client’s ability to understand information, appreciate the consequences of decisions, reason logically, and communicate choices clearly. The determination guides informed consent and advance directive discussions.
B. Health care surrogate: A health care surrogate makes decisions only when a client is deemed incapable of making their own medical decisions. The surrogate’s authority is activated after the provider determines the client lacks decision-making capacity.
C. Social worker: Social workers provide support, education, and advocacy regarding advance directives and care planning but do not have the legal authority to determine decision-making capacity. They assist in facilitating communication between the client, family, and healthcare team.
D. Charge nurse: The charge nurse oversees unit operations and coordinates care but is not responsible for determining a client’s capacity to make medical decisions. This responsibility lies with the provider evaluating the client’s clinical and cognitive status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale
A. Set the suction device to 120 mm Hg: Adult nasopharyngeal suctioning requires suction pressure between 100 and 150 mm Hg to effectively remove secretions without damaging mucosal tissue. Setting the device to 120 mm Hg falls safely within this range and provides adequate negative pressure for efficient suctioning.
B. Apply suction to the catheter during insertion: Suction should never be applied during catheter insertion because it increases the risk of mucosal injury and can cause hypoxia. The catheter must be inserted gently to the appropriate depth before suctioning is activated on withdrawal. This helps protect the airway structures and maintains patient safety during the procedure.
C. Have the client tuck his chin to his chest during suctioning: The chin-to-chest position narrows the airway passage and makes catheter insertion more difficult. Nasopharyngeal suctioning requires the "sniffing" position, where the head is slightly extended to align the airway for smoother catheter passage.
D. Apply a petroleum-based lubricant to the catheter: Petroleum-based lubricants should not be used because they can irritate mucous membranes and pose a risk if aspirated. Water-soluble lubricants are recommended since they reduce friction, minimize trauma, and dissolve easily if small amounts enter the airway.
Correct Answer is A
Explanation
Rationale
A. Insulin Glargine 20 units SUBQ qd: The abbreviation "qd" can be misinterpreted and is considered unsafe in medication orders. Insulin requires precise dosing and timing to prevent hypo- or hyperglycemia. The nurse should clarify the prescription with the provider and document "once daily" to ensure safe administration.
B. Ceftriaxone 250 mg IM stat: This prescription is clear regarding the medication, dose, route, and timing. "Stat" indicates immediate administration, which is understandable and requires no clarification.
C. Diazepam 5 mg PO Q8h PRN muscle spasms: The prescription clearly specifies the dose, route, frequency, and indication. The nurse can safely administer as needed without needing clarification.
D. Digoxin 0.5 mg IV once: The prescription provides complete information about the medication, dose, route, and single administration. No ambiguous abbreviations are present, so clarification is unnecessary.
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